Racial/Ethnic Disparities for HIV-related Risks and Health Outcomes among Black Trans Women in the African Diaspora

Award amount: 50,000.00

Trans women bear a disproportionate burden of HIV worldwide. Within this population, Black trans women face a disparity within this disparity, with higher prevalence of HIV and worse clinical outcomes. The extraordinarily high burden of HIV among Black trans women merits urgent investigation. This study proposes to investigate racial/ethnic disparities in the population most severely affected by HIV worldwide – Black trans women, with inclusion of African-Americans and Afro-Brazilians as part of the wider African diaspora. Extending the aims of the parent study (5R01MD010678), the scientific goals of this proposal are to use mixed methods to: (1) to quantify the level and determinants of racial/ethnic disparities in HIV and related risks between Black trans women and non-Black trans women in the US and Brazil; (2) to test the hypothesis that discrimination-related stress results in weathering among Black trans women making them more vulnerable to HIV risk and poorer health outcomes; and (3) explore the feasibility of collecting biomarkers of stress-related mental and physical health as endpoints and markers for future intervention research. The parent study has established the world’s largest longitudinal cohort of trans women in San Francisco, USA and São Paulo Brazil. Preliminary data corroborate the significantly higher prevalence and incidence of HIV among African-American and Afro-Brazilian trans women. This RAP grant will provide support for the first steps in developing a program of research addressing racial/ethnic disparities in HIV, HIV-related comorbidities, mental health, and non-communicable diseases (NCD) for this rising investigator.