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, 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):e16384. doi: 10.2196/16384.
HIV continues to have a disparate impact on young cisgender men who have sex with men (YMSM), young trans women (YTW), and gender-nonconforming (GNC) youth who are assigned male at birth. Outcomes are generally worse among youth of color. Experiences of discrimination and marginalization often limit educational attainment and may even more directly limit access to gainful employment. Though seemingly distal, these experiences influence young people's proximity to HIV risk by limiting their access to health care and potentially moving them toward sex work as a means of income as well as increased substance use. Work2Prevent (W2P) aims to achieve economic stability through employment as a structural-level intervention for preventing adolescent and young adult HIV infection. The study will pilot-test an effective, theoretically driven employment program (increased individual income and independence [iFOUR]), for HIV-positive adults, and adapt it to the needs of black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years who are vulnerable to HIV exposure.
This paper aimed to describe the protocol for the exploratory phase of W2P. The purpose of this phase was to determine the essential components needed for a structural-level employment intervention aimed at increasing job-seeking self-efficacy and career readiness among black and Latinx YMSM, YTW, and GNC youth aged 16 to 24 years.
The exploratory phase of the W2P study consisted of in-depth interviews and focus groups with members of the target community as well as brief interviews with lesbian, gay, bisexual, transgender, and queer (LGBTQ)-inclusive employers. The study team will conduct in-depth interviews with up to 12 YMSM and 12 YTW and GNC youth, up to 10 focus groups with a maximum of 40 YMSM and 40 YTW and GNC youth, and up to 40 brief interviews with LGBTQ-inclusive employers. Participants will be recruited through a community-based recruiter, passive recruitment in community spaces and on social media, and active recruitment by research staff in community spaces serving LGBTQ youth.
In-depth interviews were conducted with 21 participants, and 7 focus groups were conducted with 46 participants in total. In addition, 19 brief interviews with LGBTQ-inclusive employers were conducted. The analysis of the data is underway.
Preliminary findings from the formative phase of the study will be used to inform the tailoring and refinement of the iFOUR adult-based intervention into the youth-focused W2P intervention curriculum. Perspectives from YMSM, YTW, GNC youth, and LGBTQ-inclusive employers offer a multidimensional view of the barriers and facilitators to adolescent and young adult LGBTQ employment. This information is critical to the development of a culturally appropriate and relevant youth-focused intervention.
ClinicalTrials.gov NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/16384.
艾滋病毒对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）以及出生时被认定为男性的性别不一致（GNC）青年仍有不同程度的影响。有色人种青年的情况通常更糟。歧视和边缘化经历往往限制了他们的教育程度，甚至可能更直接地限制了他们获得有报酬工作的机会。尽管这些经历看似间接，但它们通过限制年轻人获得医疗保健的机会，并可能促使他们从事性工作以获取收入以及增加药物使用，从而影响年轻人接近艾滋病毒风险的程度。Work2Prevent（W2P）旨在通过就业实现经济稳定，作为预防青少年和年轻成人艾滋病毒感染的结构性干预措施。该研究将对一项针对艾滋病毒阳性成年人的有效、基于理论的就业项目（增加个人收入和独立性[iFOUR]）进行试点测试，并使其适应16至24岁易感染艾滋病毒的黑人及拉丁裔YMSM、YTW和GNC青年的需求。
本文旨在描述W2P探索阶段的方案。此阶段的目的是确定一项结构性就业干预措施所需的基本组成部分，该措施旨在提高16至24岁黑人及拉丁裔YMSM、YTW和GNC青年的求职自我效能感和职业准备程度。
W2P研究的探索阶段包括与目标社区成员进行深入访谈和焦点小组讨论，以及与接纳女同性恋、男同性恋、双性恋、跨性别者和酷儿（LGBTQ）的雇主进行简短访谈。研究团队将对多达12名YMSM以及12名YTW和GNC青年进行深入访谈，对最多40名YMSM以及40名YTW和GNC青年进行多达10个焦点小组讨论，并对接纳LGBTQ的雇主进行多达40次简短访谈。参与者将通过社区招募人员、在社区场所和社交媒体上的被动招募以及研究人员在为LGBTQ青年服务的社区场所进行的主动招募来选取。
对21名参与者进行了深入访谈，总共进行了7个焦点小组讨论，有46名参与者。此外，还对接纳LGBTQ的雇主进行了19次简短访谈。数据正在分析中。
该研究形成阶段的初步结果将用于指导将基于成人的iFOUR干预措施调整和完善为以青年为重点的W2P干预课程。YMSM、YTW、GNC青年以及接纳LGBTQ的雇主的观点提供了关于青少年和年轻成人LGBTQ就业的障碍和促进因素的多维度视角。这些信息对于制定适合文化背景且相关的以青年为重点的干预措施至关重要。
ClinicalTrials.gov NCT03313310；https://clinicaltrials.gov/ct2/show/NCT03313310。
国际注册报告标识符（IRRID）：DERR1-10.2196/16384。
