An adaptation of the Sisters Informing Sisters on Topics about AIDS (SISTA) Project, TWISTA is a social-skills training intervention for African American transgender male to female women. It is aimed at reducing HIV sexual risk behavior. It is comprised of five 2-hour sessions, delivered by peer facilitators in a community-based setting. The sessions are gender specific and culturally relevant and include behavioral skills practice, group discussions, lectures, role-playing, viewing of prevention videos, and take-home exercises.
Core elements are critical features of an intervention’s intent and design and are responsible for its effectiveness; they must be maintained WITHOUT alteration. Staff providing this intervention must have completed the required training.
The following are the core elements of TWISTA
- Convene small-group sessions to discuss the session objectives, model skills development, role-play women’s skills acquisition, and address the challenges and joys of being an African American transgender woman
- Use skilled African American peer facilitators to implement TWISTA group sessions
- Use cultural and gender appropriate materials to acknowledge pride, enhance self-worth in being an African American transgender woman (e.g., us of poetry by African American women)
- Teach women to communicate both verbally and non-verbally to show she cares for her partner and needs to protect herself (i.e., negotiation skills, assertive communication skills)
- Instruct women on how to effectively and consistently use condoms
- Discuss cultural and gender-related barriers and facilitators to using condoms (e.g., provide information on African American women’s risk of HIV infection), and
- Emphasize the importance of partner’s involvement in safer sex (i.e., enhance partner norms supportive of condom use.
To date we have implemented TWISTA to about 300 Transwomen!