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

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 4 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 5 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 years; 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 1000. Compared with baseline, at follow-up, social network members increased: STI screening (P = 0. 001), HIV testing (P = 0. 001), condom use (P = 0. 03), and preexposure prophylaxis use (P = 0. 02). Knowledge of preexposure prophylaxis (P < 0. 0001) and of community-based educational (P = 0. 047), job-training (P = 0. 002), and job-finding resources (P = 0. 02) also increased. Social support increased (P < 0. 0001) and perceived discrimination decreased (P < 0. 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.