(PS8-39) Development of the Trans-led Care Program: Results from Open Pilot Testing of a Peer-delivered Acceptance and Commitment Therapy-based Group Intervention with Trans Adults with Substance Use Problems

In this presentation, we will present findings from an NIH-funded K99/R00 project, ‘A Gender-Affirming Stigma Intervention to Improve Substance Misuse and HIV Risk among Transgender Adults.’ The overarching goal of the project is to adapt and pilot an acceptance and commitment therapy (ACT)-based gender-affirming stigma reduction intervention focused on substance misuse and HIV prevention and care with trans adults. In the first phase, the team collaborated with a community advisory board to develop a gender-affirming ACT protocol (“the TLC Program”) based on focus groups (5 groups, n=21 trans women and transfeminine adults), in-depth interviews (n=16 trans men and transmasculine adults) and stakeholder feedback (n=13 treatment providers, organizational leaders, and peer staff). We then addressed necessary refinements identified during open pilot testing (n=13 trans adults). Participants in the open pilot were on average 33 years old (median=30, range 23-63) and endorsed an average of 6 substance use problems in the past year (median=6, range 2-17). Participants represented a range of gender identities: nonbinary or genderqueer n=3, trans man n=2, trans woman n=5, transfeminine n=2, and woman/female n=1; as well as a range of racial/ethnic backgrounds: Asian n=2, Black n=1, Multiracial n=3, Latinx/e or Hispanic n=1, White n=6. Half of participants had tested for HIV in the last 6 months (n=6), three participants were living with HIV, three participants tested for HIV more than a year ago, and one participant had never tested for HIV. The open pilot is currently running and data collection is slated for completion in June 2024. We will present the results of the open pilot and final refinements to the TLC Program, which will then be efficacy tested in a randomized controlled trial (RCT) over the next three years. Open pilot results will include pre-post quantitative measures of substance use, HIV prevention and care, depression, anxiety, and PTSD symptoms, proximal measures of stigma, healthcare empowerment, and psychological flexibility, as well as qualitative data from exit interviews with participants (n=13) and peer facilitators of the TLC program (n=2). Implications for the implementation of the RCT of the TLC program will be discussed.