1. USE OF SOCIAL MEDIA TO IMPROVE ENGAGEMENT AND RETENTION IN CARE FOR GAY AND BISEXUAL MEN AND OTHER MSM AND TRANSGENDER WOMEN WITH HIV Wake Forest School of Medicine, Winston-Salem, NC Jorge Alonzo, JD Lilli Mann, MPH Eunyoung Song, PhD Amanda Tanner, PhD, MPH Katherine Shafer, MD Elias Arellano Rita Groce Scott D. Rhodes, PhD, MPH

2. Outreach and Recruitment Target population: Young racially and ethnically diverse MSM and transgender women, ages 16-34, with HIV. Setting: Wake Forest Infectious Diseases Specialty Clinic HIV testing sites and other agencies that serve persons with HIV (e.g., health departments, ASOs, and CBOs) Intervention: Facebook messenger, text messages, WhatsApp, kik, and GPS-based mobile applications (“apps”) such as A4A/Radar, badoo, Grindr, SCRUFF, and Jack’d.

3. Outreach and Recruitment Providers and staff at ID clinic, testing sites, and other agencies will refer potential participants who meet inclusion criteria to our Health Educator Flyers with a brief description of the study will be given to providers and staff to invite young MSM and transgender women to participate and ask if they are interested in speaking with the Health Educator

4. Outreach and Recruitment Health Educator will be present at HIV testing sites when positive results are given to young MSM and transgender women and at ID clinic when they attend new patient appointments to talk with and enroll them in the study.

5. Challenges Recruiting through testing sites as those who test positive are often contacted first by Disease Intervention Specialists There often is little post-test contact with the testing site After testing, recruiting participants immediately after finding out positive results: They are likely to be overwhelmed, still processing the news, etc. Recruiting at the ID clinic, as patient’s first appointment tends to be longer and busy (e.g., completing paperwork, meeting with patient navigator and/or social worker, completing lab work, etc.). May be difficult to find time for Health Educator to meet with patient during this visit. Note: Health Educator should not replace other roles.

6. Challenges Providers and clinic staff relying on Health Educator in ways he is not meant to be used Example: Using him as an interpreter Coordinating with clinic and testing staff Clinic and testing staff may not remember to: Invite potential participants to join our study Ask Health Educator to be present at the site when there is a potential participant.

7. Determining Eligibility Inclusion criteria: Young racially and ethnically diverse MSM and transgender women, ages 16-34, with HIV Fits SPNS initiative criteria of addressing needs of underserved populations with HIV Population is disproportionately affected by HIV Procedure for determining if a participant is eligible for enrollment into intervention: ID clinic, testing sites and other agency partners will refer clients/patients who meet the inclusion criteria to us Screening and enrollment process: Participants will sign informed consent/assent form and complete enrollment form where they will indicate their preferred social media platforms to be used for communication

8. Challenges Age limitations for some participants (e.g., Latinos) that are more in need of assistance because of language barriers and/or difficulty navigating the health system. We have been asked to help with clinic patients over the age criterion in other projects Some potential participants may not feel comfortable revealing their sexual orientation/behavior because of fear of stigma

9. DISCUSSION jalonzo@wakehealth.edu lmann@wakehealth.edu esong@wakehealth.edu srhodes@wakehealth.edu