Reback Cathy J, Fletcher Jesse B, Fehrenbacher Anne E, Kisler Kimberly
Friends Research Institute, Inc, Los Angeles, CA, United States.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.
JMIR Res Protoc. 2019 Jul 29;8(7):e12837. doi: 10.2196/12837.
Transgender women in the United States experience numerous risk factors for HIV acquisition and transmission, including increased rates of homelessness, alcohol and drug use, sex work, and nonprescribed hormone and soft tissue-filler injections. In addition, transgender women face discrimination and social/economic marginalization more intense and deleterious than that experienced by lesbian, gay, or bisexual individuals, further worsening health outcomes. Although little research has been done specifically with young transgender women aged 35 years and younger, existing evidence suggests even further elevated rates of homelessness, substance use, and engagement in HIV transmission risk behaviors relative to their older transgender women and nontransgender young adult counterparts. Young transgender women living with HIV experience a range of barriers that challenge their ability to be successfully linked and retained in HIV care.
The aim of this randomized controlled trial, Text Me, Girl!, is to assess the impact of a 90-day, theory-based, transgender-specific, text-messaging intervention designed to improve HIV-related health outcomes along the HIV care continuum among young (aged 18-34 years) transgender women (N=130) living with HIV/AIDS.
Participants were randomized into either Group A (immediate text message intervention delivery; n=61) or Group B (delayed text message intervention delivery whereby participants were delivered the text-messaging intervention after a 90-day delay period; n=69). Over the course of the 90-day intervention, participants received 270 theory-based text messages that were targeted, tailored, and personalized specifically for young transgender women living with HIV. Participants received 3 messages per day in real time within a 10-hour gradual and automated delivery system. The text-message content was scripted along the HIV care continuum and based on social support theory, social cognitive theory, and health belief model. The desired outcome of Text Me, Girl! was virological suppression.
Recruitment began on November 18, 2016, and the first participant was enrolled on December 16, 2016; enrollment closed on May 31, 2018. Intervention delivery ended on November 30, 2018, and follow-up evaluations will conclude on August 31, 2019. Primary outcome analyses will begin immediately following the conclusion of the follow-up evaluations.
Text messaging is a communication platform well suited for engaging young transgender women in HIV care because it is easily accessible and widely used, as well as private, portable, and inexpensive. Text Me, Girl! aimed to improve HIV care continuum outcomes among young transgender women by providing culturally responsive text messages to promote linkage, retention, and adherence, with the ultimate goal of achieving viral suppression. The Text Me, Girl! text message library is readily scalable and can be adapted for other hard-to-reach populations.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12837.
美国的跨性别女性面临着众多感染和传播艾滋病毒的风险因素，包括无家可归率上升、酗酒和吸毒、性工作以及非处方激素和软组织填充剂注射。此外，跨性别女性面临的歧视以及社会/经济边缘化比女同性恋、男同性恋或双性恋者更为严重和有害，这进一步恶化了健康状况。尽管针对35岁及以下年轻跨性别女性的专门研究较少，但现有证据表明，与年龄较大的跨性别女性和非跨性别年轻成年人相比，她们的无家可归率、药物使用以及参与艾滋病毒传播风险行为的比例甚至更高。感染艾滋病毒的年轻跨性别女性面临一系列障碍，这些障碍挑战了她们成功获得并持续接受艾滋病毒护理的能力。
这项名为“给我发短信，女孩！”的随机对照试验旨在评估一项为期90天、基于理论、针对跨性别者的短信干预措施的影响，该干预措施旨在改善感染艾滋病毒/艾滋病的年轻（18 - 34岁）跨性别女性（N = 130）在艾滋病毒护理连续过程中的相关健康结果。
参与者被随机分为A组（立即发送短信干预；n = 61）或B组（延迟发送短信干预，即参与者在90天延迟期后接受短信干预；n = 69）。在为期90天的干预过程中，参与者收到270条基于理论的短信，这些短信是专门针对感染艾滋病毒的年轻跨性别女性进行了针对性、个性化定制的。参与者在一个10小时的渐进式自动发送系统中每天实时收到3条短信。短信内容是根据艾滋病毒护理连续过程编写的，并基于社会支持理论、社会认知理论和健康信念模型。“给我发短信，女孩！”的预期结果是病毒抑制。
招募工作于2016年11月18日开始，第一位参与者于2016年12月16日入组；招募工作于2018年5月31日结束。干预措施于2018年11月30日结束，随访评估将于2019年8月31日结束。主要结局分析将在随访评估结束后立即开始。
短信是一个非常适合让年轻跨性别女性参与艾滋病毒护理的沟通平台，因为它易于获取、广泛使用，而且私密、便携且成本低廉。“给我发短信，女孩！”旨在通过提供具有文化适应性的短信来促进联系、持续护理和依从性，从而改善年轻跨性别女性在艾滋病毒护理连续过程中的结果，最终目标是实现病毒抑制。“给我发短信，女孩！”的短信库易于扩展，可适用于其他难以接触到的人群。
国际注册报告识别码（IRRID）：DERR1-10.2196/12837
