The SPNS Transgender Women of Color Initiative Interventions Manual

Improving HIV Care for Transgender Women of Color

Transgender women—especially transgender women of color—experience some of the highest HIV prevalence rates in the United States. Research shows that transgender women are nearly 50 times more likely to be living with HIV compared to other adults of reproductive age, with African American and Latina transgender women facing disproportionate burdens. These disparities are fueled by multiple, intersecting challenges: stigma and discrimination, unstable housing, limited economic opportunities, barriers to culturally competent healthcare, and high rates of violence and victimization.

In 2012, the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) launched a groundbreaking initiative to address these inequities. Nine demonstration sites in four U.S. cities implemented innovative, theory-driven interventions for transgender women of color living with HIV. A national Transgender Evaluation and Technical Assistance Center (TETAC) at UCSF’s Center for AIDS Prevention Studies and Center of Excellence for Transgender Health provided evaluation, training, and technical assistance.

This manual shares the strategies, staffing models, outreach methods, and lessons learned from these programs, along with preliminary outcomes. It is designed to help organizations adapt and implement culturally responsive, high-quality services that improve HIV care engagement, treatment adherence, and health outcomes for transgender women of color.

Download the manual to explore each program in detail, discover best practices, and learn how these approaches can be adapted in your community.