Background : Despite the need of a health care site that includes a well-trained staff in quality of life among the transgender community, Puerto Rican clinics remain suboptimal in Trans healthcare. Centro Ararat sought to address this gap within an existing multidisciplinary care setting. In February 2016, CA launched a pilot project focused on Transgender women. This project named Translucent had culturally competent health care professionals, well trained and sensitive to issues affecting the Transgender population. Translucent as a pilot project started with twenty Trans females and was so well accepted. Would it be possible to move from a project to a full trans-centric primary care clinic?
Methods : This project included four phases. The outreach phase was implemented from February to June 2016, at “private home parties” where the host leader recruits, trains, and engages their peers, serving as a behavior change endorsers. The second approach was direct recruitment stage, where person to person, the participants came to our center to receive HIV/STIs prevention services. The second phase was to create a “trans-centric safe space” in a separate location from the primary clinic, where they could find sense of community among the participants. A harm reduction education component was also integrated to complement the biopsychosocial model. The third phase launched from September 2016 to June 2017, designed to improve self-esteem, sense of belonging, legal rights and self-care, incorporating STI/HIV testing as an integral part of the process. The educational curriculum serves as a foundation for intervention development and implementation, based on social cognitive theory, trans-theoretical model of behavior change, theories of gender and power, and motivational enhancement. The fourth phase provides incentives to keep the participants engaged in the system. It included hormonal therapy after completion of the six weeks curriculum. Translucent as a pilot project started with twenty Transgender women and was so well accepted by the Trans community.
Results : As a result, it matured to a trans-centric clinic, serving around 95 Transgender women and 35 Trans males (October 2018). Translucent has been recognized by the local Department of Health and AIDS United, by granting the proposals: “Leadership Development Initiatives” and Transgender Women Engagement and Retention in Care”.
Conclusions : Within an existing multidisciplinary health care setting, a Trans-centric model can be achieved as an unified, biopsychosocial comprehensive clinic to provide a sense of community among the Transgender population. The key recruitment strategy is well established by word of mouth. Engagement and retention should take in consideration incentives focused on Transgender priorities. Continuous improvement is based on participants’ feedback and primary concerns, where the specific topics such as STI/HIV testing and behavioral changes should be included as sexual health, prevention, linkage and continuum in care under the umbrella of primary care.