Background As we enter the fifth decade of the AIDS epidemic, health researchers and AIDS activists reflect both on the progress that has been made and the importance of continued prevention efforts for those most at risk. As HIV infection rates continue to fluctuate across communities, a trend has emerged with new HIV infections becoming increasingly concentrated—with cascading effects—among people aged <30 years, from marginalized racial and ethnic groups, and who are sexual or gender minorities. Objective In this paper, we discuss the renewal of the Healthy Young Men’s (HYM) Cohort Study and the addition of a subcohort—TRUTH: A Transgender Youth of Color Study. The overarching aim of our renewed study was to inform new intervention strategies; understand linkage to care; and examine changes over time with respect to minority-related stress and intersectional identities and their relationship with substance use, mental health, and HIV risk. Findings from this study will help to inform the development of new interventions designed to engage African American and Black and Latino young men who have sex with men (YMSM) and transgender and gender minority youth in the HIV prevention and care continua and to reduce risk by addressing pathways of minority-related stress and intersectional stigma. Methods Longitudinal study (baseline and follow-up assessments every 6 months for a total of 8 waves of data collection) is ongoing with reconsented cohort from the last iteration of HYM Cohort Study. This study protocol includes self-report survey, collection of urine to assess recent use of illicit drugs, and collection of blood and rectal and throat swabs to test for current sexually transmitted infection and HIV infection. An additional sample of blood and plasma (10 mL for 4 aliquots and 1 pellet) is also collected and stored in the HYM Cohort Study biorepository for future studies. This mixed methods study design includes collection of triangulated analysis of quantitative, qualitative, and biological measures (ie, drug use, sexually transmitted infection and HIV testing, and adherence to antiretroviral therapy among participants who are HIV+) at baseline and every 6 months. Results As of February 2022, participants from the past 4 years of the HYM Cohort Study and TRUTH: A Transgender Youth of Color Study Cohort have been reconsented and enrolled into the renewal period of longitudinal data collection, which is projected from summer of 2020 until summer of 2025. Recruitment is ongoing to reach our target enrollment goal of YMSM and transgender minority youth. Conclusions The findings from this study are being used to inform the development of new, and adaptation of existing, evidence-based HIV prevention interventions designed to engage populations of transgender and gender minority youth and YMSM in the HIV prevention and care continua. International Registered Report Identifier (IRRID) DERR1-10.2196/39232
BACKGROUND The U.S. Department of Health and Human Services has proposed an end to the human immunodeficiency virus (HIV) epidemic in the United States by 2030, which will require flexible yet targeted strategies that successfully engage groups that are disproportionately affected. As we broach the fifth decade of the AIDS epidemic, health researchers and AIDS activist reflect both on progress that has been made, and the importance of continued prevention efforts for those most at risk. As HIV infections rates continue to fluctuate across communities, a trend has emerged with new HIV infections increasingly concentrated—with cascading effects—among people under 30, from marginalized racial and ethnic groups, and who are sexual or gender minorities. OBJECTIVE In this paper we discuss the renewal of the Healthy Young Men’s Study (HYM) and the addition a sub-cohort; TRUTH. The overarching aim of our renewed study is to inform new intervention strategies, understand linkage to care, and examine changes over time with respect to minority-related stress and intersectional identities, and their relationship to substance use, mental health, and HIV risk. Findings from this research will help inform the development of new interventions designed to engage AA/B- and L-YMSM and TGMY in the HIV prevention and care continua, and to reduce risk by addressing pathways of minority-related stress and intersectional stigma. METHODS Longitudinal research (baseline and follow-up assessments every 6-months for a total of 8 waves of data collection) is ongoing with reconsented cohort from the last iteration of HYM. This study protocol includes self-report survey, collection of urine to assess recent use of illicit drugs and the collection of blood and rectal/throat swabs to test for current sexually transmitted infection (STI)/HIV infection. An additional sample of blood/plasma (10mL for 4 aliquots and 1 pellet) is also collected and stored in the HYM cohort study biorepository for future research. This mixed-methods study design includes collection of triangulated analysis of quantitative, qualitative, and biological measures (i.e., drug use, STI/HIV testing, and adherence to antiretroviral therapy among HIV+ participants) at baseline and every 6-months. RESULTS To date, participants from the past four years of the HYM Cohort Study and TRUTH Study Cohort have been reconsented and enrolled into the renewal period of longitudinal data collection. Recruitment is ongoing to reach our target enrollment goal of young men who have sex with men and transgender minority youth. CONCLUSIONS The findings from this research are being used to inform the development of new and adaptation of existing evidence-based HIV prevention interventions designed to engage population TGMY and YMSM in the HIV prevention and care continua.
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