Adolescent Youth Survey on HIV Prevention in Alabama: Protocol for Community and Online Survey with Bot Detection and Fraud Screening. (Preprint)

Abstract

BACKGROUND In Alabama, the undiagnosed HIV rate is over 20%; youth and young adults, particularly those who identify as sexual and gender minorities, are at elevated risk for HIV acquisition and are the only demographic group in the United States with rising rates of new infections. Adolescence is a period marked by exploration, risk-taking, and learning, making comprehensive sexual health education a high-priority prevention strategy for HIV and sexually transmitted infections. However, in Alabama, school-based sexual health and HIV prevention education is strictly regulated and does not address the unique needs of sexual and gender minority teenagers. OBJECTIVE To understand knowledge gaps related to HIV prevention and pre-exposure prophylaxis, specifically to address these gaps via intervention, we conducted the Alabama Youth Survey to evaluate 14-17 year old of sexual and gender minorities’ preferences and knowledge related these topics. METHODS Between September 2023 and March 2024, we conducted an online survey with 14-17 years old, assigned male at birth, sexually attracted to men youth who lived in Alabama. Half of the study’s participants were recruited through community partners, namely the Magic City Acceptance Academy and the Magic City Acceptance Center, and the other half were recruited online via social media. A 7-step fraud and bot detection protocol was implemented and applied to online recruitment to reduce the likelihood of collecting false information. RESULTS Analyses are ongoing (N=206). Preliminary results include a sample mean age of 16.21 years (standard deviation = 0.88); about a quarter identified as transgender or gender non-conforming, with 6% stating their gender as a transgender woman. Thirty percent self-reported their race as African American or Black; 12% were Hispanic or Latinx. More than half reported being sexually active in the past six months. CONCLUSIONS If the study is successful, we will yield information on HIV knowledge, PrEP awareness, PrEP preferences, and related outcomes among sexual and gender minorities teenagers in Alabama, an underserved, hard-to-reach, but also high-priority population for public health efforts to End the HIV Epidemic.