TRUTH: A Trans Youth of Color Study – Study Protocol (Preprint)

BACKGROUND Growing research on transgender youth is accounting for the variety of ways in which young people define their genders and sexualities. Due to this growing representation, more research is needed to understand how intersectional identities and stigma impact risk for HIV acquisition along the HIV care continuum and engagement in mental and physical healthcare. Little is known about accessibility to HIV-related prevention services of nonbinary and transmasculine youth and further understanding of the impacts on transfeminine people, those who have historically faced the highest prevalence of HIV positivity, is crucial. OBJECTIVE The overarching aims of TRUTH: A Transgender Youth of Color Study is to conduct longitudinal research with a cohort of transgender minority youth (TGMY), to explore factors that aid in the prevention of new HIV infection and transmission and reduce HIV/AIDS-related disparities by focusing on successful engagement in care. Findings from this research will be used to inform the development of new interventions designed to engage AA/L-YMSM and TGMY in the HIV prevention and care continua. METHODS Longitudinal research (baseline and follow-up assessments every 6 months for a total of 3 waves of data collection) followed a new cohort of N=108 transgender youth of color recruited in Los Angeles, California. Participants were recruited using multiple community-informed strategies such as venue-based, social media, and participant referral. In addition to self-report surveys, urine was collected to assess recent use of illicit drugs and blood, rectal, and throat swabs were collected to test for current sexually transmitted infection (STI)/HIV infection. Additional blood and plasma samples (10 mL for 4 aliquots and 1 pellet) were collected and stored for future research. RESULTS To date, all participants in the TRUTH Study have been recruited and the first three waves of data collection have completed. Data analysis is ongoing. CONCLUSIONS The findings from this research will inform adaptations to existing evidence-based HIV prevention interventions and help guide new interventions for to engage TGMY, especially those who are Black, Indigenous, and/or people of color in the HIV prevention and care continua.