Combining the Healthy Young Men’s (HYM) Cohort Study and the TRUTH Study: Protocol for an Expanded Mixed-Methods Study Renewal (Preprint)

Abstract

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.