# Microeconomic Intervention to Reduce HIV Transmission in Economically Disadvantaged Transgender Women

> **NIH NIH R34** · VIRGINIA COMMONWEALTH UNIVERSITY · 2020 · $270,339

## Abstract

Project Summary
 The goal of this study is to develop and pilot test an integrated microeconomic (ME) intervention to
reduce the risk of HIV transmission among economically disadvantaged male-to-female (MTF) transgender
women (TGW). While some psychosocial interventions have been implemented for TGW, most lack rigorous
evaluation data and/or economic determinants are largely unaddressed. Despite the high estimated HIV
prevalence (>25%) among U.S. TGW (and up to 50% in African-American TGW), they have nevertheless not
been targeted in the few available ME initiatives for HIV prevention. Recent studies suggest that there are a
variety of factors contributing to HIV vulnerability in TGW, including economic and structural barriers such as
experiencing discrimination in employment and housing and the high cost of medical and clinical services
required for male-to-female transition, all of which lead to financial instability and reliance on high-risk income
generation; and being victims of sexual violence and having much higher incidence of psychiatric symptoms
and substance use, all linked to higher HIV prevalence and transmission. It is estimated that TGW are three
times as likely as the general population to be unemployed; four times as likely to be unstably housed; and
twice as likely to be poor. TGW of color especially experience these disadvantages.
 To address high rates of HIV and the related economic disadvantage of TGW (including many TGW of
color), this study will use a two group experimental design to develop and longitudinally assess an integrated
ME intervention tailored for economically disadvantaged TGW who are also behaviorally at risk for HIV.
Microeconomic interventions, defined as very small-scale initiatives to improve the financial status of
individuals have been shown in low-income countries to improve protective sexual behaviors, and HIV
communication and testing, by combining HIV education and financial training, mentoring, and economic
resources. Consistent with these results, we will finalize and evaluate the intervention via three project aims:
Aim 1: Conduct formative work with TGW and key informants to assess TGW’s current experiences and
preferences for each of the possible ME components (including supportive economic services, employment
readiness and financial training, gender transition supports, and economics-based HIV education).
Aim 2: Develop an integrated ME intervention for HIV prevention tailored for economically disadvantaged TGW
which addresses multiple economic vulnerabilities in two U.S., HIV-prevalent, and resource-poor metropolitan
areas (Richmond, VA and the St. Louis MO/IL metro area.)
Aim 3: Using a randomized experimental study design, assess the feasibility and efficacy of the integrated ME
for economically disadvantaged U.S. TGW in reducing economic vulnerability and HIV sexual risk-taking.
 The ultimate goal of this R34 project is to establish a feasible, acceptable, and scalable microeconomic
inter...

## Key facts

- **NIH application ID:** 9834980
- **Project number:** 5R34MH115775-03
- **Recipient organization:** VIRGINIA COMMONWEALTH UNIVERSITY
- **Principal Investigator:** ERIC G BENOTSCH
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $270,339
- **Award type:** 5
- **Project period:** 2017-12-13 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9834980

## Citation

> US National Institutes of Health, RePORTER application 9834980, Microeconomic Intervention to Reduce HIV Transmission in Economically Disadvantaged Transgender Women (5R34MH115775-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9834980. Licensed CC0.

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