Posts classified under: People of Color (POC)

Battling Stigma for Service Engagement among Women with HIV in Vietnam

Abstract:Women living with HIV/AIDS (WLHA) bear a higher level of stigma because of their socio-cultural vulnerabilities. Women are more likely to internalize social stigma and produce a sense of shame and loss of self-worth, which results in a delay in health service seeking and compromised health outcomes. In Vietnam, stigma towards WLHA is exacerbated by the deeply rooted female inferiority culture. However, research targeting WLHA is generally lacking. We propose this study to address stigma among WLHA and explore the use of virtual support system in WLHA’s service engagement in Vietnam. The 2-year study will proceed in two phases in Hanoi, Vietnam. Phase 1 will be formative studies, including in-depth interviews with 30 WLHA and focus groups with 20 service providers and community stakeholders. This phase aims to investigate the cultural and contextual background of HIV and gender roles in Vietnam and to identify effective strategies to support and engage WLHA in healthcare. These formative findings will inform the development of an intervention to be pilot tested in the next phase. Phase 2 will be a 6-month intervention pilot with 90 WLHA using an online/offline hybrid approach. During Month 1 of the pilot, WLHA will participate in an in-person section to form mutual support groups and prepare for the following online components. During Month 2-4 of the pilot, study investigators will teach WLHA a series of empowerment strategies to cope with stigma and utilize social support to seek healthcare services. These skills will be taught via interactive online group activities. During Month 4-6, WLHA will self-administer the online groups without the intervention of study investigators. WLHA’s multidimensional stigma measures, mental health burdens, and service use self- efficacy will be assessed at baseline, month 4, and month 6. Progress data of the intervention will be documented to inform the feasibility and sustainability of the online support approach. Acceptability data and feedback will be collected from the WLHA participants upon completion of the 6-month pilot period.

Project Number: 1R21TW012018-01

https://reporter.nih.gov/search/9c5dRBJyvkGOpSB3l9HRSw/project-details/10302007

 

Contact PI/ Project Leader

LIN, CHUNQING,  (lincq@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV stigma and discrimination have enormous negative impacts on women, and reducing internalized stigma has significant implications for the effort to engage women in HIV prevention and care. This proposed study will devise strategies to empower women living with HIV in Vietnam to combat HIV and gender intersectional stigma. This study will lead to implementable and scalable approaches to promote women living with HIV’s mental health and service seeking not only in Vietnam but also globally.

 

 

Project Start Date: 17-September-2021

Project End Date: 31-May-2023

Budget Start Date: 17-September-2021

Budget End Date: 31-May-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF DRUG ABUSE + FOGARTY INTERNATIONAL CENTER / FY Total Cost by IC: $219,421

Engaging Seronegative Youth to Optimize HIV Prevention Continuum

Abstract:Young people at highest risk for HIV in the U.S. will be gay, bisexual transgender youth (GBTY) and homeless youth (HY) in communities with high HIV incidence and overwhelmingly Black and Latino. Focusing on Los Angeles and New Orleans, seronegative youth at highest risk for HIV will be screened in homeless shelters and gay-identified community-based organizations (CBO). A cohort of 1500 seronegative youth will be recruited that is 82% male (79% GBTY), 66% Black, 16% Latino, and 18% white, non-Hispanic. About 27% will be 12-17 and 73% between 18-24 years old. All youth will be followed longitudinally over 24 months at four month intervals and tested for HIV, STI, serious substance abuse, health care utilization, and comorbid conditions – a Prototypical Retention/Prevention (R/P) Strategy. Over 24 months, acutely HIV infected youth will be triaged to Study 1. This Prototypical R/P Strategy operationalizes the CDC’s recommendations for the engagement of GBTY in repeat HIV testing, linkage to care, and options for combination prevention (PrEP, PEP – with behavioral interventions). Building on this team’s extensive experience with behavioral and mobile/social media interventions, a randomized controlled trial (RCT) will be conducted with four intervention conditions: 1) an Automated Messaging and Monitoring Intervention (AMMI), which will use texts to diffuse prevention messages daily and to monitor risk behaviors weekly (n=900); 2) a Peer Support intervention on a social media platform (i.e., Facebook) in which young people will post messages and stories about their experiences preventing HIV, plus the AMMI (n=200); 3) an eNavigator intervention in which a B.A.-level staff supports youth, primarily through texting and social media, but also in-person meetings, to provide support in crisis situations, refer to treatment, and assist in gaining access to health care and other services, plus Peer Support and AMMI (n=200); and, 4) a combined intervention of eNavigator, Peer Support, and AMMI (n=200). A single outcome will be composed of six key behaviors (access to medical care, accessing and adherence to PrEP or PEP, treatment of all STI, and 100% condom use). In addition to evaluating the added benefit of increasing levels of intervention, the brief 7- item weekly text-messaging monitoring surveys will provide approximately 100,000 weekly reports of indicators of primary and secondary outcomes that can inform our understandings about the relationships between risk and comorbid states. This study will have policy implications for the allocation of resources to HIV testing resources in local communities, the uptake and scalability of text and social media interventions, and the models for diffusing evidence-based interventions (EBI) globally (without requiring replication with fidelity to a manual).

Project Number: 5U19HD089886-05

https://reporter.nih.gov/search/4vgAl9SY20-gSBejiQexgQ/project-details/10161248

 

Contact PI/ Project Leader

SWENDEMAN, DALLAS TRAVIS, ASSOCIATE PROFESSOR, CENTER CO-DIRECTOR (dswendeman@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:  Unavailable

 

FOA: RFA-HD-16-035/ Study Section: ZHD1-DSR-N

 

Project Start Date: Unavailable

Project End Date: 31-May-2022

Budget Start Date: 01-June-2020

Budget End Date: 31-May-2021

 

NIH Categorical Spending

Funding IC:  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT / FY Total Cost by IC: $200,503

Emerging Issues in Minority Aging Research

Abstract: Emerging Issues in Minority Aging Research will create five different one-day conferences on current NIA priority areas relevant to minority aging research. The conference series goal is to increase the quality, quantity, and relevance to communities of color of NIA-fundable research by providing both junior and senior researchers with new knowledge and greater interest in these emerging issues as applied to minority elderly. This is significant because the U.S. racial and ethnic minority older population is growing rapidly: minorities will increase from 25% to over 40% of the older population between 2020 and 2050. Protecting and improving the health of these elderly requires a highly skilled research workforce with interests and capabilities to produce new and useful knowledge. Yet the number and success of minority researchers funded by NIH is insufficient. The NIA’s Resource Centers for Minority Aging Research (RCMAR) program works to mentor and train junior faculty who conduct research on minority aging to strengthen the next generation of NIA-funded ethnic and racial minority research and researchers. Conferences topics are: Recruitment and retention of elders of color; Access to care & improved outcomes for cognitively impaired minority elderly; Applying the science of behavior change to intervention development for elders of color; Pragmatic intervention trials with minority elders; and Using biological measures of risk in health disparities research with older adults. Each will feature leading scholars on the topic, top scholars on minority aging, and representatives from multiple NIA-funded centers and networks. The programs will disseminate the state of the art on the topic, inform researchers on how existing research can be modified or expanded to be more valid and relevant for minority elders, and provide resources that can be used by researchers to further develop the fields in research with minority elders. They will be held as preconferences to the Gerontological Society of America (GSA) annual scientific meetings with an average of 50 participants each; the majority will be minorities and/or women. The planning committee will be compromised of the confirmed keynote speakers who are leaders in the field and researchers from RCMAR sites with expertise in the topic. The executive committee will be the RCMAR directors group. The project is innovative in the topics covered, the research networks involved, and the synergy with GSA. Program evaluation includes a process evaluation, a retrospective pre/post knowledge and confidence survey, and four-month follow-up survey on conference impacts. The lead investigators are national leaders in minority and aging research who have successfully led previous GSA preconferences. This proposal is a renewal of the previous successful series with new topics but similar objectives of improving the knowledge and interest in emerging issues supported by NIA among those with research agendas in minority aging and raising awareness of minority aging among leading researchers in each topic.

Project Number: 2R13AG023033-16

https://reporter.nih.gov/search/YfhOgZ8LmEm_RStNdvCEhA/project-details/9913950

 

Contact PI/ Project Leader

WALLACE, STEVEN PAUL,PROFESSOR OF COMM.HEALTH SCI. (SWALLACE@UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:Emerging Issues in Minority Aging Research: This project will create five different one-day conferences on current NIA initiatives that are relevant to minority aging research. The goal of the proposed conference series is to increase the quality, quantity, and relevance to communities of color of NIA-fundable research by providing both junior and senior researchers with new knowledge and greater interest in these emerging issues as they apply to minority elderly.

 

 

Project Start Date: 15-September-2019

Project End Date: 31-May-2024

Budget Start Date: 15-September-2019

Budget End Date:31-May-2020

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON AGING/ FY Total Cost by IC: $50,000

Biobehavioral Research Approaches to reduce Effects of Trauma on Mental and Physical Health and Cognitive Outcomes in South Africa

Abstract: The UCLA/South African Trauma Training Research (Phodiso) Program seeks five additional years of funding to prepare future investigators to conduct research on trauma exposure and injury prevention in the context of South Africa’s high levels of interpersonal and community violence and intentional injuries. The Phodiso Program is an international collaboration between UCLA and the South African Research Consortium (SARC), which includes the Human Sciences Research Council (HSRC), North-West University (NWU), and University of Cape Town (UCT) and is based on a number of NIH-funded projects: 1) The Eban Project, a randomized clinical trial testing a culturally congruent intervention for HIV serodiscordant African American couples (R01; 2001-2009; El Bassel, et al., 2010); 2) The Implementation of the Eban Project, (NIH RO1; 2012-2017) 3) The Aftermath of Rape among South African Women (The Fulufhelo Project), a study examining the short- and long-term psychosocial sequelae of rape among South African women (R03; 2009-2013); and 4) The HIV/AIDS Substance use and Trauma Training Program for racial and ethnic minority postdoctoral scholars and early career investigators (R25; 2013-2018) (Wyatt and Milburn, co-PIs). Guided by ecological theory, social learning theory, and the Sexual Health Model, the focus of the Phodiso Scholar’s research will be to minimize the negative health and mental health effects of trauma exposure, specifically depression and post-traumatic stress disorder (PTSD), in South Africa. An additional emphasis of the training will focus on the neurobiological and neurobehavioral manifestations of trauma, disease, substance use and intentional injury. In the past 10 years of funding, a total of eleven scholars have graduated from the Phodiso program and will join the core SARC and the TAMT, to assist with mentoring new Scholars. For this renewal, the UCLA and SARC core faculty and TAMT will conduct a countrywide application process to select one early career research candidate per year for a two-year postdoctoral fellowship. Scholars will receive research mentorship including a quarter of study (i.e., a 3-month period) at UCLA, one selection and planning meeting and one short-term trauma workshop each year in South Africa. Scholars will conduct their own research projects in South Africa as a basis for future studies in this field, and work closely with their SARC host university and TAMT mentors. The Phodiso Trauma Training program and the research careers of the scholars will be tracked over time. Specifically, the sustainability of the training program and integration into academic, private, and government-supported agencies and the Scholar’s ability to establish and sustain independent research careers will be evaluated and documented. Future goals will include encouraging the South African government to adopt the Phodiso program as a successful and replicable model of cross-cultural trauma research training.

Project Number: 2D43TW007278-11

https://reporter.nih.gov/search/3mBMfcaKOkGk9o8D_fB3Zw/project-details/9232020

 

Contact PI/ Project Leader

WYATT, GAIL E, PROFESSOR (GWYATT@MEDNET.UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Myanmar has experienced one of the most serious HIV/AIDS epidemics in Southeast Asia. Because the country has been isolated from the rest of the world for 50+ years, there are very few researchers and public health specialists trained in advanced research methodologies who can do research to guide HIV/AIDS policy and staff the Myanmar University of Public Health. This program will address that need by providing degree and postdoctoral training in advanced research methodology.

 

 

Project Start Date: 25-May-2005

Project End Date: 31-August-2021

Budget Start Date: 15-September-2016

Budget End Date: 31-August-2017

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER + OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH/ FY Total Cost by IC: $269,997

Understanding and Engaging Families in HIV Biomedical Prevention for Latino Men Who Have Sex with Men

Abstract: This K01 is submitted by Dr. del Pino, Associate Professor, from Charles R. Drew University of Medicine and Science (CDU). This proposal is the next step in his transition from philosophy to public health research. He seeks to reduce HIV disparities among Latino men who have sex with men (MSM) by analyzing family support data from three prospective cohort studies in Los Angeles and Chicago and by conducting formative research to leverage the siblings of Latino MSM in an HIV biomedical prevention intervention. He has published qualitative and quantitative papers on family support, substance use, and HIV. He is currently supported by the CDU Emerging Scholars Award and CRECD. Career Development and Training Plan: Dr. del Pino’s mentoring team includes Dr. Steve Shoptaw (expert in substance use and biomedical interventions), Dr. Nina Harawa (expert in the development of culturally responsive HIV-prevention interventions for MSM of color), and Dr. Arun Karlamangla (expert in complex biostatistical data analysis and longitudinal clinical epidemiology research). The training goals (advanced biostatistics, families and stigma, and intervention development) will be achieved through coursework and individual tutorials with each mentor. He will have access to the UCLA CTSI (NCATS); UCLA CHIPTS (NIMH); and to AXIS, CDU’s center for clinical and translational research resources and trainings (NIMHD). Research Plan: Despite the prevention and treatment efforts of the past 30 years, Latino MSM continue to be disproportionately impacted by HIV. Yet a powerful cultural source of motivation has been underutilized: the family. This project seeks to address HIV disparities by addressing gaps in our knowledge of (a) how family support affects the behaviors and health of Latino MSM over time and (b) how to engage siblings in the development and delivery of PrEP-use messages. Aim 1: Determine how family support and mental health affect the HIV-related behaviors (e.g., substance use, sexual risk) and HIV-related health (e.g., STI, HIV viral load) of Latino MSM over time. Hypothesis: Latino MSM with greater family support over time will report better HIV-related risk behaviors and health outcomes than Latino MSM who report little to no family support. Aim 2: Identify barriers and facilitators to engaging Latino MSM and siblings in HIV biomedical interventions. Aim 3: Develop and pilot test sibling-delivered messages to increase PrEP use in high-risk Latino MSM to gather feasibility and acceptability data and to refine the intervention processes and messages. Summary: The Career Development and Training Plan and the Research Plan will prepare Dr. del Pino to submit an R01 to test the efficacy and effectiveness of a culturally-specific, sibling-based intervention to reduce HIV disparities among Latino MSM. His mentorship team has the required expertise and established record of mentoring junior researchers to ensure that he becomes an independently-funded investigator.

 

Project Number: 1K01MD015002-01

https://reporter.nih.gov/search/XxIAVWiEEUW3kw7szt9ZIg/project-details/9926760

 

 

Contact PI/ Project Leader

HARAWA, NINA THAWATA , PROFESSOR (NHarawa@mednet.ucla.edu)

 

 

Organization

CHARLES R. DREW UNIVERSITY OF MED & SCI

 

 

PUBLIC HEALTH RELEVANCE: Despite the prevention and treatment efforts of the past 30 years, Latino men who have sex with men (MSM) continue to be disproportionately impacted by HIV nationally, and is particularly a problem in Los Angeles, which is a predominantly Latino minority city. Yet a powerful cultural source of motivation for behavior change has been underutilized: the family. The long-term goal of this K01 is for Dr. del Pino to become an independent investigator and national thought leader (1) to expand our understanding of the impact of family relationships on Latino MSM and how to include them in the development and testing of HIV biomedical interventions and (2) to address HIV and other health disparities in diverse sexual and gender minority communities.

 

 

Project Start Date: 29-January-2020

Project End Date: 30-November-2024

Budget Start Date: 29-January-2020

Budget End Date: 30-November-2020

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES / FY Total Cost by IC:$129,465

Youth Services Navigation Intervention for HIV+ adolescents and young adults being released from incarceration: A randomized control trial

Abstract: The continuum of HIV care has forced new focus on the urgency to identify and effectively serve high-need, under-resourced, and often transient populations to facilitate their receiving the necessary ongoing care and antiretroviral therapy (ART) to suppress HIV RNA viral load (VL). Crucial target groups for improving care along the continuum are young (aged 16-25), sexual and gender minority (SGM) populations being released from jail settings. HIV prevalence among incarcerated youth living with HIV (YLWH) is three times that of the general population and one in seven of all HIV+ persons experience incarceration each year. HIV incidence, prevalence, and incarceration rates are higher for blacks and Latinos than for any other group – these disparities are especially prominent among youth. Furthermore, only an estimated 6% of HIV+ youth are virally suppressed, due to poor retention and adherence to ART. Existing linkage and retention services are insufficient to meet the acute needs of criminal justice-involved (CJI) HIV+ youth, particularly in the high-need period following release from incarceration. Moreover, because of their lack of experience, many youths may struggle to obtain needed services and stabilize their living conditions. Disparities in HIV continuum outcomes are inextricably linked to incarceration, substance use disorders (SUDs), homelessness, and mental health (MH) problems among YLWH. If HIV is to be controlled and the benefits of ART experienced broadly, the problems of CJI YLWH must be addressed with innovative, youth-, and sexual and gender minority (SGM)- sensitive approaches. We propose to enroll 240 CJI YLWH, aged 16-25, incarcerated in Los Angeles and Chicago jails and juvenile detention facilities. We will randomize participants to the YSN intervention (n=120) vs. a usual-care control group (n=120). The youth services navigators (YSNs) will assist with addressing immediate unmet needs such as housing, transportation, and food prior to clinical care and ongoing; will guide intervention participants to a range of community services to support progress along the continuum of HIV care; and will provide direct ART adherence support. The proposed study has two Primary Specific Aims: 1. Adapt an existing peer navigation intervention for adults to create a Youth Service Navigation (YSN) intervention sensitive to SGM culture that guides youth to needed services along the continuum of HIV care. This intervention combines medical, substance use and mental health care with comprehensive reentry support for CJI YLWH, aged 16-25 upon release from large county jails and juvenile detention systems; 2. Using a two-group RCT design, we will test the effectiveness of the new YSN, youth SGM-sensitive intervention among CJI YLWH aged 16-25, compared to controls offered standard referrals to services. We will evaluate the YSN Intervention’s effect on post-incarceration linkage, retention, adherence, and viral suppression, as well as on SUDs, mental health, services utilization, and met needs. Secondary Aims: We will assess YSN’s effects on recidivism, costs and potential cost-offset/effectiveness.

 

Project Number:1R01MD011773-01

https://reporter.nih.gov/search/WBAx0xWJNESVugqyMSVW8A/project-details/9395728

 

 

Contact PI/ Project Leader

HARAWA, NINA THAWATA , PROFESSOR (NHarawa@mednet.ucla.edu)

 

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

 

PUBLIC HEALTH RELEVANCE: Crucial target groups for improving care along the Continuum of Care are young (aged 16-25) HIV+ sexual and gender minority youths with criminal-justice involvement (CJI) – a population that is poorly retained in HIV care. If HIV is to be controlled and the benefits of ART advances experienced broadly, the problems of CJI young people living with HIV must be addressed with innovative, youth-, and sexual and gender minority-sensitive approaches. The proposed Youth Services Navigation intervention will address this gap, testing a youth- focused approach that is adapted from our successful intervention with HIV+ CJI adults.

 

 

Project Start Date: 08-August-2017

Project End Date: 31-March-2022

Budget Start Date: 08-August-2017

Budget End Date: 31-March-2018

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES / FY Total Cost by IC: $708,966

EHE Supp: Implementation of an Emergency Department HIV/SUD screening and treatment referral mHealth tool for Latino patient

Abstract: This supplemental application aims to establish a new partnership in the geographic area not yet reached by current EHE efforts. This area consists of two EHE priority counties – Riverside and San Bernardino, collectively called Inland Empire. More than 14,000 individuals live with HIV in the area, and the proportion of undiagnosed infections remains relatively high (18%) and unchanged. Unrecognized HIV infection is the driving force behind the 23% increase in new HIV diagnoses between 2014-2018, as 80% of these new HIV infections can be traced to undiagnosed or out of care individuals. The HIV epidemic in the Inland Empire disproportionately impacts minority populations, as 79% of these new HIV diagnoses were among non-white individuals. Substance use disorder (SUD) is a significant driver of HIV transmission among Latino population, being the cause of one third of new HIV cases in this group. Latino patients are more likely to use health care in emergencies, which suggests a significant number of Latino patients seeking care in the emergency departments (ED) may have undiagnosed HIV infection and concurrent SUD. Loma Linda University (LLU) ED is the only Level 1 Trauma Center in the Inland Empire. It represents an ideal place to consolidate HIV and SUD services and to screen and refer Latino patients to care. Expanding HIV screening in EDs is one of the critical strategies described under the CDC PS20- 2010, supporting EHE programs in the Inland Empire. This is also a strategic priority identified by the local public health departments.

In response, this study will adapt and pilot-test an existing computer-based self-screening intervention to identify Latino ED patients with HIV risk and/or SUD-related HIV risk. This screening will be facilitated by community health workers (CHWs). The CHWs, representing the target patient demographic, will be trained as HIV test counselors. They will provide rapid HIV tests to at-risk patients, required post test counseling, and linkage to appropriate care resources. This proposal will be guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) model. The study team will conduct an ED assessment during the Exploration phase to determine facilitators and barriers to implementing screening intervention. During the Preparation phase, researchers will adapt the existing screening intervention with the help of a multi- disciplinary group meeting weekly for three months. The implementation partners will train CHWs and prepare the LLU ED for a pilot test of the intervention. The Implementation phase will pilot test the intervention, focusing on its acceptability and potential to reach the at-risk Latino population. The Sustainment phase will explore the feasibility of a more extensive evaluation study and the intention to adopt this screening intervention in the LLU ED. The following implementation outcomes will be assessed: feasibility and acceptability of implementing mHealth HIV/SUD screening in the LLU ED, reach and acceptability of this intervention among patients and clinicians, intention to adopt this intervention. This data will be used to inform a more extensive evaluation study.

 

Project Number: 3P30MH058107-25S3

https://reporter.nih.gov/search/RX-fIQI03kaDBfWcJJA_mw/project-details/10395194

 

 

Contact PI/ Project Leader

SHOPTAW, STEVEN J, PROFESSOR (SSHOPTAW@MEDNET.UCLA.EDU)

DUBOV, OLEKSANDR

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

 

PUBLIC HEALTH RELEVANCE: This supplemental application aims to establish a new partnership in the geographic area not yet reached by current EHE efforts. This research aligns with a high-priority research topic (NOT-15-137) – implementing strategies to improve entry into HIV prevention services. Expanding HIV screening in EDs is one of the critical strategies described under the CDC PS20-2010, supporting EHE programs in Riverside and San Bernardino counties.

 

FOA: PA-20-272/ Study Section: Unavailable

 

Project Start Date: 30-September-1997

Project End Date: 31-January-2023

Budget Start Date: 02-July-2021

Budget End Date: 31-January-2023

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES / FY Total Cost by IC: $322,500

Investigating the Impact of Substance Use, Intimate Partner Violence, and COVID-19 on HIV Care Engagement among Young Black Sexual Minority Men with HIV in the US South

Abstract: Among sexual minority men, young Black sexual minority men are the most disproportionately impacted by HIV, with the majority of new infections among sexual minority men occurring among this group. Intimate partner violence (IPV) is one of the most understudied factors that may exacerbate these disparities. Little is known about the impact of substance use and IPV on HIV care continuum (CC) outcomes and HIV transmission risk behaviors among young Black sexual minority men with HIV (YBSMM+). Both IPV and substance use leading to IPV may help explain poorer CC engagement among YBSMM+ and are likely to be exacerbated by the COVID-19 pandemic, which is having devastating health and economic impacts. The COVID-19 pandemic is also likely to interfere with CC engagement and viral suppression. The research that we propose is designed to overcome these gaps and limitations, and to identify modifiable intervention targets for strengthening the CC during times of acute psychosocial and economic stress. We propose to use existing data and to collect new data from the United Black Element+ project (UBE+; R01 MH102171). We will use structural equation modeling to explore the associations between substance use and IPV and their impact on HIV care engagement, viral suppression, condomless anal sex, and to determine if distinct forms of resilience (global resiliency, coping skills, and social support) buffer associations between these relationships among YBSMM+ in the U.S. South. This study can shed new light on the associations between substance use, IPV and CC outcomes and risk and will support the submission of an intervention development grant (R34) to develop a resiliency and advocacy-based intervention that reduces the impact of substance use and IPV on CC engagement and retention among YBSMM+. The project’s focus on the role that resiliency factors may play in moderating harmful effects of substance abuse and IPV among YBSMM+ is innovative. This research can inform the development and adaptation of substance use, IPV, and CC interventions for YBSMM+.

 

Project Number: 1R21DA053164-01

https://reporter.nih.gov/search/OJfd0e_VikGzwfdQswpoGw/project-details/10161009

 

 

Contact PI/ Project Leader

STORHOLM, ERIK D., ASSISTANT PROFESSOR (estorholm@sdsu.edu)

 

Organization

SAN DIEGO STATE UNIVERSITY

 

 

PUBLIC HEALTH RELEVANCE: Young Black sexual minority men (YBSMM) in the US South are disproportionately burdened by HIV. Intimate partner violence (IPV) is one of the most understudied factors that may exacerbate these disparities, yet little is known about the relationship between substance use and IPV, and the combined impact these factors have on the HIV care continuum and HIV transmission risk behaviors among YBSMM living with HIV. The proposed research is designed to overcome these gaps and limitations, and to identify modifiable intervention targets for reducing substance use and IPV risk and strengthening the HIV care continuum by using existing and new data collected from an ongoing cohort study of YBSMM living with HIV in the US South.

 

 

Project Start Date: 01-July-2021

Project End Date:30-June-2023

Budget Start Date: 01-July-2021

Budget End Date: 30-June-2022

 

 

NIH Categorical Spending

Funding IC: OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH / FY Total Cost by IC:$231,383

Promoting Reductions in Intersectional Stigma to Improve HIV Testing and PrEP Use Among Latino Sexual Minority Men

Abstract: HIV prevention continuum disparities persist among Latinos in the U.S., especially those who are immigrants and sexual minority men (SMM). Latinos tend to be diagnosed with HIV (i.e., tested) at a later disease stage and use pre-exposure prophylaxis (PrEP) at much lower rates than do Whites. However, of the existing evidence-based HIV prevention interventions, only one was developed for Latino SMM, and none have yet been developed or assessed for PrEP uptake. Based on the scientific premise and empirical evidence that stigma contributes meaningfully to HIV disparities, we propose to conduct a randomized controlled trial (RCT) of an 8-session cognitive behavior therapy group intervention, Siempre Seguiré (“I will continue being”; named by community stakeholders after a popular song conveying gay empowerment), which aims to increase effective coping responses to stigma from intersectional identities (related to ethnicity, immigration status, and sexual minority identity) among Latino SMM, with the goal of improving HIV prevention continuum outcomes. Siempre Seguiré has a strong scientific basis in our prior pilot work, which found that the proposed intervention is acceptable to key stakeholders, feasible to conduct, and associated with improved effective coping and increased trust in providers and healthcare. The specific aims are: (1) To conduct a randomized controlled trial of Siempre Seguiré, a culturally congruent cognitive behavior therapy group intervention for immigrant Latino sexual minority men, to test intervention effects on regular HIV testing and PrEP uptake; (2) To examine mechanisms of intervention effects on regular HIV testing and PrEP uptake, including more effective coping (e.g., reduced internalized stigma, anticipated stigma, and medical mistrust); and (3) To conduct a cost- effectiveness analysis of the intervention. In the context of an established community-academic partnership, we will conduct the RCT with 300 immigrant Latino SMM, randomizing 150 to the intervention and 150 to an attention control group (a community-based wellness-oriented support group, with sessions matched to the intervention condition in number, timing, and length). Participants will complete surveys at baseline and 3, 6, and 12 months post-baseline to assess the primary outcomes, potential mediators, covariates, and moderators. Regular HIV testing will be confirmed with official copies of HIV testing results, and PrEP uptake will be confirmed through copies of prescriptions, medical records, and urine testing. With the exception of our own work, we are not aware of any interventions that address coping with stigma from intersecting identities in order to improve health outcomes. Our research is consistent with Healthy People 2020, which recommends developing interventions to address effects of stigma among sexual minority individuals. Although structural- level interventions are critical for reducing societal stigma as a long-term strategy, individual-level interventions—such as Siempre Seguiré—are needed in tandem to reduce stigma’s immediate health effects.

 

Project Number:5R01MH121256-03

https://reporter.nih.gov/search/IFI0_tkBV0WwBnvpf1ingA/project-details/10163917

 

 

Contact PI/ Project Leader

BOGART, LAURA M, SENIOR BEHAVIORAL SCIENTIST (LBOGART@RAND.ORG)

 

Organization

RAND CORPORATION

 

 

PUBLIC HEALTH RELEVANCE: Latinos in the U.S., especially those who are immigrants and sexual minority men (SMM), are highly affected by HIV-related disparities, tending to be diagnosed at a later disease stage, leading to delays in antiretroviral treatment use and lower rates of viral suppression. No culturally congruent interventions have been developed to address intersectional HIV-related stigmas, a key contributor to disparities in the HIV prevention continuum among Latino SMM. We propose a randomized controlled trial of an 8-session cognitive behavior therapy group intervention that aims to increase regular HIV testing and PrEP uptake by increasing effective coping responses to intersectional stigmas from ethnicity, immigration status, sexual minority identity, HIV, and PrEP among Latino SMM.

 

 

Project Start Date: 01-August-2019

Project End Date: 31-May-2024

Budget Start Date: 01-June-2021

Budget End Date: 31-May-2022

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF MENTAL HEALTH + NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES / FY Total Cost by IC: $715,688

Evaluating the Feasibility and Acceptability of a Latino MSM Focused PrEP Uptake Intervention

Abstract: HIV disparity persist among Latino men who have sex with men (MSM), especially those who are immigrants. The CDC estimates the lifetime HIV risk is 1 in 5 for Latino MSM compared to 1 in 11 for white MSM. Pre-Exposure Prophylaxis (PrEP) is a biomedical strategy highly effective in preventing HIV acquisition, with the potential to reduce the number of new HIV infections among Latino MSM in the U.S. PrEP involves once daily dosing of medications. The FDA has approved two medications, sold under the brand names Truvada® and Descovy® for daily use as PrEP. The Centers for Disease Control and Prevention (CDC) has established clinical guidelines for administering PrEP to high-risk candidates. While evidence indicates that PrEP use is rising in the U.S., disparities persist in uptake among Latino MSM, despite their reported high levels of interest in using PrEP. To address this disparity, we propose a 2-phase project to develop a pilot PrEP intervention called Estoy PrEParado (I’m PrEPared) to facilitate initiation and adherence to PrEP among immigrant Latino MSM. The project will develop an engaging, culturally tailored intervention using the Information-Motivation-Behavioral Skills (IMB) model. The specific aims of the project are: Aim 1: based on data from a prior study, the project will elicit feedback, validation and modification to the initial content areas of the Estoy PrEParado intervention to facilitate PrEP adoption and adherence among immigrant Latino MSM; and Aim 2: the project will conduct a small randomized pilot of Estoy PrEParado to assess the feasibility, acceptability and preliminary impact of the intervention in moving immigrant Latino MSM along the PrEP cascade to initiation. In formative phase 1, the project will use the innovative and novel World Café approach to facilitate a community conversation with immigrant LMSM (n≈40) to validate, modify and refine the initial intervention content areas of the Estoy PrEParado pilot intervention. The World Café is a powerful conversational process for facilitating constructive group dialogue that produces ideas and knowledge that can be put into practice. The project will also elicit feedback and input on the contents of the intervention from a project-specific Intervention Advisory Committee (IAC) comprised of academic and community experts. In phase 2, the project will conduct a small randomized pilot of 80 participants (40 participants receiving the PrEP intervention and 40 participants receiving standard care, i.e., PrEP referrals) to establish feasibility, acceptability and preliminary impact. If the intervention shows promise, the findings will support the preparation of a larger scale R01 efficacy trial.

 

Project Number: 5R34MH121228-02

https://reporter.nih.gov/search/JhB7cXNmT0WkoNOjh9xCBQ/project-details/10239232

 

 

Contact PI/ Project Leader

BROOKS, RONALD ANDREW, ASSISTANT PROFESSOR (rabrooks@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

 

PUBLIC HEALTH RELEVANCE: For Public Health, it is important to facilitate adoption of PrEP, a highly effective biomedical HIV prevention strategy that can help reduce new HIV infections among immigrant Latino MSM in the U.S. Our study will make use of HIV testing sites as an entry point to enroll participants into our pilot PrEP intervention with information tailored to address the specific needs of immigrant Latino MSM who are considering PrEP for HIV prevention. The insights from this R34 grant will serve as the basis for a subsequent R01 grant application to assess efficacy of the intervention.

 

 

Project Start Date: 15-August-2020

Project End Date: 31-July-2023

Budget Start Date: 01-August-2021

Budget End Date: 31-July-2022

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF MENTAL HEALTH/ FY Total Cost by IC: $214,211

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