LSU Health New Orleans is one of three universities that will share a $723, 931award from the National Institutes of Health to develop and test a pilot microeconomic intervention to reduce the risk of HIV transmission among economically disadvantaged male-to-female transgender women. Rick Zimmerman, PhD, Associate Dean for Research, Scholarship and Science at LSU Health New Orleans School of Nursing, is the LSU Health principal investigator. The consortium also includes Virginia Commonwealth University, the University of Missouri-St. Louis, and Johns Hopkins University.

Microeconomic interventions are defined as very small-scale initiatives to improve the financial status of individuals. Recent studies suggest that there are a variety of economic factors contributing to HIV vulnerability in transgender women. They include discrimination in employment and housing, as well as 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. Their HIV risk is also increased by being victims of sexual violence and having a much higher incidence of psychiatric symptoms and substance use, all linked to higher HIV prevalence and transmission. The estimated HIV prevalence is greater than 25% among U.S. transgender women and up to 50% in African-American transgender women.

“This population is three times as likely to be unemployed, four times as likely to be unstably housed, and twice as likely to be poor and around 80 times more likely to have HIV than the general population” notes Dr. Zimmerman.

In this project, the researchers will develop an integrated microeconomic intervention for HIV prevention tailored for economically disadvantaged transgender women that addresses multiple economic vulnerabilities in two US, HIV-prevalent and resource-poor metropolitan areas – Richmond, VA and the St. Louis MO/IL metro area. The project will subsidize 3-4 month internships to help study participants find jobs in the mainstream economy, link them to low-cost housing organizations, and provide financial literacy and employment readiness training.

“Microeconomic interventions 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,” Zimmerman concludes. “We hope that these microeconomic interventions will yield the same great results here. Our ultimate goal is to establish a feasible, acceptable, and scalable microeconomic intervention for HIV reduction in this vulnerable group.”