Employment as HIV Prevention: An Employment Support Intervention for Adolescent Men Who Have Sex With Men and Adolescent Transgender Women of Color.
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
01 09 2022
01 09 2022
Historique:
received:
11
01
2022
accepted:
25
04
2022
pubmed:
14
5
2022
medline:
19
8
2022
entrez:
13
5
2022
Statut:
ppublish
Résumé
The purpose of this study was to adapt and pilot-test an employment support, primary HIV intervention tailored to the needs of adolescent men who have sex with men and adolescent transgender women of color. The intervention was implemented in 2 settings: controlled environment (Phase 1) and real-world community-based (Phase 2) setting in Chicago, IL. Eighty-seven adolescent men who have sex with men and adolescent transgender women of color ages 16-24 participated in Work2Prevent , a 4-session employment and HIV prevention intervention, designed to increase job-readiness and reduce HIV risk. Intervention sessions consisted of group activities: educational games, roleplaying/modeling behavior, and self-regulation exercises. Participants were assessed at baseline, postintervention, and 8-month (Phase 1) or 3-month follow-up (Phase 2). Participants evaluated Work2Prevent as feasible and acceptable, rating intervention quality, usefulness, and satisfaction highly. Overall, 59.6% (Phase 1) and 85.0% (Phase 2) participants attended 2 or more sessions. At 8 months, Phase 1 participants reported a mean increase of 11.4 hours worked per week. Phase 2 participants reported a mean increase of 5.2 hours worked per week and an increase in job-seeking self-efficacy. Phase 2 participants also reported a decrease in transactional sex work. Work2Prevent is one of the first structural primary HIV interventions to specifically focus on adolescent employment readiness. Findings suggest Work2Prevent is feasible and acceptable, improved adolescent employment outcomes, and reduced HIV risk associated with transactional sex work. Our study underscores the need for alternative pathways, such as addressing socioeconomic determinants, to prevent adolescent HIV infection.
Sections du résumé
BACKGROUND
The purpose of this study was to adapt and pilot-test an employment support, primary HIV intervention tailored to the needs of adolescent men who have sex with men and adolescent transgender women of color.
SETTING
The intervention was implemented in 2 settings: controlled environment (Phase 1) and real-world community-based (Phase 2) setting in Chicago, IL.
METHODS
Eighty-seven adolescent men who have sex with men and adolescent transgender women of color ages 16-24 participated in Work2Prevent , a 4-session employment and HIV prevention intervention, designed to increase job-readiness and reduce HIV risk. Intervention sessions consisted of group activities: educational games, roleplaying/modeling behavior, and self-regulation exercises. Participants were assessed at baseline, postintervention, and 8-month (Phase 1) or 3-month follow-up (Phase 2).
RESULTS
Participants evaluated Work2Prevent as feasible and acceptable, rating intervention quality, usefulness, and satisfaction highly. Overall, 59.6% (Phase 1) and 85.0% (Phase 2) participants attended 2 or more sessions. At 8 months, Phase 1 participants reported a mean increase of 11.4 hours worked per week. Phase 2 participants reported a mean increase of 5.2 hours worked per week and an increase in job-seeking self-efficacy. Phase 2 participants also reported a decrease in transactional sex work.
CONCLUSION
Work2Prevent is one of the first structural primary HIV interventions to specifically focus on adolescent employment readiness. Findings suggest Work2Prevent is feasible and acceptable, improved adolescent employment outcomes, and reduced HIV risk associated with transactional sex work. Our study underscores the need for alternative pathways, such as addressing socioeconomic determinants, to prevent adolescent HIV infection.
Identifiants
pubmed: 35551157
doi: 10.1097/QAI.0000000000003020
pii: 00126334-202209010-00005
pmc: PMC9377485
mid: NIHMS1805462
doi:
Banques de données
ClinicalTrials.gov
['NCT03313310']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
31-38Subventions
Organisme : NIAID NIH HHS
ID : P30 AI117943
Pays : United States
Organisme : NICHD NIH HHS
ID : U24 HD089880
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001422
Pays : United States
Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Center for Disease Control and Prevention (CDC). HIV Surveillance Report, 2018 (Updated); vol. 31. Available at: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html . Accessed December 1, 2021.
Clark H, Babu AS, Wiewel EW, et al. Diagnosed HIV infection in transgender adults and adolescents: results from the National HIV Surveillance System, 2009-2014. AIDS Behav. 2017;21:2774–2783.
Baral SD, Poteat T, Strömdahl S, et al. Worldwide burden of HIV in transgender women: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13:214–222.
Brennan J, Kuhns LM, Johnson AK, et al. Syndemic theory and HIV-related risk among young transgender women: the role of multiple, co-occurring health problems and social marginalization. Am J Public Health. 2012;102:1751–1757.
Garofalo R, Osmer E, Sullivan C, et al. Environmental, psychosocial, and individual correlates of HIV risk in ethnic minority male-to-female transgender youth. J HIV AIDS Prev Child Youth. 2007;7:89–104.
Millett GA, Flores SA, Peterson JL, et al. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007;21:2083–2091.
da Silva DT, Bouris A, Voisin D, et al. Social networks moderate the syndemic effect of psychosocial and structural factors on HIV risk among young Black transgender women and men who have sex with men. AIDS Behav. 2020;24:192–205.
Dyer TV, Turpin RE, Stall R, et al. Latent profile analysis of a syndemic of vulnerability factors on incident sexually transmitted infection in a cohort of Black men who have sex with men only and Black men who have sex with men and women in the HIV Prevention Trials Network 061 Study. Sex Transm Dis. 2020;47:571–579.
Hill BJ, Rosentel K, Bak T, et al. Exploring individual and structural factors associated with employment among young transgender women of color using a no-cost transgender legal resource center. Transgend Health. 2017;2:29–34.
Operario D, Nemoto T. HIV in transgender communities: syndemic dynamics and a need for multicomponent interventions. J Acquir Immune Defic Syndr. 2010;55(suppl 2):S91–S93.
Rosentel K, VandeVusse A, Hill BJ. Racial and socioeconomic inequity in the spatial distribution of LGBTQ human services: an exploratory analysis of LGBTQ services in Chicago. Sex Res Soc Policy. 2020;17:87–103.
Mayer KH, Wang L, Koblin B, et al. Concomitant socioeconomic, behavioral, and biological factors associated with the disproportionate HIV infection burden among Black men who have sex with men in 6 U.S. cities. PLoS One. 2014;9:e87298.
Russell JS, Hickson DA, Timmins L, et al. Higher rates of low socioeconomic status, marginalization, and stress in Black transgender women compared to Black cisgender MSM in the MARI study. Int J Environ Res Public Health. 2021;18:2183.
Arrington-Sanders R, Alvarenga A, Galai N, et al. Social determinants of transactional sex in a sample of young Black and Latinx sexual minority cisgender men and transgender women. J Adol Health. 2022;70(2):275–281.
Brantley AD, Burgess S, Bickham J, et al. Using financial incentives to improve rates of viral suppression and engagement in care of patients receiving HIV care at 3 health clinics in Louisiana: the Health Models Program, 2013-2016. Public Health Rep. 2018;133:75s–86s.
El-Sadr WM, Donnell D, Beauchamp G, et al. Financial incentives for linkage to care and viral suppression among HIV-positive patients: a randomized clinical trial (HPTN 065). JAMA Intern Med. 2017;177:1083–1092.
McCoy SI, Njau PF, Fahey C, et al. Cash vs. food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania. AIDS. 2017;31:815–825.
Silverman K, Holtyn AF, Rodewald AM, et al. Incentives for viral suppression in people living with HIV: a randomized clinical trial. AIDS Behav. 2019;23:2337–2346.
HIV Prevention Research Synthesis Project. Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. Centers for Disease Control and Prevention, 2019. Available at: https://www.cdc.gov/hiv/research/interventionresearch/compendium/index.html . Accessed December 1, 2021.
Hill BJ, Motley DN, Rosentel K, et al. An employment intervention program (Work2Prevent) for young men who have sex with men and transgender youth of color (Phase 1): protocol for determining essential intervention components using qualitative interviews and focus groups. JMIR Res Protoc. 2020;9:e16384.
Hill BJ, Motley DN, Rosentel K, et al. An employment intervention program (Work2Prevent) for young men who have sex with men and transgender youth of color (Phase 2): protocol for a single-arm mixed methods pilot test to assess feasibility and acceptability. JMIR Res Protoc. 2020;9:e16401.
Hill BJ, Motley DN, Rosentel K, et al. Work2Prevent, an employment intervention program as HIV prevention for young men who have sex with men and transgender youth of color (Phase 3): protocol for a single-arm community-based trial to assess feasibility and acceptability in a real-world setting. JMIR Res Protoc. 2020;9:e18051.
Myers JE, Braunstein SL, Xia Q. Redefining prevention and care: a status-neutral approach to HIV. Open Forum Infect Dis. 2018;5:ofy097.
Razzano LA, Hamilton MM, Yost C, et al. Employment outcomes for individuals with HIV/AIDS and co-occurring mental health factors. Am J Psychiatr Rehabil. 2015;18:19–41.
US Department of Housing and Urban Development. Implementing the National HIV/AIDS Strategy: A Report to the White House Office of National AIDS Policy. Washington, DC: US Department of Hoursing and Urban Development; 2011.
Plass JL, Homer BD, Kinzer CK. Foundations of game-based learning. Educ Psychol. 2015;50:258–283.
Horvath KJ, Oakes JM, Rosser BR. Feasibility, acceptability and preliminary efficacy of an online peer-to-peer social support ART adherence intervention. AIDS Behav. 2013;17:2031–2044.
Barlow J, Wright C, Cullen L. A job-seeking self-efficacy scale for people with physical disabilities: preliminary development and psychometric testing. Br J Guid Couns. 2002;30:37–53.
Lambert TW, Smith F, Goldacre MJ. Perceived future career prospects in general practice: quantitative results from questionnaire surveys of UK doctors. Br J Gen Pract. 2016;66:e848–e857.
Porter C, Woo SE, Tak J. Developing and validating short form protean and boundaryless career attitudes scales. J Career Assess. 2016;24:162–181.
Volmer J, Spurk D. Protean and boundaryless career attitudes: relationships with subjective and objective career success. J Labour Mark Res. 2011;43:207–218.
McCumber M, Cain D, LeGrand S. Adolescent Medicine Trials Network for HIV/AIDS Interventions data harmonization: rationale and development of guidelines. JMIR Res Protoc. 2018;7:e11207.
Coates J, Swindale A, Bilinsky P. Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide. Washington, DC: United States Agency for International Development; 2007.
Sevelius JM, Patouhas E, Keatley JG, et al. Barriers and facilitators to engagement and retention in care among transgender women living with human immunodeficiency virus. Ann Behav Med. 2014;47:5–16.
Kalichman SC, Pellowski J, Kalichman MO. Food insufficiency and medication adherence among people living with HIV/AIDS in urban and peri-urban settings. Prev Sci. 2011;12:324–332.
Riley ED, Gandhi M, Hare C. Poverty, unstable housing, and HIV infection among women living in the United States. Curr HIV/AIDS Rep. 2007;4:181–186.
Maulsby C, Parker LJ, White JJ. HIV and employment among Black men who have sex with men in Baltimore. AIDS Care. 2020;32:735–743.
Nemoto T, Sausa LA, Operario D, et al. Need for HIV/AIDS education and intervention for MTF transgenders: responding to the challenge. J Homosex. 2006;51:183–202.
Sausa LA, Keatley J, Operario D. Perceived risks and benefits of sex work among transgender women of color in San Francisco. Arch Sex Behav. 2007;36:768–777.
Parker CM, Garcia J, Philbin MM. Social risk, stigma and space: key concepts for understanding HIV vulnerability among Black men who have sex with men in New York City. Cult Health Sex. 2017;19:323–337.