Perspectives and Recommendations From Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Youth of Color Regarding Engagement in Biomedical HIV Prevention

Purpose: Young people of color have high HIV incidence rates and suffer the greatest health inequities with regard to daily oral pre-exposure prophylaxis. Although the next generation of biomedical HIV prevention products is already under clinical development, little research has examined whether such products address the needs of this population or identified specific strategies for educating this population about prevention options that might result in the greatest interest in and uptake of new prevention modalities.

Methods: We analyzed data from seven focus groups (n = 93) conducted between July 2016 and March 2017 in partnership with a lesbian, gay, bisexual, transgender, and queer/questioning youth-serving community-based organization in the northeastern U.S. The study aimed to understand concerns, priorities, and preferences around biomedical HIV prevention modalities (i.e., daily oral pill, long-acting injectable, and topical microbicide) among lesbian, gay, bisexual, transgender, and queer/questioning youth of color.

Results: Our findings identified four key dynamics specific to educating young people about biomedical prevention, including (1) providing information with a sufficient level of detail and complexity, (2) contextualizing messaging in terms of young people's existing knowledge and beliefs, (3) providing detailed information about side effects, drug- and multi-method interactions, and dosing/usage contingencies, and (4) working proactively to support transgender youth and ensure that prevention products are accessible to them.

Conclusions: As we plan for a future of choice in biomedical HIV prevention, we should consider how novel products can address inequities in pre-exposure prophylaxis access and HIV incidence by valuing the concerns and needs of this highest priority population.