Category Archives: Feature

This content originally appeared on NIDA. View the full article here.

On World AIDS Day, December 1, we remember those lost to the HIV epidemic, take stock of how far we have come, and map the way forward. In the past decades, scientific and community leadership have achieved great things in helping people with HIV live long, healthy lives, as well as reducing HIV transmission through prevention. Yet as the United States grapples with the dual epidemics of HIV and drug overdose, people who use drugs continue to be left behind—especially sexual and gender minorities who are disproportionately impacted by HIV.

But even with multiple forms of HIV prevention now available, including pre-exposure prophylaxis (PrEP) pills for people who are HIV-negative and antiretroviral therapy that can help people with HIV maintain an undetectable viral load and thus not transmit the virus, HIV transmission rates remain frustratingly elevated. Increased methamphetamine use over the past decade may play an overlooked role. A 2020 study in the Journal of Acquired Immune Deficiency Syndromes (JAIDS) showed that a third of new HIV transmissions among sexual and gender minorities who have sex with men were in people who regularly use methamphetamine.

Methamphetamine use is more prevalent among gay and bisexual men than among other men, and it often accompanies sex (sometimes called “partying and playing” or “chemsex”). While in previous decades the mixing of methamphetamine and sex was mainly associated with White gay men, Black and Hispanic men who have sex with men are increasingly using methamphetamine too.

The disinhibiting effects of methamphetamine can increase certain sexual behaviors that make transmission of HIV more likely. There is also evidence that methamphetamine may make the body more vulnerable to HIV acquisition and contribute to HIV disease progression. Methamphetamine use can also lead to other serious health concerns, including addiction and fatal overdose.

In a new NIDA video, “Sex, Meth and HIV,” we highlight that to end the HIV epidemic with the effective tools at our disposal requires that we first recognize and respect the complexity and needs of sexual and gender minorities who use drugs. Like other drugs, methamphetamine may help individuals cope with mental health challenges like depression, anxiety, and trauma. Some gay and bisexual men use methamphetamine to enhance sexual experience and sense of connectedness. It can also temporarily boost self-confidence among individuals who may experience stigma and shame surrounding sexuality or other aspects of their lives.

 

 

For clinicians working to educate patients about health at the intersection of HIV and drug use, understanding the role that methamphetamine plays in an individual’s life is critical to providing quality care.

As Sarit Golub, a City University of New York (CUNY) Hunter College psychologist researching HIV and stigma, says in a companion video for clinicians, “Trust, Stigma and Patient Care,” telling gay and bisexual men about risks of combining drugs and sex can come across as instilling fear and shame, and may alienate rather than empower. As Dr. Golub notes, such communication can disregard the totality of an individual’s needs—for connection, for pleasure, and for confidence in a world that judges and shames.

 

 

Even in healthcare settings, people commonly experience stigma around drug use and sexuality, as well as racism and other forms of discrimination. A history of encountering stigma and discrimination in these settings often leads people to avoid disclosing their substance use and sexual practices with their providers. Clinicians must work with patients to rebuild that lost trust by listening to patients’ concerns rather than imposing their own.

“Meeting people where they are”—that is, providing care regardless of substance use or other behaviors that confer some health risk—has become the guiding philosophy of harm reduction. But it should also apply to prevention and treatment of both HIV and substance use disorders. We cannot hope to reach communities with effective prevention measures such as PrEP without recognizing and accepting the totality of people’s experiences, wants, and needs. Listening and acceptance from others help people take control of their own health. Equally important is to ensure that access and coverage for HIV prevention and treatment are accessible to all who can benefit from them.

Research to find better ways to reach people who use drugs with HIV prevention tools like PrEP, as well as to guide policymakers and insurance providers in ensuring the coverage of these tools, is a key focus area in NIDA’s 2022-2026 Strategic Plan. Expanding education regarding drugs and HIV, reducing stigma, and overcoming other barriers to care are also crucial. Carrico and CUNY School of Public Health researcher Christian Grov (lead author of the JAIDS study) are currently conducting NIDA-funded research on strategies to increase the use of PrEP among sexual minority men who use stimulants, including use of telehealth and incentives (contingency management) to facilitate adherence.

The new videos are the latest in NIDA’s series, “At the Intersection: Stories of Research, Compassion, and HIV Services for People Who Use Drugs.”

As NIH honors World AIDS Day, we particularly remember the people lost to the dual epidemics of HIV and overdose. For those grieving loved ones, NIDA stands among you. Through scientific advancement, NIDA is committed to saving lives. Recovery and healthy, long lives are possible through the use of evidence-based treatments alongside social support.

The 2022 CHIPTS HIV Next Generation Virtual Conference is this upcoming Friday, December 2, 2022 from 9:00 AM – 12:15 PM PT! The conference is VIRTUAL and FREE to attend.

Please REGISTER if you would like to attend.

The goal of this conference is to support the next generation of HIV researchers, HIV prevention and treatment practitioners, and service providers working towards an end to HIV/AIDS through networking and sharing visions for future priorities. The theme of this year’s conference is “Implementation Science for HIV Prevention and Treatment to End the Epidemics.” The conference will feature oral and poster presentations by faculty, student and emerging researchers from various institutions.

• Conference program: 2022 CHIPTS HIV Next Generation Conference Program
• Download agenda only: 2022 CHIPTS HIV Next Generation Conference - Agenda
• Download presenter guidelines: 2022 CHIPTS HIV Next Generation Virtual Conference - Guidelines
• Download oral presentations: 2022 CHIPTS HIV Next Generation Conference Oral Presentations List
• Download poster presentations: 2022 CHIPTS HIV Next Generation Conference Poster Presentations
• Download: Zoom Breakout Room Instructions

CEU credits: Attend the conference, and sign in and out using the form that will be provided to receive credits. The PAETC will follow up post-conference.

The Pacific AIDS Education and Training Center – Los Angeles Area is accredited to provide the following: Continuing LCSW and MFT Education Credit. Courses meet the qualification for a maximum 3.5 hour of continuing education credit for LMFTs, LCSWs, LPCCs, and LEPs as required by the California Board of Behavioral Sciences. Provider #PCE 128280. Continuing Nursing Education Credit. Course is approved for a maximum of 3.5 contact hour by the California Board of Registered Nursing. Provider #15484.

We invite you to take a look at the poster presentations below which will be featured at the 2022 Next Generation Virtual Conference.

 

 

POSTER PRESENTATION 1

Presenter(s):

• Gabriel Edwards, MD, MPH, Associate Project Scientist, Department of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine

Presentation Title: Mobile Enhanced Prevention Support: App Design for People Leaving Jail

Summary: This is a project which received funding as part of the CHIPTS 2022 Mentored Pilot Grant Program. It focuses on a population at high risk for HIV -sexual and gender minorities with a recent history of incarceration and substance use, and aims to gather qualitative data on the way the population engages with mobile technology to address health and social needs. We use an implementation science framework centering around health equity to guide data collection.

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POSTER PRESENTATION 2

Presenter(s):

• Khadesia Howell, MPH, RAND Corporation, Doctoral Student, Pardee RAND Graduate SchooL

Presentation Title: A ‘Think Aloud’ Qualitative Study to Improve Coping with Discrimination and Reduce Health Disparities among Black Sexual Minority Men

Summary: ‘Think Aloud’ is a processes can add depth to the quantitative and qualitative research and gives dimension to thought processes and behavioral responses. There are a variety of studies looking at Black sexual minority men and intersectionality’s impact on mental health and stigma; however, they do not combine ‘Think Aloud’ with self-reported discrimination for a better understanding of the impact of discrimination and stigma on mental health and coping mechanisms.

 

 

POSTER PRESENTATION 3

Presenter(s):

• Aliaa Ibnidris, PhD, Postdoctoral Research Fellow, Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town

Presentation Title: Association of combined antiretroviral therapy with altered brain function and cognition dysfunction in people with HIV

Summary: Neurocognitive impairment in later stages of HIV is common ad still occurs even in controlled HIV infections with combined antiretroviral therapy (cART). This project aims to look at the association between being on cART with brain function as well as with cognitive performance in people with HIV.

 

 

POSTER PRESENTATION 4

Presenter(s):

• Ricardo Mendoza Lepe, PhD, Bilingual Research Coordinator, Bienestar Human Services

Presentation Title: Desde su Persectiva: Inclusivity and Research Community Advisory Boards in Transgender Research

Summary: Meetings to improve research about their communities, learn and be part of their research, learn about research development, and create inclusive and trusted programs for the transgender community.

 

 

POSTER PRESENTATION 5

Presenter(s):

• Amanda P. Miller, MS, PhD, Postdoctoral Fellow, San Diego State University & University of California San Diego (Joint T32 program)

Presentation Title: Evaluating the relationship between hazardous alcohol use andintimate partner violence and PrEP use in pregnant and breastfeeding women at high risk of HIV in Cape Town, South Africa

Summary: HIV, perinatal alcohol use and intimate partner violence (IPV) represent a syndemic that produces a tremendous public health burden for both mother and fetus in South Africa. Contextualizing drivers of alcohol use and risk factors for IPV among pregnant and breastfeeding women and how alcohol use, IPV victimization and other social determinants of health experienced by South African women influence decision making around PrEP use will provide critical insight into potential points of intervention to address these intersecting health issues. We qualitatively explored these themes among pregnant women at high risk of HIV infection who report using alcohol and/or experiencing intimate partner violence during pregnancy.

 

 

 

 

POSTER PRESENTATION 6

Presenter(s):

• Bret Moulton, MPH, Supervising Epidemiologist, Los Angeles County Department of Public Health, Division of HIV and STD Programs

Presentation Title: “Ending the HIV Epidemic” in Los Angeles County: HIV Diagnoses Among Clients Utilizing Free, Mailed HIV Self-Test Kits

Summary: As an emerging strategy to expand HIV testing availability, self-testing can expand screening access to persons who might experience barriers to accessing health care. Since 2020, Los Angeles County has provided free HIV self-test kits through  the mail to targeted residents. One-third of people who ordered a kit reported never testing for HIV before, and 1.1% of participants had an HIV diagnosis within one year

 

 

POSTER PRESENTATION 7

Presenter(s):

• Jada Williams, BS, Graduate Student, UCLA Division of Population Behavioral Health

Presentation Title: Experiences of the COVID-19 Pandemic Among Queer Black Men in Los Angeles: Reflections from a Virtual Listening Session

Summary: The CFAR Health Disparities Core convened a virtual listening session with queer Black men living in Los Angeles to describe the meanings of a shared lived experience, as well as the situations, conditions, and contexts that are part of the lived experience of participants. The current study was designed to better understand the experiences of queer Black men, including experiences associated with their sexual minority and race or racialized identities during the COVID-19 pandemic.

 

 

POSTER PRESENTATION 8

Presenter(s):

• Jocelyn Limas, BSc, Graduate Student Researcher, UCLA Fielding School of Public Health – Epidemiology, UCLA Semel Institute Center for Community Health

Presentation Title: Barriers to PrEP initiation among at-risk youth in Los Angeles and New Orleans

Summary: HIV PrEP uptake among adolescents and young adults remains low, prompting research and interventions to address barriers to PrEP initiation with a focus on expanding PrEP awareness and knowledge. In this analysis, data from a study of the Adolescents HIV Medicines Trial Network (ATN 149) was used to identify other underlying and often overlooked barriers to PrEP initiation amongst this population and how these barriers changed over time.

 

POSTER PRESENTATION 9

Presenter(s):

• Reshmi Mukerji, MPH, Graduate Student, University College London, Institute for Global Health

Presentation Title: Qualitative study of intersectional stigma of HIV and other marginalized identities among women living with HIV in India

Summary: Women living with HIV carry a disproportionate burden of HIV stigma, especially in countries where gender discrimination is rampant. Women who have additional marginalized identities often experience worsened violence as a result of multiple stigmas. The nature of this violence can be temporal in nature, as there is a reduction in enacted and internalized stigma over time.

 

 

POSTER PRESENTATION 10

Presenter(s):

• Ali Mhungu, PhD Student, School of Health Sciences University of Dundee

Presentation Title: Adult Girls and Young Women’s experiences of HIV in the context of patriarchal culture in Murewa, Zimbabwe

Summary: This presentation presents the personal, relational and social experiences of living with HIV amongst the adolescent girls and young women (AGYW). The results of this study indicated that despite being disfranchised by HIV, AGYW demonstrated agency and resilience.

 

 

 

 

 

POSTER PRESENTATION 11

Presenter(s):

• Antwan De’Sean Matthews, BSc, Director Of Youth Programs, Code Tenderloin

Presentation Title: Code Tenderloin Empowering Black Youth Program Provides Incentives And Resources to Address Health Disparities in San Francisco, CA.

Summary: Throughout this workshop, the audience will learn how Nonprofits can effectively provide resources and solutions for the communities they serve through program implementation. Through the EBY program process, students are incentivized to participate in the development of the program by providing financial opportunities throughout the 16 weeks. With a diverse funding source, EBY 2022 cohort funded ten interns at $8,000 per student and three fellows at $10,500 per student. Audience members will have learned by the end of the presentation how to develop effective programs through advocacy and program development and implementation to help address health disparities in their communities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSTER PRESENTATION 12

Presenter(s):

• Vanessa R. Warri, MSW, PhD Student, UCLA Department of Social Welfare, Luskin School of Public Affairs, Center for the Study of Women

Presentation Title: Towards Justice-Centered Futures in Transgender Research: Community-Driven Insights for Repairing and Forging Stronger Academic and Community Relations

Summary: : Robust safeguards against exploitative or harmful research practices related to transgender, gender-expansive, and intersex (TGI) communities have not yet fully been articulated, much less systematically implemented in institutional settings. This presentation offers reflective insights from phase one qualitative interviews of an ongoing collaboration between research universities and TGI communities in California to examine research priorities, ethical considerations, and opportunities to foster greater relationships among TGI and academic research communities

This content originally appeared on HIV.Gov. View the full article here.

Each year on December 1st, we commemorate World AIDS Day. This important awareness day remains a time to reflect on our worldwide response to HIV/AIDS while honoring the lives of those lost to AIDS-related illnesses. On this day, we also renew our commitment to supporting the wellbeing of those with HIV, as well as those at risk for infection.

The U.S. Government (USG) theme for World AIDS Day 2022— Putting Ourselves to the Test: Achieving Equity to End HIV— emphasizes accountability and action, affirming the Biden-Harris Administration’s dedication to ending HIV, both in the United States and around the globe, through an approach that centers on communities disproportionately affected by the pandemic. This year, we observe World AIDS Day in the context of two other infectious disease threats—COVID-19 and monkeypox—which have heavily impacted many of those same communities. These epidemics have further highlighted that our public health response to HIV will require us to address health disparities holistically.

The theme also highlights the importance of HIV testing. “Everyone should get tested for HIV and know their status. We are advancing a status-neutral approach to HIV testing that puts equity at the forefront. Under this approach, no matter what the outcome of the test, people should be connected with the necessary HIV prevention and treatment services, including strategies to address social determinants of health and barriers to access,” said Kaye Hayes, HHS Deputy Assistant Secretary for Infectious Disease and the Director of the Office of Infectious Disease and HIV/AIDS Policy.

We have made remarkable strides since the first World AIDS Day commemoration 34 years ago. Scientific research has yielded innovations in HIV care, treatment, and prevention so that individuals with HIV can enjoy longer, healthier lives. Robust scientific studies have also shown that people who are on HIV medication and achieve and maintain viral suppression cannot spread HIV to others, which means that successful treatment further drives down new transmissions. These advances have been possible due to strategic collaborations between governments, public-sector partners, multilateral institutions, nongovernment and philanthropic organizations, private companies, and research institutions. People with HIV have been central to this progress, and community-based organizations working in areas most affected by HIV are at the forefront of ensuring that the advances we have made translate into real improvements in the health and lives of the people they serve.

Yet despite our tremendous progress, our work is not finished. Globally, there are approximately 1.5 million new cases of HIV every year, including over 35,000 new infections in the United States. Due to stigma, discrimination, and other structural factors, certain populations and geographic areas continue to bear most of the burden of this disease. We remain deeply committed to ending HIV everywhere by engaging and empowering communities, and by ensuring that our programs, research, and policies are informed by the voices of those populations most impacted by HIV.

Globally, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest commitment by any nation to address a single disease in history. Led by the U.S. Department of State in collaboration with seven other USG partner agencies, PEPFAR has worked for the past 19 years with more than 50 countries across the globe to address HIV/AIDS. In collaboration with partnerships across multiple sectors, PEPFAR’s programs have saved more than 21 million lives, prevented millions of HIV infections, and helped countries build a strong foundation to prevent, detect, and respond to other health threats, including COVID-19. “The greatest public health asset and the greatest public health response is PEPFAR. Through collaboration and partnership, we have made considerable progress toward ending the HIV/AIDS pandemic, but the last mile of the response is the greatest challenge. We are working with our multisectoral partners to focus on areas where gaps still exist among key and vulnerable populations to end HIV/AIDS as a public health threat by 2030,” said Ambassador Dr. John Nkengasong, U.S. Global AIDS Coordinator and Special Representative for Health Diplomacy, who leads PEPFAR.

Here in the United States, the Ending the HIV Epidemic in the U.S. (EHE) initiative continues to provide a bold vision for dramatically reducing the number of new HIV cases over the next several years, while the updated National HIV/AIDS Strategy (NHAS), released by President Biden during World AIDS Day last year, provides stakeholders across the nation with a complementary framework for addressing HIV among the populations and communities most impacted. The NHAS Federal Implementation Plan (PDF, 707 KB), released in August 2022, outlines specific actions and activities that various federal agencies will take to achieve the goals set forth in the Strategy.

“This World AIDS Day, we acknowledge the role equity plays in either the success or failure of our Nation’s HIV response. Providing equitable access to HIV testing, prevention, care, treatment, and research is key to ending the HIV epidemic,” said Harold Phillips, Director of the White House Office of National AIDS Policy. “The COVID-19 pandemic has tested our resolve and our ability to focus on ending the HIV epidemic. This World AIDS Day, we must recommit and re-energize all sectors of society to center equity within our HIV response by ensuring that everyone with HIV and those at-risk for infection have access to appropriate HIV testing, treatment, and prevention services. We encourage everyone to get an HIV test and to help us combat HIV-related stigma. As we work to implement the National HIV AIDS Strategy, this year’s theme reminds us that the time has come to act, and for all of us to put ourselves to the test of ending HIV.”

This content originally appeared on the NIAID Newsroom website. View the full article here.

Starting antiretroviral treatment (ART) early in the course of HIV infection when the immune system is stronger results in better long-term health outcomes compared with delaying ART, according to findings presented at the IDWeek Conference in Washington, D.C.

The findings are based on an extended follow-up of participants in the National Institutes of Health-funded Strategic Timing of Antiretroviral Treatment (START) study. In 2015, START demonstrated Exit Disclaimera 57% reduced risk of AIDS and serious non-AIDS health outcomes among participants who began ART when their CD4+ T-cell counts—a key indicator of immune system health—were greater than 500 cells per cubic millimeter (mm³) compared with those who did not begin ART until either their CD4+ counts fell below 350 cells/mm³ or they developed AIDS. Following the 2015 report of these findings, the participants in the deferred treatment arm were advised to begin ART.

Approximately, 1.2 million people in the United States are living with HIV, and roughly 13% do not know they are infected, according to the Centers for Disease Control and Prevention. When HIV diagnosis and treatment are delayed, HIV continues to replicate. This can negatively impact the infected individual’s health and increase the risk of transmitting the virus to others.

The international START study proved the benefit of early ART initiation, but longer-term follow-up of 4,446 participants was undertaken to determine whether the health benefits of early ART compared with deferred ART increased, remained constant, or declined after the participants in the deferred arm were advised to begin ART. The primary study endpoints included the number of participants who developed AIDS; those who developed serious non-AIDS health conditions, such as major cardiovascular disease, kidney failure, liver disease and cancer; and those who died.

For participants who began ART before the end of 2015, the median CD4+ cell count at the time of ART initiation was 648 cells/mm³ for the immediate arm and 460 cells/mm³ for the deferred arm. The analysis presented [on 10/21/22] compared the primary study endpoints before the end of 2015, with those in the extended follow-up period, from Jan. 1, 2016, to Dec. 31, 2021. In the latter period, most deferred-arm participants were taking ART. During the second period, people initiating ART in the deferred group had rapid and sustained declines in HIV viral load (less than or equal to 200 copies/mL); however, CD4+ cell counts remained, on average, 155 cells lower compared with that of individuals in the immediate ART group. While the risk of serious health outcomes was substantially diminished soon after ART was initiated in the deferred treatment group, some excess risk remained compared with the immediate treatment group. The deferred ART group continued to have a somewhat greater risk (21%) of serious health consequences or death in comparison to the immediate treatment group. Twenty-seven cases of AIDS occurred in the five-year follow-up period in the deferred treatment group compared with 15 cases in the early treatment group. Similarly, 88 cases of serious non-AIDS health issues occurred in the deferred treatment arm compared with 76 cases in the immediate treatment arm. Lastly, there were 57 deaths in the deferred treatment group compared to 47 in the immediate treatment arm.

These findings confirm that ART significantly improves the health of an individual with HIV and reduce the person’s risk of developing AIDS and serious health issues, and that early diagnosis and treatment are key to maximizing these benefits and reducing risk, according to the presenters.

The START study and its extended follow up was conducted by the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT), funded in part by the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. It was led by principal investigator James D. Neaton, Ph.D., of the University of Minnesota, Minneapolis, and START study co-chairs Abdel Babiker, Ph.D., of the University College London, and Jens Lundgren, M.D., of the University of Copenhagen.

This content originally appeared on the Fogarty International Center website. View the full article here.

CHIPTS Combination Core Affiliate Dr. Wei-Ti Chen was recognized by the Fogarty International Center for her recently funded project, “Buddhism and HIV Stigma in Thailand: An Intervention Study.” This project is supported by the NIH Climate Change and Health Initiative, which aims to reduce health threats from climate change across the lifespan and build health resilience in individuals, communities, and nations worldwide. Learn more about the NIH Climate Change and Health Initiative and Dr. Chen’s project below.

Scientists internationally agree that climate change threatens human health; the complexity of its impact is enormous. In an effort to include new researchers from multiple disciplines in climate change and health (CCH) research from both the U.S. and low- and middle-income countries, NIH has awarded supplemental funds to fourteen Fogarty projects. All of the awarded projects address at least one of the CCH Initiative’s core pillars—health effects research, health equity, intervention research, and training and capacity building—or one of the priority areas of science identified by the initiative, which include behavioral and social science research, disaster research response, and adaptation research.

Dr. Wei-Ti Chen’s project on “Buddhism and HIV Stigma in Thailand: An Intervention Study” is included in these awarded supplement grants. Thailand remains one of the countries with the largest population of people living with HIV (PLWH) in the Asian-Pacific region. In Thailand, as in other middle-income Asian countries, HIV stigma is a pressing health concern. The purpose of this study is to culturally adapt and evaluate the feasibility of a four-week, two-hour, group-based stigma reduction intervention to promote health engagement.

The scientific premise is that Buddhist-Thai culture provides a unique cultural context for Thai PLWH to understand HIV stigma and suffering. The study hypothesizes that Thai PLWH will display lower internal stigma and more care engagement following the intervention. This study addresses the critical need to optimize care engagement through addressing HIV stigma within local cultural contexts. Its long-term goal is to help establish a comprehensive, culturally-sensitive stigma reduction intervention for Thai PLWH.

In September 2022, CHIPTS and the UCLA-Charles Drew University Center for AIDS Research (UCLA-CDU CFAR) received funding for a total of seven new Ending the HIV Epidemic supplement awards from the National Institutes of Health. These awards support one- and two-year implementation research projects as part of a national effort to enhance the implementation science knowledge base needed for the Ending the HIV Epidemic in the U.S. (EHE) initiative. CHIPTS also received renewal funding for our EHE implementation science hub, the UCLA Rapid, Rigorous, Relevant (3R) Implementation Science Hub.

Learn more about the seven innovative projects that were awarded funding this year below.

CHIPTS

“Financially incentivizing HIV prevention among high-incidence populations in LA County: Preparing for implementation”: This project aims to collect pre-implementation data in order to design an HIV prevention conditional cash transfers (CCT) intervention and implementation strategy for young Black and Latino cisgender men who have sex with men in Los Angeles County. This includes (A) collecting qualitative data about acceptability, appropriateness, and feasibility of this proposed CCT from consumers and key stakeholders (policymakers, service providers, community members, etc.); and (B) conducting a discrete choice experiment to identify the most-preferred attributes of such a CCT. (PIs: Corrina Moucheraud/Raphael Landovitz)

“Implementation Strategies to Promote Equitable Dissemination of Long-Acting injectable PrEP to Black/Latino MSM and Transgender Women in Los Angeles”: This project will use a community-engaged approach to promote the equitable dissemination of long-acting injectable pre-exposure prophylaxis (LAI PrEP) among Black and Latino men who have sex with men and transgender women (BLMSM/TGW) in Los Angeles County (LAC) through informational/educational community workshops and community-derived, culturally appropriate LAI PrEP messaging. The project has three specific aims. Aims 1 and 2 are to increase awareness and knowledge of, and trust and confidence in LAI PrEP as a new HIV prevention option among BLMSM/TGW and providers serving them. Aim 3 is to develop a LAI PrEP strategic messaging guide to support ongoing diffusion of LAI PrEP information by the LAC Public Health Department’s Division of HIV and STD Programs and BLMSM/TGW service providers to facilitate greater community awareness and stimulate community discourse about the use of this new HIV prevention tool among BLMSM/TGW in LAC. (PI: Ronald Brooks)

“De-Medicalizing PrEP by Partnering with House and Ball Community Using Social Work and Guiding Principles: Prioritizing Young Black LGBTQ+ Individuals”: This study will facilitate the involvement of a locally trusted social work provider agency and a community health center to develop and evaluate the effectiveness of non-medicalized social work and community engagement strategies. The study will proceed in 3 phases over 2 years. The Specific Aims of the proposed study are: Aim 1: Examine barriers and challenges affecting the PrEP care continuum among young Black LGBTQ+ members of the House & Ball Community (H&BC); Aim 2: Formalize H&BC empowerment services that facilitate linkages to support and retention services provided at a comprehensive social work and grassroots engagement agency; and Aim 3: Pilot test equity-focused, community-engaged grassroots model approaches that can support the PrEP care continuum for young Black LGBTQ+ members of the H&BC. (PI: Sung-Jae Lee)

“Applying Behavioral Economic Incentives to Support Implementation of PrEP in a Trans Community Center”: This study will be the first test three discrete behavioral economic strategies for implementing PrEP services in a Trans Community Center (TWC). The proposed supplement will leverage the parent study PrEP Well, a 3-year California HIV/AIDS Research Program-funded implementation science grant to bring comprehensive and gender-affirming PrEP services to scale in a first-of-its-kind transgender community center. Aim 1 will assess the acceptability, appropriateness, feasibility, and preliminary effects of the individual identity behavioral economic incentives (IBEI) approach to support the implementation of the PrEP Well program along with overall self-care at TWC. Aim 2 will assess the acceptability, appropriateness, feasibility, and preliminary effects of offering the community-based identity behavioral economics incentives (CBEI) approach to support the implementation of the PrEP Well program at TWC. Aim 3 will assess the acceptability, appropriateness, feasibility, and preliminary effects of offering the staff-based identity behavioral economic incentives (SBEI) approach to support the implementation of the PrEP Well program at TWC. (PI: Erik Storholm)

UCLA-CDU CFAR

“Understanding the implementation of SB 159: Pharmacist delivered pre- and post-exposure prophylaxis in three high priority EHE counties in CA (Los Angeles, Riverside and San Bernardino Counties)”: Pharmacist-delivered PrEP/PEP has the potential to expand access to key biomedical prevention strategies under the EHE Prevention Pillar. This study will inform best practices for pharmacies seeking to expand service delivery to include PrEP/PEP and help to identify what changes in law, policy, and/or funding, if any, will be required to propel pharmacist-delivered PrEP/PEP in California. Tithe aims of this study include: 1) build a coalition of key regional stakeholders to understand implementation barriers and facilitators to pharmacist-delivered PrEP/PEP among key populations; 2) determine differential barriers and facilitators to implementation of pharmacist-delivered PrEP/PEP, targeting geographic areas of vulnerability to HIV and reduced access to PrEP (“PrEP deserts”) compared to “non-PrEP deserts;” and 3) engage a key regional stakeholder coalition to identify locally-based strategies to reduce barriers and enhance facilitators to implementing pharmacist-delivered PrEP/PEP. (PI: Ian Holloway)

“Addressing intersectional oppression in Asian Pacific Americans with HIV in Southern CA: An Implementation Science Framework”: The purpose of this study is to collaborate with the local Asian and Pacific Americans with HIV (APAWH) community to adapt and evaluate the appropriateness, acceptability, feasibility, and preliminary efficacy of a 4-session, 4-week Social justice Oriented, Family Informed self-management intervention to promote health among APAWH in Los Angeles and Orange counties (SOFIAA). The aims include: 1) adapt an evidence-based intervention (the SOFIAA) to address intersectional oppression experienced by APAWH in Southern California, and 2) evaluate the SOFIAA’s implementation outcomes and preliminary effectiveness on APAWH’s mental and physical health. (PI: Wei-Ti Chen)

“Implementing a Community-Engaged Equity Approach to Identify Barriers and Facilitators to the PrEP Care Continuum in Long Beach, CA”: This study is designed to identify individual and structural barriers and facilitators affecting engagement in the PrEP care continuum among BLMSM and transwomen in Long Beach, CA. The aims include: 1) to explore, using qualitative methods, contextually specific barriers to and facilitators of PrEP engagement among BLMSM and transwomen and PrEP services among providers; 2) to obtain, using survey methods, locally relevant estimates of the scope and magnitude of PrEP experiences, barriers and facilitators, and services; and 3) to disseminate and implement study results to increase PrEP care continuum engagement in ways that are meaningful for the Long Beach community. (PI: Laura D’Anna)

If you have any questions about these projects or would like to be connected to a project PI, please contact chipts@mednet.ucla.edu.

This content originally appeared on the UCLA Health Newsroom website. View the full article here.

New UCLA-led research suggests certain gut bacteria — including one that is essential for a healthy gut microbiome – differ between people who go on to acquire HIV infection compared to those who have not become infected.

The findings, published in the peer-reviewed journal eBioMedicine, suggest that the gut microbiome could contribute to one’s risk for HIV infection, said study lead Dr. Jennifer Fulcher, assistant professor of medicine, division of infectious diseases, at the David Geffen School of Medicine at UCLA.

“This is an important area that needs further research to better understand if and how these bacteria could affect HIV transmission,” said Fulcher, who also has an appointment with VA Greater Los Angeles Healthcare System. “Microbiome-based therapies are becoming a hot area of research with great potential. With further research this could be a novel way to help in HIV prevention.”

It is known that there is link between chronic HIV and changes in gut bacteria, Fulcher said. The researchers wanted to get a better understanding of when following HIV infection these changes begin to take place.

To this end, they examined gut microbiome samples from 27 men who have sex with men that were collected both before and after they became infected. They then compared those samples with 28 men who were at similar behavioral risk for infection but did not have HIV.

The samples came from the UCLA-led Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO), a resource and data center for millions of pieces of research, lab samples, statistics and other data aimed at boosting investigations into the effects of substance abuse on HIV/AIDS.

The researchers found that during the first year there was very little change in the infected men’s gut bacteria. They found, however, that the men who acquired HIV had pre-existing differences in gut bacteria, even before they became infected, compared with their uninfected counterparts.

Specifically, these men had decreased levels of Bacteroides species, a type of bacteria prevalent in the lower intestinal tract that have important metabolic functions in maintaining a healthy gut environment, and increased levels Megasphaera elsdenii, whose role in the human gut is not yet known, compared with the uninfected at-risk controls. The researchers also found that prior to infection the men who acquired HIV had elevated inflammatory cytokines and bioactive lipids, both of which are associated with systemic inflammation, indicating that their bodies were constantly on the defense against infection or injury, compared to the matched controls.

Study limitations include the relatively small sample size, and the focus being on only young men who have sex with men, most of whom use drugs, which may reduce its generalizability to other populations.

Study co-authors in addition to Fulcher are Fan Li, Dr. Nicole Tobin, Sara Zabih, Julie Elliott, Dr. Jesse Clark, Steven Shoptaw, Pamina Gorbach, and Dr. Grace Aldrovandi of UCLA; Dr. Richard D’Aquila and Brian Mustanski of Northwestern University; and Michele Kipke of Children’s Hospital Los Angeles and USC.

The study was funded by the National Institute of Allergy and Infectious Diseases (K08 AI124979,  P30 AI117943), National Institute on Drug Abuse (U01 DA036267, U01 DA036939, U01 DA036926, U24 DA044554), National Institute of Mental Health (P30 MH058107, R34 MH105272), the UCLA AIDS Institute, the UCLA Center for AIDS Research (NIAID AI028697), and the UCLA Pediatric AIDS Coalition.

September 27, 2022 – Today, CHIPTS joins partners across the U.S. in observing National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD), a day dedicated to recognizing the disproportionate impact of the HIV epidemic on gay men and promoting HIV prevention and treatment services that allow gay men to live long, healthy lives. In honor of NGMHAAD, we are excited to feature a reflection from CHIPTS Combination Prevention Core Scientist Dr. Michael Li. Read Michael’s reflection below.

In observance of National Gay Men’s HIV/AIDS Awareness Day, it is important to highlight the significant impact of HIV/AIDS on the gay community since the epidemic began over 40 years ago. In recent years, advancements in antiretroviral therapy have allowed people with HIV to live full, healthy lives, and the availability of pre-exposure prophylaxis (PrEP) provides a critical tool for preventing infection. However, there is still much work to be done. HIV continues to disproportionately impact gay, bisexual, and other men who have sex with men (MSM), with findings from the Centers for Disease Control in 2020 showing that 56% percent of people with HIV and 71% of people with new HIV diagnoses are members of these populations.

Understanding the contextual factors driving HIV infections among gay men is necessary to ensure successful approaches to HIV prevention and care for this population. Gay men who experience stigma and discrimination are more likely to be unstably housed, use psychostimulants (e.g. methamphetamine), and develop mental health issues. All of these factors are linked to increased risk of acquiring HIV, reduced access to preventive services such as PrEP, and reduced access to HIV care and antiretroviral therapy. Furthermore, the impact of adverse social experiences on health may not only be explained by behavior, but possibly complex interactions between one’s social environment and the immune system. In research on diverse MSM, recent experiences of homophobia, violence, and housing instability have been linked to dysregulated pro-inflammatory and antiviral gene expression even when accounting for HIV viral load.

Intersectionality also plays a significant role in HIV prevention and healthcare engagement among gay men. How might race, ethnicity, age, disability, class, or other types of “membership” inform one’s preventive and care needs? How might experiences of intersectional stigma impact medical mistrust? As of 2017, it is estimated that about a third of MSM in the US have used PrEP. Although this represents an overall increase since 2014, Black/African American and Latinx gay and bisexual men were still less likely to discuss PrEP with their providers or use PrEP than their White peers. Similarly, though viral suppression has improved by an average of 9.4% per year since 2014, Black/African American MSM are still less likely to be virally suppressed than other MSM with HIV.

As we reflect on NGMHAAD, I encourage HIV researchers and service providers to adopt an intersectional lens and collaborate with the gay community as we work together to address HIV. In doing so, we will be better positioned to address the diverse, whole-person needs of gay, bisexual, and other MSM, and achieve key goals for Ending the HIV Epidemic in this community.

Thursday, September 22, 2022 – CHIPTS hosted a career-development webinar entitled, “Proposal Basics: Preparing Applications for Research Funding” featuring Laura Sheehan, Manager of Research Administration for the Department of Family Medicine in the David Geffen School of Medicine at UCLA. Ms. Sheehan discussed funding opportunities, the fundamentals of preparing a proposal (including creating a budget), and the lifespan of a research project from inception to close-out.

Ms. Sheehan was joined by over 80 graduate students, post-doctoral students, early/mid-career investigators from academic institutions, and others interested in learning about research proposal development. She began by providing a basic overview of the research funding process, including identifying appropriate funding opportunities, exploring different kinds of sponsors, and understanding typical proposal components. The majority of her presentation focused on essential considerations when preparing a research proposal, including tailoring research plans to specific opportunities, creating a budget, organizing your team, building a timeline for submission, and how to avoid common mistakes. She left participants with words of encouragement to “just keep swimming” if a proposal is unsuccessful – if you find the right funding mechanism, follow the guidelines closely, and write a compelling narrative, your research will get funded.

View the recorded webinar here: https://www.youtube.com/watch?v=UGHOxvFvJ_8

Download the webinar slide set here: Proposal Basics: Preparing Applications for Research Funding - Slides

Check out these great resources from Ms. Sheehan’s presentation:

• UCLA Office of Research Administration (ORA) Training Programs 
• UCLA Clinical and Translational Science Institute (CTSI) Funding Search Tools & Grant-Writing Tips
• National Institutes of Health (NIH) Grants & Funding: Developing Your Budget
• NIH Grants Basics: https://grants.nih.gov/grants/grant_basics.htm
• NIH Grants Process Overview: https://grants.nih.gov/grants/grants_process.htm
• UCLA OCGA FAQs: https://ocga.research.ucla.edu/faq/#proposal-preparation

This content originally appeared on HIV.Gov. View the full article here.

As National HIV/AIDS and Aging Awareness Day approaches on September 18, HIV.gov spoke with Harold Phillips, Director of the White House Office of National AIDS Policy. Watch the video to hear him discuss the growing population of people aging with HIV, their specific needs, and what the Federal Government is doing to support this community.

 

Mr. Phillips began by providing data about the population of people aging with HIV. He shared that more than 50% of people with diagnosed HIV are aged 50 and older. Additionally, he noted that there is an estimated 18,000 people in this same age group who have undiagnosed HIV, which significantly affects health outcomes, as they are often late getting into HIV care and treatment, compared to those who are younger.

Regardless of the frequency with which those 50 and older visit healthcare providers, they can be, as Mr. Phillips said, less likely to discuss sex and drug use behaviors with their health providers and be impacted by HIV stigma. He stressed that HIV and aging is an issue of great concern because this population also experiences special challenges and is susceptible to other conditions, such as geriatric illnesses, psychosocial needs, and other non-communicable diseases.

National HIV/AIDS Strategy Federal Implementation Plan

On August 26, 2022, the White House released the National HIV/AIDS Strategy (NHAS) Federal Implementation Plan, an important milestone in implementing the NHAS. The new Plan includes “a number of federal activities to improve the quality of life for those over 50 with HIV,” said Mr. Phillips, as he continued to expound upon what other agencies and programs—including the Health Resources & Services Administration’s (HRSA) Ryan White HIV/AIDS Program, National Institutes of Health-funded research initiatives, the Substance Abuse and Mental Health Services Administration’s (SAMHSA) work on substance use disorder, and CDC’s efforts to scale-up access to HIV testing—are doing to end the HIV epidemic in the United States.

To learn more about HIV and aging and to support National HIV/AIDS and Aging Awareness Day, watch our latest discussion with Mr. Phillips. We also encourage you to visit CDC’s HIV by Age webpage, subscribe to the HIV.gov blog, and check out other federal partner sites—like CDC, HRSA, and SAMHSA—for tools and resources to help you “think about innovative ways to reach, approach, and serve people who are over 50 and living with HIV.”