Using Formative Research to Adapt the GYT Campaign for Sexual and Gender Minority Youth of Color in New York City

Background: Sexual and gender minority youth of color are at increased risk of STDs and HIV, but few testing interventions have been specifically designed to reach this population.  Formative research was conducted to adapt existing Get Yourself Tested (GYT) campaign messages and materials to reach this high-risk population.

Methods: In partnership with community-based organizations serving sexual and gender minority populations, 3 focus groups were conducted with youth age 15-25 in New York City to discuss barriers to STD and HIV testing.  Groups also reviewed existing and adapted GYT messages to promote testing and link youth with testing services. Qualitative data collection was guided by a semi-structured discussion guide. Grounded theory was used to identify themes. 

Results: The 40 participants (age 15-25) were racially and ethnically diverse (63% African-American, 35% Latino).  Half of participants were male; 38% transfemale, and 12% female.  Two central barriers to STD testing uptake were cited: concerns about confidentiality in the clinical setting and a lack of privacy in community-based testing venues.  Drawbacks of existing STD testing messages cited by participants included a lack of appreciation of heterogeneity (conflating sexual orientation identity and gender identity) and the stigmatizing effect of messaging about increased risk of HIV /STDs among sexual minority populations. Three central approaches were identified to make testing promotion efforts more effective: increasing cultural competency of clinicians; expanding the availability of testing (e.g. self-collection); and developing non-sexualized inclusive messaging about testing.  The messaging and images on GYT materials were adapted according to this feedback.  Over 3,400 youth were reached with adapted materials through direct outreach; another 7,000 were reached through organizations.

Conclusions: Messages to promote the availability of testing should be inclusive of gender and sexual minority populations.  To increase STD testing uptake in this population, programs must increase access while minimizing stigma and maintaining privacy/confidentiality.