Increasing STI and HIV preventive behaviors and addressing community-prioritized social determinants of health among young GBQMSM and transgender women of color: Piloting a bilingual multilevel intervention

Abstract

Abstract Background Sexually transmitted infections (STIs) and HIV disproportionately affect young people; gay, bisexual, queer, and other men who have sex with men (GBQMSM); transgender women; and persons of color. Our community-based participatory research partnership developed and implemented Impact Triad, a bilingual multilevel intervention harnessing peer navigation and mHealth to increase STI/HIV preventive behaviors and address four community-prioritized social determinants of health -- education, employment, social support, and discrimination -- among young African American/Black and Latine GBQMSM and transgender women. Methods Fifteen community-based peer navigators were trained to work within their social networks for 12 months. Each navigator engaged five social network members who completed baseline and immediate post-intervention assessments (retention rate = 97.3%). Regression modeling was used to assess changes in outcomes between baseline and follow-up. Results Among 74 enrolled social network members, the average age was 27.8; 61% identified as African American/Black, 31% as Latine, and 8% as multiracial/multiethnic. The majority self-identified as cisgender men and 8% as transgender women; 78% identified as gay. About half reported monthly income below $1,000. Compared to baseline, at follow-up, social network members increased: STI screening (P = .001), HIV testing (P = .001), condom use (P = .03), and PrEP use (P = .02). Knowledge of PrEP (P < .0001) and of community-based educational (P = .047), job-training (P = .002), and job-finding resources (P = .02) also increased. Social support increased (P < .0001) and perceived discrimination decreased (P < .01). Conclusions Pilot findings suggest that Impact Triad is promising in increasing STI/HIV protective behaviors and addressing social determinants of health among young GBQMSM and transgender women of color; further testing is warranted.