Transgender Women Involved in Strategies for Transformation (TWIST) is a peer-led small group-level intervention for transgender women living with HIV aged 18–and older of any race or ethnicity. The intervention reflects the lived experiences of transgender women, and includes their resilience and reclamation in the face of social marginalization.
As an adaptation of the WILLOW (Women Involved in Life Learning from Other Women) intervention, TWIST is delivered in four 4-hour sessions to groups of 8–10 transgender women. The intervention emphasizes gender affirmation, informs transgender women how to identify and maintain supportive social networks, teaches coping strategies to reduce life stressors, enhances awareness of HIV transmission risk behaviors, teaches communication skills for negotiating safer sex, reinforces proper and consistent condom use, distinguishes between healthy and unhealthy relationships, and defines types of abusive relationships and their effect on a transgender woman’s ability to negotiate safer sex practices.
The TWIST intervention is not designed to be a “counseling” or “service provision” program for transgender women living with HIV. Rather, it is designed to provide transgender women with information, skills, and strategies to encourage a lifelong commitment to HIV care, treatment, medication adherence, and living well with HIV.
- Use the TWIST HIP intervention package to implement the TWIST HIP intervention with fidelity
- Use effective communication skills, facilitation skills, and teaching strategies during implementation
- Enhance knowledge about cultural competency and cultural humility to support the of TWIST implementation with TWLWH
- Ensure readiness to implement TWIST upon return to the home agency