Perceived acceptability and feasibility of HIV self-testing and app-based data collection for HIV prevention research with transgender women in the United States

ABSTRACT

In the United States, transgender women are disproportionately burdened by HIV infection. Research aimed at curbing the HIV epidemic for this population may benefit from innovative technology to engage participants in research. Adult transgender women (n = 41) from six cities in the southern and eastern United States participated in seven online focus groups between August 2017 and January 2018. Analyses focused on perceived acceptability of novel technologies for research purposes, particularly HIV self-testing (HIVST) and remote data collection through a mobile app. While participants noted a number of benefits to HIVST and remote study participation, including increased participant engagement and sentiments of agency, they also expressed concerns that may impact HIVST and remote participation including housing instability, inconsistent access to technology, and confidentiality. Study findings provide insight into gaps that must be addressed when using technology-enhanced methods to support HIV testing and research participation among transgender women in the US. Substantial effort is required on the part of investigators to ensure equitable access across subgroups and, thus, minimize bias to avoid reproducing health disparities in research.

KEYWORDS:

• Transgender
• HIV Prevention
• HIV Self Testing
• Technology
• mobile applications/apps
• remote study participation

Acknowledgements

We would like to express our gratitude to the transgender women who participated in this study. This study would not be possible without their participation. Research reported in this publication was jointly supported by the National Institute Of Allergy And Infectious Diseases, the National Institute of Mental Health, and the National Institute of Child Health and Human Development of the National Institutes of Health under Award Number UG3AI133669/ UH3AI133669 (Wirtz/Reisner). Research reported in this publication was also supported by HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA), Washington DC Department of Health. The LITE study is also appreciative of support from the Centers for AIDS Research (CFAR) at partner institutions including: Johns Hopkins University (P30AI094189), Emory University (P30AI050409), Harvard University (P30AI060354), DC CFAR (AI117970), and the University of Miami (P30AI073961). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health nor HAHSTA. The following are members of the collaborative author, American Cohort to Study HIV Acquisition Among Transgender Women (LITE): Sari Reisner (multiple Principal Investigator [mPI]) (Harvard University, Boston Children’s Hospital); Andrea Wirtz (mPI) (Johns Hopkins University); Keri Althoff (Johns Hopkins University); Chris Beyrer (Johns Hopkins University); James Case (Johns Hopkins University); Erin Cooney (Johns Hopkins University); Oliver Laeyendecker (Johns Hopkins University); Tonia Poteat (University of North Carolina); Ken Mayer (Fenway Health); Asa Radix (Callen-Lorde Community Health Center); Christopher Cannon (Whitman Walker Health); W David Hardy (Whitman Walker Health); Jason Schneider (Emory University and Grady Hospital); Sonya Haw (Emory University and Grady Hospital); Allan Rodriguez (University of Miami); and Andrew Wawrzyniak (University of Miami).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Research reported in this publication was jointly supported by the National Institute Of Allergy And Infectious Diseases, the National Institute of Mental Health, and the National Institute of Child Health and Human Development of the National Institutes of Health under Award Number UG3AI133669/ UH3AI133669 (Wirtz/Reisner). Research reported in this publication was also supported by HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA), Washington DC Department of Health. The LITE study is also appreciative of support from the Centers for AIDS Research (CFAR) at partner institutions including: Johns Hopkins University (P30AI094189), Emory University (P30AI050409), Harvard University (P30AI060354), DC CFAR (AI117970), and the University of Miami (P30AI073961).