Exploring Individual and Structural Factors Associated with Employment Among Young Transgender Women of Color Using a No-Cost Transgender Legal Resource Center

Hill, Brian H.; Rosentel, Kris; Bak, Trevor; Silverman, Michael J.; Crosby, Richard A.; Salazar, Laura F.; Kipke, Michele D.

doi:10.1089/trgh.2016.0034

Cited by 29 publications

(21 citation statements)

References 35 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 12-item Job-Seeking Self-Efficacy scale by Barlow et al [ 42 ] yields a total score where higher values indicate higher self-efficacy. Job-seeking self-efficacy has been found to be associated with employment in a previous study of transgender women of color [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…Sex work and HIV risk are further complicated by drug and alcohol abuse [ 16 ]. In order to effectively target economic stability as a route toward reducing HIV risk, there is an acute need for scalable, low-cost but potentially high impact structural-level interventions that address the distal drivers of economic marginalization and adolescent and young adult HIV infection [ 24 , 25 , 29 , 30 ]. The objective of the Work2Prevent (W2P) study is to adapt and pilot-test Increased Individual Income and Independence (iFOUR), an effective, theoretically driven employment program for HIV-positive adults [ 31 - 34 ] to the needs of vulnerable YMSM, YTW, and GNC youth of color aged 16 to 24 years.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 2): Protocol for a Single-Arm Mixed Methods Pilot Test to Assess Feasibility and Acceptability

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Young cisgender men who have sex with men (YMSM), young transgender women (YTW), and gender nonconforming (GNC) youth of color face substantial economic and health disparities. In particular, HIV risk and infection among these groups remains a significant public health issue. In 2017, 17% of all new HIV diagnoses were attributed to male-to-male sexual contact among adolescents and young adults aged 13 to 24 years. However, such disparities cannot be attributed to individual-level factors alone but rather are situated within larger social and structural contexts that marginalize and predispose YMSM, YTW, and GNC youth of color to increased HIV exposure. Addressing social and structural risk factors requires intervention on distal drivers of HIV risk, including employment and economic stability. The Work2Prevent (W2P) study aims to target economic stability through job readiness and employment as a structural-level intervention for preventing adolescent and young adult HIV among black and Latinx YMSM, YTW, and GNC youth. This study seeks to assess intervention feasibility and acceptability in the target populations and determine preliminary efficacy of the intervention to increase employment and reduce sexual risk behaviors. Objective The goal of the research is to pilot-test a tailored, theoretically informed employment intervention program among YMSM, YTW, and GNC youth of color. This intervention was adapted from Increased Individual Income and Independence, an existing evidence-based employment program for HIV-positive adults during phase 1 of the W2P study. Methods The employment intervention will be pilot-tested among vulnerable YMSM, YTW, and GNC youth of color in a single-arm pre-post trial to assess feasibility, acceptability, and preliminary estimates of efficacy. Results Research activities began in March 2018 and were completed in November 2019. Overall, 5 participants were enrolled in the pretest and 51 participants were enrolled in the pilot. Conclusions Interventions that address the social and structural drivers of HIV exposure and infection are sorely needed in order to successfully bend the curve in the adolescent and young adult HIV epidemic. Employment as prevention has the potential to be a scalable intervention that can be deployed among this group. Trial Registration ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310 International Registered Report Identifier (IRRID) DERR1-10.2196/16401

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 2): Protocol for a Single-Arm Mixed Methods Pilot Test to Assess Feasibility and Acceptability

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Across Adolescent Medical Trials Network for HIV/AIDS Interventions (ATN) sites in 17 US cities, 64.6% of adolescents and young adults reported being unemployed, despite 67.8% having completed high school and being a mean working age of 20.4 years [ 36 ]. Thus, many youths vulnerable to HIV may benefit from a tailored intervention that specifically addresses job preparedness and workforce engagement [ 18 , 22 , 37 ]. Additionally, employment interventions may also need to specifically address the experiences of overt and implicit discrimination and mistreatment that sexual and gender minority youth report while job seeking and within the workplace [ 38 - 40 ].…”

Section: Introductionmentioning

confidence: 99%

Work2Prevent, an Employment Intervention Program as HIV Prevention for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 3): Protocol for a Single-Arm Community-Based Trial to Assess Feasibility and Acceptability in a Real-World Setting

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background In the United States, young cisgender men who have sex with men (YMSM), young transgender women (YTW), and gender nonconforming (GNC) youth face elevated rates of HIV infection. However, racial and ethnic disparities in adolescent HIV infection cannot be attributed to individual-level factors alone and are situated within larger social and structural contexts that marginalize and predispose sexual and gender minority youth of color to HIV. Addressing broader ecological factors that drive transmission requires interventions that focus on the distal drivers of HIV infection, including violence exposure, housing, food insecurity, educational attainment, and employment. Given the ways that economic instability may make YMSM, YTW, and GNC youth of color vulnerable to HIV exposure, this study focuses on employment as an HIV prevention intervention. More specifically, the intervention, called Work2Prevent (W2P), targets economic stability through job readiness and employment as a means of preventing behaviors and factors associated with adolescent and young adult HIV, such as transactional sex work and homelessness. The intervention was adapted from iFOUR, an evidence-based employment program for HIV-positive adults in phase 1 of this study, and pilot tested in a university-based setting in phase 2. Objective This paper aims to describe the protocol for the community-based test phase of W2P. The purpose of this phase was to pilot test a tailored, theoretically informed employment intervention program among YMSM, YTW, and GNC youth of color within a lesbian, gay, bisexual, transgender, and queer (LGBTQ) community setting. Methods The employment intervention was pilot tested using a single-arm pretest-posttest trial design implemented among a sample of vulnerable YMSM, YTW, and GNC youth of color using services within a community-based LGBTQ center. Assessments will examine intervention feasibility, acceptability, and preliminary estimates of efficacy. Results Phase 3 of W2P research activities began in May 2019 and was completed in December 2019. Overall, 41 participants were enrolled in the community-based pilot. Conclusions This study will assess intervention feasibility and acceptability in the target populations and determine preliminary efficacy of the intervention to increase employment and reduce vulnerability to HIV when implemented in a community-based setting serving LGBTQ youth of color. Testing the intervention in a community setting is an opportunity to evaluate how recruitment, retention, and other outcomes are impacted by delivery in a venue akin to where this intervention could eventually be used by nonresearchers. If W2P demonstrates feasibility and acceptability, a larger multisite trial implemented in multiple community settings serving YMSM, YTW, and GNC youth of color is planned. Trial Registration ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310 International Registered Report Identifier (IRRID) DERR1-10.2196/18051

show abstract

“…Furthermore, men who have sex with men (MSM), trans women, and GNC individuals of color report having to navigate unwarranted background checks, limited support in the workplace, and an absence of nondiscrimination laws to protect them from discrimination [ 32 ]. As a result, a substantial proportion of YMSM, YTW, and GNC youth of color live in poverty and experience negative structural outcomes, including homelessness, unemployment, and limited access to health care, LGBTQ services, and HIV prevention and care [ 6 , 10 - 14 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although the impact of structural interventions on HIV incidence may not be seen immediately, these interventions can effect changes in a community’s cultural, legal, political, and economic context that may facilitate subsequent reductions in HIV vulnerability [ 16 , 17 ]. Scalable but potentially high impact, structural interventions that trace and disrupt the pathways between social and economic marginalization and adolescent and young adult HIV infection are sorely needed [ 16 , 17 , 34 ]. However, few structural interventions targeting adolescent and young adult sexual and gender minorities exist, and we know of no studies that have explicitly examined the role of employment on HIV risk and prevention for black and Latinx YMSM, YTW, and GNC youth.…”

Section: Introductionmentioning

confidence: 99%

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 1): Protocol for Determining Essential Intervention Components Using Qualitative Interviews and Focus Groups

Hill¹,

Motley²,

Rosentel³

et al. 2020

JMIR Res Protoc

Self Cite

View full text Add to dashboard Cite

Background HIV continues to have a disparate impact on young cisgender men who have sex with men (YMSM), young trans women (YTW), and gender-nonconforming (GNC) youth who are assigned male at birth. Outcomes are generally worse among youth of color. Experiences of discrimination and marginalization often limit educational attainment and may even more directly limit access to gainful employment. Though seemingly distal, these experiences influence young people’s proximity to HIV risk by limiting their access to health care and potentially moving them toward sex work as a means of income as well as increased substance use. Work2Prevent (W2P) aims to achieve economic stability through employment as a structural-level intervention for preventing adolescent and young adult HIV infection. The study will pilot-test an effective, theoretically driven employment program (increased individual income and independence [iFOUR]), for HIV-positive adults, and adapt it to the needs of black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years who are vulnerable to HIV exposure. Objective This paper aimed to describe the protocol for the exploratory phase of W2P. The purpose of this phase was to determine the essential components needed for a structural-level employment intervention aimed at increasing job-seeking self-efficacy and career readiness among black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years. Methods The exploratory phase of the W2P study consisted of in-depth interviews and focus groups with members of the target community as well as brief interviews with lesbian, gay, bisexual, transgender, and queer (LGBTQ)–inclusive employers. The study team will conduct in-depth interviews with up to 12 YMSM and 12 YTW and GNC youth, up to 10 focus groups with a maximum of 40 YMSM and 40 YTW and GNC youth, and up to 40 brief interviews with LGBTQ-inclusive employers. Participants will be recruited through a community-based recruiter, passive recruitment in community spaces and on social media, and active recruitment by research staff in community spaces serving LGBTQ youth. Results In-depth interviews were conducted with 21 participants, and 7 focus groups were conducted with 46 participants in total. In addition, 19 brief interviews with LGBTQ-inclusive employers were conducted. The analysis of the data is underway. Conclusions Preliminary findings from the formative phase of the study will be used to inform the tailoring and refinement of the iFOUR adult-based intervention into the youth-focused W2P intervention curriculum. Perspectives from YMSM, YTW, GNC youth, and LGBTQ-inclusive employers offer a multidimensional view of the barriers and facilitators to adolescent and young adult LGBTQ employment. This information is critical to the development of a culturally appropriate and relevant youth-focused intervention. Trial Registration ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310 International Registered Report Identifier (IRRID) DERR1-10.2196/16384

show abstract

Exploring Individual and Structural Factors Associated with Employment Among Young Transgender Women of Color Using a No-Cost Transgender Legal Resource Center

Cited by 29 publications

References 35 publications

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 2): Protocol for a Single-Arm Mixed Methods Pilot Test to Assess Feasibility and Acceptability

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 2): Protocol for a Single-Arm Mixed Methods Pilot Test to Assess Feasibility and Acceptability

Work2Prevent, an Employment Intervention Program as HIV Prevention for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 3): Protocol for a Single-Arm Community-Based Trial to Assess Feasibility and Acceptability in a Real-World Setting

An Employment Intervention Program (Work2Prevent) for Young Men Who Have Sex With Men and Transgender Youth of Color (Phase 1): Protocol for Determining Essential Intervention Components Using Qualitative Interviews and Focus Groups

Contact Info

Product

Resources

About