Medical Mistrust as a Barrier to COVID-19 and HIV Services Among Transgender Women of Color

PROJECT SUMMARY This administrative supplement project seeks to study COVID-19 testing and vaccine uptake and HIV services (e.g., pre-exposure prophylaxis [PrEP] uptake and adherence) among transgender women (TW) of color (TWOC) in the New York City metropolitan statistical area (MSA). With this supplement, we will randomly enroll participants from the ongoing NIH-funded Trying To Understand Relationships, Networks and Neighborhoods among Trans women of color (TURNNT) Study (R01MD013554; PI: Dustin Duncan) in the quantitative phase of the proposed study (n=150) and the qualitative phase of the proposed study (n=40) to address the aims of the research. We are currently recruiting 300 Black, Latina and Asian TW in the TURNNT cohort using clinic- and community-based recruitment methods in partnership with Callen-Lorde Community Health Center (a major provider of healthcare for TW in NYC) and via venue-based recruitment (e.g., community organizations and dance clubs). The proposed project represents the largest study of COVID-19 in any population of TWOC to-date and presents a remarkable opportunity to study COVID-19 and HIV services among TWOC who experience intersectional stigmas and multiple forms of marginalization and inequality. This supplement will accelerate the science and impact of the parent grant, capitalizing on the existing TURNNT infrastructure and generate new knowledge that can be used to increase COVID-19 testing and vaccine uptake and HIV services, including by investigating the role of medical mistrust as a contributing factor for TWOC. This proposal is aligned with the administrative supplement and NIMHD's special attention to sexual and gender minority (SGM) populations and research on HIV/AIDS in populations that experience health disparities. This project will accelerate the science on COVID-19 and HIV disparities. This research will provide a context-specific and nuanced understanding of how social contextual factors, i.e. medical mistrust, may contribute to COVID-19 and HIV prevention and care behaviors in TWOC, which will in turn inform contextually appropriate HIV prevention and care interventions.