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In 2012, there were 2.3 million new HIV infections globally. A large proportion of people newly diagnosed with HIV worldwide are in their reproductive years and these men and women are likely to want children in the future. Addressing the sexual and reproductive health and rights of this population is critical to addressing the spread of HIV because HIV infection in childbearing women is the main cause of HIV infection in children. Treatment for those who are already infected is also central to stopping the spread of HIV to infants and to uninfected sexual partners.

• 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.

The overall goal of this study is to enhance the physical and mental health of rural Indian women living with AIDS and their children. We will achieve these goals through the use of trained village women as Accredited Social Health Activists (ASHA) to enhance the health of women and children through improved ART adherence, CD4 levels, and physical and mental health. This Indo-US collaboration between University of California, Los Angeles, University of California, San Francisco and All India Institutes of Medical Sciences (AIIMS) builds on our previous work with rural women living with AIDS and our successful ASHA program. Specific objectives include: Using a 2x2 factorial design, we plan to assess the effects of nutrition training and/or food supplements on primary outcomes for rural women living with AIDS in improving body composition and immune status (CD4 levels) as assessed at 6-, 12- and 18-month follow-up. Examining the effects of the program arms and their interaction on adherence to ART, psychological health, nutritional adequacy, and lipid profile over time.

This is a three-phase study to identify the specific mechanisms by which MSM stigma affect sexual risk behaviors among MSM in Beijing, China.

• In Phase 1, we will explore the range of management strategies used to cope with MSM stigma via 30 in-depth qualitative interviews with MSM.
• In Phase 2, we will develop, using Phase 1 qualitative data and adapting existing quantitative scales, culturally-relevant measures of explanatory constructs of interest (e.g., MSM stigma management) to establish reliability and validity (N=170).
• In Phase 3, we will examine potential mediators (e.g., stigma management strategies, psychological distress, sexual contexts/situations) that explain how MSM stigma are linked to sexual risk for HIV with a respondent-driven sample of 500 MSM who will complete baseline and two follow-up assessments at 6 and 12 months.

We will also conduct 20 in-depth qualitative individual interviews with a subset of men selected from the Phase-3 participants to examine the acceptability of potential intervention components to address the link between MSM stigma and HIV risk.