美国高危地区跨性别女性中HIV感染情况队列研究（LITE研究）：美国东部和南部多中心前瞻性队列研究方案

American Cohort to Study HIV Acquisition Among Transgender Women in High-Risk Areas (The LITE Study): Protocol for a Multisite Prospective Cohort Study in the Eastern and Southern United States.

作者信息

Wirtz Andrea L, Poteat Tonia, Radix Asa, Althoff Keri N, Cannon Christopher M, Wawrzyniak Andrew J, Cooney Erin, Mayer Kenneth H, Beyrer Chris, Rodriguez Allan E, Reisner Sari L

机构信息

Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

University of North Carolina School of Medicine, Chapel Hill, NC, United States.

出版信息

JMIR Res Protoc. 2019 Oct 3;8(10):e14704. doi: 10.2196/14704.

BACKGROUND

In the United States, 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

This study aims to investigate the rate and correlates of HIV acquisition and other health outcomes among TW in eastern and southern United States.

METHODS

LITE is a multisite prospective cohort in 6 eastern and southern US cities, which will be followed across 24 months of technology-enhanced biobehavioral follow-up. Adult TW, regardless of HIV status, are recruited via convenience sampling (eg, peer referrals, social media, and dating apps). Participants are enrolled in a baseline study visit, complete a sociobehavioral survey, and test for HIV and sexually transmitted infections. Participants who are not living with HIV at baseline are offered enrollment into the cohort (N=1100); follow-up assessments occur quarterly.

RESULTS

Cohort assembly was informed by synchronous Web-based focus group discussions with TW (n=41) and by continuing engagement with community advisory board members from each site. Enrollment launched in March 2018. The study 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 of the participants are racial/ethnic minorities, with 45% of the TW identifying as black and 28% of the TW identifying as Hispanic/Latinx. More than one-quarter (28%) of the TW are living with HIV infection (laboratory-confirmed). Online recruitment methods support engagement with TW, although 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 socioeconomic situations in this sample of TW highlights the need to leverage technology to permit a flexible, adaptive methodology that enhances engagement of potential participants living in marginalized contexts while still ensuring rigorous and sound study design.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14704.

背景

在美国，跨性别女性（TW）感染艾滋病毒的负担过重。需要进行队列研究，以评估长期以来推动TW感染艾滋病毒的因素。这些研究将需要实施TW社区能够接受且切实可行的策略。

目的

本研究旨在调查美国东部和南部TW中艾滋病毒感染率及其相关因素以及其他健康结果。

方法

LITE是一项在美国东部和南部6个城市开展的多地点前瞻性队列研究，将在24个月的技术增强生物行为随访中对参与者进行跟踪。通过便利抽样（如同伴推荐、社交媒体和约会应用程序）招募成年TW，无论其艾滋病毒感染状况如何。参与者参加基线研究访视，完成社会行为调查，并进行艾滋病毒和性传播感染检测。基线时未感染艾滋病毒的参与者被纳入队列（N = 1100）；随访评估每季度进行一次。

结果

通过与TW进行同步网络焦点小组讨论（n = 41）以及持续与每个地点的社区咨询委员会成员互动，为队列组建提供了信息。招募工作于2018年3月启动。该研究正在亚特兰大、巴尔的摩、波士顿、迈阿密、纽约市和华盛顿特区的都会区进行。截至2019年3月，795名TW完成了基线访视（平均年龄35岁）。大多数参与者是少数族裔，45%的TW为黑人，28%的TW为西班牙裔/拉丁裔。超过四分之一（28%）的TW感染了艾滋病毒（实验室确诊）。在线招募方法有助于与TW建立联系，尽管同伴推荐以及通过可信赖的卫生设施和组织进行的推荐仍然最为有效。