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Table 1 Quantitative Survey Measures

From: 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.

Area of FocusConstructs Assessed
DemographicsAge, education, income, health insurance status, housing status, race/ethnicity, relationship status, access to healthcare services; intersex status [35]
Gender identity, sex assigned at birth, and gender expressionTwo-step method to assess current gender identity and assigned sex at birth [36]; current nonconforming gender expression [37]; visibility of TGD status [35].
Sexual orientation and attractionSexual orientation identity [35, 38]; changes in sexual attractions [39].
Gender-related developmental milestonesFirst awareness of gender discordance, age of coming out, age of first hormone use [38].
Gender affirmationSocial gender affirmation (living full-time; pronoun), medical gender affirmation (types accessed; hormone access), legal gender affirmation (name change, gender marker change) [38].
HIV and STIsSelf-reported HIV status, HIV testing behaviors, STI screening, history of STIs.
HIV preventionaAccess to and utilization of primary HIV prevention services, including PrEP and PEP.
HIV-specific demographicsbAge at HIV diagnosis, mode of HIV acquisition, HIV serostatus disclosure, history/current engagement in HIV care, history/current medication status, medication adherence, access to and utilization of secondary HIV prevention services [40].
Mental healthDepressive symptoms (CES-D [41]); anxiety symptoms (GAD PHQ [42]); PTSD symptoms [43]; mental healthcare service utilization, family/friend support of gender status, intimate partner violence, child abuse prior to age 15, suicidal ideation, suicidal attempt, self-harm [35, 38, 44]; self-esteem [45].
Substance use/abuseSubstance abuse (CRAFFT [46]); frequency of use of various drugs in past 6 months; Injection drug use in past 6 months; use of prescription drugs not prescribed to you in past 6 months; lifetime receipt of drug or alcohol abuse treatment; current holder of medical marijuana prescription; substance use and sex [47].
Psychosocial risks and supportsHistory of incarceration, homelessness, family socioeconomic status/poverty, foster-care system engagement, sex work, substance abuse treatment history [35, 38, 44]; general social support [48].
Sexual behaviorSexual activity (oral, anal, and vaginal sex) with cisgender male, transgender male, cisgender female, and transgender female partners. Items included number of partners, partners’ HIV serostatus, frequency of oral, anal, and vaginal sex with and without a barrier (condom or dental dam) (adapted from [47]); Reasons for sexual activity [49].
Discrimination and violence/victimizationExperiences of discrimination in day-to-day life in past year and month [50] adapted from [51]; experiences of anti-transgender violence and victimization (adapted from [52]).
TGD Stress ConstructsInternalized transphobia; transphobia in context of sexual encounters [38]; physical and emotional symptoms attributed to gender-related mistreatment [53]; general life stress; affective growth subscale [54].
Healthcare experiencesResponsiveness of healthcare services to gender-related needs [35]; need for and access to gender affirmation in healthcare settings, experiences of anticipated and enacted stigma in healthcare settings, experiences of stigma across the HIV continua of care (scales developed for this study with involvement of YAB).
  1. aAsked only of TGD youth who reported not living with HIV or unknown HIV status
  2. bAsked only of TGD youth who reported living with HIV