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Currently submitted to: JMIR Research Protocols

Date Submitted: May 14, 2019
Open Peer Review Period: May 17, 2019 - May 31, 2019
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American Cohort to Study HIV Acquisition among Transgender Women in High Risk Areas: a protocol for technology-enhanced methods to study HIV acquisition risks in eastern and southern United States

  • Andrea L Wirtz; 
  • Tonia Poteat; 
  • Asa Radix; 
  • Keri N Althoff; 
  • Christopher Cannon; 
  • Andrew J Wawrzyniak; 
  • Erin Cooney; 
  • Ken Mayer; 
  • Sari L Reisner; 
  • American Cohort To Study HIV Acquisition Among Transgender Women (LITE)

ABSTRACT

Background:

In the U.S., transgender women (TW) are disproportionately burdened by HIV infection. Cohort studies are needed to evaluate factors driving HIV acquisition among TW over time. These will require implementation strategies that are acceptable to the TW community and feasible to implement.

Objective:

American Cohort to Study HIV Acquisition among Transgender Women in High Risk Areas (also known as the LITE study) is a multi-site prospective cohort investigating the rate and correlates of HIV acquisition and other health outcomes among TW in six eastern and southern U.S. cities across 24-months of technology-enhanced biobehavioral follow-up.

Methods:

Adult transgender women, regardless of HIV status, are recruited via convenience sampling (e.g., peer referrals, social media, dating apps). Participants are enrolled in a baseline study visit and complete a socio-behavioral survey and HIV/ STI testing; follow-up assessments occur quarterly.

Results:

Cohort assembly was informed by synchronous online focus group discussions with TW (n=41) and continuing engagement with community advisory board members from each site. Enrollment launched in March 2018 and is underway in the Atlanta, Baltimore, Boston, Miami, New York City, and Washington, DC metro areas. As of March 2019, 795 TW completed a baseline visit (mean age=35 years). The majority are racial/ethnic minorities with 45% identifying as Black and 28% as Hispanic/Latinx. More than one-quarter (28%) are living with HIV infection (laboratory-confirmed). Online recruitment methods support engagement with TW, though peer referral and referral through trusted health facilities and organizations remain most effective.

Conclusions:

This study is responsive to increasing research interest in technology-enhanced methods for cohort research, particularly for hard-to-reach populations. Importantly, the diversity of literacy, technology use, and overall socio-economic situations in this sample of TW highlights the need to leverage technology to permit flexible, adaptive methodology that enhances engagement of potential participants living in marginalized contexts while still ensuring rigorous and sound study design.


 Citation

Please cite as:

Wirtz AL, Poteat T, Radix A, Althoff KN, Cannon C, Wawrzyniak AJ, Cooney E, Mayer K, Reisner SL, American Cohort To Study HIV Acquisition Among Transgender Women (LITE)

American Cohort to Study HIV Acquisition among Transgender Women in High Risk Areas: a protocol for technology-enhanced methods to study HIV acquisition risks in eastern and southern United States

JMIR Preprints. 14/05/2019:14704

DOI: 10.2196/preprints.14704

URL: https://preprints.jmir.org/preprint/14704


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