Macapagal Awarded R01 Grant to Improve Teen Sexual Health and HIV Testing Rates

Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) faculty member Kathryn Macapagal, Ph.D., was awarded a prestigious R01 grant from the NIH’s National Institute of Mental Health to increase HIV testing rates and sexual health knowledge among sexual and gender minority teenagers.

The five-year, $3.5 million grant will support the development and testing of a text message-based intervention designed to reach cisgender adolescent sexual minority males (ASMM) and transgender and gender diverse (TGD) teens.

Most ASMM and TGD teens in the United States are not being screened for HIV and do not know their HIV status, despite accounting for 79% of HIV infections among all adolescents. Macapagal’s study intends to address this public health problem by educating teens about HIV testing and sexual health resources more broadly.

“It’s important for all teenagers to know that they can do something about their sexual health now, not just when they’re adults,” said Macapagal. “Rates of HIV testing in sexual and gender minority teenagers are very low, even though the CDC and American Academy of Pediatrics recommend adolescents get tested for HIV at least once, and more often if they are engaging in higher risk sexual behaviors. The goal of this study is not only to get teens tested for HIV, but to also empower them to take charge of their own health and health care, especially health care that they may not feel comfortable talking to parents or guardians about.”

This work builds on a 2014 pilot randomized controlled trial of an intervention called G2G, a five-week HIV prevention program originally designed for ASMM. In that pilot study, teens received 8-10 daily text messages that provided HIV prevention information, promoted positive social norms regarding prevention, and encouraged prevention-related skill-building. Teens in G2G’s treatment group were more than three times more likely to report being tested for HIV at follow-up than the control group.

“We know that traditional school-based sex education can be incomplete, inconsistent, and exclude information that sexual and gender minority teens need. Our expansion of G2G will offer more inclusive and thorough education about sexual health, HIV testing, and HIV prevention options like PrEP,” said Macapagal.

The content delivered to teens through this updated intervention will include a combination of informational messages, motivating stories, and skill building activities. Content will be made more gender-inclusive, address new HIV prevention and testing developments since the original pilot trial, and use newer technologies like a chatbot to answer common sexual health questions.

The driving force behind this study is Macapagal’s dedication to the health and wellbeing of sexual and gender minority teenagers.

“Many health researchers and clinicians avoid working with teenagers for a variety of reasons, and that unfortunately means teenagers are left out of conversations about their own health. Teens have a lot of wisdom and expertise about their own lives, but we rarely ask them about their perspectives or what they need and how those needs can be met. By speaking with teens and involving them in the development of this intervention, I’m hoping this project can tap into and to use their perspectives to guide the work,” said Macapagal.

Macapagal is the principal investigator on this R01 grant. ISGMH’s Dennis Li, Ph.D.; Brian Mustanski, Ph.D.; and Michael Newcomb, Ph.D., are co-investigators. ISGMH affiliate faculty member C. Hendricks Brown, Ph.D., will serve as an advisor on the grant.