Kickin' it with the Gurlz: An evaluation of an HIV status-neutral intervention designed to address violence and trauma among transgender women of color in Detroit.

Objectives: Intersectional oppression exposes transgender women of color to gender-based violence and contributes to inequities across the HIV prevention and care continua. This pilot study aimed to adapt and examine the feasibility and acceptability of Kickin' it with the Gurlz, an HIV status-neutral multicomponent intervention designed to address violence, promote healing from trauma, and reduce barriers to engagement in HIV prevention and care.

Methods: Intervention components included Violence and Gender Affirmation Screening, peer navigation sessions, and a rigorous adaptation of Seeking Safety peer-delivered group sessions. We conducted a one-arm pilot study in which participants completed pre-test, immediate post-test, and 3-month follow-up surveys. A subset of participants completed qualitative exit interviews.

Results: Results indicated good feasibility with all participants completing the Violence and Gender Affirmation Screening, all completing at least one peer navigation session, 79% attending at least 7 of 8 group sessions across 7 cohorts, and 89% completing at least one follow-up survey. Exit interviews and group session evaluations indicated high acceptability. As this pilot study was not powered nor intended to evaluate intervention efficacy, intent-to-treat analyses did not detect significant changes in most hypothesized mediators, mental health, substance use, and HIV outcomes; however, there were significant changes in intimate partner violence and medical and legal gender affirmation.

Conclusions: Kickin' it with the Gurlz demonstrated promise as a peer-delivered HIV status-neutral intervention designed to address violence, healing from trauma, and improve engagement in HIV prevention and care with transgender women of color.