LS4M was carried out in an iterative approach with community input along the way, which allowed for refinement of the intervention manual and enhanced participant acceptability. Overall attendance, participation rates, and positive feedback from participants demonstrate that LS4M is highly acceptable and feasible to carry out with young TMSM.
Further testing of the intervention enrolling young TMSM with recent sexual risk behavior at baseline and with a control group is warranted. Lessons learned for future work with young TMSM are discussed. Little research has been conducted on HIV and STIs in transgender Alternative hookup transsexual surgery woman to man hiv who have a current gender identity or expression that differs from their assigned sex at birth, and existing research is most often focused in young transgender women.
Transgender men are often assumed to be heterosexual—meaning they have sex with cisgender non-transgender females only—and are therefore often perceived to be at low risk for HIV and STIs. In Alternative hookup transsexual surgery woman to man hiv, research highlights the heterogeneity of sexual identities and behaviors among transgender men.
Sexual minority stress theory hypothesizes that health disparities for gay or bisexual MSM are due to the differential distribution of social stress processes e.
However, behavioral interventions have shown promise for empowering young transgender women to protect their sexual health. LS4M was carried out using an innovative intervention refinement process, which allowed for refinement of the intervention manual and enhanced participant acceptability.
The approach included the following: LS4M Task Force members were engaged as members of the target population e. Each focus group discussion was facilitated by two members of the target population using a semi-structured qualitative focus group guide.
Focus groups were audio recorded, transcribed verbatim, and analyzed inductively by two independent coders using methods of constant comparative analysis. LS4M Task Force input and focus group data were used to design the LS4M intervention, including a manualized curriculum written by members of the study team SR, DP in collaboration with a local community member experienced in facilitating local group programs with the target population.
Members of the target study population collaborated with the team to refine the Alternative hookup transsexual surgery woman to man hiv curriculum in order to ensure the intervention consisted of developmentally appropriate scenarios and themes reflecting the unique experiences of young TMSM. Development and design of the LS4M intervention was iterative.
The study team drafted intervention content; LS4M Task Force members reviewed, offered feedback and suggestions; and the study team revised activities and content accordingly.
Recruitment methods and study eligibility for the open-phase pilot were the same as for focus groups see criteria above. The baseline study visit consisted of informed consent process, quantitative survey via ACASI, and a life history calendar interview of sexual and gender development.
At baseline, in addition to the survey and life history interview, participants completed a brief semi-structured qualitative interview to solicit feedback about the quantitative survey. Age was assessed in years. Race and ethnicity were assessed separately and coded as White non-Hispanic vs.
For education, participant responses were coded as some college or less vs. For employment, participant responses were coded as employed full-time, employed part-time, and unemployed.
Participant responses regarding their educational attainment were coded as college degree or higher vs. Sexual orientation identity was assessed by asking how they describe their sexual orientation today. Four sexual health knowledge and efficacy indicators were assessed.
Items were summed with higher scores indicating greater efficacy in behavioral skills. The interview was adapted to reflect the diversity of identity and experience that exists within the TMSM population. Participants were tested for HIV and C. Pre- and 4-month
Alternative hookup transsexual surgery woman to man hiv data were analyzed descriptively frequencies, means, standard deviations Alternative hookup transsexual surgery woman to man hiv SAS v9.
Given the small size of this open-phase pilot intervention, emphasis is placed on the direction of anticipated behavior change and trends in statistical significance, rather than on achieving statistical significance at the alpha 0.
Qualitative data were both merged and connected with quantitative data to contextualize findings. Immediately following each qualitative focus group event and individual qualitative exit interview, study staff took field notes in the form of brief rapid thematic summaries. Transcripts from focus groups and exit interviews were then transcribed verbatim. Themes from staff field notes were used to compile an initial code set, which was then refined by the study team to integrate additional coding content and re-review to ensure
Alternative hookup transsexual surgery woman to man hiv were as representative possible.
Of the 18 participants who enrolled at baseline, One participant was lost to follow-up due to physical health issues, which made him unable to complete his in-person 4-month follow-up visit.
Participants had a mean age of Although the majority of the sample had a college degree or higher The most commonly endorsed sexual identities were bisexual and pansexual both Changes in psychosocial and sexual risk outcomes trended in the hypothesized direction for all psychosocial and sexual health indicators. Psychosocial measures at baseline and 4-month post-baseline follow-up: The baseline and follow-up prevalence of HIV was 0.
Satisfaction with the intervention was high: I was able to make connections between behaviors and how I felt about myself, which was helpful. I liked the Alternative hookup transsexual surgery woman to man hiv - particularly the scenarios and discussing how we felt. Participants described LS4M as a much needed sexual health resource to meet their sexual health needs: Having a sexual health resource specifically for young TMSM was affirming for many participants: Liked the new things I learned; I really do need to take sexual health seriously.
Like that it was happening here [at the intervention site]. It was empowering to know that space and money were put aside for TMSM. Really informative which was unexpected. It made me feel better about myself.
Others liked the way the intervention integrated group and personal experiences: Activities were open enough to allow the group members to get what they needed.
Trends in outcome measures suggest Alternative hookup transsexual surgery woman to man hiv participation in the intervention may improve mental health and reduce internalized stigma; whether the intervention reduces HIV- and STI-related risks warrants future research and evaluation. First, it is imperative to engage TMSM during initial "Alternative hookup transsexual surgery woman to man hiv" development and ensure meaningful ongoing participation of local communities throughout the project.
This includes engaging one or more TMSM community members to collaborate closely with the study team Alternative hookup transsexual surgery woman to man hiv should already be one or more TMSM on the study team preferably people with experience facilitating local community programs with the target population. It is also critical that TMSM are compensated for their time, even a modest stipend communicates to community members that their time and energy is as valuable as that of any other individual.
Second, recognize that diverse heterogeneity of gender identities and expressions exist among TMSM. This can be difficult for interventions insofar as it is challenging to meet all the needs of the diverse community, especially when doing small-group-based intervention work. Third, ensure sexual risk behavior assessments are gender affirmative and accurately assess sexual risks. Sexual risk assessments need to ask about specific sexual risk behaviors bioanatomically using gender-affirmative language with diverse sexual partner genders e.
This exploratory study should be interpreted in light of several limitations. First, the adaptation and initial pilot testing of LS4M was conducted in Boston, Massachusetts; thus, differences in young TMSM communities and terminology by geographic region may necessitate consideration in future research. Second, given that the pilot of LS4M did not include recent sexual risk behavior as an inclusion criterion for eligibility, further testing of the intervention with sexual risk inclusion criteria and with a control group is needed.
For their invaluable collaboration and input to ensure transgender community engagement in this research project: For their assistance with qualitative focus group data coding and thematic analysis: For sharing their voices and lived experiences: The present ancillary study was funded under an administrative supplement to the parent R01 grant PI: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
National Center for Biotechnology InformationU. Journal List J Urban Health v. Published online Jan ReisnerJaclyn M. White HughtoDana J. Mimiaga Department of Epidemiology, Harvard T. Author information Copyright and License information Disclaimer. Department of Epidemiology, Harvard T.
This article has been cited by other articles in PMC. Iterative Design and Development of the LS4M Intervention Curriculum LS4M Task Force input and focus group data were used to design the LS4M intervention, including a manualized curriculum written by members of the study team SR, DP in collaboration with a local community member experienced in facilitating local group programs Alternative hookup transsexual surgery woman to man hiv the target population.
Open in a separate window. Open-Phase Pilot Recruitment methods and study eligibility for the open-phase pilot were the same as for focus groups see criteria above.
Intervention Acceptability and Satisfaction At baseline, in addition to the survey and life history interview, participants completed a brief semi-structured qualitative interview to solicit feedback about the quantitative survey. Measures Sociodemographics Age was assessed in years. Psychosocial Health Indicators Five psychosocial health indicators were investigated.
Three measures of stigmatization based on sexual orientation and gender identity were developed to assess the extent to which participants perceived, experienced, and internalized transphobia and homophobia. The measure included three domains: The item Brief Symptom Inventory assessed psychological distress and psychiatric disorders. The collective self-esteem scale 44 assessed thoughts and feelings associated with being a member of the transgender community.
A shortened version of the scale was used and adapted to denote participant membership in transgender community. Sexual Health Knowledge and Efficacy Indicators Four sexual health knowledge and efficacy indicators were Data Analysis Pre- and 4-month post-intervention data were analyzed descriptively frequencies, means, standard deviations in SAS v9.
Results Feasibility Of the 18 participants who enrolled at baseline, Total sample Mean SD Age in years baseline Acceptability Satisfaction with the intervention was high: Acknowledgments For their invaluable collaboration and input to ensure transgender community engagement in this research project: HIV/AIDS Basics HIV and other Diseases HIV/AIDS and Older Adults GMHC Commemorates National Gay Men's HIV/AIDS Awareness Day · In the News on National Day of Action to End Violence Against Women Living with HIV Day · GMHC Announces Services for Transgender and Gender Non- Conforming.
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