Using Bundled Interventions to Improve Health Outcomes for Black Cisgender and Transgender Women: Findings From the Black Women First Initiative.

Abstract

Objectives. To examine the effects of replicating a bundled package of evidence-informed interventions on social determinants, HIV health outcomes, and health-related quality of life (HRQoL) for 697 Black cisgender and transgender women with HIV across 12 US sites from 2021 to 2023. Methods. Women participated in a minimum of 2 interventions. We collected self-reported HRQoL and social determinants via interview at baseline, 6 months, and 12 months. We collected retention in care and viral suppression via medical chart review. We examined effects by gender identity and type and number of bundled interventions received. Results. In the 12-month postenrollment period, 85.0% of women reached viral suppression and 74.3% were retained in care. Social determinants and HRQoL improved over time. Transgender women had significantly lower odds of retention in care compared with cisgender women (adjusted odds ratio = 0.85; 95% confidence interval = 0.77, 0.93) but an overall higher physical HRQoL score (46.8 vs 40.8). Viral suppression and mental HRQoL did not differ by gender identity. Conclusions. Using a bundled intervention is a promising approach to reach and provide culturally relevant care for Black women with HIV. (Am J Public Health. 2025;115(S1):S46-S56. https://doi.org/10.2105/AJPH.2025.308019).