LifeSkills – Past, Present and Future!

Recruiting at Fenway Health in Boston and Lurie Children’s Hospital in Chicago, LifeSkills is a 5-year, randomized controlled trial funded by the National Institutes of Health (NIH). The purpose of the LifeSkills Study is to assess a holistic and culturally responsive primary and secondary HIV prevention intervention originally developed in Chicago to address sexual risk among young transgender women, ages 16-29.

LifeSkills acknowledges that many issues disproportionately face our trans communities, such as gender-based violence, bullying, discrimination, school drop-out, poverty, unstable housing, survival sex, the need for gender affirmation, and challenges accessing culturally competent healthcare, many of which directly or indirectly result from social stigma and may contribute to sexual risk taking. Developed and led by women who also identify on the trans feminine spectrum, the 6 session LifeSkills curriculum addresses the many issues young trans women face and uses empowerment-based education to provide participants with the knowledge and life skills needed to reduce sexual risk taking and improve their lives. The LifeSkills program also includes HIV and sexually transmitted infection (STI) testing and counseling and assessment visits 4 times over a year-long period.

The LifeSkills intervention is the largest NIH-funded study for transgender youth to date. If successful, LifeSkills could lead to more knowledge about trans communities and funding for future programs and services for transgender youth nationwide.

Since enrollment opened in April 2012, the LifeSkills team has screened over 100 transgender women and enrolled 67 participants in Boston and 149 across both sites. In just 18 months, we have run 7 LifeSkills cohorts, presented at nearly 20 local and national conferences and workshops, staffed more than 50 community events, and produced more than 10 community engagement events including the 2012 and 2013 LifeSkillz Balls. We could not have done this without or incredible community partners and allies, including MTPC, BAGLY, JRI/Glass, TransCEND, and many others.

With our next cohort starting December 3, 2013 and 2 more years to go, we are looking to recruit 100 additional participants.

Who may be eligible to participate:

  • Between the ages of 16 to 29
  • Transgender/transsexual woman (born/assigned male at birth and or identify as woman, on the trans feminine (MTF) spectrum
  • Sexually active

* Participants can be of any HIV status!

How you can help:

  • Tell your patients, clients, colleagues and friends about our study
  • Refer potentially eligible individuals
  • Share our materials via social media, list serves, and around your place of work or neighborhood
  • Invite us to your organization and let us know how we can help you
  • Send us your feedback!

To learn more, please contact us at 617.299.9013 or email us at LifeSkills@fenwayhealth.org. Also visit our website at www.ProjectLifeSkills.org or Facebook page, http://www.facebook.com/LifeSkillsboston.

 

Introducing LifeSkills for Men!

Fenway investigators Drs. Sari Reisner and Matthew Mimiaga were awarded an administrative supplement from NIMH to adapt the LifeSkills curriculum for sexually experienced young female-to-male (FTM) transgender men ages 18-29 in the Boston area who are gay/ bisexual/ queer/ questioning FTM/ and/or transgender men who have sex with men (TMSM). LifeSkills for Men will address the unique social, developmental, and interpersonal challenges to sexual safety among TMSM age 18-29 and work with TMSM to develop a program responsive to their sexual health needs. The investigators are currently seeking a Senior Research Associate to coordinate the study [here is a link to the job posting for anyone who is interested in learning more].

Background: Transgender men remain invisible in HIV prevention efforts. Often transgender men are assumed to be at low risk of HIV infection. This is largely because people assume FTMs are heterosexual-identified and engage in sexual behaviors with cisgender (non-transgender) females only. However, transgender men have diverse sexual orientations and attractions – indeed heterogeneity of sexual identities seems to characterize many within trans masculine communities (~45%-60% across studies not heterosexual). Many transgender men can and do engage in sexual behaviors with partners of many different genders, including with other men, and many identify as non-heterosexual. In addition, studies document sexual risk behaviors among TMSM that may put them at risk for HIV acquisition or transmission, including unprotected receptive sex with cisgender (non-transgender) male partners (Bauer et al., 2012, 2013; Reisner et al., 2010; Sevelius, 2009).

Sexuality and Gender: Sexual health programs are needed for young TMSM that focus on interrelationships between sexuality and gender identity development. In the study team’s pilot work, 44% of TMSM had never had sex with a man until after gender transition, and 69% indicated that they never told anyone they had sex with men: “There’s a re-socialization that happens. You have to learn what it means to be a man…Boundary pushing is part of self-discovery–you have to see how far you’ll go to see how far you won’t go. It can definitely put some guys at risk” (TMSM, age 24) (Reisner et al., 2010). The program will address issues specific to TMSM—masculine norms, negotiating changing attractions, increased libido with hormone use, gender validation, positive sexuality, and so forth.

 

Citations

Reisner SL, Perkovitch B, Mimiaga MJ. (2010). A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men. AIDS Patient Care STDs, 24, 501-513.

Sevelius J. (2009). “There’s no pamphlet for the kind of sex I have”: HIV-related risk factors and protective behaviors among transgender men who have sex with non-transgender men. J Assoc Nurses AIDS Care, 20, 398-410.

Bauer GR, Travers R, Scanlon K, Coleman TA. (2012). High heterogeneity of HIV-related sexual risk among transgender people in Ontario, Canada: A province-wide respondent-driven sampling survey. BMC Public Health, 12, 292.

Bauer GR, Redman N, Bradley K, Scheim AI. (2013). Sexual health of trans men who are gay, bisexual or who have sex with men: Results from Ontario, Canada. International Journal of Transgenderism, 14, 66-74.

 

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