Survey of Today's Adolescent Relationships and Transitions (START)

Project Overview
logo: Survey  of Today's Adolescent Relationships and Transitions (START)

To respond to the increase in HIV infection, particularly among Black and Latino adolescent males who have sex with males (AMSM), CDC’s Division of Adolescent and School Health (DASH), with support from the Secretary’s Minority AIDS Initiative Fundexternal icon, contracted with the National Opinion Research Center (NORC) to develop an innovative, social media-based recruitment and data collection project targeting gay, bisexual, and questioning males (13-18 years old) and transgender youth (13-24 years old). Using the results from the confidential web-based survey and qualitative research, DASH will develop appropriate, effective HIV prevention materials to assist young gay and bisexual men and transgender youth in accessing HIV prevention and testing resources.

social media icons and iphone

There are major gaps in evidence-based prevention tools designed to reach adolescent MSM and engage them in new, innovative HIV prevention efforts, such as pre-exposure prophylaxis (PrEP).

This national project is important because it will—

  • increase understanding of the unique individual, interpersonal, and social characteristics of AMSM,
  • provide appropriate context to HIV prevention efforts; including the preferences and behaviors of AMSM, and especially AMSM of color,
  • inform acceptability and adherence to promising HIV prevention strategies, and
  • translate these findings into HIV prevention tools and guidance for preventing HIV among adolescent men who have sex with men.

This research project will help DASH better understand the unique characteristics and behaviors of adolescent MSM in order to develop tools and guidance to inform them of HIV prevention strategies.

Project Time Line: 2016 - 2019

START was a four year study that began in 2016. In collaboration with DASH, NORC developed and tested a web-based survey of sexual minority males 13-18 and transgender youth 13-24 with input from research experts and a youth advisory board.  A social media recruitment strategy was also developed in partnership with a social media consulting firm.  The survey was implemented in spring 2018 through Instagram, Snapchat, and Facebook and resulted in over 3,000 respondents.

The Fenway Institute led efforts to collect qualitative data from multiple perspectives.  Adults who served youth at risk for HIV in schools, health care facilities, and community-based organizations provided information about barriers to HIV prevention in their fields.  Sexual minority males and transgender youth also provided information about their experiences accessing HIV prevention services.

Using the information from these surveys and focus groups, the research team developed several tools to improve prevention efforts and research papers for the field.

With the significant burden of HIV among AMSM, particularly among black youth, understanding the factors and behaviors associated with an increased risk of HIV diagnosis is key for developing targeted prevention strategies and reducing the burden of HIV.