Hill Brandon J, Motley Darnell N, Rosentel Kris, VandeVusse Alicia, Garofalo Robert, Schneider John A, Kuhns Lisa M, Kipke Michele D, Reisner Sari, Rupp Betty M, Sanchez Maria, McCumber Micah, Renshaw Laura, West Goolsby Rachel, Loop Matthew Shane
Planned Parenthood Great Plains, Overland Park, KS, United States.
Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States.
JMIR Res Protoc. 2020 Aug 10;9(8):e16401. doi: 10.2196/16401.
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.
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.
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.
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.
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.
ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/16401.
与男性发生性关系的年轻顺性别男性（YMSM）、年轻跨性别女性（YTW）以及有色人种的性别不一致（GNC）青年面临着巨大的经济和健康差距。特别是，这些群体中的艾滋病毒风险和感染仍然是一个重大的公共卫生问题。2017年，所有新的艾滋病毒诊断病例中有17%归因于13至24岁青少年和年轻成年人中的男男性接触。然而，这种差距不能仅归因于个体层面的因素，而是存在于更大的社会和结构背景中，这些背景使YMSM、YTW和有色人种的GNC青年处于边缘地位，并使他们更容易接触到艾滋病毒。解决社会和结构风险因素需要对艾滋病毒风险的远端驱动因素进行干预，包括就业和经济稳定。“工作预防艾滋”（W2P）研究旨在通过就业准备和就业来针对经济稳定，作为一种结构层面的干预措施，以预防黑人和拉丁裔YMSM、YTW和GNC青年中的青少年和年轻成年人感染艾滋病毒。本研究旨在评估干预措施在目标人群中的可行性和可接受性，并确定干预措施增加就业和减少性风险行为的初步效果。
该研究的目标是在有色人种的YMSM、YTW和GNC青年中对一个量身定制的、基于理论的就业干预项目进行试点测试。这种干预措施改编自“增加个人收入和独立性”，这是W2P研究第一阶段针对艾滋病毒阳性成年人的一项现有循证就业项目。
就业干预将在一个单组前后试验中，在弱势的有色人种YMSM、YTW和GNC青年中进行试点测试，以评估可行性、可接受性和效果初步估计。
研究活动于2018年3月开始，并于2019年11月完成。总体而言，5名参与者参加了预测试，51名参与者参加了试点。
为了成功扭转青少年和年轻成年人艾滋病毒流行趋势，迫切需要针对艾滋病毒暴露和感染的社会和结构驱动因素的干预措施。以就业作为预防手段有可能成为一种可扩展的干预措施，可在这一群体中实施。
ClinicalTrials.gov NCT03313310；https://clinicaltrials.gov/ct2/show/NCT03313310。
国际注册报告识别码（IRRID）：DERR1-10.2196/16401。
