Abstract
BACKGROUND: Transgender Latina women in the United States face disproportionate HIV risk due to intersecting social and structural vulnerabilities that limit access to care. While gender-affirming, culturally responsive, and eHealth strategies show promise for improving access, social media-based approaches remain underused despite their potential to reach marginalized groups at scale. OBJECTIVE: This study aimed to develop and pilot a culturally tailored social media campaign to increase awareness of HIV prevention and care services offered by a community-based organization (CBO) in King County, Washington, for transgender Latina women and to assess the campaign's feasibility and acceptability. METHODS: We conducted a community-engaged, mixed methods pilot study using a multiphase design. In phase 1, we conducted cross-sectional, in-depth interviews with transgender Latina women (n=20) recruited by a CBO in King County, Washington. Interviews were analyzed using thematic analysis, guided by the Unified Theory of Behavior, to inform campaign messaging priorities. A subsequent focus group (n=7) then reviewed and refined 6 draft campaign concepts according to the community preferences. In phase 2, the finalized campaign was piloted on Facebook and Instagram. A cross-sectional REDCap (Research Electronic Data Capture; Vanderbilt University) survey was conducted with a subset (n=100) of transgender Latina women exposed to the campaign who voluntarily consented to complete the survey after being directed from the campaign. Survey data were summarized using descriptive statistics to assess campaign reach and feasibility and acceptability outcomes. RESULTS: In-depth interview participants were a mean age of 37.6 (SD 9.5) years and reported an average of 10.2 (SD 10.8) years residing in the United States (n=20). Interviews revealed four key themes: (1) importance of HIV prevention and awareness, (2) accessibility of HIV services, (3) provision of culturally tailored care, and (4) need for confidentiality. Among survey respondents (mean age of 29.7, SD 5.2 years), 97% (97/100; 95% CI 91.5%-99.0%) had ever tested for HIV and 44% (44/100; 95% CI 34.3%-53.7%) reported testing within the past 6 months. A total of 3 respondents were living with HIV, all on antiretroviral therapy. Nearly all (91/100, 91%; 95% CI 84.3%-95.2%) reported campaign-motivated action, including HIV testing or seeking information or services. CONCLUSIONS: Findings demonstrate the feasibility and acceptability of a culturally tailored campaign, cocreated with community members, to promote HIV prevention and care among transgender Latina women. By integrating participatory methods with digital outreach, this study contributes an innovative model that centers community voices in campaign design while leveraging widely used platforms. The study has implications for providing CBOs with scalable, low-cost strategies to expand culturally responsive HIV services, reduce stigma, and motivate health-seeking behaviors in populations often overlooked by mainstream public health messaging. This work underscores how codesigned social media campaigns can complement traditional outreach and inform future HIV prevention strategies for underserved populations.