Holly B Fontenot1,2, Sean R Cahill3,4,5, Timothy Wang3, Sophia Geffen3, Bradley P White2, Sari Reisner3,6, Kerith Conron3,7, Christopher R Harper8, Michelle M Johns8, Sabrina A Avripas9, Stuart Michaels9, Richard Dunville9. 1. The Fenway Institute, Fenway Health, Boston, Massachusetts; holly.fontenot@bc.edu. 2. W.F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts. 3. The Fenway Institute, Fenway Health, Boston, Massachusetts. 4. School of Public Health, Boston University, Boston, Massachusetts; and. 5. Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts. 6. Division of Endcrinology, Diabetes, and Hypertension, Brigham and Women's Hosptial, Boston, Massachusetts. 7. The Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, University of California, Los Angeles, Los Angeles, California. 8. Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia. 9. NORC at The University of Chicago, Chicago, Illinois.
Abstract
BACKGROUND: In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services. METHODS: Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis. RESULTS: A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care). CONCLUSIONS: Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity.
BACKGROUND: In the United States, transgender youth are at especially high risk for HIV infection. Literature regarding HIV prevention strategies for this vulnerable, often-hidden population is scant. Before effective, population-based HIV prevention strategies may be adequately developed, it is necessary to first enhance the contextual understanding of transgender youth HIV risk and experiences with HIV preventive services. METHODS: Two 3-day, online, asynchronous focus groups were conducted with transgender youth from across the United States to better understand participant HIV risk and experiences with HIV preventive services. Participants were recruited by using online advertisements posted via youth organizations. Qualitative data were analyzed by using content analysis. RESULTS: A total of 30 transgender youth participated. The average age was 18.6 years, and youth reported a wide range of gender identities (eg, 27% were transgender male, 17% were transgender female, and 27% used ≥1 term) and sexual orientations. Four themes emerged: (1) barriers to self-efficacy in sexual decision-making; (2) safety concerns, fear, and other challenges in forming romantic and/or sexual relationships; (3) need for support and education; and (4) desire for affirmative and culturally competent experiences and interactions (eg, home, school, and health care). CONCLUSIONS: Youth discussed experiences and perspectives related to their gender identities, sexual health education, and HIV preventive services. Findings should inform intervention development to improve support and/or services, including the following: (1) increasing provider knowledge and skills to provide gender-affirming care, (2) addressing barriers to services (eg, accessibility and affordability as well as stigma and discrimination), and (3) expanding sexual health education to be inclusive of all gender identities, sexual orientations, and definitions of sex and sexual activity.
Authors: Allegra R Gordon; Jerel P Calzo; Rose Eiduson; Kendall Sharp; Scout Silverstein; Ethan Lopez; Katharine Thomson; Sari L Reisner Journal: Int J Qual Methods Date: 2021-02-09
Authors: Sean R Cahill; Timothy M Wang; Holly B Fontenot; Sophia R Geffen; Kerith J Conron; Kenneth H Mayer; Michelle M Johns; Sabrina A Avripas; Stuart Michaels; Richard Dunville Journal: J Pediatr Health Care Date: 2021-06-19 Impact factor: 1.838