Development and Testing of MyPEEPS Mobile for Young Transgender Men

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PROJECT SUMMARY Transgender youth in the United States have unique health needs but often face barriers to accessing and receiving health care services which contribute to disparate health outcomes including high vulnerability to HIV and other sexually transmitted infections. Emerging evidence has begun to document HIV-related sexual risk among young transgender men (YTM), as well as low uptake of pre-exposure prophylaxis among those with indications, suggesting high vulnerability to HIV infection. Despite the high prevalence and increased risk of HIV in YTM who have sex with cisgender men, only one prior HIV prevention intervention has been developed to address the specific sexual health needs of YTM, which indicates a critical gap in HIV prevention science. In response to this need, and building off our strong preliminary work, we propose to develop a mobile intervention for YTM building on MyPEEPS Mobile, which was originally developed for very young sexual minority men. Central to this intervention is the premise that it will be delivered to youth during a developmental period that precedes or coincides with sexual debut, an important time for intervention, prior to or concurrent with initiation of high-risk behaviors. Given both the gap in HIV prevention science and the lack of current targeted interventions, and building upon our multidisciplinary team’s extensive experience in HIV prevention, mHealth, behavioral interventions, randomized controlled trials, and transgender health, we propose the following specific aims: 1) Using qualitative methodology, expert feedback, and usability assessments, develop MyPEEPS Mobile for YTM, 2) Conduct a pilot randomized controlled trial to examine the feasibility, acceptability, and preliminary efficacy of the revised MyPEEPS Mobile App in a sample of 80 YTM (15-19 years) and refine the study methods for a future efficacy trial, and 3) Assess predisposing, enabling, and reinforcing factors for MyPEEPS Mobile among YTM through theoretically-guided in-depth interviews. The proposed MyPEEPS intervention for YTM is a novel and evidence-driven intervention using mobile technology to deliver HIV prevention information to high-risk youth. This will be the first study to develop and pilot a scaled- up, mobile HIV prevention intervention designed by, and piloted for, a diverse group of YTM. The final product of this study will be the basis for an R01 application to conduct a large-scale efficacy study for this population. The proposed MyPEEPS Mobile intervention for YTM is a novel and evidence-driven intervention using mobile technology to deliver HIV prevention information specifically developed for YTM. Consequently, we are confident that the proposed intervention will be of high impact intervention for improving HIV prevention behaviors in YTM and have long-term implications for overall improvement in the public’s health.