TY - JOUR
T1 - American cohort to study HIV acquisition among transgender women in high-risk areas (the LITE study)
T2 - Protocol for a multisite prospective cohort study in the eastern and southern United States
AU - American Cohort To Study HIV Acquisition Among Transgender Women (LITE)
AU - Wirtz, Andrea L.
AU - Poteat, Tonia
AU - Radix, Asa
AU - Althoff, Keri N.
AU - Cannon, Christopher M.
AU - Wawrzyniak, Andrew J.
AU - Cooney, Erin
AU - Mayer, Kenneth H.
AU - Beyrer, Chris
AU - Rodriguez, Allan E.
AU - Reisner, Sari L.
N1 - Funding Information:
The authors would like to express their gratitude to the TW who take part in this study. This study would not be possible without their participation. Research reported in this publication was jointly supported by the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, and the National Institute of Child Health and Human Development of the National Institutes of Health under Award Number UG3AI133669 (ALW and SLR). Research reported in this publication was also supported by HIV/AIDS, Hepatitis, STD, and TB Administration (HAHSTA), Washington DC Department of Health. The LITE study is also appreciative of support from the CFAR at partner institutions, including JHU (P30AI094189), Emory University (P30AI050409), Harvard University (P30AI060354), DC CFAR (AI117970), and the University of Miami (P30AI073961). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or HAHSTA.
Funding Information:
This is a multiple principal investigator (PI) study led by faculty from Johns Hopkins University (JHU; PI: Wirtz) and Boston Children’s Hospital (BCH), Harvard University (PI: Reisner). The study is supported by leading research institutions, spanning eastern and southern United States, including the following: JHU, Baltimore, Maryland; BCH, Harvard University, and The Fenway Institute at Fenway Health, Boston, Massachusetts; Callen-Lorde, New York City, New York; Emory University and Grady Memorial Hospital, Atlanta, Georgia; University of Miami, Miami, Florida; and Whitman-Walker Health, Washington, DC. The coinvestigators in this team specialize in HIV epidemiology among key populations, transgender health and clinical care, sociobehavioral sciences, management and analysis of longitudinal cohorts, and cross-sectional incidence estimation and laboratory methods. All partner organizations are affiliated with or are themselves clinical sites serving TW, and they have established strong relationships with local community-based organizations that specifically offer services for TW. These relationships continue to be nurtured to ensure the study is acceptable to the transgender community and is consistent with TW’s preferences in terms of study content, as well as to obtain valuable feedback on the study, which can support both recruitment and retention of study participants.
Publisher Copyright:
©Andrea L Wirtz, Tonia Poteat, Asa Radix, Keri N Althoff, Christopher M Cannon, Andrew J Wawrzyniak, Erin Cooney, Kenneth H Mayer, Chris Beyrer, Allan E Rodriguez, Sari L Reisner, American Cohort To Study HIV Acquisition Among Transgender Women (LITE).
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Background: In the United States, transgender women (TW) are disproportionately burdened by HIV infection. Cohort studies are needed to evaluate factors driving HIV acquisition among TW over time. These will require implementation strategies that are acceptable to the TW community and feasible to implement. Objective: This study aims to investigate the rate and correlates of HIV acquisition and other health outcomes among TW in eastern and southern United States. Methods: LITE is a multisite prospective cohort in 6 eastern and southern US cities, which will be followed across 24 months of technology-enhanced biobehavioral follow-up. Adult TW, regardless of HIV status, are recruited via convenience sampling (eg, peer referrals, social media, and dating apps). Participants are enrolled in a baseline study visit, complete a sociobehavioral survey, and test for HIV and sexually transmitted infections. Participants who are not living with HIV at baseline are offered enrollment into the cohort (N=1100); follow-up assessments occur quarterly. Results: Cohort assembly was informed by synchronous Web-based focus group discussions with TW (n=41) and by continuing engagement with community advisory board members from each site. Enrollment launched in March 2018. The study is underway in the Atlanta; Baltimore; Boston; Miami; New York City; and Washington, DC, metro areas. As of March 2019, 795 TW completed a baseline visit (mean age 35 years). The majority of the participants are racial/ethnic minorities, with 45% of the TW identifying as black and 28% of the TW identifying as Hispanic/Latinx. More than one-quarter (28%) of the TW are living with HIV infection (laboratory-confirmed). Online recruitment methods support engagement with TW, although peer referral and referral through trusted health facilities and organizations remain most effective. Conclusions: This study is responsive to increasing research interest in technology-enhanced methods for cohort research, particularly for hard-to-reach populations. Importantly, the diversity of literacy, technology use, and overall socioeconomic situations in this sample of TW highlights the need to leverage technology to permit a flexible, adaptive methodology that enhances engagement of potential participants living in marginalized contexts while still ensuring rigorous and sound study design.
AB - Background: In the United States, transgender women (TW) are disproportionately burdened by HIV infection. Cohort studies are needed to evaluate factors driving HIV acquisition among TW over time. These will require implementation strategies that are acceptable to the TW community and feasible to implement. Objective: This study aims to investigate the rate and correlates of HIV acquisition and other health outcomes among TW in eastern and southern United States. Methods: LITE is a multisite prospective cohort in 6 eastern and southern US cities, which will be followed across 24 months of technology-enhanced biobehavioral follow-up. Adult TW, regardless of HIV status, are recruited via convenience sampling (eg, peer referrals, social media, and dating apps). Participants are enrolled in a baseline study visit, complete a sociobehavioral survey, and test for HIV and sexually transmitted infections. Participants who are not living with HIV at baseline are offered enrollment into the cohort (N=1100); follow-up assessments occur quarterly. Results: Cohort assembly was informed by synchronous Web-based focus group discussions with TW (n=41) and by continuing engagement with community advisory board members from each site. Enrollment launched in March 2018. The study is underway in the Atlanta; Baltimore; Boston; Miami; New York City; and Washington, DC, metro areas. As of March 2019, 795 TW completed a baseline visit (mean age 35 years). The majority of the participants are racial/ethnic minorities, with 45% of the TW identifying as black and 28% of the TW identifying as Hispanic/Latinx. More than one-quarter (28%) of the TW are living with HIV infection (laboratory-confirmed). Online recruitment methods support engagement with TW, although peer referral and referral through trusted health facilities and organizations remain most effective. Conclusions: This study is responsive to increasing research interest in technology-enhanced methods for cohort research, particularly for hard-to-reach populations. Importantly, the diversity of literacy, technology use, and overall socioeconomic situations in this sample of TW highlights the need to leverage technology to permit a flexible, adaptive methodology that enhances engagement of potential participants living in marginalized contexts while still ensuring rigorous and sound study design.
KW - Cohort studies
KW - HIV
KW - HIV infection
KW - Transgender persons
KW - United States
UR - http://www.scopus.com/inward/record.url?scp=85073097997&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073097997&partnerID=8YFLogxK
U2 - 10.2196/14704
DO - 10.2196/14704
M3 - Article
C2 - 31584005
AN - SCOPUS:85073097997
SN - 1929-0748
VL - 8
JO - JMIR Research Protocols
JF - JMIR Research Protocols
IS - 10
M1 - e14704
ER -