No abstract

The assessment of the suitability of novel targets to intervention by different modalities, small molecules or antibodies, is increasingly seen as important in helping to select the most progressable targets at the outset of a drug discovery project. This perspective considers differing aspects of tractability and how it can be assessed using and experimental approaches. We also share some of our experiences in using these approaches.

Purpose: Transgender youth are at high risk for human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), but their rates of screening are unknown. This study sought to quantify HIV and other STI testing levels and to examine variations in testing levels across three categories of gender identity: transgender men, transgender women, and nonbinary individuals.Methods: Between June 2017 and June 2018, 186 transgender youth aged 15–24 years were recruited into a randomized trial of home HIV testing supplemented with telehealth-based counseling. Information on sociodemographics, health care utilization, sexual activity, stress and resilience, and history of HIV and other STI testing was obtained. Multivariable logistic regression models were formulated to identify variations in testing for HIV and other STIs across gender identities.Results: Twenty-eight of 186 participants (15.1%) reported testing for HIV in the past year, and 42 (22.6%) reported testing for other STIs. Transgender women were less likely to have been tested for HIV (adjusted odds ratio [aOR]: 0.15, 95% confidence interval [CI]: 0.03–0.78) and other STIs (aOR: 0.33, 95% CI: 0.11–0.99), but nonbinary individuals were equally likely to have been tested compared with transgender men. Participants who agreed that their health care provider is knowledgeable about transgender health issues were thrice as likely to have been tested for HIV (aOR: 3.29, 95% CI: 1.36–7.97) and other STIs (aOR: 3.05, 95% CI: 1.40–6.63) compared with those who disagreed.Conclusion: Low levels of testing among transgender youth highlight the exigency of improving gender- and age-appropriate HIV and other STI prevention services. Given that provider knowledge of transgender health issues was strongly associated with testing, training health care providers in transgender-related care could prove beneficial.

Purpose: Emerging literature suggests there may be important differences in the demographic characteristics and health profiles of nonbinary transgender youth compared to binary transgender youth.Methods: Between June 2017 and June 2018, 202 transgender youth aged 15–24 years were recruited into a randomized trial of home HIV testing, Project Moxie. This analysis compares demographic and health risk behavior characteristics between youth reporting nonbinary and binary transgender identities in baseline surveys.Results: Nonbinary youth were significantly less likely to have accessed medical interventions to affirm their gender than binary youth (8.4% vs. 46.2%), and less likely to be living currently as the gender that most affirms them (80.7% vs. 91.6%). While there were no significant differences in the low levels of resilience reported across the sample, nonbinary youth reported significantly higher levels of stress. Health risk behaviors were generally high across nonbinary and binary participants, with no significant differences in sexual partner count, condomless sex, alcohol use, tobacco, marijuana, or other drug use.Conclusion: Findings affirmed many similarities, and key disparities, between nonbinary and binary transgender youth. Research and interventions dedicated to the unique needs and experiences of nonbinary transgender youth to address high levels of health risk behaviors and stress are critical.