Assessing the Engagement of Transgender and Other Gender Minority Youth Across the HIV Continuum of Care
Condition: Transgender, HIV Continuum of Care
Study type: Observational

Summary: 
      This study uses a transformative multiphasic mixed-methods research design that incorporates
      elements of the following designs:

        -  Sequential: a secondary data analysis was conducted, using data from ATN 039, ATN 086,
           and ATN 106, to influence the development of the qualitative interview and quantitative
           survey instruments for primary data collection.

        -  Convergent parallel: concurrent collection and analysis of both qualitative and
           quantitative primary data that will be combined to address the study objectives.
    

Detailed description: 
      The ultimate goal of this study is to assess engagement of TGMY across the HIV Continuum of
      Care. This will be accomplished through a transformative multiphasic mixed-methods research
      study that will engage all sites in the ATN network and collect data from both internal and
      external sources regarding the facilitators and barriers affecting TGMY's engagement across
      the HIV Continuum of Care. Empirical and theoretical models will be produced that will guide
      the future development of HIV-related interventions for TGMY (to be published by the study
      team in peer-reviewed literature). In addition, findings will be translated into more
      immediate provider-focused recommendations and multi-media resources that provide concrete
      guidance and tools that can be applied across socio-ecological levels to promote the full
      inclusion of TGMY in the various stages of the HIV Continuum of Care. The production of
      multidisciplinary provider-focused materials that will support the delivery of gender
      affirming and appropriate HIV care to TGMY is in alignment with many contemporary views of
      translational research and will have an immediate impact on the ability of providers at AMTU
      sites and elsewhere to provide HIV-related care to TGMY across the full HIV Continuum of
      Care.

      The research design incorporates elements of both a sequential design (secondary data
      analysis from ATN 039 and ATN 086/106 influenced the development of measures for primary data
      collection) and a convergent parallel design (concurrent collection and analysis of both
      qualitative and quantitative primary data that will be combined to address the specific aims.
      This design is considered a transformative mixed-methods design due to the study's
      theoretical and conceptual grounding in Bioecological Systems Theory (BST), Gender
      Affirmation, and Gender Minority Stress, and the focus on advancing the needs of
      underrepresented and marginalized populations. Mixed methods studies typically involve
      collecting and analyzing data derived from both quantitative and qualitative data sources in
      order to gain greater insight into a research problem than would be gained by using only one
      of the two methods in isolation. By combining methods, the limitations and biases inherent in
      one single methodology can be lessened by using multiple forms of data collection. The
      qualitative phase of the study will use a phenomenological investigative approach, which will
      help to understand the sociocultural behaviors, language, roles, and interactions within a
      culture-sharing group (i.e., TGMY) and triangulation of the qualitative data with the
      quantitative data strengthens the validity of the information received by using a combination
      of data sources.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        The three population groups are:

          1. TGMY (16-24 years of age) currently in HIV care at an Adolescent Medicine Trials Unit
             (AMTU) site or elsewhere.

          2. TGMY (16-24 years of age) not currently in care who are living with HIV, not living
             with HIV, or those who are unaware of their HIV status.

          3. Health care and social service providers who work with TGMY at AMTU sites or elsewhere
             that serve TGMY within the AMTU cities.
      
Keywords: HIV; Transgender; HIV Continuum of Care