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We pilot tested Trans Amigas, a theory-based, trans-specific peer navigation (PN) intervention to address barriers to care in S\u00e3o Paulo, Brazil. TWH were randomized to the PN intervention (n\u2009=\u200975) or control (n\u2009=\u200938) condition. Control participants were referred to trans-friendly HIV care. Intervention participants were assigned a navigator who conducted nine in-person one-on-one sessions and bi-weekly phone or text check-ins to help participants overcome barriers to care and work towards gender affirmation and healthcare goals. We followed participants for 9\u00a0months to determine intervention feasibility, acceptability, and preliminary efficacy in improving retention in care. Analyses were intention to treat (ITT). Intervention acceptability was high: at end line, 85.2% of PN participants said they would continue receiving services and 94.4% would recommend peer navigation to a friend. A priori feasibility criteria were met: 92% of eligible participants enrolled and 70% were retained at 9\u00a0months; however, only 47% achieved moderate or better adherence to both in-person and phone\/text program components. Though the pilot was not powered for efficacy, ITT findings trended toward significance, with intervention participants 40% more likely to be retained in care at the end of the study. Population-specific peer programming to support care engagement is acceptable, feasible, and can improve HIV outcomes for Trans women living with HIV.<\/jats:p>","DOI":"10.1007\/s10461-022-03595-8","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T15:02:43Z","timestamp":1643986963000},"page":"2588-2599","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Peer Navigation to Support Transgender Women\u2019s Engagement in HIV Care: Findings from the Trans Amigas Pilot Trial in S\u00e3o Paulo, Brazil"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3152-9372","authenticated-orcid":false,"given":"Sheri A.","family":"Lippman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae M.","family":"Sevelius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo Santa Roza","family":"Saggese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailey","family":"Gilmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katia Cristina","family":"Bassichetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Dutra","family":"de Barros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Batisteli","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca Fasciolo","family":"Maschi\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Amelia","family":"de Sousa Mascena Veras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"issue":"2","key":"3595_CR1","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1097\/COH.0000000000000031","volume":"9","author":"R De Boni","year":"2014","unstructured":"De Boni R, Veloso VG, Grinsztejn B. 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