Engagement in HIV Care Among New York City Transgender Women of Color: Findings from the Peer-Led, TWEET Intervention, a SPNS Trans Women of Color Initiative.

Transgender women (TW) have higher HIV prevalence rates than cisgender (i.e., non-transgender) women. However, utilization of healthcare for transgender people in the U.S. is low. As part of a multisite initiative to facilitate entry and retention in HIV care for TW of color, we compared health outcomes between participants who became Peer Leaders and those who did not. From 2013 to 2016, 163 New York City, mostly Latina, TW enrolled in the Transgender Women Engagement and Entry to Care Project (TWEET). The TWEET intervention included peer-led, group-based educational sessions called Transgender Leader-Teach Back; 39% completed Peer Leadership requirements. Comparing pre-post change by Peer Leader status, Peer Leaders had a significant decrease in viral load and significant increase in CD4 at the last HIV care visit compared to the first. In multivariable logistic regression, predictors associated with Peer Leadership included having at least some college education, being in a relationship, stable housing, receiving legal assistance for political asylum, and having two or more HIV care visits during the intervention. Findings suggest that, for trans women who have completed at least secondary school education, participating in a peer-led intervention can lead to improved HIV care engagement. Understanding which program components lead to becoming a Peer Leader, and how to better engage non-Peer Leaders, are important next steps.

Methods for Collection of Participant-aided Sociograms for the Study of Social, Sexual and Substance-using Networks Among Young Men Who Have Sex with Men.

In this study, we adapted and tested a participant-aided sociogram approach for the study of the social, sexual, and substance use networks of young men who have sex with men (YMSM); a population of increasing and disproportionate risk of HIV infection. We used a combination of two interviewer-administered procedures: completion of a pre-numbered list form to enumerate alters and to capture alter attributes; and a participant-aided sociogram to capture respondent report of interactions between alters on an erasable whiteboard. We followed the collection of alter interactions via the sociogram with a traditional matrix-based tie elicitation approach for a sub-sample of respondents for comparison purposes. Digital photographs of each network drawn on the whiteboard serve as the raw data for entry into a database in which group interactions are stored. Visual feedback of the network was created at the point of data entry, using NetDraw network visualization software for comparison to the network structure elicited via the sociogram. In a sample of 175 YMSM, we found this approach to be feasible and reliable, with high rates of participation among those eligible for the study and substantial agreement between the participant-aided sociogram in comparison to a traditional matrix-based approach. We believe that key strengths of this approach are the engagement and maintenance of participant attention and reduction of participant burden for alter tie elicitation. A key weakness is the challenge of entry of interview-based list form and sociogram data into the database. Our experience suggests that this approach to data collection is feasible and particularly appropriate for an adolescent and young adult population. This builds on and advances visualization-based approaches to social network data collection.

Researching special populations: retention of Latino gay and bisexual men and transgender persons in longitudinal health research.

Few studies have sought to assess predictors of retention of racial/ethnic or sexual minorities in longitudinal health research. The purpose of this study is to investigate predictors of retention of Latino gay and bisexual men and transgender (GBT) research participants after the baseline interview. Data come from a sample of 643 Latino GBT individuals in two cities (Chicago and San Francisco). We assessed potential predictors of retention (operationalized as successful re-contact) using binary logistic regression of retention on five factors (sociodemographic/health, residential stability, acculturation/attachment to the United States, gay community attachment/stigmatization and research process/design). Our overall follow-up rate was 83 and 80% at 3 and 6 months, respectively. We found that traditional factors (e.g. education, income) were not associated with retention among Latino GBT. The strongest predictors of successful retention were the number of pieces of contact information provided by participants and city of residence (San Francisco). Furthermore, successful methods of contact (i.e. telephone, email) varied by city. We conclude that a largely immigrant urban population of Latino GBT individuals can be successfully followed in longitudinal research. The strong relationship between study design variables and successful retention indicates that collection of thorough contact information is vital to successful follow-up with this population.