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After more than 20 years of the HIV epidemic, with advances in treatment and increases in understanding and acceptance of HIV, getting an HIV+ diagnosis still can be a traumatic experience. HIV+ persons must come to terms with their own infection and be concerned with possible infection in past and future partners. Talking to partners about HIV is especially hard because even though it is a manageable disease, HIV still is not curable. Disclosure assistance services (also known as partner counseling and referral services or PCRS) are an array of voluntary and confidential services available to persons living with HIV and their exposed sex and/or needle-sharing partner(s). Disclosure assistance is cost effective and can play a critical role in identifying those individuals most at risk for HIV infection, and linking those who are infected to early medical care and treatment. Most HIV+ persons make the decision to disclose or not disclose to their partners on their own. But HIV+ persons may want support for telling their partners about HIV, whether by encouragement for self-disclosure or by having someone who is well-trained carefully and confidentially notify a partner for them. In one study, persons who received disclosure assistance were over three times more likely to have informed a partner of their risk. In the past few years, HIV counseling and testing programs across the US have shifted their emphasis from testing anyone, to finding and testing persons at greatest risk for HIV infection. At general HIV testing sites, around 1% of clients tested are found to be HIV+, whereas 8-39% of clients tested through disclosure assistance are found to be HIV+.

• Goal 1 (Evaluation) To provide support to the demonstration sites as they design and implement their site-specific evaluation plans, and to conduct rigorous, cross-site evaluation research that will make a significant contribution to improving the timely entry, engagement, and retention (from the cascade of care model) in quality HIV primary care for transwomen of color.
• Goal 2 (TA) To provide TA tailored to the specific needs of each demonstration site through teleconferences, a website, webinars, site visits, and meetings in a variety of domains including (1) program development, implementation, and sustainability; (2) clinical consultation; (3) multi-site and location evaluation; (4) human research protection; (5) IRBs; and (6) intervention manuals.
• Goal 3 (Capacity Building) To provide capacity building assistance (CBA) relating to the provision of quality clinical and culturally competent HIV primary care and social services to transwomen of color.
• Goal 4 (Dissemination) To synthesize and disseminate findings from demonstration projects to optimize impact on the timely entry, engagement, and retention in quality HIV primary care for transwomen of color.

Black women and men in the US are hard hit by HIV, and have been since the beginning of the epidemic. In 2006, Black women accounted for 61% of new HIV cases among women, but make up only 12% of US female population. The rate of HIV diagnoses for Black women is 15 times the rate for White women. Black women also have high rates of sexually transmitted diseases (STDs), which can facilitate transmission of HIV. Among Black women in 2006, the rate of chlamydia was 7 times higher, gonorrhea 14 times higher, and syphilis 16 times higher than the rate among White women. These numbers and statistics, however, don’t show the richness and diversity of Black women’s lives. Black women can be White collar and working class, Christians and Muslims. They live in inner-city and suburban neighborhoods, are the descendants of slaves and recent Caribbean immigrants. They work, go to school, raise families, fall in love. HIV among Black women is not simply about individual behavior, but a complex system of social, cultural, economic, geographic, religious and political factors that combine to affect health.