A group based behavioral intervention reduced the sexual risk for HIV infection and transmission by nearly 40% in young transgender women, according to new findings published in JAMA Pediatrics.

Intervention studies focused on reducing sexual risk in transgender women have been limited to date. The primary goal of this study was to assess the efficacy of Project LifeSkills, an intervention that addresses the specific challenges to sexual safety in young transgender women, in reducing sexual risk for HIV acquisition and transmission in transgender women age 16 to 29. The cohort was comprised of 190 sexually active young transgender women who were randomly assigned to the LifeSkills intervention (n=116) or standard of care only (n=74). The LifeSkills intervention was delivered in six 2-hour sessions during the course of 3 weeks.

The LifeSkills group had a 30.8% greater Poisson mean (SE) reduction in condomless sex acts (2.26 [.40] at baseline vs 1.22 [.22] at 4 months) compared with the control group (2.69 [.59] at baseline vs 2.10 [.47] at 4 months). Investigators also demonstrated this statistical difference via risk ratio [RR], .69; 95% CI, .60-.80; P < .001. The intervention group also achieved a 39.8% greater mean reduction in condomless sex acts at 12-months vs patients receiving standard of care group (.71 [.13] vs 1.40 [.32]; RR, .60; 95% CI, .50-.72; P < .001).

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Investigators assert that according to their study results, Project LifeSkills may be both feasible and efficacious in reducing behaviors that increase the risk for HIV exposure/transmission in young transgender women. “Additional research is needed to show independent replication of these findings and to guide the implementation and dissemination of Project LifeSkills to other US communities as well as to other parts of the world where HIV prevention among transgender women is a public health priority,” the investigators concluded.

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Garofalo R, Kuhns LM, Reisner SL, Biello K, Mimiaga MJ. Efficacy of an empowerment-based, group-delivered HIV prevention intervention for young transgender women: the project LifeSkills randomized clinical trial. [published online August 13, 2018] JAMA Pediatr. doi:10.1001/jamapediatrics.2018.1799