Skip to main content
Top
Published in: Journal of Urban Health 1/2016

01-02-2016

LifeSkills for Men (LS4M): Pilot Evaluation of a Gender-Affirmative HIV and STI Prevention Intervention for Young Adult Transgender Men Who Have Sex with Men

Authors: Sari L. Reisner, Jaclyn M. White Hughto, Dana J. Pardee, Lisa Kuhns, Rob Garofalo, Matthew J. Mimiaga

Published in: Journal of Urban Health | Issue 1/2016

Login to get access

Abstract

Young adult transgender men who have sex with men (TMSM) engage in sexual behaviors that place them at risk of sexually transmitted infections (STIs) including HIV. To date, no HIV and STI prevention interventions have been developed specifically for young adult TMSM. To address this gap, the current study aimed to (1) adapt a small group-based behavioral HIV prevention intervention designed for young transgender women (“LifeSkills”) to address the unique HIV and STI prevention needs of young TMSM ages 18–29 years and (2) conduct a pilot evaluation of the intervention (“LifeSkills for Men”; LS4M). LS4M was carried out in an iterative approach with community input along the way, which allowed for refinement of the intervention manual and enhanced participant acceptability. A LS4M Task Force was convened to guide intervention development/adaptation and study implementation. Initially, focus groups were conducted to examine the sexual health needs, concerns, and stressors facing young TMSM (n = 12; mean age = 23.8 years; 16.7 % people of color). Next, LS4M was pilot tested (n = 17; mean age = 24.3 years; 23.5 % people of color) to assess acceptability with the study population and feasibility of all study procedures. Overall attendance, participation rates, and positive feedback from participants demonstrate that LS4M is highly acceptable and feasible to carry out with young TMSM. Trends in outcome measures across 4 months of follow-up suggest that participation in the intervention may improve mental health, reduce internalized stigma, and reduce HIV- and STI-related risk behaviors. Further testing of the intervention enrolling young TMSM with recent sexual risk behavior at baseline and with a control group is warranted. Lessons learned for future work with young TMSM are discussed.
Literature
2.
go back to reference Kann L, Kinchen S, Shanklin SL, et al. Youth risk behavior surveillance—United States, 2013. MMWR Surveill Summ. 2014; 63(Suppl 4): 1–168. Kann L, Kinchen S, Shanklin SL, et al. Youth risk behavior surveillance—United States, 2013. MMWR Surveill Summ. 2014; 63(Suppl 4): 1–168.
4.
go back to reference Reisner SL, Vetters R, White JM, et al. Laboratory-confirmed HIV and sexually transmitted infection seropositivity and risk behavior among sexually active transgender patients at an adolescent and young adult urban community health center. AIDS Care. 2015; 27(8): 1031–1036.CrossRefPubMedPubMedCentral Reisner SL, Vetters R, White JM, et al. Laboratory-confirmed HIV and sexually transmitted infection seropositivity and risk behavior among sexually active transgender patients at an adolescent and young adult urban community health center. AIDS Care. 2015; 27(8): 1031–1036.CrossRefPubMedPubMedCentral
5.
go back to reference Wilson EC, Chen YH, Arayasirikul S, et al. Differential HIV risk for racial/ethnic minority trans*female youths and socioeconomic disparities in housing, residential stability, and education. Am J Public Health. 2015; 105(Suppl 3): e41–e47.CrossRefPubMedPubMedCentral Wilson EC, Chen YH, Arayasirikul S, et al. Differential HIV risk for racial/ethnic minority trans*female youths and socioeconomic disparities in housing, residential stability, and education. Am J Public Health. 2015; 105(Suppl 3): e41–e47.CrossRefPubMedPubMedCentral
6.
go back to reference 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(9): 1751–1757.CrossRefPubMedPubMedCentral 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(9): 1751–1757.CrossRefPubMedPubMedCentral
7.
go back to reference Hotton AL, Garofalo R, Kuhns LM, Johnson AK. Substance use as a mediator of the relationship between life stress and sexual risk among young transgender women. AIDS Educ Prev. 2013; 25(1): 62–71.CrossRefPubMed Hotton AL, Garofalo R, Kuhns LM, Johnson AK. Substance use as a mediator of the relationship between life stress and sexual risk among young transgender women. AIDS Educ Prev. 2013; 25(1): 62–71.CrossRefPubMed
8.
go back to reference Kenagy GP, Hsieh CM. The risk less known: female-to-male transgender persons' vulnerability to HIV infection. AIDS Care. 2005; 17(2): 195–207.CrossRefPubMed Kenagy GP, Hsieh CM. The risk less known: female-to-male transgender persons' vulnerability to HIV infection. AIDS Care. 2005; 17(2): 195–207.CrossRefPubMed
9.
go back to reference Sevelius J. "There's no pamphlet for the kind of sex I have": HIV-related risk factors and protective behaviors among transgender men who have sex with nontransgender men. Am Psychiatr Nurses Assoc. 2009; 20(5): 398–410. Sevelius J. "There's no pamphlet for the kind of sex I have": HIV-related risk factors and protective behaviors among transgender men who have sex with nontransgender men. Am Psychiatr Nurses Assoc. 2009; 20(5): 398–410.
10.
go back to reference Reisner SL, Perkovich B, Mimiaga MJ. A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men. AIDS Patient Care STDs. 2010; 24(8): 501–513.CrossRefPubMedPubMedCentral Reisner SL, Perkovich B, Mimiaga MJ. A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men. AIDS Patient Care STDs. 2010; 24(8): 501–513.CrossRefPubMedPubMedCentral
11.
go back to reference Adams A, Lundie M, Marshall Z, et al. Getting primed: informing HIV prevention with gay/bi/queer trans men in Ontario. Ontario, Canada: Ontario Ministry of Health and Long-Term Care; 2008. Adams A, Lundie M, Marshall Z, et al. Getting primed: informing HIV prevention with gay/bi/queer trans men in Ontario. Ontario, Canada: Ontario Ministry of Health and Long-Term Care; 2008.
12.
go back to reference Bauer GR, Redman N, Bradley K, Scheim AI. Sexual health of trans men who are gay, bisexual, or who have sex with men: results from Ontario, Canada. Int J Transgend. 2013; 14(2): 66–74.CrossRefPubMedPubMedCentral Bauer GR, Redman N, Bradley K, Scheim AI. Sexual health of trans men who are gay, bisexual, or who have sex with men: results from Ontario, Canada. Int J Transgend. 2013; 14(2): 66–74.CrossRefPubMedPubMedCentral
13.
go back to reference Reisner SL, Pardo ST, Garamel KE, White JM, Pardee DJ, Meier SC. Trans masculine experiences of stigma in U.S. healthcare: a gender minority stress model of substance use to cope with mistreatment. LGBT Health. In Press. Reisner SL, Pardo ST, Garamel KE, White JM, Pardee DJ, Meier SC. Trans masculine experiences of stigma in U.S. healthcare: a gender minority stress model of substance use to cope with mistreatment. LGBT Health. In Press.
14.
go back to reference Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Public Health. 2001; 91(6): 915.CrossRefPubMedPubMedCentral Clements-Nolle K, Marx R, Guzman R, Katz M. HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention. Am J Public Health. 2001; 91(6): 915.CrossRefPubMedPubMedCentral
15.
16.
go back to reference Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003; 129(5): 674–697.CrossRefPubMedPubMedCentral Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003; 129(5): 674–697.CrossRefPubMedPubMedCentral
17.
go back to reference Hendricks ML, Testa RJ. A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the minority stress model. Prof Psychol Res Pract. 2012; 43(5): 460.CrossRef Hendricks ML, Testa RJ. A conceptual framework for clinical work with transgender and gender nonconforming clients: an adaptation of the minority stress model. Prof Psychol Res Pract. 2012; 43(5): 460.CrossRef
18.
go back to reference Hamilton CJ, Mahalik JR. Minority stress, masculinity, and social norms predicting gay men's health risk behaviors. J Couns Psychol. 2009; 56(1): 132.CrossRef Hamilton CJ, Mahalik JR. Minority stress, masculinity, and social norms predicting gay men's health risk behaviors. J Couns Psychol. 2009; 56(1): 132.CrossRef
19.
go back to reference Fields EL, Bogart LM, Smith KC, Malebranche DJ, Ellen J, Schuster MA. "I always felt I had to prove my manhood": homosexuality, masculinity, gender role strain, and HIV risk among young black men who have sex with men. Am J Public Health. 2015; 105(1): 122–131.CrossRefPubMedPubMedCentral Fields EL, Bogart LM, Smith KC, Malebranche DJ, Ellen J, Schuster MA. "I always felt I had to prove my manhood": homosexuality, masculinity, gender role strain, and HIV risk among young black men who have sex with men. Am J Public Health. 2015; 105(1): 122–131.CrossRefPubMedPubMedCentral
20.
go back to reference Stieglitz KA. Development, risk, and resilience of transgender youth. J Assoc Nurses AIDS Care. 2010; 21(3): 192–206.CrossRefPubMed Stieglitz KA. Development, risk, and resilience of transgender youth. J Assoc Nurses AIDS Care. 2010; 21(3): 192–206.CrossRefPubMed
21.
go back to reference Scheim AI, Bauer GR. Sex and gender diversity among transgender persons in Ontario, Canada: results from a respondent-driven sampling survey. J Sex Res. 2015; 52(1): 1–14.CrossRefPubMedPubMedCentral Scheim AI, Bauer GR. Sex and gender diversity among transgender persons in Ontario, Canada: results from a respondent-driven sampling survey. J Sex Res. 2015; 52(1): 1–14.CrossRefPubMedPubMedCentral
22.
go back to reference Reisner SL, White Hughto JM, Pardee D, Sevelius JM. Syndemics and gender affirmation: HIV sexual risk in female-to-male trans masculine adults reporting sexual contact with cisgender males. Int J STD & AIDS. in press. Reisner SL, White Hughto JM, Pardee D, Sevelius JM. Syndemics and gender affirmation: HIV sexual risk in female-to-male trans masculine adults reporting sexual contact with cisgender males. Int J STD & AIDS. in press.
23.
go back to reference Sevelius JM. Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color. Sex Roles. 2013; 68(11–12): 675–689.CrossRefPubMedPubMedCentral Sevelius JM. Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color. Sex Roles. 2013; 68(11–12): 675–689.CrossRefPubMedPubMedCentral
24.
go back to reference Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000; 55(5): 469.CrossRefPubMed Arnett JJ. Emerging adulthood: a theory of development from the late teens through the twenties. Am Psychol. 2000; 55(5): 469.CrossRefPubMed
25.
go back to reference Garofalo R, Johnson AK, Kuhns LM, Cotten C, Joseph H, Margolis A. Life skills: evaluation of a theory-driven behavioral HIV prevention intervention for young transgender women. J Urban Health. 2012; 89(3): 419–431.CrossRefPubMedPubMedCentral Garofalo R, Johnson AK, Kuhns LM, Cotten C, Joseph H, Margolis A. Life skills: evaluation of a theory-driven behavioral HIV prevention intervention for young transgender women. J Urban Health. 2012; 89(3): 419–431.CrossRefPubMedPubMedCentral
26.
go back to reference Bronfenbrenner U. The ecology of human development: experiments by design and nature. Cambridge, MA: Harvard University Press; 1979. Bronfenbrenner U. The ecology of human development: experiments by design and nature. Cambridge, MA: Harvard University Press; 1979.
27.
go back to reference Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013; 13: 482.CrossRefPubMedPubMedCentral Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013; 13: 482.CrossRefPubMedPubMedCentral
28.
go back to reference Lemieux AF, Fisher JD, Pratto F. A music-based HIV prevention intervention for urban adolescents. Health Psychol. 2008; 27(3): 349–357.CrossRefPubMed Lemieux AF, Fisher JD, Pratto F. A music-based HIV prevention intervention for urban adolescents. Health Psychol. 2008; 27(3): 349–357.CrossRefPubMed
29.
go back to reference Robertson AA, Stein JA, Baird-Thomas C. Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model. J Adolesc Health. 2006; 38(1): 18–25.CrossRefPubMed Robertson AA, Stein JA, Baird-Thomas C. Gender differences in the prediction of condom use among incarcerated juvenile offenders: testing the information-motivation-behavior skills (IMB) model. J Adolesc Health. 2006; 38(1): 18–25.CrossRefPubMed
30.
go back to reference Malow RM, Stein JA, McMahon RC, Devieux JG, Rosenberg R, Jean-Gilles M. Effects of a culturally adapted HIV prevention intervention in Haitian youth. J Assoc Nurses AIDS Care. 2009; 20(2): 110–121.CrossRefPubMedPubMedCentral Malow RM, Stein JA, McMahon RC, Devieux JG, Rosenberg R, Jean-Gilles M. Effects of a culturally adapted HIV prevention intervention in Haitian youth. J Assoc Nurses AIDS Care. 2009; 20(2): 110–121.CrossRefPubMedPubMedCentral
31.
go back to reference Singh S. Study of the effect of information, motivation and behavioural skills (IMB) intervention in changing AIDS risk behaviour in female university students. AIDS Care. 2003; 15(1): 71–76.CrossRefPubMed Singh S. Study of the effect of information, motivation and behavioural skills (IMB) intervention in changing AIDS risk behaviour in female university students. AIDS Care. 2003; 15(1): 71–76.CrossRefPubMed
32.
go back to reference Fisher JD, Fisher WA, Misovich SJ, Kimble DL, Malloy TE. Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychol. 1996; 15(2): 114–123.CrossRefPubMed Fisher JD, Fisher WA, Misovich SJ, Kimble DL, Malloy TE. Changing AIDS risk behavior: effects of an intervention emphasizing AIDS risk reduction information, motivation, and behavioral skills in a college student population. Health Psychol. 1996; 15(2): 114–123.CrossRefPubMed
33.
go back to reference Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from stage I. Clin Psychol Sci Pract. 2001; 8(2): 133–142.CrossRef Rounsaville BJ, Carroll KM, Onken LS. A stage model of behavioral therapies research: getting started and moving on from stage I. Clin Psychol Sci Pract. 2001; 8(2): 133–142.CrossRef
34.
go back to reference Leung MW, Yen IH, Minkler M. Community based participatory research: a promising approach for increasing epidemiology's relevance in the 21st century. Int J Epidemiol. 2004; 33(3): 499–506.CrossRefPubMed Leung MW, Yen IH, Minkler M. Community based participatory research: a promising approach for increasing epidemiology's relevance in the 21st century. Int J Epidemiol. 2004; 33(3): 499–506.CrossRefPubMed
35.
go back to reference Reisner S, Pardee D. Access to care barriers among transgender people in the US: findings from the U.S. National Transgender Discrimination Survey. The 2015 National Transgender Health Summit. Oakland, CA; 2015, April. Reisner S, Pardee D. Access to care barriers among transgender people in the US: findings from the U.S. National Transgender Discrimination Survey. The 2015 National Transgender Health Summit. Oakland, CA; 2015, April.
36.
go back to reference Zhang Y, Wildemuth BM. Qualitative analysis of content. In: Wildemuth B, ed. Applications of social research methods to questions in information and library science. Santa Barbara, CA: Greenwood Press; 2009: 308–319. Zhang Y, Wildemuth BM. Qualitative analysis of content. In: Wildemuth B, ed. Applications of social research methods to questions in information and library science. Santa Barbara, CA: Greenwood Press; 2009: 308–319.
37.
go back to reference Nelson IA. From quantitative to qualitative: adapting the life history calendar method. Field Methods. 2010; 22(4): 413–428.CrossRef Nelson IA. From quantitative to qualitative: adapting the life history calendar method. Field Methods. 2010; 22(4): 413–428.CrossRef
38.
go back to reference Yoshihama M, Gillespie B, Hammock AC, Belli RF, Tolman RM. Does the life history calendar method facilitate the recall of intimate partner violence? Comparison of two methods of data collection. Soc Work Res. 2005; 29(3): 151–163.CrossRef Yoshihama M, Gillespie B, Hammock AC, Belli RF, Tolman RM. Does the life history calendar method facilitate the recall of intimate partner violence? Comparison of two methods of data collection. Soc Work Res. 2005; 29(3): 151–163.CrossRef
39.
go back to reference Pearce L, Ghimire D. Innovations in life history calendar applications. Soc Sci Res. 1999; 28: 243–264.CrossRef Pearce L, Ghimire D. Innovations in life history calendar applications. Soc Sci Res. 1999; 28: 243–264.CrossRef
40.
go back to reference Freedman D, Thornton A, Camburn D, Alwin D, Young-demarco L. The life history calendar: a technique for collecting retrospective data. Sociol Methodol. 1988; 18: 37–68.CrossRefPubMed Freedman D, Thornton A, Camburn D, Alwin D, Young-demarco L. The life history calendar: a technique for collecting retrospective data. Sociol Methodol. 1988; 18: 37–68.CrossRefPubMed
41.
go back to reference Fisher CM. Assessing developmental trajectories of sexual minority youth: discrepant findings from a life history calendar and a self-administered survey. J LGBT Youth. 2012; 9(2): 114–135.CrossRefPubMedPubMedCentral Fisher CM. Assessing developmental trajectories of sexual minority youth: discrepant findings from a life history calendar and a self-administered survey. J LGBT Youth. 2012; 9(2): 114–135.CrossRefPubMedPubMedCentral
42.
go back to reference Sjoberg MD, Walch SE, Stanny CJ. Development and initial psychometric evaluation of the transgender adaptation and integration measure (TG AIM). Int J Transgenderism. 2006; 9(2): 35–45.CrossRef Sjoberg MD, Walch SE, Stanny CJ. Development and initial psychometric evaluation of the transgender adaptation and integration measure (TG AIM). Int J Transgenderism. 2006; 9(2): 35–45.CrossRef
43.
go back to reference Derogatis LR. Brief symptom inventory 18. Minneapolis, MN: NCS Pearson; 2000. Derogatis LR. Brief symptom inventory 18. Minneapolis, MN: NCS Pearson; 2000.
44.
go back to reference Crocker J, Luhtanen R. Collective self-esteem and ingroup bias. J Pers Soc Psychol. 1990; 58: 60–67.CrossRef Crocker J, Luhtanen R. Collective self-esteem and ingroup bias. J Pers Soc Psychol. 1990; 58: 60–67.CrossRef
45.
go back to reference Starace F, Massa A, Amico KR, Fisher JD. Adherence to antiretroviral therapy: an empirical test of the information-motivation-behavioral skills model. Health Psychol. 2006; 25(2): 153.CrossRefPubMed Starace F, Massa A, Amico KR, Fisher JD. Adherence to antiretroviral therapy: an empirical test of the information-motivation-behavioral skills model. Health Psychol. 2006; 25(2): 153.CrossRefPubMed
46.
go back to reference Amico K, Toro-Alfonso J, Fisher JD. An empirical test of the information, motivation and behavioral skills model of antiretroviral therapy adherence. AIDS Care. 2005; 17(6): 661–673.CrossRefPubMed Amico K, Toro-Alfonso J, Fisher JD. An empirical test of the information, motivation and behavioral skills model of antiretroviral therapy adherence. AIDS Care. 2005; 17(6): 661–673.CrossRefPubMed
47.
go back to reference Forsyth AD, Carey MP, Fuqua RW. Evaluation of the validity of the condom use self-efficacy scale (CUSES) in young men using two behavioral simulations. Health Psychol. 1997; 16(2): 175–178.CrossRefPubMedPubMedCentral Forsyth AD, Carey MP, Fuqua RW. Evaluation of the validity of the condom use self-efficacy scale (CUSES) in young men using two behavioral simulations. Health Psychol. 1997; 16(2): 175–178.CrossRefPubMedPubMedCentral
48.
go back to reference Brafford LJ, Beck KH. Development and validation of a condom self-efficacy scale for college students. J Am Coll Heal. 1991; 39(5): 219–225.CrossRef Brafford LJ, Beck KH. Development and validation of a condom self-efficacy scale for college students. J Am Coll Heal. 1991; 39(5): 219–225.CrossRef
49.
go back to reference Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev: Off Publ Int Soc AIDS Educ. 2002; 14(2): 172.CrossRef Carey MP, Schroder KE. Development and psychometric evaluation of the brief HIV knowledge questionnaire. AIDS Educ Prev: Off Publ Int Soc AIDS Educ. 2002; 14(2): 172.CrossRef
50.
go back to reference Kuhns LM, Reisner SL, Mimiaga MJ, Gayles T, Shelendich M, Garofalo R. Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women. AIDS Behav. Sep 3 2015. Kuhns LM, Reisner SL, Mimiaga MJ, Gayles T, Shelendich M, Garofalo R. Correlates of PrEP Indication in a Multi-Site Cohort of Young HIV-Uninfected Transgender Women. AIDS Behav. Sep 3 2015.
51.
go back to reference Donenberg GR, Emerson E, Bryant FB, Wilson H, Weber-Shifrin E. Understanding AIDS-risk behavior among adolescents in psychiatric care: links to psychopathology and peer relationships. J Am Acad Child Adolesc Psychiatry. 2001; 40(6): 642–653.CrossRefPubMedPubMedCentral Donenberg GR, Emerson E, Bryant FB, Wilson H, Weber-Shifrin E. Understanding AIDS-risk behavior among adolescents in psychiatric care: links to psychopathology and peer relationships. J Am Acad Child Adolesc Psychiatry. 2001; 40(6): 642–653.CrossRefPubMedPubMedCentral
52.
go back to reference Reisner SL, Pardee D. gender affirmative assessment of HIV risk behaviors in female-to-male trans masculine youth who have sex with cisgender males (TMSM). Paper presented at: 2015 National Transgender Health Summit, 2015; Oakland, CA. Reisner SL, Pardee D. gender affirmative assessment of HIV risk behaviors in female-to-male trans masculine youth who have sex with cisgender males (TMSM). Paper presented at: 2015 National Transgender Health Summit, 2015; Oakland, CA.
Metadata
Title
LifeSkills for Men (LS4M): Pilot Evaluation of a Gender-Affirmative HIV and STI Prevention Intervention for Young Adult Transgender Men Who Have Sex with Men
Authors
Sari L. Reisner
Jaclyn M. White Hughto
Dana J. Pardee
Lisa Kuhns
Rob Garofalo
Matthew J. Mimiaga
Publication date
01-02-2016
Publisher
Springer US
Published in
Journal of Urban Health / Issue 1/2016
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-015-0011-z

Other articles of this Issue 1/2016

Journal of Urban Health 1/2016 Go to the issue