PROJECT SUMMARY Disparities in HIV diagnoses and care continuum outcomes are paramount among racial and ethnic minority women in the United States. These disparities are further impacted by the complex interaction of syndemic conditions (e.g., interpersonal violence, adverse mental health, substance use). Simultaneously, structural factors (e.g., intersectional stigma, medical mistrust, discrimination) engender health inequities among racial and ethnic populations and have been qualitative linked to poor engagement in HIV care. Racism perpetuates HIV stigma and medical mistrust; less commonly studied, structural racism, refers to the interplay between systems, social forces, institutions, and processes, which may also impact engagement in HIV care. The proposed administrative supplement seeks to fill this gap and aims to understand potential racial and ethnic differences in the role of structural racism and other socio-structural barriers (e.g., intersectional stigma, medical mistrust, discrimination) in the utilization and retention of HIV care and other ancillary support services among women living with HIV in California. The proposed administrative supplement will leverage data from participants enrolled in the Women SHINE study (Addressing Trauma from Interpersonal Violence through a Web-based Peer Navigation-Social Support Intervention to Improve ART Adherence among Women; #R01MH125785; PI: Stockman), a two-arm randomized control trial among non-ART adherent cisgender WLH with a history of adulthood interpersonal violence residing in California. Quantitatively, we will leverage baseline survey data from the parent study (n=200) that includes measures to capture structural factors (intersectional stigma, medical mistrust discrimination) to conduct a series of logistic regression models that test for potential racial and ethnic group differences (i.e., White, Black, Latina, and Other [Indigenous, Asian American, and Native Hawaiian and Pacific Islander]) in the association between socio-structural factors and past year and retention in HIV care and other ancillary support services (i.e., domestic violence agencies, mental health, substance use outpatient clinics) (Aim 1). Qualitatively, we will generate data through in-depth interviews with WLH (n=40, 10 per racial and ethnic group) randomized to the control arm to explore the role of structural racism and other socio-structural factors on utilization and retention in HIV care and other ancillary support services (Aim 2). Finally, we will triangulate the quantitative and qualitative data while conducting member checking through four focus groups by racial and ethnic group (n=4-6 women each) (Aim 3). Collectively, this study will expand the current limited knowledge base on racial and ethnic differences in socio-structural factors that influence care engagement among WLH and inform innovative ways in which researchers can intervene upon these socio-structural factors to improve HIV care engagem...