Limited Interaction Targeted Epidemiology of HIV in Sexual and Gender Minority American Adolescents and Adults: Feasibility of the Keeping it LITE Study

Abstract

Background HIV infection rates among sexual minority men and transgender individuals, particularly adolescents and young adults, remain elevated in the United States despite continued improvement in the HIV public health response. However, there remains a knowledge gap in understanding the barriers faced by this community in receiving HIV care and prevention resources. To address this, the Keeping it LITE study was conducted to assess HIV risk factors and barriers to preventive treatment in a large national cohort of young sexual minority men and transgender individuals at high risk of HIV infection. Objective This study aims to evaluate the feasibility of enrolling a large remote cohort, challenges encountered in recruitment, and adjustments made to address these challenges. Methods A large national cohort (n=3444) of young sexual minority men and transgender individuals were recruited. Participants were recruited via advertisements on social media; social apps for lesbian, gay, bisexual, transgender, and queer individuals; print advertising; and word-of-mouth. Before enrolling, participants verified their HIV status using an at-home HIV test or by providing their own testing documentation. Descriptive statistics were generated, and a series of logistic regressions were conducted to evaluate demographic differences between recruitment methods, HIV testing methods, and enrollment status. Results The Keeping it LITE study was particularly successful in recruiting participants via social media, with over half of the participants recruited from advertisements on social media platforms such as Facebook, Instagram, and Snapchat. Participants were also recruited via word-of-mouth; lesbian, gay, bisexual, transgender, and queer apps (ie, Grindr, Scruff); and print advertisements, and participants recruited from these sources tended to be older and have a higher risk profile. The study was also successful in recruiting a large sample of transgender youth, particularly transgender men and nonbinary individuals. At-home HIV testing was acceptable and more heavily used by younger participants, although several barriers were encountered and overcome in the implementation of this testing. The study had more limited success in recruiting participants aged 13-17 years because of lower enrollment rates and barriers to advertising on social media platforms. The implications of these findings for the future development of HIV research and intervention protocols among sexual minorities and trans youth are discussed. Conclusions The methods used in the Keeping it LITE study, particularly recruitment via social media, were found to be feasible and acceptable to participants.

The relationship between anti-LGBTQ+ legislation and HIV prevention among sexual and gender minoritized youth

“…A cohort of SGM youth and young adults [28] was linked to state-level policy data [7] and county-level election results [29,30]. Details are below.…”

“…Keeping it LITE-1 was a national, longitudinal cohort study that prospectively enrolled 3444 SGM youth and young adults ages 13-34 from 2017 to 2019, and followed participants through 2022 [28]. Participants were recruited via social media and LGBTQþ dating apps using community sampling.…”

Prediction of Sex and the Potential Use of On-Demand PrEP Among Young Men Who Have Sex With Men in the United States

“…We enrolled YMSM into a prospective cohort from April through June 2021 and followed each participant for 8 weeks using digital daily surveys (DDSs). Participants were recruited nationally from social media advertisements and an existing YMSM cohort 15 to complete study eligibility screening through an online survey. Eligible participants were (1) 16-24 years of age; (2) assigned male sex at birth and identified their current gender as male; (3) sexually active with men, defined as engaging in at least 1 episode of anal sex with a man in the past 6 months; and (4) HIV negative according to self-report.…”

Social media to promote treatment adherence among adolescents and young adults with chronic health conditions: A topical review and TikTok application.

“…However, there can also be barriers in social media recruitment that can make targeted AYA recruitment efforts a challenge. For example, Snapchat does not allow advertisements for research studies to youth under the age of 18 (Gleason et al, 2021). Without appropriate safeguards, social media recruitment is susceptible to data quality problems when individuals use private servers to fraudulently complete surveys for profit (Pozzar et al, 2020).…”