JMIR Publications

ABSTRACT

Background:

In the U.S., young cisgender men who have sex with men (YMSM), young transgender women (YTW), and gender nonconforming (GNC) youth face elevated rates of human immunodeficiency virus (HIV) infection. However, racial and ethnic disparities in adolescent HIV infection cannot be attributed to individual-level factors alone, and are situated within larger social and structural contexts that marginalize and predispose sexual and gender minority youth of color to HIV. Addressing broader ecological factors that drive transmission requires interventions that focus on the distal drivers of HIV infection, including violence exposure, housing, food insecurity, educational attainment, and employment. Given the ways that economic instability may make YMSM, YTW, and GNC youth of color vulnerable to HIV exposure, this study focuses on employment as an HIV prevention intervention. More specifically, the intervention, called Work2Prevent (W2P), targets economic stability through job readiness and employment as a means of preventing behaviors and factors associated with adolescent and young adult HIV, such as transactional sex work and homelessness. The intervention was adapted from iFOUR, an evidence-based employment program for HIV-positive adults in Phase 1 of this study, and pilot-tested in a university-based setting in Phase 2.

Objective:

To pilot-test a tailored, theoretically-informed employment intervention program among YMSM, YTW, and GNC youth of color within a LGBTQ community setting.

Methods:

The employment intervention will be pilot-tested using a single-arm pre-post trial implemented among a sample of vulnerable YMSM, YTW, and GNC youth of color utilizing services within a community-based LGBTQ center. Assessments will examine intervention feasibility, acceptability, and preliminary estimates of efficacy.

Results:

Phase 3 of W2P research activities began in May 2019 and were completed in December 2019. Overall, 41 participants were enrolled in the community-based pilot.

Conclusions:

This study will assess intervention feasibility and acceptability in the target populations and determine preliminary efficacy of the intervention to increase employment and reduce vulnerability to HIV when implemented in a community-based setting serving LGBTQ youth of color. Testing the intervention in a community setting is an opportunity to evaluate how recruitment, retention, and other outcomes are impacted by delivery in a venue akin to where this intervention could eventually be utilized by non-researchers. If W2P demonstrates feasibility and acceptability, a larger multi-site trial implemented in multiple community settings serving YMSM, YTW, and GNC youth of color is planned. Clinical Trial: ClinicalTrials.gov registration NCT03313310; https://clinicaltrials.gov/ct2/show/NCT03313310, Archived by WebCite® at http://www.webcitation.org/76BSFOQXA