LITE CONNECT: Addressing Testing Gaps and Epidemiologic Disparities of COVID-19 Among Transgender People in the United States

Background: Transgender people are a health disparities population with high morbidity and mortality across HIV, mental health, and substance use due to long-standing discrimination and limited access to healthcare. At the start of the COVID-19 pandemic, no data existed on COVID-19 disease or testing access in transgender communities. This study aimed to address this gap by identifying barriers to COVID-19 testing, assess disease burdens, and inform public health interventions tailored for transgender people.

Materials/Methods: The study leveraged the existing LITE cohort of transgender women and expanded it through LITE-CONNECT, a rapid mixed-methods assessment developed with two community-based organizations. LITE-CONNECT enrolled transgender men and women across the U.S. The study characterized access and barriers to COVID-19 testing, provided home-based antibody testing to identify past infection, and linked participants to community-based testing and support services. Data collection included digital methods and community-engaged approaches to ensure reach and relevance.

Outcome/Impact: The study generated new data on COVID-19 disease, testing access, and related disparities among transgender people, including transgender men who were rarely represented in prior research. Findings were used to inform community efforts and national response strategies. The work supported early identification of gaps in testing and care, and guided interventions to improve access and health outcomes for transgender communities during the pandemic.