Project Abstract Sexual and reproductive health (SRH) is a critical public health issue among young people in the U.S., especially as it relates to sexually transmitted infections (STIs). Campaigns promoting STI prevention, contraceptive use, and other preventive health behaviors have demonstrated positive impacts among young people. However, given the massive increases in STI rates, there is a critical need to further these efforts in new and creative venues, to better reach important priority populations. More than 85% of women in the U.S. aged 18-24 years, and almost as many young men, participate in some method of pubic hair removal (PHR). Like barbershops/beauty salons, PHR salons may cultivate a safe, culturally relevant space for estheticians (skincare professionals) to deliver interventions. People who seek PHR services, especially young women and men and sexual/gender minorities (SGMs; e.g., young gay/bisexual men [GBM]), may be at higher SRH risk. Accordingly, PHR salons may exemplify novel and innovative venues for health promotion/risk reduction interventions. Little is known about this setting, and even less is known about estheticians and how these professionals may be engaged in possible intervention efforts. In previous work, the Sexual Health and Estheticians (or SHE) Study, we found that estheticians notice clients’ possible health concerns, such as skin cancer, herpes, genital warts, and evidence of physical abuse. Estheticians’ interactions with clients often turn towards sex-related discussions, creating spaces where otherwise taboo conversations take place with ease, and where estheticians provide resources/support. Accordingly, estheticians may be ideal intervention facilitators. However, how those intervention components may look will depend on additional formative research. Moreover, many estheticians in our initial study did not serve men. Given that men engage in PHR, and GBM especially, this is an important population on which to focus. The objective of this proposed project is to build on the SHE Study, focusing on estheticians who serve men, and determine the acceptability of/feasibility for salon-based interventions. We will accomplish this objective, employing an exploratory sequential mixed method design, via 3 SPECIFIC AIMS: We will 1) Replicate the SHE Study with estheticians who primarily serve men, including GBM. 2) Assess the transferability of SHE Study/AIM 1 findings to a large, national sample of licensed estheticians who perform PHR. 3) Triangulate findings from SHE Study/AIM 1/AIM 2 using focus groups to determine specific components informing the development of a salon-based, esthetician-facilitated, health-related intervention for young people. Information from this research will lead to the development and pilot testing of a mutually beneficial salon- based health promotion and risk reduction intervention (e.g., R21)—designed through a community-engaged research process—and a randomized controlled trial evaluation (e.g., R01). Such innovative efforts are sorely needed to address significant SRH issues that disproportionately affect young people and SGMs.

Project Narrative For young people in the U.S., sexual and reproductive health is a critical public health issue, especially pertaining to sexually transmitted infections (STIs). Campaigns promoting STI prevention, contraceptive use, and other preventive health behaviors have demonstrated many positive impacts among young people; however, given the massive increases in STI rates, there is a critical need to reach young people “where they are”. Since many young men and women in the U.S. visit estheticians (skincare professionals) for their pubic hair removal, estheticians may be ideal, health-adjacent facilitators for health promotion and other risk reduction interventions.