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Transgender, HIV Continuum of CareNCT02449629

Assessing the Engagement of Transgender and Other Gender Minority Youth Across the HIV Continuum of Care

An observational study of Transgender, HIV Continuum of Care, run by University of North Carolina, Chapel Hill at 14 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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… Read more about this study

Who is it for?
Ages 16 to 24 yearsHealthy volunteers can take part
Conditions the study is for
Transgender, HIV Continuum of Care
How many people
187 participants
Where
14 sitesUnited States
Study dates
Jun 2015to Jan 2016
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 24 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

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.

Who may be able to join

  • To be considered eligible for enrollment, an individual must meet the criteria listed below.
  • Received at least one HIV related service (e.g., medical care, social services, case management, etc.) at an AMTU or elsewhere in the six months prior to consent;
  • Does not identify solely with sex assigned at birth (may identify as trans, transgender, trans woman, trans man, man, woman, gender nonconforming, genderqueer, or any other gender, so long as their current gender identity and/or expression do not match their sex assigned at birth);
  • Self reports to be HIV-infected;
  • Self reports to be between the ages of 16-24 years inclusive at time of consent;
  • Ability to understand both written and spoken English;
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  • Willingness to participate in an in-depth face-to-face qualitative interview about gender minority identity and personal experiences seeking services across the HIV Continuum of Care;
  • Willingness to participate in a web-based quantitative survey about gender minority identity and personal experiences seeking services across the HIV Continuum of Care; and
  • Able to understand and willing to provide signed informed consent as applicable for study participation.
  • Exclusion Criteria: Youth Currently in HIV Care To be considered eligible for enrollment, an individual must not meet any of the criteria listed below.
  • Active psychiatric condition that, in the opinion of the site personnel, would interfere with the ability to give true informed consent and to adhere to the study requirements;
  • Visibly distraught or visibly emotionally unstable (e.g., active hallucinations, exhibiting suicidal, homicidal, or violent behavior) condition that, in the opinion of the site personnel, would interfere with the ability to give true informed consent and to adhere to the study requirements;
  • Active drug or alcohol use or dependence that, in the opinion of the site personnel, would interfere with the ability to give true informed consent and to adhere to the study requirements;
  • Acute illness that, in the opinion of the site personnel, would interfere with the subject's ability to adhere to the protocol requirements and/or interfere with the protocol objectives; and
  • Site IRB requires parental permission and subject is <18 years of age.
  • Inclusion Criteria: Youth Not Currently in Care To be considered eligible for enrollment, an individual must meet the criteria listed below.
  • Did not receive HIV related services (e.g., medical care, social services, case management, etc.) at an AMTU or elsewhere in the six months prior to the time of consent;
  • Does not identify solely with sex assigned at birth (may identify as trans, transgender, trans woman, trans man, woman, man, gender nonconforming, genderqueer, or any other gender, so long their current gender identity and/or expression do not match their sex assigned at birth);
  • Self reports to be between the ages of 16-24 years inclusive at time of consent;
  • Ability to understand both written and spoken English;
  • Willingness to participate in an in-depth face-to-face qualitative interview about gender minority identity and personal experiences seeking services across the HIV Continuum of Care;
  • Willingness to participate in a web-based quantitative survey about transgender and other gender minority identity and personal experiences seeking services across the HIV Continuum of Care; and
  • Willingness to provide signed informed consent for study participation.
  • Exclusion Criteria: Youth Not Currently in HIV Care To be considered eligible for enrollment, an individual must not meet any of the criteria listed below.
  • Active psychiatric condition that in the opinion of the site personnel would interfere with the ability to give true informed consent and to adhere to the study requirements;
  • Visibly distraught or visibly emotionally unstable (e.g., active hallucinations, exhibiting suicidal, homicidal, or violent behavior) condition that, in the opinion of the site personnel interferes with the ability to give true informed consent and to adhere to the study requirements;
  • Active drug or alcohol use or dependence that, in the opinion of the site personnel, would interfere with the ability to give true informed consent and to adhere to the study requirements;
  • Acute illness that, in the opinion of the site personnel, would interfere with the subject's ability to adhere to the protocol requirements and/or interfere with the protocol objectives; and
  • Site IRB requires parental permission and subject is <18 years of age.
  • Inclusion Criteria: Health Care and Social Service Providers
  • To be considered eligible for enrollment, an individual must meet the criteria listed below.
  • Fits into one of the following categories: (1) medical provider (physician, nurse, nurse practitioner, physician's assistant); (2) mental health professional (psychologist, psychiatrist, clinical social worker, counselor); (3) case manager/care coordinator; (4) HIV test counselor; (5) or health educator/outreach worker;
  • Provides services at one of the 14 AMTU or elsewhere within the AMTU cities; and
  • Currently works directly with or has formerly worked directly with TGMY.
  • Exclusion Criteria: Health Care and Social Service Providers
  • There are no exclusion criteria.

Who cannot join

None listed.

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

United States14 sites
  • University of Colorado - The Children's Hospital of Denver

    Aurora, Colorado, 80045

  • Johns Hopkins University

    Baltimore, Maryland, 21287

  • Fenway Institute

    Boston, Massachusetts, 02215

  • Stroger Hospital of Cook County

    Chicago, Illinois, 60612

  • Wayne State University-Children's Hospital of Michigan

    Detroit, Michigan, 48201

  • Baylor College of Medicine/Texas Children's Hospital

    Houston, Texas, 77030

  • Children's Hospital of Los Angeles

    Los Angeles, California, 90027

  • St. Jude Childrens Research Hospital

    Memphis, Tennessee, 38105

  • University of Miami

    Miami, Florida, 33101

  • Tulane Medical Center

    New Orleans, Louisiana, 70112

  • Children's Hopsital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • University of South Florida

    Tampa, Florida, 33606

  • Montefiore Medical Center

    The Bronx, New York, 10467

  • Children's Hosp National Med Center

    Washington D.C., District of Columbia, 20010

Other trials in United States

About this study

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.
Read the 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.

Keywords
HIV, Transgender, HIV Continuum of Care

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02449629
Study groupRoleWhat they receive
TGMY in HIV CareTGMY (16-24 years of age) currently in HIV care at an Adolescent Medicine Trials Unit (AMTU) site or elsewhere.
TGMY Not in HIV CareTGMY (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.
Health Care and Social Service ProvidersHealth care and social service providers who work with TGMY at AMTU sites or elsewhere that serve TGMY within the AMTU cities.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Types of facilitators that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of TGMY with HIV in HIV Care

    Explore, from the perspective of TGMY living with HIV who are in HIV care, what socio-ecological facilitators exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART, and viral suppression.

    Measured: Entry Visit

  2. Types of barriers that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of TGMY with HIV in HIV Care

    Explore, from the perspective of TGMY living with HIV who are in HIV care, what socio-ecological barriers exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART, and viral suppression.

    Measured: Entry Visit

  3. Types of facilitators that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of TGMY not in HIV Care

    Explore, from the perspective of TGMY who are not in HIV care (including those who are living with HIV, not living with HIV, and those who are unaware of their HIV status), what socio-ecological facilitators exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART, and viral suppression.

    Measured: Entry Visit

  4. Types of barriers that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of TGMY not in HIV Care

    Explore, from the perspective of TGMY who are not in HIV care (including those who are living with HIV, not living with HIV, and those who are unaware of their HIV status), what socio-ecological barriers exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART, and viral suppression.

    Measured: Entry Visit

  5. Types of facilitators that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of health care and social service providers

    Explore, from the perspective of health care and social service providers who provide care and supportive services to TGMY, what socio-ecological facilitators exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART and viral suppression.

    Measured: Entry Visit

  6. Types of barriers that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of health care and social service providers

    Explore, from the perspective of health care and social service providers who provide care and supportive services to TGMY, what socio-ecological barriers exist that influence the full participation of TGMY in the various stages of the HIV Continuum of Care: prevention and testing, diagnosis, linkage to care, engagement in care, retention in care, initiation of ART, adherence to ART and viral suppression.

    Measured: Entry Visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 May 2015 (estimated)
  2. Study startJun 2015
  3. Primary completionJan 2016
  4. Study completionJan 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
187 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02449629
Sponsor's protocol ID
ATN 130
Status last verified
Mar 2016
First submitted
18 May 2015
Last updated
28 Feb 2017
Results posted
No
Data monitoring committee
No

Publications

  • Jadwin-Cakmak L, Reisner SL, Hughto JMW, Salomon L, Martinez M, Popoff E, Rivera BA, Harper GW. HIV prevention and HIV care among transgender and gender diverse youth: design and implementation of a multisite mixed-methods study protocol in the U.S. BMC Public Health. 2019 Nov 15;19(1):1531. doi: 10.1186/s12889-019-7605-4.

    PubMed 31730450

Questions about this trial

What is this clinical trial studying?

An observational study of Transgender, HIV Continuum of Care, run by University of North Carolina, Chapel Hill at 14 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 36 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Feb 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Types of facilitators that influence the full participation of TGMY in the various stages of the HIV Continuum of Care from the perspective of TGMY with HIV in HIV Care (time frame: Entry Visit). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02449629, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Feb 2017.

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