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ASST_NON_H79TI086854_7522

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

THE MIRIAM HOSPITAL

THE MIRIAM HOSPITAL

COMMUNITY-BASED SUBSTANCE USE TREATMENT AND HIV PREVENTION FOR AFRICAN AMERICAN AND HISPANIC/LATINO MEN WHO HAVE SEX WITH MEN - THE PURPOSE OF OUR PROPOSED PROJECT, "COMMUNITY-AND CLINIC-BASED SUBSTANCE USE TREATMENT AND HIV PREVENTION FOR AFRICAN AMERICAN AND HISPANIC/LATINO MEN WHO HAVE SEX WITH MEN" IS TO INCREASE STATUS NEUTRAL ACCESS TO AND ENGAGEMENT IN CARE FOR RACIAL AND ETHNIC MEDICALLY UNDERSERVED INDIVIDUALS AT RISK FOR OR LIVING WITH SYNDEMIC CONDITIONS INCLUDING SUBSTANCE USE, MENTAL ILLNESS, HIV, VIRAL HEPATITIS, AND MINORITY STRESS. WITH NEARLY 1.1 MILLION RESIDENTS, RHODE ISLAND HAS ONE OF THE HIGHEST PERCENTAGES OF LGBTQ+ RESIDENTS OF ANY STATE IN THE COUNTRY AND THE MAJORITY RESIDE IN PROVIDENCE, THE CAPITAL CITY. PROVIDENCE IS THE EPICENTER OF SUBSTANCE USE IN RHODE ISLAND AND HAS AMONG THE HIGHEST RATES OF ILLICIT DRUG USE IN THE UNITED STATES. DISPARITIES EXIST BETWEEN THE GENERAL POPULATION AND THE LGBTQ+ COMMUNITY WITH HIGHER RATES AND SEVERITY OF SUBSTANCE USE DISORDERS (SUDS) AND CO-OCCURRING MENTAL HEALTH DISORDERS (CODS) AND LOWER RATES OF ACCESS TO- AND ENGAGEMENT IN- SUBSTANCE USE TREATMENT AMONG RACIAL AND ETHNIC MINORITIES WITH INTERSECTIONAL LGBTQ+ IDENTITIES.DESPITE THE LARGE PERCENTAGE OF UNDERSERVED INDIVIDUALS AND THE KNOWLEDGE OF THESE DISPARITIES, RHODE ISLAND DOES NOT HAVE A DEDICATED TREATMENT PROGRAM THAT ADDRESSES THE IMPORTANT AND UNIQUE NEEDS OF RACIAL AND ETHNIC MEDICALLY UNDERSERVED INDIVIDUALS WITH INTERSECTIONAL LGBTQ+ IDENTITIES WHO SUFFER DISPROPORTIONATE RATES OF SYNDEMIC SUBSTANCE USE, CO-OCCURRING MENTAL HEALTH, MEDICAL, AND SOCIAL CONCERNS. . OUR PROPOSED COMMUNITY- AND CLINIC-BASED PROJECT WILL AIM TO ADDRESS THESE UNMET NEEDS BY PROVIDING AFFIRMING, EVIDENCE-BASED, STATUS NEUTRAL, AND INCLUSIVE OUTREACH AND TREATMENT FOR SUD AND CODS FOR 225 INDIVIDUALS FROM THIS UNDERSERVED COMMUNITY IN RHODE ISLAND. ALIGNED WITH OUR PURPOSE, THE GOALS FOR OUR PROJECT INCLUDE: 1) INCREASING ACCESS TO AND ENGAGEMENT IN CULTURALLY CONGRUENT SUD CARE, 2) DECREASING SUBSTANCE USE AND MENTAL HEALTH SYMPTOMS AMONG CLIENTS WHO ENGAGE IN AND COMPLETE OUR PROJECT SERVICES, 3) INCREASING KNOWLEDGE OF MEDICAL STATUSES OF HIV, VIRAL HEPATITIS, AND STDS, 4) DECREASING HIV INFECTIONS, AND 5) PROMOTING PERSONAL AND ORGANIZATIONAL HEALTH LITERACY TO PREVENT THE PERPETUATION OF MINORITY STRESS, STIGMA, AND DISCRIMINATION WHICH CONTRIBUTE TO SUDS AND CODS. OUR PROGRAM GOALS AND DESIGN ARE DERIVED FROM OUR PROCESS OF CENTERING THE VOICES OF THOSE WITH LIVED EXPERIENCES. WE PLAN TO USE A STATUS NEUTRAL APPROACH BY BRAIDING TOGETHER EXISTING RESOURCES WITH THE NEW PROGRAM SERVICES ACROSS SITES TO DECREASE DISPARITIES IN HEALTH AND ATTEND TO "WHOLE PERSON" HEALTH CARE. TO MEET THE NEEDS OF OUR COMMUNITY AND ACCOMPLISH OUR GOALS, THE OBJECTIVES OF OUR PROJECT INCLUDE:) SCREENING AT LEAST 800 RACIAL AND ETHNIC MEDICALLY UNDERSERVED INDIVIDUALS WITH INTERSECTIONAL LGBTQ+ IDENTITIES IN COMMUNITY AND CLINIC SETTINGS; 2) PROVIDING COLLABORATIVE, CULTURALLY CONGRUENT, STATUS NEUTRAL MULTIDISCIPLINARY CARE TO 225 INDIVIDUALS TO ADDRESS THE SYNDEMIC OF SUD, CODS, MEDICAL CONCERNS, AND SOCIAL DETERMINANTS OF HEALTH NEEDS, 3) TESTING FOR HIV, VIRAL HEPATITIS, AND STDS IN THE COMMUNITY AND CLINICS, 4) PROVIDING EDUCATION ABOUT UNDETECTABLE = UNTRANSMISSIBLE AND SUPPORT FOR ADHERENCE AND PREP CARE, AND 5) COLLABORATIVELY CREATING AND ENGAGING IN A DYNAMIC EDUCATIONAL CURRICULUM TO SUPPORT DIVERSITY, EQUITY, INCLUSION, BELONGING, AND ANTI-RACISM ACROSS THE THREE PROGRAM SITES.IN SUMMARY, THE PROJECT WILL PROVIDE CRITICAL SERVICES FOR THE SCREENING AND TREATMENT OF SUBSTANCE USE AND OTHER CO-OCCURRING DISORDERS AMONG RACIAL AND ETHNIC UNDERSERVED INDIVIDUALS WITH INTERSECTIONAL LGBTQ+ IDENTITIES IN THE STATE OF RHODE ISLAND WHICH HAS AMONG THE HIGHEST RATES OF ILLICIT DRUG USE IN THE COUNTRY.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_H79TI086854_7522/

ASST_NON_R01MD019957_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF HOUSTON SYSTEM

UNIVERSITY OF HOUSTON SYSTEM

A NATIONAL TEST OF A CULTURALLY TAILORED MHEALTH INTEGRATED SMOKING CESSATION AND MENTAL HEALTH INTERVENTION FOR BLACK ADULTS WITH HIV - ABSTRACT PEOPLE WITH HIV/AIDS (PWH) ARE TWICE AS LIKELY TO SMOKE CIGARETTES COMPARED WITH THE GENERAL POPULATION. FURTHER, PWH ARE LESS LIKELY TO QUIT SMOKING, LIKELY DUE TO BARRIERS INCLUDING CO-OCCURRING BEHAVIORAL RISK FACTORS, STIGMA, LIMITED RESOURCES, EXPERIENCES OF RACISM AND DISCRIMINATION, AND DIMINISHED ACCESS TO HEALTH CARE. IMPORTANTLY, CIGARETTE SMOKING IS A SIGNIFICANT RISK FACTOR FOR BOTH HIV-RELATED AND NON-HIV-RELATED MORBIDITY AND MORTALITY AMONG PWH. HEALTH DISPARITIES OBSERVED AMONG SMOKERS WITH HIV ARE COMPOUNDED BY THE TENDENCY FOR PWH TO HAVE LOWER INCOMES, LOWER EDUCATION ATTAINMENT, AND LOWER ACCESS TO HEALTHCARE. SUBOPTIMAL RATES OF SMOKING CESSATION AND HIV DISEASE MANAGEMENT AMONG BLACK PWH WHO SMOKE APPEAR TO BE RELATED TO INCREASED EXPOSURE TO INTEROCEPTIVE- STRESS SYMPTOMS (E.G., ANXIETY, BODILY SENSATIONS, STRESS-RELATED BURDEN DUE TO RACISM OR HIV DIAGNOSIS DISCRIMINATION OR STIGMA). CONSEQUENTLY, SMOKING CESSATION INTERVENTIONS AND HIV DISEASE MANAGEMENT DIRECTED TOWARD BLACK PWH WHO SMOKE MIGHT BENEFIT FROM A SPECIFIC FOCUS ON DECREASING EMOTIONAL REACTIVITY TO INTEROCEPTIVE STRESS. ANXIETY SENSITIVITY (AS) IS A CANDIDATE MECHANISM PERTAINING TO THE EXPECTANCY THAT INTEROCEPTIVE SENSATIONS ARE PERSONALLY DANGEROUS, WHICH ESCALATES EMOTIONAL REACTIVITY. YET, ONLY ONE STUDY HAS LEVERAGED THE POTENTIAL OF AS TO BETTER UNDERSTAND SMOKING, HIV DISEASE MANAGEMENT OUTCOMES, AND INTEROCEPTIVE STRESS RELATIONS AMONG BLACK PWH WHO SMOKE. OUR GROUP, ALONG WITH COLLABORATING COLLEAGUES, HAS DEVELOPED SMOKING CESSATION INTERVENTIONS FOR PWH THAT ENGAGE AS TO INCREASE SMOKING CESSATION SUCCESS. EARLY WORK INCLUDED IN PERSON SMOKING CESSATION INTERVENTIONS. OUR MORE RECENT EFFORTS HAVE FOCUSED ON DEVELOPING AND TESTING AN INTEGRATED, CULTURALLY APPROPRIATE, MHEALTH INTERVENTION FOR SMOKING CESSATION, AS REDUCTION, AND HIV DISEASE MANAGEMENT IMPROVEMENT FOR BLACK PWH WHO SMOKE (MASP+). MASP+ TARGETS MULTIPLE HEALTH CONDITIONS THAT INTERFERE WITH SUCCESSFUL AGING: SMOKING, MENTAL HEALTH, AND HIV DISEASE MANAGEMENT. TO DATE, MASP+ HAS ONLY BEEN AVAILABLE TO PATIENTS RECEIVING HIV CARE WITHIN A SINGLE, URBAN COMMUNITY CLINIC. THIS PROPOSAL AIMS TO TEST MASP+ IN A NATIONAL SAMPLE OF PARTICIPANTS WITH TREATED AND UNTREATED HIV. FIRST, WE PROPOSE TO REVIEW ALREADY DEVELOPED MASP+ MATERIALS WITH 30 MEMBERS FROM OUR PRIORITY POPULATION TO ENSURE THEIR APPROPRIATENESS AND THERAPEUTIC FIT. NEXT, WE WILL RECRUIT AND ENROLL 300 BLACK PWH WHO SMOKE TO PARTICIPATE IN A RANDOMIZED CONTROLLED TRIAL (RCT). PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO: (1) MASP+; (2) THE NATIONAL CANCER INSTITUTE (NCI) QUITGUIDE SMARTPHONE APP FOR STANDARD MOBILE SMOKING CESSATION TREATMENT; OR (3) AN ASSESSMENT ONLY CONTROL. PARTICIPANTS WILL COMPLETE A BASELINE ASSESSMENT, DAILY ECOLOGICAL MOMENTARY ASSESSMENTS, AND FOLLOW-UP ASSESSMENTS AT WEEKS 1, 2 (QUIT DATE FOR MASP+ AND QUITGUIDE), 3, 4, 5, 6 (WEEK 6 INCLUDES A QUALITATIVE INTERVIEW FOR A SUBSET OF PARTICIPANTS), 28, AND 54 VIA OUR INSIGHTTM APP. ALL PARTICIPANTS WILL HAVE THE OPTION TO RECEIVE NICOTINE REPLACEMENT THERAPY. IF THE EFFICACY OF MASP+ IS ESTABLISHED, IT WOULD SERVE AS A LOW-BURDEN AND HIGHLY ACCESSIBLE TREATMENT OPTION FOR SMOKING CESSATION, IMPROVED MENTAL HEALTH, AND IMPROVED HIV CARE ADHERENCE/ENGAGEMENT, WHICH ALL SERVE TO SUPPORT SUCCESSFUL AGING AND IMPROVED WELL-BEING.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MD019957_7529/

ASST_NON_R01MD019957_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF HOUSTON SYSTEM

UNIVERSITY OF HOUSTON SYSTEM

A NATIONAL TEST OF A CULTURALLY TAILORED MHEALTH INTEGRATED SMOKING CESSATION AND MENTAL HEALTH INTERVENTION FOR BLACK ADULTS WITH HIV - ABSTRACT PEOPLE WITH HIV/AIDS (PWH) ARE TWICE AS LIKELY TO SMOKE CIGARETTES COMPARED WITH THE GENERAL POPULATION. FURTHER, PWH ARE LESS LIKELY TO QUIT SMOKING, LIKELY DUE TO BARRIERS INCLUDING CO-OCCURRING BEHAVIORAL RISK FACTORS, STIGMA, LIMITED RESOURCES, EXPERIENCES OF RACISM AND DISCRIMINATION, AND DIMINISHED ACCESS TO HEALTH CARE. IMPORTANTLY, CIGARETTE SMOKING IS A SIGNIFICANT RISK FACTOR FOR BOTH HIV-RELATED AND NON-HIV-RELATED MORBIDITY AND MORTALITY AMONG PWH. HEALTH DISPARITIES OBSERVED AMONG SMOKERS WITH HIV ARE COMPOUNDED BY THE TENDENCY FOR PWH TO HAVE LOWER INCOMES, LOWER EDUCATION ATTAINMENT, AND LOWER ACCESS TO HEALTHCARE. SUBOPTIMAL RATES OF SMOKING CESSATION AND HIV DISEASE MANAGEMENT AMONG BLACK PWH WHO SMOKE APPEAR TO BE RELATED TO INCREASED EXPOSURE TO INTEROCEPTIVE- STRESS SYMPTOMS (E.G., ANXIETY, BODILY SENSATIONS, STRESS-RELATED BURDEN DUE TO RACISM OR HIV DIAGNOSIS DISCRIMINATION OR STIGMA). CONSEQUENTLY, SMOKING CESSATION INTERVENTIONS AND HIV DISEASE MANAGEMENT DIRECTED TOWARD BLACK PWH WHO SMOKE MIGHT BENEFIT FROM A SPECIFIC FOCUS ON DECREASING EMOTIONAL REACTIVITY TO INTEROCEPTIVE STRESS. ANXIETY SENSITIVITY (AS) IS A CANDIDATE MECHANISM PERTAINING TO THE EXPECTANCY THAT INTEROCEPTIVE SENSATIONS ARE PERSONALLY DANGEROUS, WHICH ESCALATES EMOTIONAL REACTIVITY. YET, ONLY ONE STUDY HAS LEVERAGED THE POTENTIAL OF AS TO BETTER UNDERSTAND SMOKING, HIV DISEASE MANAGEMENT OUTCOMES, AND INTEROCEPTIVE STRESS RELATIONS AMONG BLACK PWH WHO SMOKE. OUR GROUP, ALONG WITH COLLABORATING COLLEAGUES, HAS DEVELOPED SMOKING CESSATION INTERVENTIONS FOR PWH THAT ENGAGE AS TO INCREASE SMOKING CESSATION SUCCESS. EARLY WORK INCLUDED IN PERSON SMOKING CESSATION INTERVENTIONS. OUR MORE RECENT EFFORTS HAVE FOCUSED ON DEVELOPING AND TESTING AN INTEGRATED, CULTURALLY APPROPRIATE, MHEALTH INTERVENTION FOR SMOKING CESSATION, AS REDUCTION, AND HIV DISEASE MANAGEMENT IMPROVEMENT FOR BLACK PWH WHO SMOKE (MASP+). MASP+ TARGETS MULTIPLE HEALTH CONDITIONS THAT INTERFERE WITH SUCCESSFUL AGING: SMOKING, MENTAL HEALTH, AND HIV DISEASE MANAGEMENT. TO DATE, MASP+ HAS ONLY BEEN AVAILABLE TO PATIENTS RECEIVING HIV CARE WITHIN A SINGLE, URBAN COMMUNITY CLINIC. THIS PROPOSAL AIMS TO TEST MASP+ IN A NATIONAL SAMPLE OF PARTICIPANTS WITH TREATED AND UNTREATED HIV. FIRST, WE PROPOSE TO REVIEW ALREADY DEVELOPED MASP+ MATERIALS WITH 30 MEMBERS FROM OUR PRIORITY POPULATION TO ENSURE THEIR APPROPRIATENESS AND THERAPEUTIC FIT. NEXT, WE WILL RECRUIT AND ENROLL 300 BLACK PWH WHO SMOKE TO PARTICIPATE IN A RANDOMIZED CONTROLLED TRIAL (RCT). PARTICIPANTS WILL BE RANDOMLY ASSIGNED TO: (1) MASP+; (2) THE NATIONAL CANCER INSTITUTE (NCI) QUITGUIDE SMARTPHONE APP FOR STANDARD MOBILE SMOKING CESSATION TREATMENT; OR (3) AN ASSESSMENT ONLY CONTROL. PARTICIPANTS WILL COMPLETE A BASELINE ASSESSMENT, DAILY ECOLOGICAL MOMENTARY ASSESSMENTS, AND FOLLOW-UP ASSESSMENTS AT WEEKS 1, 2 (QUIT DATE FOR MASP+ AND QUITGUIDE), 3, 4, 5, 6 (WEEK 6 INCLUDES A QUALITATIVE INTERVIEW FOR A SUBSET OF PARTICIPANTS), 28, AND 54 VIA OUR INSIGHTTM APP. ALL PARTICIPANTS WILL HAVE THE OPTION TO RECEIVE NICOTINE REPLACEMENT THERAPY. IF THE EFFICACY OF MASP+ IS ESTABLISHED, IT WOULD SERVE AS A LOW-BURDEN AND HIGHLY ACCESSIBLE TREATMENT OPTION FOR SMOKING CESSATION, IMPROVED MENTAL HEALTH, AND IMPROVED HIV CARE ADHERENCE/ENGAGEMENT, WHICH ALL SERVE TO SUPPORT SUCCESSFUL AGING AND IMPROVED WELL-BEING.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MD019957_7529/

ASST_NON_R01DA061345_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF CALIFORNIA, LOS ANGELES

UNIVERSITY OF CALIFORNIA, LOS ANGELES

RACE & PLACE: THE IMPACTS OF RACIAL INEQUALITY ON SUBSTANCE USE AND HIV OUTCOMES IN LOS ANGELES - ABSTRACT IT IS WELL ESTABLISHED THAT RACIAL DISPARITIES IN HIV CARE OUTCOMES AND USE OF SUBSTANCES AMONG SEXUAL MINORITY MEN (SMM) OF COLOR PERSIST BECAUSE OF STRUCTURAL RACISM IN LOS ANGELES COUNTY (LAC). FURTHERMORE, WE KNOW ACCESSIBLE, COMPREHENSIVE, AND CULTURALLY CONGRUENT HEALTHCARE IS KEY TO ACHIEVING RACIAL EQUITY IN HIV AND SUBSTANCE USE (SU) OUTCOMES. PRELIMINARY RESEARCH, INCLUDING OUR OWN STUDIES, INDICATE MAJOR BARRIERS TO CARE INCLUDE HARD TO REACH LOCATIONS OF HIV AND SU CARE, TRANSPORTATION CHALLENGES ACROSS LARGE URBAN SETTINGS SUCH AS LAC, AND LACK OF CONGRUENCE WITH HIV CARE STAFF. WHILE RESEARCH SHOWS THAT HEALTHCARE ACCESS IS IMPORTANT, THERE ARE MIXED RESPONSES OF WHERE BLACK AND LATINX SMM (BLSMM) PREFER TO RECEIVE CARE. THESE FINDINGS UNDERSCORE THE NEED FOR HEALTHCARE EXPERIENCES THAT ADDRESS GEOGRAPHIC CHALLENGES AND ARE CULTURALLY APPROPRIATE. UNDERSTANDING HOW STRUCTURAL RACISM INFLUENCES HOW BLSMM NAVIGATE THE GEOGRAPHY OF LAC TO RECEIVE SU AND HIV CARE AND HOW PEER CASE MANAGERS, WITH RACIAL AND SU CONGRUENCE, MAY ENHANCE ACCESS TO CARE WILL PROVIDE NOVEL INSIGHTS INTO THE RELATIONSHIP BETWEEN RACISM AND HIV AND SU TREATMENT. WE PROPOSE RESEARCH AND ADAPTATION OF AN EVIDENCE-BASED INTERVENTION LINK-LA BUILT ON AN ESTABLISHED NIDA-FUNDED COHORT OF BLSMM, THE MSTUDY (U01DA036267), AND PRELIMINARY FINDINGS OF AN R21 ON SPATIAL CONNECTIONS CONDUCTED BY THIS MULTI-DISCIPLINARY RESEARCH TEAM (DA049643). USING INTERSECTIONAL ANTI-RACISM FRAMEWORKS THE PUBLIC HEALTH CRITICAL RACE PRAXIS (PHCR) AND THE SOCIO-ECOLOGICAL MODEL OF HEALTH AND MIXED METHODS, WE WILL INTERROGATE HOW 1) HISTORICAL RACIST PRACTICES INFLUENCE UNEQUAL SPATIAL PATTERNS AND HOW SUCH UNEQUAL STRUCTURAL FACTORS ARE ASSOCIATED WITH DISTINCT PATTERNS OF MOVEMENT ACROSS SOCIAL AND GEOGRAPHIC SPACE AMONG BLSMM IN LAC AND HOW THESE PATTERNS INFLUENCE WHERE PEOPLE WITH HIV (PWH) ELECT TO RECEIVE CARE; (2) AND HOW PEER CASE MANAGERS WHO BRING ACCESS TO SERVICES AND SUPPORT TO PARTICIPANTS IN THE NEIGHBORHOODS OF THEIR CHOICE IN LAC ENHANCES USE OF SERVICES, THEIR CONTEXTUAL OUTCOMES, AND HIV AND SU OUTCOMES BY ADAPTING AN EBI LINK-LA. OUR PROPOSED STUDY DIRECTLY FITS WITH NIDA’S RACIAL EQUITY INITIATIVE (REI). THE PROPOSED STUDY WILL EXTEND ONGOING COLLABORATIONS BETWEEN THE UNIVERSITY OF CALIFORNIA, LOS ANGELES (UCLA), THE UNIVERSITY OF CALIFORNIA, SANTA BARBARA (UCSB) TEAM, AND WILL BE CO-LED BY THE LOS ANGELES LGBT CENTER RESULTING IN A COMMUNITY-BASED RESEARCH PROGRAM DESIGN THAT IS DIRECTLY INFORMED BY AND RESPONSIVE TO COMMUNITY NEEDS. THIS COLLABORATIVE TEAM OF SCIENTISTS INCLUDES MPIS ACROSS ALL THREE CAREER LEVELS AND COMMUNITY-BASED PRACTITIONERS THAT REPRESENT AN INTENTIONALLY INTERDISCIPLINARY AND COMPREHENSIVE RESPONSE TO RFA-DA-23-061. FINDINGS WILL BE USED TO ESTABLISH ENHANCED HEALTHCARE DELIVERY MODELS THAT IMPROVE RACIAL EQUITY AND REDUCE HIV CARE DISPARITIES.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA061345_7529/

ASST_NON_R01MD019956_7529

Department of Health and Human Services

National Institutes of Health

THEORETICALLY INFORMED BEHAVIORAL INTERVENTION TO ENHANCE QOL AND PREVENT HIV-RELATED COMORBIDITIES IN ETHNIC AND RACIAL SEXUAL MINORITY MEN - PROJECT SUMMARY BLACK AND LATINX GAY AND BISEXUAL MEN ARE AT HIGHEST RISK OF COMORBID CONDITIONS RESULTING FROM HIV. CARDIOVASCULAR DISEASE HAS BECOME THE LEADING CONTRIBUTOR TO MORTALITY AMONG PERSONS WITH HIV, AS BOTH CONDITIONS ARE OFTEN CO-MORBID. THIS IS DUE TO CHRONIC INFLAMMATION, AS A RESULT OF HIV, WHICH INCREASES CVD RISK. AS A RESULT, PROMINENT HIV COMORBID CONDITIONS ALSO INCLUDE HIGH BLOOD PRESSURE AND TYPE II DIABETES MELLITUS. COMPARED TO THE GENERAL POPULATION, CVD RISK IS 1.5 TO 2 TIMES HIGHER IN PEOPLE WITH HIV, AND THIS RISK INCREASES WITH AGE. BY THE YEAR 2030, AN ESTIMATED 78% OF PERSONS WITH HIV WILL BE 50 YEARS OLD OR OLDER, AND NEARLY 80% WILL HAVE ONE OR MORE CHRONIC CONDITIONS. INCREASED RISK OF HIV-RELATED COMORBIDITIES, SUCH AS HEART DISEASE ARE DUE TO RACISM, DISCRIMINATION, AND HOMOPHOBIA, AND INEQUITABLE SOCIAL DETERMINANTS THAT DRIVE CVD RISK (NICOTINE EXPOSURE, DIET QUALITY, LOW PHYSICAL ACTIVITY, INSUFFICIENT SLEEP, HIGH CHOLESTEROL LEVELS, BLOOD PRESSURE, BLOOD SUGAR, AND BODY MASS INDEX). EVEN WHEN HIV VIRAL LOAD IS WELL-CONTROLLED, HIV-INFECTION CAUSES IMMUNE ACTIVATION AND CHRONIC INFLAMMATION, WHICH CAN CAUSE A NARROWING OF BLOOD VESSELS, AND CAN RESULT IN HIGH BLOOD PRESSURE, CHEST PAIN, AND/OR BUILDUP OF PLAQUE IN THE HEART, ULTIMATELY RESULTING IN HEART DISEASE. THE STATUS QUO AS IT PERTAINS TO TRADITIONAL CHRONIC ILLNESS PREVENTION HAS BEEN CONVENTIONAL PATIENT TEACHING IN THE CLINICAL SETTING. HOWEVER, PREVENTION EFFORTS TO THWART HEART DISEASE HAVE NOT REACHED ACCEPTABLE LEVELS TO HAVE A POPULATION IMPACT, AND HAVE MOSTLY FARED BETTER IN HETEROSEXUAL, NON-MINORITIZED POPULATIONS. THE LEARN STUDY IS A PILOT WAITLIST CONTROL TRIAL TO TEST A VIRTUAL ENVIRONMENT AS PREVENTION EDUCATION IN BLACK AND LATINX SEXUAL MINORITY MEN WITH HIV. OUR LEARN FINDINGS SUGGESTED THAT BLACK AND LATINX SEXUAL MINORITY MEN WITH HIV ARE CONCERNED ABOUT HTN, T2DM, CVA, AND CANCER. CANCER RISK WAS DUE TO THE INCREASED RISK OF CANCERS, OTHER THAN AIDS-DEFINING ILLNESSES, AMONG PEOPLE WITH HIV AS WELL AS RISK FOR CARDIOVASCULAR-RELATED COMORBIDITIES. WE PROPOSE A FOLLOW-UP STUDY TO THESE FINDINGS IN LEARN 2 USING AN INNOVATIVE CLINICAL/COMMUNITY-BASED PARTNERSHIP, AN EQUITY-FOCUSED MULTIDISCIPLINARY TEAM, WITH A CULTURALLY SALIENT AND TAILORED VIRTUAL ENVIRONMENT TO PREEMPTIVELY MITIGATE HIV-RELATED COMORBIDITIES WITH SHARED RISK FACTORS THAT DISPROPORTIONATELY AFFECT BLACK AND LATINX SEXUAL MINORITIZED MEN. PROJECT OBJECTIVES ARE TO: 1) TO UTILIZE FORMATIVE RESEARCH TO MODIFY OUR INTERVENTION TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH THAT IMPACT PREVENTION OF SHARED CLINICAL RISK FACTORS FOR HIV-COMORBIDITIES; 2) DETERMINE THE EFFICACY OF LEARN2, AS PREVENTION EDUCATION FOR HIV-COMORBIDITIES; AND 3) TO CONDUCT A PROCESS EVALUATION OF LEARN2 FEASIBILITY AND ACCEPTABILITY AND DETERMINE WHICH INTERVENTION COMPONENTS ARE MOST SUCCESSFUL IN INITIATING CHANGE. THIS PROJECT REPRESENTS A SHIFT IN THE STATUS QUO AND SIGNIFIES A TRAILBLAZING EFFORT THAT LEVERAGES A MULTIDISCIPLINARY TEAM, VIRTUAL TOOLS, AND CLINICAL/COMMUNITY-CENTEREDNESS TO ADVANCE HEALTH EQUITY IN DIVERSE, SEXUAL MINORITY POPULATIONS, WHILE INFORMING RESEARCH, CLINICAL PRACTICE, AND POLICY.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MD019956_7529/

ASST_NON_R01AG078675_7529

Department of Health and Human Services

National Institutes of Health

RUTGERS, THE STATE UNIVERSITY

RUTGERS, THE STATE UNIVERSITY

EXAMINING INFLUENCES OF PLACE-BASED HISTORICAL AND CONTEMPORARY STRUCTURAL RACISM ON RACIAL DISPARITIES IN AGING-RELATED DISEASE RISK TRAJECTORIES: LEVERAGING THE HANDLS DATASET - PROJECT SUMMARY AFRICAN AMERICANS (AA) ARE AT DISPROPORTIONATE RISK FOR EARLIER AND MORE PRONOUNCED COGNITIVE AND FUNCTIONAL DECLINE AND INCREASED FRAILTY. STRUCTURAL RACISM (SR)—THE SYSTEMS AND PROCESSES THAT CREATE AND SUSTAIN RACE- BASED INEQUITIES—IS POSITED AS THE FUNDAMENTAL DRIVER OF ACCELERATED AGING AND MULTI-LEVEL DETERMINANTS THROUGH ITS IMPACT ON THE BUILT AND SOCIAL ENVIRONMENT (BSE). WE POSIT THAT GREATER AND PROLONGED EXPOSURE TO HISTORICAL, ENDURING, AND CONTEMPORARY (HEC) SR-BSE ACROSS THE LIFE COURSE PROMOTES GREATER COGNITIVE AND FUNCTIONAL DECLINES AND INCREASED FRAILTY AMONG AAS. IT REMAINS CRUCIAL TO A) UNDERSTAND THE LONGITUDINAL RELATIONS OF CUMULATIVE, LIFETIME EXPOSURE TO MULTIPLE INDICATORS OF HEC SR-BSE PRACTICES TO COGNITIVE AGING, FUNCTIONAL DECLINE, AND EMERGING FRAILTY; B) DELINEATE VARIATIONS BY RACE, AGE, SEX AND PEROSN-LEVEL SOCIOECNOIC STATUS IN THESE LINKAGES; C) EVALUATE THE ROLE OF INTERPERSONAL DISCRIMINATION IN THIS CONTEXT; AND D) IDENTIFY UNDERLYING MECHANISTIC PATHWAYS OF RISK (E.G., CARDIOMETABOLIC DISEASE) AND RESILIENCE (E.G., SOCIAL CAPITAL). THE CURRENT PROJECT WILL BE THE FIRST TO THOROUGHLY ASSESS AND INTEGRATE THESE GOALS. LINKED TO THE ONGOING HEALTHY AGING IN NEIGHBORHOODS OF DIVERSITY ACROSS THE LIFE SPAN (HANDLS) EPIDEMIOLOGICAL COHORT STUDY, WE PROPOSE AN INVESTIGATION OF UP TO 800 MIDLIFE TO OLDER AA AND WHITE MEN AND WOMEN (AGES 30-64 AT BASELINE), TRACKED UP TO 13 YEARS ACROSS THREE WAVES, RESIDING IN BALTIMORE, MARYLAND. OUR SAMPLE WAS BORN IN BALTIMORE, THE U.S. CITY WITH THE LONGEST HISTORY OF LEGALIZED BSE-BASED STRUCTURAL RACISM. THIS WILL ALLOW DETAILED STUDY OF CUMULATIVE LIFE EXPOSURE TO THE H&C MARKERS WE CHARACTERIZE THROUGH LIFETIME RESIDENTIAL HISTORIES AND CONTEMPORARY ACTIVITY SPACES, OBTAINED BY CALENDAR INTERVIEW AND LEXISNEXIS COMMERCIAL DATA AND LINKED TO RICH ADMINISTRATIVE AND ARCHIVAL DATA FROM THE LAST 100 YEARS. WE WILL FIRST MODEL POTENTIAL INTERACTIVE AND INDEPENDENT RELATIONS OF H&C SR TO LONGITUDINAL CHANGE IN COGNITIVE AND PHYSICAL FUNCTION AND FRAILTY WITH EFFECT MODIFICATION BY RACE AND SEX. WE WILL THEN BUILD STRUCTURAL EQUATION MODELS TO ADDRESS THE DIRECT AND INDIRECT PATHS OF INFLUENCE EXERTED BY H&C SR ON TRAJECTORIES OF CHANGE IN THESE OUTCOMES VIA NEIGHBORHOOD BSE, INTERPERSONAL DISCRIMINATION, AND ADDITIONAL PSYCHOLOGICAL, BEHAVIORAL, AND BIOMEDICAL FACTORS. WE WILL PARTNER WITH THE BALTIMORE NEIGHBORHOOD INDICATORS ALLIANCE TO DISSEMINATE OUR FINDINGS TO SUPPORT LOCAL, ONGOING ADVOCACY AND POLICY WORK FOR TRANSFORMATIVE HEALTH EQUITY CHANGES TO THE BSE, PARTICULARLY AROUND HOUSING. UNDERSTANDING AND DISSEMINATING PATTERNS AND MECHANISTIC PROCESSES LINKING H&C SR TO ACCELERATED COGNITIVE AGING, FUNCTIONAL DECLINE, AND FRAILTY IS CRITICAL TO THE DEVELOPMENT OF APPROPRIATE STRATEGIES TO DISRUPT RACIAL INEQUITIES IN ACCELERATED AGING VIA THE BSES WHERE THEY LIVE.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01AG078675_7529/

ASST_NON_R34MH137775_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF GEORGIA RESEARCH FOUNDATION, INC.

UNIVERSITY OF GEORGIA RESEARCH FOUNDATION, INC.

OPTIMIZING PREP UPTAKE FOR AFRICAN AMERICAN WOMEN IN THE SOUTH BY EMPOWERING WOMEN TO MAKE INFORMED HIV PREVENTION AND SEXUAL HEALTH CHOICES - PROJECT SUMMARY BLACK WOMEN ARE DISPROPORTIONATELY IMPACTED BY HIV ACCOUNTING, FOR 54% OF NEW INFECTIONS WHILE CONSTITUTING ONLY 13% OF WOMEN IN THE US IN 2019. THESE DISPARITIES ARE EVEN MORE PREVALENT IN THE SOUTH. PRE-EXPOSURE PROPHYLAXIS (PREP) IS AN EFFECTIVE BIOMEDICAL PREVENTIVE MEASURE FOR HIV. PREP IS AVAILABLE IN BOTH ORAL AND INJECTABLE FORMULATIONS, PROVIDING OPTIONS FOR ENHANCING PREP UPTAKE AND PERSISTENCE. HOWEVER, PREP IS UNDERUTILIZED AMONG WOMEN, WITH ONLY 10% OF ELIGIBLE WOMEN BEING PRESCRIBED PREP IN 2019. IN THE SOUTH, HISTORICAL RACISM, GENDER-BASED DISCRIMINATION, AND THE ABSENCE OF INTEGRATED FAMILY PLANNING AND PREVENTION-ORIENTED SEXUAL HEALTHCARE COMBINE TO CONTRIBUTE TO LOW PREP USE BLACK WOMEN. SUCH FACTORS INCLUDE: LIMITED PREP AWARENESS, LOW PERCEIVED RISK OF ACQUIRING HIV, HIV-RELATED STIGMA AND DISCRIMINATION, CONCERNS ABOUT SIDE EFFECTS, COSTS, LIMITED MARKETING TO BLACK WOMEN, MEDICAL MISTRUST, AND LIMITED AVAILABILITY AND ACCESS TO PREP. FURTHER, SYSTEMIC RACISM, SEXISM AND CLASSISM, RACE-BASED STEREOTYPES, GENDERED SOCIAL NORMS, AND MICROAGGRESSION MAY RENDER BLACK WOMEN LESS EMPOWERED TO MAKE DECISIONS ON THEIR SEXUAL HEALTH. GIVEN THE COMPLEX INTERPLAY OF HIV-RELATED STIGMA, RACISM AND DISCRIMINATION EXPERIENCED BY BLACK WOMEN, A HOLISTIC APPROACH ENCOMPASSING PREP EDUCATION, ENHANCING ACCESS, BUILDING RESILIENCE, AND SEXUAL EMPOWERMENT HAS THE POTENTIAL TO FACILITATE PREP DELIBERATION, DECISION-MAKING, UPTAKE, AND PERSISTENCE. ALTHOUGH BLACK WOMEN ARE AT HIGHER RISK FOR HIV, LIMITED INTERVENTIONS ARE AVAILABLE TO OPTIMIZE PREP UPTAKE AND PERSISTENCE AMONG THIS POPULATION. THIS STUDY AIMS TO ADDRESS THIS BY DEVELOPING AND PILOT TESTING THE TELEHEALTH INTERVENTION EMPOWER (ENHANCING AND MOTIVATING PREP OPTIONS AMONG WOMEN THROUGH EMPOWERMENT AND RESILIENCE). THE STUDY AIMS INCLUDE: AIM 1. ASSESS THE SEXUAL HEALTH AND PREP- RELATED VALUES, PREFERENCES, PERCEPTIONS AND NEEDS OF BLACK WOMEN TO INFORM DEVELOPMENT OF THE EMPOWER INTERVENTION. GUIDED BY A CONCEPTUAL FRAMEWORK OF INTERSECTING RACIAL AND GENDER-BASED DISCRIMINATION THEORIES (THEORY OF GENDER AND POWER AND THE MINORITY STRESS MODEL), IN-DEPTH INTERVIEWS WILL BE CONDUCTED WITH 20 BLACK WOMEN AND 20 HEALTHCARE PROVIDERS. AIM 2. REFINE THE EMPOWER INTERVENTION AND ONLINE PLATFORM FOR IMPROVING PREP DECISION-MAKING AMONG BLACK WOMEN. AN OPEN TRIAL WITH 20 BLACK WOMEN WILL BE USED TO EVALUATE AND REFINE INTERVENTION CONTENT AND DELIVERY, INTERVENTIONIST TRAINING AND SUPERVISION, FIDELITY RATING, AND STUDY ASSESSMENT PROCEDURES. AIM 3. CONDUCT A WAITLIST-CONTROLLED, RANDOMIZED PILOT TRIAL OF THE 6-SESSION GROUP INTERVENTION USING A CROSS-OVER DESIGN WITH 80 BLACK WOMEN. WE WILL ASSESS THE INTERVENTION’S FEASIBILITY AND ACCEPTABILITY. CLINICAL OUTCOMES WILL BE PREP UPTAKE AND PERSISTENCE MEASURED BY TENOFOVIR DIPHOSPHATE (TDV-DP) CONCENTRATIONS IN DRIED BLOOD SPOT AT BASELINE, 3- AND 6-MONTHS POST-INTERVENTION COMPARED WITH STANDARD OF CARE (OPT-OUT PREP) AT THE INTERVENTION SITE.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R34MH137775_7529/

ASST_NON_R36MH134774_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF CALIFORNIA, SAN DIEGO

UNIVERSITY OF CALIFORNIA, SAN DIEGO

THE EFFECTS OF STRUCTURAL INEQUITIES AND SYNDEMICS ON WILLINGNESS TO PARTICIPATE IN HIV RESEARCH AMONG BLACK WOMEN - PROJECT SUMMARY BLACK WOMEN (BW) IN THE US ARE DISPROPORTIONATELY AFFECTED BY HIV. CONCURRENTLY, BLACK WOMEN FACE SOCIOSTRUCTURAL INEQUITIES INCLUDING STRUCTURAL RACISM, HIV STIGMA, AND MEDICAL MISTRUST, IN ADDITION TO THE SYNDEMIC EFFECTS OF SUBSTANCE USE, AND INTIMATE PARTNER VIOLENCE, AND ADVERSE MENTAL HEALTH. THESE FACTORS ACT AS BARRIERS TO HEALTH SEEKING BEHAVIORS THAT CONTRIBUTE TO POOR HIV OUTCOMES. BW’S PARTICIPATION IN HIV CLINICAL RESEARCH REMAINS HISTORICALLY LOW AND BW’S PARTICIPATION IN HIV RESEARCH (I.E., PREVENTION, TREATMENT, CURE), WHICH REMAINS HISTORICALLY LOW, IS CONTEXTUALIZED WITHIN A SYSTEM THAT DOES NOT CONSIDER THEIR INTERSECTIONAL IDENTITIES (I.E., RACE, GENDER), WHILE ROUTINELY EXCLUDING WOMEN DUE TO BIOLOGICAL (E.G., REPRODUCTIVE POTENTIAL, MENSTRUATION, PREGNANCY), SOCIAL (E.G., RESTRICTIVE CONTRACEPTION REQUIREMENTS, PROVIDER BIAS, PERCEIVED AS “HARD TO REACH”), AND STRUCTURAL FACTORS (E.G., LACK OF WELCOMING RESEARCH SPACES INCLUDING EXTENDED HOURS AND CHILDCARE SUPPORT). WHILE STUDIES HAVE IDENTIFIED FACTORS THAT LIMIT WOMEN’S PARTICIPATION IN HIV RESEARCH, THERE IS LIMITED DATA ON PERCEPTIONS OF HIV RESEARCH PARTICIPATION AMONG BW. THE PREVALENCE OF ILLICIT SUBSTANCE USE (E.G., COCAINE, AMPHETAMINES) AMONG BLACK WOMEN IS HIGHER THAN THE NATIONAL AVERAGE. CONSEQUENTLY, THERE IS A SIGNIFICANT RISK OF BW NOT BENEFITTING FROM HIV RELATED SCIENTIFIC ADVANCES (I.E., ACCESS TO HIV MEDICATIONS, CURATIVE THERAPIES) DERIVED FROM RESEARCH. GUIDED BY SYNDEMIC THEORY AND INTERSECTIONALITY FRAMEWORK, THIS EXPLANATORY SEQUENTIAL MIXED METHODS STUDY WILL UTILIZE A CASE CONTROL APPROACH TO ELUCIDATE THE EFFECTS OF SOCIOSTRUCTURAL INEQUITIES AND PAST-YEAR SUBSTANCE USE, AND PAST-YEAR INTIMATE PARTNER VIOLENCE, AND ADVERSE MENTAL HEALTH ON PARTICIPATION IN HIV RESEARCH AMONG BW (AIM 1). FOR THE CASE-CONTROL PORTION OF THE STUDY, WE WILL RECRUIT, SCREEN, AND MATCH PARTICIPANTS 1:1 ACROSS CASE AND CONTROL GROUPS (N=280, CASES (N=140): PARTICIPATED IN RESEARCH; CONTROLS (N=140): NOT YET PARTICIPATED IN HIV RESEARCH) ALONG FACTORS OF (A) HIV SEROSTATUS AND (B) RECRUITMENT SOURCE (SOCIOBEHAVIORAL, CLINICAL, VACCINE, BIOMEDICAL PREVENTION STUDY AND NON-RESEARCH EFFORTS. UNDERSTANDING THESE EFFECTS ON BW PARTICIPATION IN HIV RESEARCH MAY ELUCIDATE ASPECTS FOR INTERVENTION (E.G., POLICY CHANGES REGARDING STOPPING RULES, MINIMUM PARTICIPANT THRESHOLDS) TO ENSURE MORE DIVERSE STUDY POPULATIONS IN HIV RESEARCH. THE PROPOSED STUDY WILL INCLUDE THREE GROUPS: A) BW ENROLLED IN ONGOING SOCIOBEHAVIORAL RESEARCH STUDIES BY MEMBERS OF THE MENTORING TEAM, LINKPOSITIVELY (R34MH122014; PI: STOCKMAN) AND WOMEN SHINE; (R01MH125785 PI STOCKMAN) WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES (N=40), B) BW WITH HISTORIES OF RESEARCH PARTICIPATION WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES, AND THOSE SEEKING CARE AT AIDS CLINICAL TRIALS GROUP CLINICAL RESEARCH SITES WITHOUT A HISTORY OF RESEARCH PARTICIPATION (N=65), C) PARTICIPATED IN LINKPOSITIVELY (GRANT #R34MH122014; PI: STOCKMAN; N=70), AN MHEALTH HIV INTERVENTION FOR BWH IN CALIFORNIA AND OKLAHOMA AFFECTED BY INTERPERSONAL VIOLENCE, C) PARTICIPANTS OF THE ENHANCED PEER INVOLVEMENT IN CARE AMPLIFYING THE VOICES OF BW (EPIC) PROGRAM EMBEDDED WITHIN EXISTING PEER NAVIGATION PROGRAMS IN COMMUNITY-BASED ORGANIZATIONS LOCATED IN ENDING THE HIV EPIDEMIC JURISDICTIONS IN THE SOUTHERN UNITED STATES, AND D) BW WITHOUT HIV AND WITH HISTORIES OF RESEARCH PARTICIPATION WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES AND THOSE SEEKING CARE AT AN HIV VACCINE TRIALS NETWORK CLINICAL RESEARCH SITE WITHOUT A HISTORY OF RESEARCH PARTICIPATION (N=140). NEXT, WE WILL QUALITATIVELY EXPLORE PERCEPTIONS OF AND FACILITATORS AND BARRIERS TO PARTICIPATION IN HIV RESEARCH AMONG BW WITH AND WITHOUT HIV (AIM 2).THE PROPOSED STUDY, WHICH IS IN RESPONSE TO PAR-22-172, WILL SUPPORT THE SCIENTIFIC INVESTIGATION BY UNDERREPRESENTED PRE- DOCTORAL STUDENTS, AND IS THE FIRST TO ATTEMPT TO QUANTIFY AND CONTEXTUALIZE THE IMPACTS OF SOCIOSTRUCTURAL INEQUITIES AND SYNDEMICS ON BW’S WILLINGNESS TO PARTICIPATE IN HIV RESEARCH TO INFORM MULTILEVEL EFFORTS AND INTERVENTIONS TO CONDUCT EQUITABLE AND DIVERSE RESEARCH.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R36MH134774_7529/

ASST_NON_R01DA059240_7529

Department of Health and Human Services

National Institutes of Health

FLORIDA STATE UNIVERSITY

FLORIDA STATE UNIVERSITY

CHARACTERIZING INTERSECTIONAL GEOSPATIAL STIGMA AND AFFIRMATION LANDSCAPES AND THEIR INFLUENCE ON BLACK AND LATINO BISEXUAL MEN AT RISK FOR SUBSTANCE ABUSE AND HIV - PROJECT SUMMARY GUIDED BY FUNDAMENTAL CAUSE THEORY WITH INNOVATIVE METHODOLOGIES, THIS PROPOSAL EXAMINES THE IMPACT OF GEOSPATIAL INTERSECTIONAL STIGMA AND AFFIRMATION ON SUBSTANCE USE AND HIV RISK AMONG BISEXUAL BLACK AND LATINO MEN. BISEXUAL MEN EXPERIENCE CO-MORBID HEALTH DISPARITIES INCLUDING ELEVATED SUBSTANCE USE AND HIV RISK. BLACK AND LATINO MEN ARE DISPROPORTIONATELY REPRESENTED IN BISEXUAL POPULATIONS RELATIVE TO THE GENERAL POPULATION IN THE UNITED STATES MAKING UP 45% OF BISEXUAL MEN. BISEXUAL BLACK AND LATINO MEN EXPERIENCE ELEVATED SUBSTANCE USE AND HIV RISK RELATIVE TO HETEROSEXUAL BLACK AND LATINO MEN. ONE CONTRIBUTING FACTOR IS STIGMA. INTERSECTIONALITY INFORMS US THAT BISEXUAL BLACK AND LATINO MEN EXPERIENCE A RANGE OF STIGMA TYPES INCLUDING BINEGATIVE STIGMA BASED ON THEIR SEXUAL IDENTITY, RACIST STIGMA, SUBSTANCE USE STIGMA, AND HIV STIGMA. WHILE STIGMA IS THEORIZED TO BE MULTILEVEL AND INTERSECTIONALITY EXPERIENCES HAVE CALLED FOR GEOSPATIAL EXAMINATIONS OF STIGMA, FEW STUDIES HAVE SOUGHT TO MEASURE STIGMA GEOSPATIALLY. THIS PROPOSAL SEEKS TO ADDRESS THESE LIMITATIONS BY FIRST COLLECTING A GENERAL SAMPLE OF ADULTS TO GENERATE GEOSPATIAL STIGMA SCORES THEN USING ECOLOGICAL MOMENTARY ASSESSMENT (EMA) TO QUANTIFY ACTIVITY SPACE FOR A SAMPLE OF BISEXUAL BLACK AND LATINO MEN INCLUDING MOMENTARY ASSESSMENTS OF SUBSTANCE USE AND HIV RISK. THIS WILL BE ADDRESSED THROUGH 3 SPECIFIC AIMS: AIM 1: DESCRIBE GEOSPATIAL DISTRIBUTION OF INTERSECTIONAL STIGMA IN COOK COUNTY, IL AND PALM BEACH COUNTY, FL INCLUDING BI-NEGATIVITY, RACISM, SUBSTANCE USE STIGMA AND HIV STIGMA. APPROACH. WE WILL GENERATE GEOSPATIAL STIGMA SCORES THROUGH A HOUSEHOLD-BASED PROBABILITY SAMPLE OF THE GENERAL ADULT POPULATION (N = 2,000 ). SURVEY RESPONSES WILL BE GEOCODED TO GENERATE GEOLOCATED AVERAGES OF STIGMA SCORES. HYPOTHESIS. THERE WILL BE UNEQUAL DISTRIBUTION OF STIGMA INCLUDING AREAS OF INCREASED OR DECREASED STIGMA. AIM 2: EXAMINE THE IMPACT OF GEOSPATIAL STIGMA ON THE RELATIONSHIP BETWEEN SUBSTANCE USE AND HIV RISK. APPROACH. WE WILL LINK GEOSPATIAL ESTIMATES OF STIGMA GENERATED IN AIM 1 TO A SECOND SURVEY SAMPLE OF HIV- BLACK AND LATINX BISEXUAL MEN USING EMA TO CAPTURE ACTIVITY SPACE (N = 600 ). HYPOTHESIS. BISEXUAL MEN WHO RESIDE OR HAVE ACTIVITY SPACES IN AREAS WITH HIGHER STIGMA WILL BE MORE LIKELY TO USE SUBSTANCE, AND ENGAGE IN HIV RISK BEHAVIORS, WHILE ACCESS TO AFFIRMING SOCIAL RESOURCES WILL BUFFER AGAINST GEOSPATIAL STIGMAS. AIM 3: ANALYZE QUALITATIVE PERSPECTIVES ON THE IMPACTS OF INTERSECTING STIGMAS ON SUBSTANCE USE AND HIV RISK IN BISEXUAL MEN, PROVIDER INTERACTIONS, AND MESSAGING. APPROACH. WE WILL COLLECT QUALITATIVE INTERVIEWS WITH BISEXUAL MEN (N = 48), AND KEY INFORMANTS (N = 24) ADDRESSING PERSPECTIVES ON THE IMPACT OF STIGMA ON SUBSTANCE USE AND ACCESS TO HIV PREVENTION AND COMMUNITY SERVICES AS WELL AS PREFERENCES FOR PREVENTION MESSAGING. FINDINGS WILL INFORM THE DEVELOPMENT OF MULTILEVEL INTERVENTION STRATEGIES.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA059240_7529/

ASST_NON_R01DA061324_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF MARYLAND, BALTIMORE

UNIVERSITY OF MARYLAND, BALTIMORE

PEER BEHAVIORAL ACTIVATION UTILIZATION TO ADDRESS STRUCTURAL RACISM AND DISCRIMINATION AND IMPROVE HIV OUTCOMES IN HIGH-RISK, SUBSTANCE-USING POPULATIONS- PUSH - BACKGROUND. SUBSTANCE USE CONTINUES TO BE A MAJOR DRIVER OF HIV ACQUISITION AND HAS BEEN ASSOCIATED WITH SUBOPTIMAL ART ADHERENCE, TREATMENT INTERRUPTION, AND INABILITY TO ACHIEVE OR MAINTAIN VIRAL SUPPRESSION.1 USE OF PREP, A KEY TOOL FOR HIV PREVENTION, IS DISPROPORTIONATELY LOWER IN RACIAL/ETHNIC MINORITIES, AS WELL AS PEOPLE WHO INJECT DRUGS. FACTORS RELATED TO STRUCTURAL RACISM AND DISCRIMINATION (SRD) MAY CONTRIBUTE TO LOW RATES OF ADHERENCE IN THESE POPULATIONS.2 NEW LONG-ACTING INJECTABLE (LAI) FORMULATIONS OF PREP/ART PROVIDE A POTENTIAL BIOMEDICAL INTERVENTION TO OVERCOME ADHERENCE CHALLENGES, HOWEVER, DUE TO THE PROLONGED SUBTHERAPEUTIC PERIOD AFTER LAI DISCONTINUATION, ENSURING ADHERENCE IS CRUCIAL. A PEER-DELIVERED REINFORCEMENT-BASED INTERVENTION MAY BE A PROMISING SOLUTION FOR IMPROVING LAI ADHERENCE. OUR TEAM HAS DEVELOPED THROUGH SEVERAL ROUNDS OF STAKEHOLDER FEEDBACK A PEER-DELIVERED BEHAVIORAL ACTIVATION AND PROBLEM-SOLVING INTERVENTION, PEER ACTIVATE. PEER ACTIVATE FOCUSES ON PROBLEM-SOLVING SKILLS TO IMPROVE ADHERENCE TO ART AND/OR PREP BOTH AT THE INDIVIDUAL LEVEL AND SOCIAL/STRUCTURAL BARRIERS TO CARE (I.E., TRANSPORTATION, HOUSING) AND INCLUDES BEHAVIORAL ACTIVATION TO PROMOTE ENGAGEMENT IN REWARDING, SUBSTANCE-FREE ACTIVITIES IN ONE'S ENVIRONMENT AND STRUCTURED DAILY ACTIVITIES TO PROMOTE TREATMENT ADHERENCE. DELIVERY BY A PEER WITH FORMAL TRAINING AND SHARED LIVED EXPERIENCES ENHANCES THE IMPACT OF THE INTERVENTION ON SRD-RELATED FACTORS. HOWEVER, PEER ACTIVATE HAS NOT BEEN EVALUATED IN THE CONTEXT OF LAI PREP/ART. PRELIMINARY STUDIES. THIS PROPOSAL BUILDS UPON OUR TEAM'S PRIOR STUDIES DEMONSTRATING 1) OUR ABILITY TO ENGAGE PATIENTS WITH AND AT RISK FOR HIV, FACING MULTIPLE BARRIERS DUE TO SRD, AND PROVIDE LAI PREP/ART IN COMMUNITY-BASED SETTINGS; 2) THE FEASIBILITY AND ACCEPTABILITY OF PEER ACTIVATE AND PROMISE IN IMPROVING HIV TREATMENT ADHERENCE FOR PEOPLE WHO USE SUBSTANCES.; AND 3) PROMISE FOR COST-EFFECTIVENESS. APPROACH. WE PROPOSE A RANDOMIZED TYPE 1 HYBRID EFFECTIVENESS-IMPLEMENTATION TRIAL (N=186) TO TEST THE EFFECTIVENESS AND IMPLEMENTATION OF PEER ACTIVATE FOR LAI PREP/ART (“PEER ACTIVATE-LAI”) VS. ENHANCED TREATMENT AS USUAL FOR A PREDOMINANTLY BLACK SUBSTANCE USING POPULATION LIVING WITH OR AT HIGH RISK FOR HIV, EVALUATING THE FOLLOWING OVER 12 MONTHS: (1) EFFECTIVENESS: A) LAI PREP/ART ADHERENCE (PRIMARY; RECEIPT OF ALL 6 MAINTENANCE INJECTIONS WITHIN 7-DAY WINDOW); B) SUBSTANCE USE (SECONDARY; URINE TOXICOLOGY, SELF-REPORT); C) SRD AS MODERATORS OF EFFECTIVENESS (EXPLORATORY); (2) IMPLEMENTATION OF PEER ACTIVATE-LAI INCLUDING FEASIBILITY, ACCEPTABILITY, FIDELITY, AND ADOPTION GUIDED BY RE-AIM AND PROCTOR'S MODEL,9,10 ASSESSED USING MIXED METHODS, INCLUDING A RAPID ETHNOGRAPHIC ASSESSMENT OF HOW SRD-RELATED FACTORS MAY AFFECT IMPLEMENTATION; AND (3) ECONOMIC VIABILITY OF PEER ACTIVATE-LAI, INCLUDING COST OF IMPLEMENTATION AND SUSTAINMENT AND COST- EFFECTIVENESS FROM MULTIPLE STAKEHOLDER PERSPECTIVES. IMPLICATIONS. THIS STUDY WILL INFORM A POTENTIALLY SCALABLE, COST-EFFECTIVE MODEL FOR FACILITATING EFFECTIVE ADHERENCE TO LAI FORMULATIONS OF ART/PREP WITHIN BLACK, SUBSTANCE USING POPULATIONS WHO TO DATE HAVE HAD LIMITED SUPPORT FOR IMPROVING LAI ADHERENCE FOR HIV ART/PREP.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA061324_7529/

ASST_NON_R36MH134774_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF CALIFORNIA, SAN DIEGO

UNIVERSITY OF CALIFORNIA, SAN DIEGO

THE EFFECTS OF STRUCTURAL INEQUITIES AND SYNDEMICS ON WILLINGNESS TO PARTICIPATE IN HIV RESEARCH AMONG BLACK WOMEN - PROJECT SUMMARY BLACK WOMEN (BW) IN THE US ARE DISPROPORTIONATELY AFFECTED BY HIV. CONCURRENTLY, BLACK WOMEN FACE SOCIOSTRUCTURAL INEQUITIES INCLUDING STRUCTURAL RACISM, HIV STIGMA, AND MEDICAL MISTRUST, IN ADDITION TO THE SYNDEMIC EFFECTS OF SUBSTANCE USE, AND INTIMATE PARTNER VIOLENCE, AND ADVERSE MENTAL HEALTH. THESE FACTORS ACT AS BARRIERS TO HEALTH SEEKING BEHAVIORS THAT CONTRIBUTE TO POOR HIV OUTCOMES. BW’S PARTICIPATION IN HIV CLINICAL RESEARCH REMAINS HISTORICALLY LOW AND BW’S PARTICIPATION IN HIV RESEARCH (I.E., PREVENTION, TREATMENT, CURE), WHICH REMAINS HISTORICALLY LOW, IS CONTEXTUALIZED WITHIN A SYSTEM THAT DOES NOT CONSIDER THEIR INTERSECTIONAL IDENTITIES (I.E., RACE, GENDER), WHILE ROUTINELY EXCLUDING WOMEN DUE TO BIOLOGICAL (E.G., REPRODUCTIVE POTENTIAL, MENSTRUATION, PREGNANCY), SOCIAL (E.G., RESTRICTIVE CONTRACEPTION REQUIREMENTS, PROVIDER BIAS, PERCEIVED AS “HARD TO REACH”), AND STRUCTURAL FACTORS (E.G., LACK OF WELCOMING RESEARCH SPACES INCLUDING EXTENDED HOURS AND CHILDCARE SUPPORT). WHILE STUDIES HAVE IDENTIFIED FACTORS THAT LIMIT WOMEN’S PARTICIPATION IN HIV RESEARCH, THERE IS LIMITED DATA ON PERCEPTIONS OF HIV RESEARCH PARTICIPATION AMONG BW. THE PREVALENCE OF ILLICIT SUBSTANCE USE (E.G., COCAINE, AMPHETAMINES) AMONG BLACK WOMEN IS HIGHER THAN THE NATIONAL AVERAGE. CONSEQUENTLY, THERE IS A SIGNIFICANT RISK OF BW NOT BENEFITTING FROM HIV RELATED SCIENTIFIC ADVANCES (I.E., ACCESS TO HIV MEDICATIONS, CURATIVE THERAPIES) DERIVED FROM RESEARCH. GUIDED BY SYNDEMIC THEORY AND INTERSECTIONALITY FRAMEWORK, THIS EXPLANATORY SEQUENTIAL MIXED METHODS STUDY WILL UTILIZE A CASE CONTROL APPROACH TO ELUCIDATE THE EFFECTS OF SOCIOSTRUCTURAL INEQUITIES AND PAST-YEAR SUBSTANCE USE, AND PAST-YEAR INTIMATE PARTNER VIOLENCE, AND ADVERSE MENTAL HEALTH ON PARTICIPATION IN HIV RESEARCH AMONG BW (AIM 1). FOR THE CASE-CONTROL PORTION OF THE STUDY, WE WILL RECRUIT, SCREEN, AND MATCH PARTICIPANTS 1:1 ACROSS CASE AND CONTROL GROUPS (N=280, CASES (N=140): PARTICIPATED IN RESEARCH; CONTROLS (N=140): NOT YET PARTICIPATED IN HIV RESEARCH) ALONG FACTORS OF (A) HIV SEROSTATUS AND (B) RECRUITMENT SOURCE (SOCIOBEHAVIORAL, CLINICAL, VACCINE, BIOMEDICAL PREVENTION STUDY AND NON-RESEARCH EFFORTS. UNDERSTANDING THESE EFFECTS ON BW PARTICIPATION IN HIV RESEARCH MAY ELUCIDATE ASPECTS FOR INTERVENTION (E.G., POLICY CHANGES REGARDING STOPPING RULES, MINIMUM PARTICIPANT THRESHOLDS) TO ENSURE MORE DIVERSE STUDY POPULATIONS IN HIV RESEARCH. THE PROPOSED STUDY WILL INCLUDE THREE GROUPS: A) BW ENROLLED IN ONGOING SOCIOBEHAVIORAL RESEARCH STUDIES BY MEMBERS OF THE MENTORING TEAM, LINKPOSITIVELY (R34MH122014; PI: STOCKMAN) AND WOMEN SHINE; (R01MH125785 PI STOCKMAN) WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES (N=40), B) BW WITH HISTORIES OF RESEARCH PARTICIPATION WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES, AND THOSE SEEKING CARE AT AIDS CLINICAL TRIALS GROUP CLINICAL RESEARCH SITES WITHOUT A HISTORY OF RESEARCH PARTICIPATION (N=65), C) PARTICIPATED IN LINKPOSITIVELY (GRANT #R34MH122014; PI: STOCKMAN; N=70), AN MHEALTH HIV INTERVENTION FOR BWH IN CALIFORNIA AND OKLAHOMA AFFECTED BY INTERPERSONAL VIOLENCE, C) PARTICIPANTS OF THE ENHANCED PEER INVOLVEMENT IN CARE AMPLIFYING THE VOICES OF BW (EPIC) PROGRAM EMBEDDED WITHIN EXISTING PEER NAVIGATION PROGRAMS IN COMMUNITY-BASED ORGANIZATIONS LOCATED IN ENDING THE HIV EPIDEMIC JURISDICTIONS IN THE SOUTHERN UNITED STATES, AND D) BW WITHOUT HIV AND WITH HISTORIES OF RESEARCH PARTICIPATION WHO AGREED TO BE CONTACTED ABOUT FUTURE RESEARCH OPPORTUNITIES AND THOSE SEEKING CARE AT AN HIV VACCINE TRIALS NETWORK CLINICAL RESEARCH SITE WITHOUT A HISTORY OF RESEARCH PARTICIPATION (N=140). NEXT, WE WILL QUALITATIVELY EXPLORE PERCEPTIONS OF AND FACILITATORS AND BARRIERS TO PARTICIPATION IN HIV RESEARCH AMONG BW WITH AND WITHOUT HIV (AIM 2).THE PROPOSED STUDY, WHICH IS IN RESPONSE TO PAR-22-172, WILL SUPPORT THE SCIENTIFIC INVESTIGATION BY UNDERREPRESENTED PRE- DOCTORAL STUDENTS, AND IS THE FIRST TO ATTEMPT TO QUANTIFY AND CONTEXTUALIZE THE IMPACTS OF SOCIOSTRUCTURAL INEQUITIES AND SYNDEMICS ON BW’S WILLINGNESS TO PARTICIPATE IN HIV RESEARCH TO INFORM MULTILEVEL EFFORTS AND INTERVENTIONS TO CONDUCT EQUITABLE AND DIVERSE RESEARCH.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R36MH134774_7529/

ASST_NON_K23DA060073_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

DEVELOPMENT OF A TECHNOLOGY-BASED HIV PREVENTION INTERVENTION FOR BLACK WOMEN WHO USE SUBSTANCES - PROJECT SUMMARY/ABSTRACT THE RESEARCH OBJECTIVE OF THIS PROPOSAL IS TO DEVELOP A TECHNOLOGY-BASED HIV PREVENTION INTERVENTION FOR BLACK WOMEN IN SUBSTANCE USE DISORDER (SUD) TREATMENT. THE INTERVENTION WILL BE BASED ON THE PREVIOUSLY DEVELOPED CULTURALLY-ADAPTED SAFER SEX SKILLS BUILDING INTERVENTION (SSSB), ALIGNED WITH MODERN PREVENTION EFFORTS, AND INFORMED BY INTERSECTIONALITY. BLACK WOMEN WITH SUD CONTINUE TO BE GRAVELY IMPACTED BY THE HIV EPIDEMIC. IN 2020, BLACK WOMEN MADE UP 13% OF THE GENERAL FEMALE POPULATION YET ACCOUNTED FOR OVER 50% OF NEW HIV INFECTIONS. GIVEN THE GENDER NORMS AND SOCIAL EXPECTATIONS (PRESENT WITHIN BOTH BLACK AND SUBSTANCE USING COMMUNITIES) RELATED TO SEXUAL BEHAVIOR, BLACK WOMEN WITH SUD ARE UNIQUELY AT RISK. THESE WOMEN ARE ALSO IMPACTED BY INTERSECTING SYSTEMS OF OPPRESSION (E.G., RACISM, SEXISM, SUBSTANCE USE STIGMA) THAT INFLUENCE HIV RISK. THESE UNIQUE EXPERIENCES UNDERSCORE THE NEED FOR CULTURALLY SPECIFIC INTERVENTIONS. FURTHERMORE, FROM 2015-2019, ONLY 16.5% OF BLACK WOMEN WHO NEEDED SUD TREATMENT RECEIVED IT. THIS DISPARITY COULD RESULT IN A LIMITED NUMBER OF BLACK WOMEN WITHIN A SINGLE SUD TREATMENT SETTING AT THE SAME TIME, WHICH COULD BE A BARRIER TO IN-PERSON INTERVENTIONS. TECHNOLOGY-BASED INTERVENTIONS HAVE DEMONSTRATED EFFECTIVENESS FOR SUD TREATMENT AND HIV PREVENTION/TREATMENT AMONG BLACK WOMEN, SUGGESTING THAT TECHNOLOGY COULD BE LEVERAGED TO ADDRESS THIS GAP. THE PROPOSAL HAS THE FOLLOWING AIMS: 1) EXAMINE PSYCHOLOGICAL AND SOCIAL DETERMINANTS OF SEXUAL RISK BEHAVIORS AMONG BLACK WOMEN IN SUD TREATMENT THROUGH AN INTERSECTIONAL LENS, 2) DEEPEN UNDERSTANDING OF SEXUAL RISK BEHAVIOR THROUGH AN INTERSECTIONALITY FRAMEWORK AND IDENTIFY CULTURALLY-INFORMED APPROACHES FOR REDUCING SEXUAL RISK BEHAVIOR, AND 3) DESIGN A TECHNOLOGY-BASED HIV PREVENTION INTERVENTION FOR BLACK WOMEN IN SUD TREATMENT. ALIGNED WITH THESE RESEARCH AIMS, MY CAREER GOAL IS TO BE AN INDEPENDENT RESEARCHER FOCUSED ON THE DESIGN, IMPLEMENTATION, AND TESTING OF CULTURALLY SPECIFIC INTERVENTIONS TO REDUCE HIV PREVALENCE AND OTHER HEALTH DISPARITIES FOR RACIAL/ETHNIC MINORITIES WITH SUD. THE TRAINING GOALS OF THIS K23 MENTORED PATIENT ORIENTED CAREER DEVELOPMENT AWARD THAT WILL ASSIST ME IN MEETING MY LONG-TERM GOAL ARE: 1) DEVELOP ADVANCED KNOWLEDGE OF THE MECHANISMS WITHIN INTERSECTIONALITY AND SOCIAL DETERMINANTS OF HEALTH THAT INFLUENCE SEXUAL RISK BEHAVIOR FOR RACIAL/ETHNIC MINORITIES, 2) INCREASE KNOWLEDGE IN QUALITATIVE AND MIXED METHOD RESEARCH METHODOLOGIES, 3) OBTAIN TRAINING IN THE DEVELOPMENT OF TECHNOLOGY-BASED INTERVENTIONS THAT TARGET HEALTH BEHAVIOR CHANGE AMONG RACIAL/ETHNIC MINORITIES SUD, 4) GAIN KNOWLEDGE IN CLINICAL TRIAL DESIGN FOR CULTURALLY SPECIFIC INTERVENTIONS, AND 5) PARTICIPATE IN PROFESSIONAL DEVELOPMENT ACTIVITIES, IMPROVE GRANT WRITING SKILLS, AND INCREASE SCHOLARLY WRITING AND DISSEMINATION. THE RESEARCH IN THIS PROPOSAL WILL COMPLEMENT THE PROPOSED TRAINING ACTIVITIES THAT I PLAN TO COMPLETE AT THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO AND WILL PROVIDE ME WITH HANDS-ON TRAINING WITH MY PROPOSED MENTORSHIP TEAM.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K23DA060073_7529/

ASST_NON_R21MD019228_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF ROCHESTER

UNIVERSITY OF ROCHESTER

DEVELOPING AND TESTING A NOVEL MULTIDIMENSIONAL STIGMA-RESILIENCE MEASURE FOR STIGMA REDUCTION RESEARCH WITH BLACK MEN WHO HAVE SEX WITH MEN - ABSTRACT BLACK MEN WHO HAVE SEX WITH MEN (BMSM) CONTINUE TO EXPERIENCE DISPROPORTIONATE BURDENS OF HIV COMPARED TO OTHER MSM SUBGROUPS IN THE US. THIS DISPARITY IS EXACERBATED BY THE MULTILEVEL INTERSECTIONAL STIGMAS THAT BMSM FACE, INCLUDING THOSE BASED ON RACE, SAME-SEX ATTRACTION/BEHAVIOR, AND PRESUMED HIV-POSITIVE STATUS, WHICH RESULTS IN HIGH LEVELS OF PSYCHOLOGICAL DISTRESS AND POOR HIV PREVENTION OUTCOMES. RESILIENCE IS A CRITICAL COMPONENT IN STUDIES TO MITIGATE THE NEGATIVE IMPACT OF MULTILEVEL INTERSECTIONAL STIGMAS ON HIV PREVENTION UPTAKE AMONG BMSM. HOWEVER, EXISTING RESILIENCE MEASURES ARE DESIGNED FOR NON-MARGINALIZED POPULATIONS AND ARE INADEQUATE FOR ASSESSING BMSM'S RESILIENCE TO MULTILEVEL INTERSECTIONAL STIGMAS. TO ADDRESS THIS GAP, WE PROPOSE TO DEVELOP A NOVEL, BMSM-SPECIFIC, MULTIDIMENSIONAL STIGMA-RESILIENCE SCALE THAT CAPTURES THE NUANCED RESILIENCY MECHANISMS COUNTERING INTERSECTIONAL STIGMAS ACROSS MULTIPLE SOCIOECOLOGICAL LEVELS. THE PROPOSED STUDY WILL BE CONDUCTED IN NASHVILLE, AN HIV HOTSPOT IN THE SOUTHERN US, WHERE GROWING HIV BURDENS AND INTERSECTIONAL STIGMAS AMONG BMSM HAVE BEEN IDENTIFIED. THE STUDY HAS TWO SPECIFIC AIMS. IN AIM 1, WE WILL DEFINE THE MECHANISMS OF MULTIDIMENSIONAL RESILIENCE THAT BMSM USE TO COUNTER INTERSECTIONAL STIGMAS. WE WILL CONDUCT IN-DEPTH INTERVIEWS WITH 30 HIV-NEGATIVE BMSM IN NASHVILLE, GUIDED BY A CONCEPTUAL FRAMEWORK THAT INTEGRATES THE SOCIOECOLOGICAL MODEL, RESILIENCE THEORY, AND INTERSECTIONALITY FRAMEWORK. WE WILL EXPLORE HOW RESILIENCE IS DEVELOPED, MANIFESTED, AND IMPLEMENTED TO OVERCOME INTERSECTING FORMS (E.G., INTERNALIZED, ENACTED, EXPERIENCED, AND ANTICIPATED) AND TYPES (E.G., STIGMA AGAINST RACISM, HOMOSEXUALITY, AND PRESUMED HIV STATUS) OF STIGMAS ACROSS MULTIPLE SOCIOECOLOGICAL LEVELS (E.G., INDIVIDUAL, INTERPERSONAL, COMMUNITY AND HEALTHCARE). AIM 2 WILL NECESSITATE AN ITERATIVE AND SYSTEMATIC BMSM COMMUNITY ENGAGEMENT PROCESS TO DEVELOP AND VALIDATE A NEW MULTIDIMENSIONAL STIGMA-RESILIENCE MEASURE TAILORED FOR BMSM. INSIGHTS FROM AIM 1 WILL HELP INFORM THE ADAPTATION OF AN EXISTING SCALE (E.G., MULTILEVEL RESILIENCE MEASURE FOR BLACK ADULTS LIVING WITH HIV) TO BE CONTEXTUALLY APPROPRIATE AND STIGMA-FOCUSED FOR BMSM. WE WILL THEN ASSESS FACE VALIDITY AND CULTURAL RELEVANCY THROUGH COGNITIVE INTERVIEWS WITH 10 BMSM, FOLLOWED BY CONDUCTING PSYCHOMETRIC ANALYSES WITH 250 BMSM TO TEST THE NEW SCALE'S RELIABILITY (E.G., INTERNAL CONSISTENCY) AND VALIDITY (E.G., CONVERGENT, DIVERGENT, AND PREDICTIVE VALIDITY). THE PROPOSED STUDY IS SIGNIFICANT IN PROVIDING A ROBUST, CULTURALLY-TAILORED STIGMA-RESILIENCE MEASURE, WHICH WILL INFORM OUR FUTURE R34/R01 STUDY TO DEVELOP AND EVALUATE A MULTILEVEL RESILIENCE-BASED INTERVENTION TO MITIGATE INTERSECTIONAL STIGMAS AND HIV PREVENTION UPTAKE AMONG BMSM. ADDITIONALLY, THE NEW BMSM MULTIDIMENSIONAL STIGMA-RESILIENCE SCALE WILL PROVIDE THE GROUNDWORK FOR FUTURE STUDIES TO REFINE AND ADAPT THE SCALE FOR RESILIENCE-FOCUSED RESEARCH CONDUCTED WITH OTHER MARGINALIZED POPULATIONS (E.G., LATINO/HISPANIC MSM; TRANSWOMEN OF COLOR).

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R21MD019228_7529/

ASST_NON_R01MD019178_7529

Department of Health and Human Services

National Institutes of Health

THE JOHNS HOPKINS UNIVERSITY

THE JOHNS HOPKINS UNIVERSITY

A MULTI-LEVEL TRAUMA-INFORMED APPROACH TO INCREASE HIV PRE-EXPOSURE PROPHYLAXIS INITIATION AMONG BLACK WOMEN - PROJECT SUMMARY BLACK CISGENDER WOMEN (HEREAFTER, BLACK WOMEN) CARRY A DISPROPORTIONATE HIV BURDEN THAN WOMEN IN OTHER RACIAL AND ETHNIC GROUPS. DESPITE ITS PROMISE, THERE IS AN UNMET NEED FOR PRE-EXPOSURE PROPHYLAXIS (PREP) AMONG BLACK WOMEN. INTIMATE PARTNER VIOLENCE (IPV) AND GENDERED RACISM MAY EXACERBATE RACIAL DISPARITIES IN PREP ACCESS AND ALSO CURB POTENTIAL REAL-WORLD EFFECTIVENESS. IPV REDUCES PREP UPTAKE AMONG WOMEN. BLACK WOMEN ALSO EXPERIENCE UNFAIR TREATMENT DUE TO DEEPLY INGRAINED STEREOTYPES BY HEALTHCARE SYSTEMS. AS SUCH, BLACK WOMEN MAY FEEL UNCOMFORTABLE DISCUSSING PREP WITH A PROVIDER OR PROVIDER BIASES MAY PREVENT PREP ACCESS. INTEGRATING TRAUMA-INFORMED CARE INTO COMMUNITY HEALTH CENTERS THAT SERVE BLACK WOMEN MAY ENHANCE PREP ADOPTION. TRAUMA-INFORMED CARE CAN HELP PROVIDERS UNDERSTAND IPV, MEDICAL MISTRUST AND GENDERED RACISM WITHIN THE CONTEXT OF BLACK WOMEN’S EXPERIENCES. SYSTEM POLICIES CAN ALSO BE MODIFIED TO BE TRAUMA-INFORMED FOR BOTH STAFF AND BLACK WOMEN CLIENTS. IN ADDITION TO CHANGING HEALTH SYSTEMS, PEER NAVIGATION COULD BE A SUCCESSFUL MODEL OF CARE TO IMPROVE PREP ENGAGEMENT. PEER NAVIGATION CAN BUILD SELF-EFFICACY IN PATIENT-PROVIDER COMMUNICATION AND DECREASE MEDICAL MISTRUST OFFSETTING THE IMPACT OF SOCIO-STRUCTURAL BARRIERS. THE PROPOSED RESEARCH AIMS TO ADDRESS THIS GAP VIA THE IMPLEMENTATION AND EVALUATION OF A TRAUMA-INFORMED MULTILEVEL INTERVENTION DESIGNED TO INCREASE PREP INITIATION AMONG BLACK WOMEN. THIS INTERVENTION INCLUDES A TRAUMA- INFORMED PREP IMPLEMENTATION TOOLKIT FOR STAFF IN COMMUNITY HEALTHCARE CLINICS IN ADDITION TO A TRAUMA-INFORMED PEER NAVIGATION MODEL. WE PROPOSE A HYBRID TYPE 2 EFFECTIVENESS-IMPLEMENTATION STUDY WITH CLINICAL STAFF, PEER NAVIGATORS, AND CLIENTS. AIM 1 INCLUDES ADAPTING AN EXISTING TRAUMA-INFORMED PEER NAVIGATION FOR PREP-ELIGIBLE BLACK WOMEN. QUALITATIVE DATA FROM SEMI-STRUCTURED INTERVIEWS WITH 20 BLACK WOMEN CLIENTS WILL BE USED TO ADAPT THE PEER NAVIGATION. AIM 2 INCLUDES ASSESSING THE EFFECTIVENESS OF THE TRAUMA-INFORMED MULTILEVEL INTERVENTION. THE TOOLKIT WILL BE EMPLOYED IN CLINICS USING A STEPPED WEDGE DESIGN WITH MONTHLY AGGREGATED CLINIC DATA COLLECTED 8 MONTHS BEFORE AND AFTER TOOLKIT IMPLEMENTATION IN EACH CLINIC. TOOLKIT EFFECTIVENESS WILL BE ASSESSED USING WITHIN- AND BETWEEN-CLINIC CHANGES IN PREP INITIATION. STAFF WILL COMPLETE BASELINE, IMMEDIATE POST, AND 3-MONTH POST SURVEYS TO ASSESS MECHANISMS OF CHANGE. IN A PARALLEL TWO-ARM TRIAL, 300 BLACK WOMEN CLIENTS WILL BE RANDOMIZED TO RECEIVE EITHER PEER NAVIGATION (INTERVENTION ARM) OR SUPPORT GROUP ONLY (CONTROL ARM) AND WILL COMPLETE BASELINE, 1-, 3-, AND 6- MONTH POST-RANDOMIZATION SURVEYS. THE PRIMARY CLIENT OUTCOMES WILL BE 1-, 3-, AND 6-MONTH PREP INITIATION. AIM 3 INCLUDES ASSESSING THE IMPLEMENTATION OF THE MULTILEVEL INTERVENTION. ADOPTION, ACCEPTABILITY, APPROPRIATENESS, AND SUSTAINABILITY WILL BE ASSESSED WITH 3-MONTH POST-TOOLKIT STAFF SURVEYS; AND AT 1-, 3-, AND 6- MONTH CLIENT POST-RANDOMIZATION SURVEYS. INTERVENTION COSTS WILL BE COMPUTED USING AN INGREDIENTS-BASED APPROACH. FIDELITY WILL BE ASSESSED WITH THE FIDELITY-MONITORING APPROACH FOR MULTILEVEL TRIALS.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MD019178_7529/

ASST_NON_K01MH134764_7529

Department of Health and Human Services

National Institutes of Health

WHITMAN-WALKER INSTITUTE INC

WHITMAN-WALKER INSTITUTE INC

DISTRICT OF COLUMBIA

INTERSECTIONAL DISCRIMINATION AND LINKAGE TO HIV PREVENTION AND CARE IN TRANSGENDER WOMEN IN ECUADOR - 7. PROJECT SUMMARY-ABSTRACT LATIN AMERICA DID NOT ACHIEVE ANY REDUCTIONS IN NEW HIV CASES IN THE LAST DECADE. IN ECUADOR, TRANSGENDER WOMEN—THOSE WHO IDENTIFY AS WOMEN OR ON THE TRANSFEMININE SPECTRUM AND WHO WERE ASSIGNED A MALE SEX AT BIRTH—WHO HAVE SEX WITH CISGENDER MEN ARE A KEY POPULATION IN THE HIV EPIDEMIC. HIV PREVALENCE IN ECUADOR IS BETWEEN 20.7%-34.8% AMONG TRANSGENDER WOMEN—THE HIGHEST IN LATIN AMERICA. STUDIES ARE URGENTLY NEEDED TO GUIDE HIV PREVENTION AND CARE EFFORTS TO CURB HIV INFECTION RATES. PEOPLE WITH MULTIPLE MARGINALIZED IDENTITIES, SUCH AS TRANSGENDER WOMEN OF AFRICAN DESCENT LIVING IN POVERTY, ARE AT HIGHER RISK OF EXPOSURE TO INTERSECTIONAL DISCRIMINATION THAN THE GENERAL U.S. POPULATION AND HAVE HIGH RATES OF HIV. YET THE EXTENT TO WHICH ECUADORIAN TRANSGENDER WOMEN ARE BURDENED BY INTERSECTIONAL DISCRIMINATION AND ITS EFFECT ON THE LINKAGE TO HIV PREVENTION AND CARE OUTCOMES REMAINS UNKNOWN. THIS K01 AWARD WILL PROVIDE THE CANDIDATE WITH TRAINING IN INTERSECTIONAL QUALITATIVE, QUANTITATIVE, INTERVENTION DEVELOPMENT, AND GRANT WRITING TO ADDRESS THE CHALLENGE OF INTERSECTIONAL DISCRIMINATION AND HIV BURDEN IN TRANSGENDER WOMEN IN ECUADOR. THE PROPOSED RESEARCH WILL ASSESS THE MECHANISMS THROUGH WHICH INTERSECTIONAL DISCRIMINATION EXERTS ITS IMPACT ON LINKAGE TO HIV PREVENTION AND CARE FOR TRANSGENDER WOMEN IN ECUADOR WHILE EXTENDING AND DEEPENING CANDIDATE’S RESEARCH SKILLS. IN RESEARCH AIM 1, THE CANDIDATE WILL ASSESS EXPERIENCES OF INTERSECTIONAL DISCRIMINATION (E.G., HIV STIGMA, RACISM, CLASSISM) IN RELATION TO HIV PREVENTION AND CARE THROUGH IN-DEPTH QUALITATIVE INTERVIEWS WITH TRANSGENDER WOMEN (TRAINING AIM 1: APPLICATION OF INTERSECTIONALITY TO QUALITATIVE METHODS). IN RESEARCH AIM 2, THE CANDIDATE WILL CONDUCT A SURVEY TO CHARACTERIZE AND LONGITUDINALLY TEST THE PATHWAYS THAT LINK INTERSECTIONAL DISCRIMINATION WITH HIV PREVENTION AND CARE LINKAGE OUTCOMES OVER A 6-MONTH PERIOD (TRAINING AIM 2: EPIDEMIOLOGICAL METHODS AND LONGITUDINAL QUANTITATIVE RESEARCH DESIGN). IN RESEARCH AIM 3, THE CANDIDATE WILL IMPLEMENT THE FIRST SIX PHASES OF THE SYSTEMATIC ADAPT-ITT MODEL TO ADAPT AN HIV INTERVENTION FOR TRANSGENDER WOMEN (TRAINING AIM 3: SKILLS FOR INTERVENTION DEVELOPMENT). FINDINGS FROM THIS STUDY AND TRAINING WILL POSITION THE CANDIDATE TO DEVELOP AN R01 PROPOSAL TO IMPLEMENT REMAINING STEPS OF THE ADAPT-ITT MODEL AND CONDUCT A RANDOMIZED CONTROLLED TRIAL OF THE INTERVENTION (TRAINING AIM 4: GRANT WRITING). AS AN ECUADORIAN NON-BINARY QUEER U.S. IMMIGRANT RESEARCHER, THE CANDIDATE HAS THE CULTURAL AND RESEARCH BACKGROUND TO LEVERAGE THIS PROPOSED K01 TO TRANSITION TO CAREER INDEPENDENCE AND ADDRESS KEY KNOWLEDGE AND INTERVENTION GAPS FOR HIV PREVENTION AND CARE IN ECUADOR.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K01MH134764_7529/

ASST_NON_R21NR021079_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF SOUTH CAROLINA

UNIVERSITY OF SOUTH CAROLINA

SOUTH CAROLINA

PATTERNS AND PREDICTORS OF RACIAL/ETHNIC DISPARITIES IN HIV CARE CONTINUUM IN THE SOUTH - PROJECT SUMMARY/ABSTRACT THE HIV CARE CONTINUUM (HCC), A COMPELLING FRAMEWORK TO DESCRIBE THE CURRENT CLINICAL GOALS FOR MANAGING HIV INFECTION, TRACKS THE PROGRESSION OF PEOPLE LIVING WITH HIV (PLWH) FROM DIAGNOSIS, THROUGH LINKAGE TO CARE, RETENTION IN CARE, AND ULTIMATELY TO THE GOAL OF VIRAL SUPPRESSION. UNFORTUNATELY, HEALTH DISPARITIES EXIST AT EVERY STEP OF THE CONTINUUM AMONG RACIAL/ETHNIC MINORITY POPULATION. SUCH RACIAL/ETHNIC DISPARITIES MAY HAVE SIGNIFICANTLY DELAYED THE PROGRESS IN HCC IN THE SOUTHERN US STATES THAT ARE STRONGLY REPRESENTED AMONG GEOGRAPHIC FOCUS AREAS IN THE 2019 FEDERAL INITIATIVE TITLED “ENDING THE HIV EPIDEMIC: A PLAN FOR AMERICA” (ETHE). GIVEN THE UNABATED HIGH LEVELS OF SEGREGATION OVER TIME IN SOME AREAS OF THE SOUTH, IT IS CRITICAL TO IDENTIFYING DRIVERS OF HEALTH DISPARITIES IN HCC OUTCOMES AND ADVANCE HEALTH EQUITY AND IMPROVE POPULATION HEALTH. A SINGULAR FOCUS ON INDIVIDUAL-LEVEL STRATEGIES TO IMPROVE HEALTH AND AMELIORATE HEALTH DISPARITIES HAS BEEN REPORTED INEFFECTIVE. RECOGNITION OF THE IMPACT OF SOCIAL FACTORS, WHICH HAVE BEEN COINED AS FUNDAMENTAL CAUSES OF RACIAL/ETHNIC HEALTH DISPARITIES BECAUSE OF THEIR ROLE IN SHAPING OTHER MYRIAD FACTORS IMPORTANT FOR PROMOTING HEALTH EQUITIES, HAS PROMPTED A GLOBAL SHIFT IN FOCUS AWAY FROM SIMPLY ADDRESSING SYMPTOMS AND CONDITIONS TO ALSO CONSIDERING PATIENT SOCIAL NEEDS AND LIVED EXPERIENCES IN ASSESSMENT AND TREATMENT. HOWEVER, LIMITED EFFORTS HAVE BEEN MADE TO QUANTIFY THE LONG-TERM SPATIOTEMPORAL VARIATIONS OF HCC DISPARITIES AND THEIR CONTRIBUTING FACTORS OVER TIME, PARTICULARLY IN THE CONTEXT OF COVID-19 PANDEMIC. WITH NIH SUPPORT (R01AI127203) SINCE 2017, WE HAVE BEEN UTILIZING A BIG DATA APPROACH TO EXAMINE TREATMENT GAPS AMONG PLWH IN SOUTH CAROLINA (SC). THE ONGOING RESEARCH EXTRACTED AND LINKED LONGITUDINAL EHR DATA FROM SIX STATE AGENCIES. THE COHORT IN THE EXISTING PROJECT INCLUDE ALL PLWH WHO WERE DIAGNOSED THROUGH DECEMBER 2020 IN SC. TO ADDRESS THE GAPS IN HCC-RELATED HEALTH DISPARITY RESEARCH, WE WILL LEVERAGE THE EXITING DATA FROM R01AI127203 PROJECT AND LINK THESE DATA TO AGGREGATED COMMUNITY AND SOCIAL STRUCTURAL LEVEL DATA (E.G., STRUCTURAL RACISM, COVID-19 PANDEMIC) FROM MULTIPLE PUBLICLY AVAILABLE DATA SOURCES. BEYOND THE SCOPE OF ORIGINAL PROJECT, WE WILL FIRST IDENTIFY THE SPATIOTEMPORAL PATTERNS OF RACIAL DISPARITIES (E.G., EXACERBATING OR ATTENUATING TREND) OF EACH HCC OUTCOME, THEN DETERMINE THE CONTRIBUTION OF CONTEXTUAL FEATURES FOR TEMPORAL CHANGE OF DISPARITIES IN HCC USING THE MULTIVARIABLE GENERALIZED REGRESSION WITH LASSO PENALTY. THE PROPOSED RESEARCH IS INNOVATIVE AND SIGNIFICANT BECAUSE IDENTIFYING AND REDUCING RACIAL/ETHNIC DISPARITIES IN HCC OUTCOMES IS ESSENTIAL TO UNDERSTAND THE FUNDAMENTAL CAUSES AND EVOLVING RISK OF POOR HCC OUTCOMES AND ACHIEVE THE ETHE GOALS IN SC AND OTHER SOUTHERN STATES IN THE US. THE RESEARCH FINDINGS COULD INFORM STATE HEALTH DEPARTMENT TO PROMOTE SOCIAL EQUALITY, MOTIVATE HEALTHCARE SYSTEMS TO ADDRESS PATIENTS’ SOCIAL NEEDS AS PART OF HEALTHCARE DELIVERY, AND DEVISE MORE PRECISE, TARGETED INTERVENTION STRATEGIES FOR SOCIALLY DISADVANTAGED AREAS TO ACHIEVE THE HEALTH EQUALITY AND IMPROVE HIV TREATMENT OUTCOMES.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R21NR021079_7529/

ASST_NON_R01MD019024_7529

Department of Health and Human Services

National Institutes of Health

WAKE FOREST UNIVERSITY HEALTH SCIENCES

WAKE FOREST UNIVERSITY HEALTH SCIENCES

NORTH CAROLINA

ADVANCING COMMUNICATION STRATEGIES TO SUPPORT FUTURE HIV VACCINE USE AMONG AFRICAN AMERICANS IN THE SOUTH. - ABSTRACT AS WE ENTER THE FIFTH DECADE OF THE HIV PANDEMIC, INNOVATIONS IN HIV VACCINE RESEARCH AND DEVELOPMENT HAVE MOVED US CLOSER THAN EVER TO THE AVAILABILITY OF EFFECTIVE VACCINES THAT COULD END HIV ACQUISITION. UNFORTUNATELY, VACCINE HESITANCY (I.E., DELAY IN ACCEPTANCE OR REFUSAL OF VACCINATION DESPITE AVAILABILITY OF VACCINATION SERVICES) POSES A MAJOR THREAT TO THE FUTURE UPTAKE OF A PROVEN VACCINE. GLOBALLY, PEOPLE OF AFRICAN DESCENT HAVE BEEN DISPROPORTIONATELY BURDENED BY THE HIV PANDEMIC, FACING HIGHER MORBIDITY AND MORTALITY. IN THE UNITED STATES, THE CONVERGENCE OF RACISM, MISTRUST IN THE HEALTHCARESYSTEM, INADEQUATE COMMUNITY ENGAGEMENT,AND CONCERNS REGARDING VACCINE LITERACY MAY EXACERBATE VACCINE HESITANCY, REDUCING FUTURE UPTAKE WITHIN THIS POPULATION. TO PREPARE FOR AN INEVITABLE HIV VACCINE, INCLUDING THOSE WITH PARTIAL EFFICACY, WE NEED TO FIELD-TEST TARGETED MESSAGING CAMPAIGNS THAT: ARE PERSUASIVE, COUNTER VACCINE-RELATED MYTHS AND MISINFORMATION, COME FROM TRUSTED SOURCES, AND ARE CULTURALLY RELEVANT AND IMPACTFUL. MOREOVER, CAMPAIGNS MUST LEVERAGE DIGITAL PLATFORMS TO WHICH GREATER PROPORTIONS OF THE POPULATION TURN FOR CRITICAL HEALTH INFORMATION. GUIDED BY THE CAPABILITY OPPORTUNITY MOTIVATION—BEHAVIOR AND MINORITY HEALTH AND HEALTH DISPARITIES RESEARCH FRAMEWORKS, THIS STUDY WILL LEVERAGE PARTICIPATORY RESEARCH METHODS, ARTIFICIAL INTELLIGENCE, AND INFRASTRUCTURE FROM ONGOING HIV VACCINE RESEARCH AT DUKE UNIVERSITY TO: 1) IDENTIFY PREFERENCES REGARDING HIV VACCINE ATTRIBUTES AND COMMUNICATION STRATEGIES FOR AFRICAN AMERICANS IN NORTH CAROLINA USING DISCRETE CHOICE EXPERIMENTS; 2) DEVELOP AND PILOT CROWDSOURCED AND DEEP LEARNING INTERVENTIONS TO ASSESS ACCEPTABILITY, FEASIBILITY, AND PRELIMINARY IMPACT ON HIV VACCINE LITERACY, CONFIDENCE, AND WILLINGNESS; AND 3) EVALUATE THE IMPACT OF A CROWDSOURCED VS. A DEEP LEARNING COMPUTER ANIMATION INTERVENTION ON HIV VACCINE LITERACY, CONFIDENCE, AND WILLINGNESS TO VACCINATE COMPARED TO A CONTROL ARM USING A THREE-ARM RANDOMIZED EXPERIMENT. THE RESULTS OF THIS STUDY WILL: A) ENABLE US TO COMPARE OUTCOMES ASSOCIATED WITH COMMUNITY-DRIVEN, COMMUNITY-ENGAGED, AND EXPERT-DRIVEN INTERVENTIONS TO PROMOTE FAVORABLE ATTITUDES TOWARDS AN HIV VACCINE; B) IDENTIFY EFFECTIVE HIV VACCINE PROMOTION MESSAGES FOR AFRICAN AMERICANS; C) INFORM GUIDELINES INFORMING THE ROLLOUT AND PROMOTION OF FUTURE NOVEL VACCINES.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MD019024_7529/

ASST_NON_R01DA058965_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF CHICAGO

UNIVERSITY OF CHICAGO

ACHIEVING EQUITY IN PATIENT OUTCOME REPORTING FOR TIMELY ASSESSMENTS OF LIFE WITH HIV AND SUBSTANCE USE (EPORTAL HIV-S) - PROJECT SUMMARY SUBSTANCE USE DISORDER (SUD) AND HIV ARE SYNERGISTIC EPIDEMICS (SYNDEMICS) DISPROPORTIONATELY AFFECTING BLACK AMERICANS. STRUCTURAL RACISM RELATED TO INADEQUATE ACCESS TO HEALTHCARE, STIGMA, AND CRIMINALIZATION, ESPECIALLY AMONG THOSE WITH INTERSECTIONAL IDENTITIES RELATED TO GENDER AND SEXUAL MINORITIES, FURTHER EXACERBATE DISPARITIES IN HIV AND SUD OUTCOMES. SUD IS OFTEN UNRECOGNIZED AND UNTREATED AMONG PLWH. ONLY ABOUT HALF OF HIV CARE SITES ROUTINELY SCREEN AND REFER TO SUD TREATMENT. IN PRELIMINARY WORK, WE FOUND THAT NEARLY HALF OF PATIENTS ASSESSED IN AN HIV CLINIC WAITING ROOM MET CRITERIA FOR A SUD, BUT 65% HAD NOT BEEN DIAGNOSED WITH SUD. A PROMISING STRATEGY TO ADDRESS STRUCTURAL BARRIERS TO SUD SCREENING FOR PLWH IS USE OF ELECTRONIC PATIENT PORTALS. PORTALS ARE SECURE WEBSITES THAT GIVE PATIENTS ACCESS TO HEALTH INFORMATION AND ALLOW FOR SECURE MESSAGING WITH PROVIDERS. THEY ARE ASSOCIATED WITH IMPROVED HEALTH OUTCOMES AND PATIENT ENGAGEMENT. IMPORTANTLY, WHILE MOST SUD SCREENING CURRENTLY OCCURS DURING CLINIC VISITS, PORTALS CAN BE UTILIZED FOR SUD SCREENING TO REACH PATIENTS WHO MISS CLINIC VISITS, WHICH IS MORE COMMON AMONG PEOPLE WITH HIV AND SUD. OUR PRELIMINARY WORK HAS DEMONSTRATED THE POTENTIAL OF THE PORTAL FOR USE IN A POPULATION HEALTH APPROACH TO BEHAVIORAL HEALTH SCREENING, BUT MINORITIZED POPULATIONS ARE LESS LIKELY TO ENROLL IN PORTALS. APPROACHES ARE NEED TO ENHANCE ENGAGEMENT OF BLACK PLWH FOR UTILIZATION OF THE PORTAL FOR SUD SCREENING. BEYOND SUD SCREENING, BLACK PLWH FACE STRUCTURAL BARRIERS TO SUD TREATMENT, INCLUDING THE LACK OF TREATMENT CENTERS IN COMMUNITIES WITH HIGHER PROPORTIONS OF BLACK RESIDENTS. HOWEVER, A NEW MODEL OF TREATMENT (COLLABORATIVE CARE MODEL (COCM)) INTEGRATES A SOCIAL WORK CARE MANAGER AND CONSULTING PSYCHIATRIST INTO THE PRIMARY SETTING AND HAS BEEN SHOWN IMPROVE SUD OUTCOMES. COCM FOR SUD COULD ADDRESS TREATMENT BARRIERS RELATED TO STIGMA AND STRUCTURAL RACISM FOR BLACK PLWH AND SUD. THIS PROPOSAL WILL IMPLEMENT AND EVALUATE MULTI-LEVEL INTERVENTIONS TO DECREASE BARRIERS TO SUD SCREENING (CLINIC-BASED, IN-PERSON) AND TREATMENT (REFERRAL-FOCUSED), A PROGRAM WE CALL EPORTAL HIV-S. EPORTAL HIV- S WILL BE IMPLEMENTED AT THE CHICAGO DEPARTMENT OF PUBLIC HEALTH-FUNDED SOUTH SIDE HEALTH HOME (S2H2), THE MAIN PROVIDER OF HIV PREVENTION AND CARE SERVICES FOR CHICAGO’S SOUTH SIDE, A MAJORITY BLACK COMMUNITY DISPROPORTIONATELY IMPACTED BY HIV AND SUD. ALONGSIDE OUR COMMUNITY ADVISORY BOARD, WE PROPOSE TO CARRY OUT 4 AIMS: 1) DESIGN AND IMPLEMENT A STRATEGY TO INCREASE PATIENT PORTAL ENGAGEMENT AMONG BLACK PLWH; 2) PERFORM A RANDOMIZED CONTROLLED TRIAL TO ASSESS EFFECTIVENESS OF POPULATION HEALTH VS. USUAL (CLINIC-VISIT) SUD SCREENING AMONG PLWH IN AN HIV CLINIC; 3) IMPLEMENT AND EVALUATE COCM FOR SUD IN AN HIV CLINIC; AND 4) DEVELOP AN IMPLEMENTATION GUIDE FOR EXTERNAL DISSEMINATION OF EPORTAL HIV-S. OUR ULTIMATE GOAL IS TO ACHIEVE HEALTH EQUITY IN SUD SCREENING AND TREATMENT AMONG BLACK PLWH.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA058965_7529/

ASST_NON_R01MH134269_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF MIAMI

UNIVERSITY OF MIAMI

FIVE POINT INITIATIVE: A CLUSTER RANDOMIZED TRIAL OF A BUNDLED IMPLEMENTATION STRATEGY TO ADDRESS THE HIV EPIDEMIC IN BLACK COMMUNITIES - BACKGROUND: WHILE BLACK INDIVIDUALS MAKE UP 16% OF THE POPULATION IN MIAMI, FL (AN EPICENTER) THEY ACCOUNT FOR 29% OF NEW HIV DIAGNOSES3 LINKED TO STRUCTURAL RACISM, OTHER ISMS, AND THEIR MANIFESTATIONS. MANIFESTATIONS OF STRUCTURAL RACISM INCLUDE HEALTHCARE DESSERTS, BARRIERS TO ACCESS CARE (I.E., DISTANCE, TRANSPORTATION, FINANCES), DISCRIMINATION, AND MEDICAL MISTRUST THAT THWART HIV TESTING AND PROPHYLAXIS (PREP) UPTAKE.47-49 PRELIMINARY WORK. OUR FIVE POINT INITIATIVE (FPI) IS A LOCALLY DEVELOPED BUNDLED IMPLEMENTATION STRATEGY (BIS) TO EXPAND THE REACH OF EVIDENCE-BASED CLINICAL INTERVENTIONS (I.E., HIV TESTING, PREP, CONDOMS) TO BLACK COMMUNITIES THAT HARNESSES PARTNERSHIPS WITH COMMUNITY HIV EXPERTS, LOCAL BUSINESSES, AND FEDERALLY FUNDED COMMUNITY HEALTH ORGANIZATIONS, REMOVES BARRIERS TO ACCESS BY GOING TO COMMUNITIES, AND ENHANCES TRUST THROUGH RACIAL/CULTURAL COMPETENCE AND LIVED EXPERTISE.35-36 SUCCESSFUL 1-YEAR PLANNING EHE SUPPLEMENT (2019-2020). WE BUILT PARTNERSHIPS ACROSS 4 HIV HIGH IMPACT ZIP CODES (13 BUSINESSES, 5 HEALTH PARTNERS, 10 EVENTS), PILOTED THE APPROACH (E.G., HIV TESTING WAS OPTIONAL), AND ENGAGED RESIDENTS (N=677). SUCCESSFUL 2-YEAR EHE IMPLEMENTATION SUPPLEMENT (2020-2022). WE REFINED FPI BIS, REACHED 1,887 COMMUNITY MEMBERS WHO ARE NOT REACHED BY STANDARD PUBLIC HEALTH APPROACH (64% NO KNOWLEDGE OF PREP, ONLY 4% PRESCRIBED PREP, 46% HIV TEST > 12 MONS; 40% CONDOMLESS SEX PAST 3 MONS), REQUIRED HIV TESTING (90% [4% REACTIVE]), PROVIDED PREP INFORMATION (100%) AND LINKAGE (22%), AND EXPANDED THE REACH (13 HIGH IMPACT ZIP CODES, 73 BUSINESSES, 54 EVENTS, AND 8 HEALTH PARTNERS). CONCEPTUAL MODEL: THIS HYBRID IMPLEMENTATION TRIAL TYPE 2 PROPOSAL IS GUIDED BY THE REACH EFFECTIVENESS ADOPTION IMPLEMENTATION MAINTENANCE FRAMEWORK (RE-AIM) TO EVALUATE THE FPI IMPLEMENTATION STRATEGY. RESEARCH PLAN: VIA A CLUSTER STEPPED WEDGED RCT WE WILL RANDOMLY INTRODUCE 8 HIV HIGH IMPACT ZIP CODES IN MIAMI, FL TO THE FPI INTERVENTION (2 OUTREACH EVENTS PER MONTH OVER 21 MONTHS [42 TOTAL EVENTS PER ZIP CODE]). WE WILL: (1) ASSESS WHETHER THE FPI INTERVENTION HAS A SIGNIFICANT INCREASE AT THE COMMUNITY LEVEL ON (I) HIV TESTING (PRIMARY), (II) PREP LINKAGE/PRESCRIPTION (PRIMARY) AND KNOWLEDGE, AND (III) CONDOM ACCESS/USE. OUTCOMES I-III WILL BE ASSESSED VIA (A) PRE-INTERVENTION SURVEYS (N=225 RESIDENTS PER 8 ZIP CODES: 1800 RESIDENTS TOTAL) AND POST-INTERVENTION ASSESSMENTS (N=225 RESIDENTS PER 8 ZIP CODE: 1800 RESIDENTS TOTAL) (B) DATA FROM FPI INTERVENTION EVENTS, AND (C) ADMINISTRATIVE DATA FROM PUBLICLY FUNDED HEALTH PARTNERS DURING NON-INTERVENTION (PRE- & POST- FPI INTERVENTION) PERIODS. (2) FPI AND HEALTH PARTNER ADMINISTRATIVE DATA WILL BE USED TO ASSESS (2A) HOW EFFECTIVE FPI BIS IS AT ENGAGING BLACK RESIDENTS IN HIV TESTING AND PREP LINKAGE (REACH), (2B) DESCRIBE AMONG WHOM (ADOPTION) AND HOW (FIDELITY, ADAPTATIONS, COSTS) THE FPI INTERVENTION WAS IMPLEMENTED, AND (2C) ASSESS SUSTAINABILITY VIA SURVEY AND PERIODIC REFLECTIONS WITH IMPLEMENTATION PARTNERS (MAINTENANCE). (3) CONDUCT SPATIAL ANALYSIS TO EXAMINE IF THE FPI INTERVENTION IN ZIP CODES RANDOMIZED TO THE INTERVENTION EXPLAINS VARIATIONS IN THE OUTCOMES (AIM 1 I– III; AIM 2A) AND HIV BASE RATES FOR NEIGHBORING ZIP CODES WHO DID NOT RECEIVE THE INTERVENTION. IMPLICATIONS: ASSESSING EFFECTIVENESS AND IMPLEMENTATION OUTCOMES OF FPI MAY EQUIP US WITH A BUNDLED STRATEGY TO INCREASE HIV TESTING AND PREP UPTAKE AMONG BLACK AND OTHER MINORITIZED COMMUNITIES.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MH134269_7529/

ASST_NON_K01DA059328_7529

Department of Health and Human Services

National Institutes of Health

LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER NEW ORLEANS

LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER NEW ORLEANS

HIV RISK, PREP DISPARITIES, AND STIGMA AMONG WOMEN WHO USE DRUGS(WWUD) IN THE U.S. SOUTH, WITH ATTENTION TO RACE AND SEXUAL ORIENTATION: A MIXED-METHODINTERSECTIONALITY STUDY - PROJECT SUMMARY/ABSTRACT HIV INFECTION AMONG CISGENDER WOMEN WHO USE DRUGS (WWUD) IN THE US SOUTH IS A CRITICAL PUBLIC HEALTH ISSUE. WWUD WITH DIVERSE MARGINALIZED IDENTITIES (E.G., BLACK HETEROSEXUAL, WHITE SEXUAL MINORITY) EXPERIENCE INTERSECTIONAL STIGMA UNIQUELY, WHICH CAN RESULT IN HIV RISK/PROTECTIVE BEHAVIOR (E.G., CONDOMLESS SEX, SOCIAL SUPPORT) AND IMPACT ACCESS TO HIV PREVENTION HEALTHCARE RESOURCES (PREP). WWUD ARE PREP INDICATED, BUT THEIR PREP CONTINUUM OUTCOMES (I.E. AWARENESS, ACCEPTABILITY, UPTAKE) REMAIN LOW. WWUD HAVE COMPLEX PROXIMAL (E.G., SYRINGE SHARING) AND DISTAL (E.G., INTERSECTIONAL STIGMA EXPERIENCES IN HEALTHCARE SETTINGS) HIV RISK/RESILIENCE EXPERIENCES THAT REQUIRE FURTHER EXAMINATION TO DEVELOP EFFECTIVE INTERVENTIONS. INTERSECTIONALITY THEORY, UNDERGIRDING THIS PROPOSAL, ACKNOWLEDGES INTERLOCKING POWER DYNAMICS (E.G., RACISM) PLAYING OUT IN SOCIAL PROCESSES (E.G., INTERSECTIONAL STIGMA) TO IMPACT HEALTH OUTCOMES AND DISPARITIES. THE PROPOSED MIXED- METHOD RESEARCH AIMS TO STUDY HIV RISK/RESILIENCE, HEALTHCARE BARRIERS/FACILITATORS, AND PREP CONTINUUM DISPARITIES AMONG WWUD IN THE US SOUTH, EMPLOYING AN INTERSECTIONAL STRENGTHS-BASED ANALYTICAL LENS TO INFORM MULTI-LEVEL STIGMA-REDUCTION, HIV PREVENTION, AND PREP PROMOTION INITIATIVES. TO DO SO, I WILL FIRST DESCRIBE HIV RISK AND PREP CONTINUUM DISPARITIES BY IDENTIFYING WWUD SUBGROUPS BASED ON INTERSECTIONAL IDENTITY (I.E., RACE X SEXUAL ORIENTATION) AND CONTEXTUAL FACTORS (E.G., SEX EXCHANGE) USING INTERSECTIONAL QUANTITATIVE APPROACHES GAINED FROM TRAINING (E.G., LATENT CLASS ANALYSES) WITH SOUTHERN NATIONAL HIV BEHAVIORAL SURVEILLANCE DATA (AIM 1). NEXT, I WILL EXPLORE MULTI-LEVEL BARRIERS/FACILITATORS (E.G., INTERSECTIONAL STIGMA) IN HIV PREVENTION-RELATED HEALTHCARE, HIV RISK, AND PREP CONTINUUM VIA QUALITATIVE HEALTHCARE GO-ALONG INTERVIEWS WITH A PURPOSIVELY SELECTED SAMPLE OF PREP INDICATED WWUD IN NEW ORLEANS, LA (AIM 2). SUBSEQUENTLY, I WILL EXPLORE INSTITUTIONAL PRACTICES RELATED TO WWUD IDENTIFIED BARRIERS/FACILITATORS TO HIV PREVENTION-RELATED HEALTHCARE SEEKING, HIV RISK, AND PREP CONTINUUM UTILIZING INSTITUTIONAL ETHNOGRAPHY (AIM 3). THIS PROPOSED RESEARCH WILL FACILITATE APPLICATION OF TRAINING OBJECTIVES TOWARDS MY LONG-TERM CAREER GOAL OF BECOMING AN INDEPENDENT NIH-FUNDED HIV PREVENTION AND HEALTH EQUITY INVESTIGATOR. MY CAREER DEVELOPMENT PLAN, INCLUDING AN EXPERT TEAM OF MENTORS, (DRS. LATKIN, BOWLEG, THEALL, GERMAN, BARAL), CENTERS THE FOLLOWING TRAINING OBJECTIVES: 1) DEVELOP COMPREHENSIVE EXPERTISE IN INTERSECTIONALITY THEORY APPLICATION, ASSOCIATED MIXED-METHODS STUDY DESIGN APPROACHES, AND ADVANCED ETHNOGRAPHIC METHODOLOGY (E.G., GO-ALONG INTERVIEWS); 2) DEVELOP ADVANCED STATISTICAL THEORY AND METHODS TO CONDUCT QUANTITATIVE INTERSECTIONALITY ANALYSES(E.G., LATENT CLASS ANALYSIS); 3) GAIN EXPERTISE IN MULTI-LEVEL INTERSECTIONAL STIGMA THEORY AND ETHNOGRAPHIC METHODS(E.G., INSTITUTIONAL ETHNOGRAPHIES); AND 4) DEVELOP SKILLS NEEDED FOR A SUCCESSFUL ACADEMIC CAREER IN INTERSECTIONAL MIXED-METHOD HIV PREVENTION RESEARCH WITH VULNERABILIZED POPULATIONS (E.G., RESEARCH BIOETHICS, MULTI-STAKEHOLDER DISSEMINATION, GRANT WRITING; AND INTERDISCIPLINARY NETWORKING).

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K01DA059328_7529/

ASST_NON_UG3MH133258_7529

Department of Health and Human Services

National Institutes of Health

GEORGE WASHINGTON UNIVERSITY (THE)

GEORGE WASHINGTON UNIVERSITY (THE)

DISTRICT OF COLUMBIA

IDENTIFYING SOCIOECOLOGICAL PROFILES THAT IMPACT CHANGES IN CARE OUTCOMES AMONG BLACK SEXUAL MINORITY MEN LIVING WITH HIV - PROJECT SUMMARY/ABSTRACT THE U.S. WILL NOT MEET THE TARGETS OF THE ENDING THE HIV EPIDEMIC PLAN (EHE) WITHOUT AN INTENTIONAL FOCUS ON IMPROVING OUTCOMES AMONG BLACK SEXUAL MINORITY MEN LIVING WITH HIV (BSMM LWH). ONLY 55% OF BSMM LWH MAINTAIN 100% DAILY TREATMENT ADHERENCE AND ONLY 62% ARE VIRALLY SUPPRESSED. RESEARCH PROVES THAT MULTILEVEL FACTORS SUCH AS RACISM, STIGMA, DEPRESSION, VICTIMIZATION, AND ECONOMIC INSTABILITY ARE IMPORTANT UNADDRESSED DETERMINANTS OF HIV CARE OUTCOMES. UPDATES TO HEALTH CARE DELIVERY MODELS DUE TO COVID-19 (I.E. TELEHEALTH) PROVIDED NOVEL WAYS TO IMPROVE HIV CARE ENGAGEMENT, RETENTION, AND ADHERENCE. HOWEVER, BSMM STILL EXPERIENCE WORSE OUTCOMES THAN OTHERS EVEN WHEN ACCOUNTING FOR DIFFERENCES IN ACCESS TO RESOURCES. THE LITERATURE COLLECTIVELY SUGGESTS THAT MULTILEVEL FACTORS COULD CREATE DISTINCT SOCIOECOLOGICAL PATTERNS THAT IMPACT HIV CARE OUTCOMES FOR BSMM LWH, ESPECIALLY ACROSS AGE GROUPS. BSMM LWH HAVE NOT ADEQUATELY ENGAGED OR RETAINED IN CARE ACTIVITIES BECAUSE PREVIOUS APPROACHES DO NOT ACCOUNT FOR THEIR CURRENT OR COMBINED SOCIOECOLOGICAL EXPERIENCES. PREVIOUS STUDIES ARE OUTDATED, CROSS-SECTIONAL, UTILIZE CULTURALLY INAPPROPRIATE MEASURES, AND HAVE SMALL SAMPLES OF BLACK PARTICIPANTS. SUSTAINABLE APPROACHES TO ENGAGE THIS POPULATION REMAIN ELUSIVE, ESPECIALLY FOR YOUNG BSMM LWH. THERE IS NO DIGITAL, LIMITED INTERACTION COHORT STUDY CENTERED ON BSMM LWH DESPITE FOCUS GIVEN TO OTHER PRIORITY POPULATIONS SUCH AS TRANSWOMEN, DRUG USERS, AND ADOLESCENTS. THE GOAL OF THIS LIMITED INTERACTION TARGETED EPIDEMIOLOGY PROPOSAL IS TO CONDUCT A PROSPECTIVE COHORT STUDY TO IDENTIFY THE HIV CARE RISKSCAPE FOR BSMM LWH AND EXAMINE HOW MULTILEVEL FACTORS IMPACT CHANGES IN RETENTION IN HIV CARE, TREATMENT ADHERENCE, AND VIRAL SUPPRESSION. PHASE 1 WILL IDENTIFY EFFECTIVE RECRUITMENT STRATEGIES (AIM 1) AND VALIDATE COMMONLY ACCEPTED SCALES AMONG BSMM LWH TO AID IN SURVEY DESIGN (AIM 2). THEN WE WILL EXPLORE THE FEASIBILITY AND ACCEPTABILITY OF ENROLLING A LARGE DIGITAL COHORT OF MID-ATLANTIC BSMM LWH (AIM 3). PHASE 2 WILL COLLECT AND ANALYZE PROSPECTIVE COHORT DATA COLLECTED AT BASELINE, 3-MONTHS, 6-MONTHS TO QUANTIFY THE CROSS SECTIONAL AND LONGITUDINAL RELATIONSHIPS BETWEEN MULTILEVEL FACTORS AND HIV CARE OUTCOMES AMONG 1,500 BSMM LWH (AIM 4). THIS STUDY WILL BE THE LARGEST PROSPECTIVE COHORT FOCUSED ON BSMM LWH EVER CONDUCTED AND TARGETS HIGH-PRIORITY EHE LOCALES. THIS STUDY ALIGNS WITH NIH PRIORITIES TO MAP LONGITUDINAL TRAJECTORIES OF THE HIV CARE CONTINUUM, IDENTIFY PREDICTORS OF CHANGES IN VIRAL SUPPRESSION, AND SUPPORT LARGE STUDIES LED BY BLACK INVESTIGATORS. THIS WORK ALSO BUILDS UPON THE EXISTING COLLABORATION, RESOURCES, AND SUPPORT OF THE MID ATLANTIC CFAR CONSORTIUM AND IS THE NEXT STEP NEEDED IN OUR WORK TO DESIGN EQUITABLE APPROACHES TO IMPROVE HIV CARE OUTCOMES FOR BSMM LWH.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_UG3MH133258_7529/

ASST_NON_U01MH136574_7529

Department of Health and Human Services

National Institutes of Health

SAN FRANCISCO STATE UNIVERSITY

SAN FRANCISCO STATE UNIVERSITY

HERMANOS DE LUNA Y SOL: A COMMUNITY-BASED HIV PREVENTION INTERVENTION - ABSTRACT THE OVERALL GOAL OF OUR RESEARCH IS TO REDUCE HIV-RELATED HEALTH INEQUITIES AMONG LATINX IMMIGRANT POPULATIONS. WE PROPOSE TO DETERMINE THE EFFECTIVENESS OF HERMANOS DE LUNA Y SOL (HLS), A COMMUNITY-BASED, GROUP INTERVENTION DELIVERED IN SPANISH, DESIGNED TO REDUCE HIV SEXUAL RISK AMONG LATINX IMMIGRANTS WHO IDENTIFY AS GAY/BISEXUAL MEN OR MEN WHO HAVE SEX WITH MEN (GBMSM). THE STUDY IS DESIGNED AS A QUASI-EXPERIMENTAL, COMMUNITY CONTROL, WITH OAKLAND, CA AS THE INTERVENTION GROUP AND CHICAGO, IL AS THE CONTROL. ASSESSMENTS WILL BE CONDUCTED AT -3 AND 0 MOS., AND FOLLOW-UPS AT 3, 6, AND 12 MOS. PARTICIPANTS (N=360; N=180 PER CITY) WILL BE RECRUITED USING TIME-LOCATION SAMPLING (A VENUE-BASED SAMPLING DESIGNED TO REDUCE SAMPLE BIAS). HLS, THE INTERVENTION AT THE HEART OF THIS STUDY, OFFERS SEVERAL NOVEL FEATURES: IT FOCUSES ON IMMIGRANT, SPANISH- SPEAKING POPULATIONS; IT ADDRESSES RACISM AND HOMOPHOBIA AS FACTORS SHAPING HIV RISK; AND USES A COMMUNITY-BASED APPROACH CENTERED ON COMMUNITY INVOLVEMENT (E.G., CIVIC PARTICIPATION, VOLUNTEERING) AS A MEANS TO FOSTER SEXUAL HEALTH AND COMMUNITY BUILDING. THE STUDY WILL HELP IDENTIFY EFFECTIVE INTERVENTIONS TO PREVENT HIV AMONG LATINX IMMIGRANT GBMSM, A MARGINALIZED POPULATION FOR WHICH HIV PREVENTIVE INTERVENTIONS ARE SEVERELY LACKING. THIS STUDY CAPITALIZES ON AN EXISTING INTERVENTION DESIGNED FOR SPANISH SPEAKING POPULATIONS; IS THE FIRST OF ITS KIND TO RIGOROUSLY TEST THE INTERVENTION’S EFFECTIVENESS AMONG LATINX IMMIGRANT GBMSM USING A COMMUNITY CONTROL DESIGN. THE STUDY APPLIES THE BEST POSSIBLE SCIENTIFIC APPROACH TO OBTAIN ESTIMATES OF INTERVENTION EFFECTIVENESS. IF SUCCESSFUL, THE INTERVENTION WOULD BE RELATIVELY EASY TO DISSEMINATE VIA COMMUNITY ORGANIZATIONS AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. ULTIMATELY, THE STUDY WILL HELP MOVE FORWARD EFFORTS TO REDUCE RACIAL/ETHNIC HEALTH INEQUITIES, ONE OF THE NATION’S MAJOR PUBLIC HEALTH PRIORITIES. THIS PROPOSAL IS DIRECTLY RELEVANT TO THE RFA ON TRANSFORMATIVE RESEARCH TO ADDRESS HEALTH DISPARITIES AND ADVANCE HEALTH EQUITY AT MINORITY SERVING INSTITUTIONS. THE PROJECT IS LED BY SFSU – A HISPANIC SERVING INSTITUTION-- IN COLLABORATION WITH TWO LATINX COMMUNITY-BASED ORGANIZATIONS: LA FAMILIA AND CHICAGO QUEER LATINX COLLABORATIVE. WE ARE A MULTIDISCIPLINARY RESEARCH TEAM WITH THE DEPTH AND BREADTH OF EXPERIENCE ON HIV PREVENTION WITH LATINX AND GBMSM COMMUNITIES TO SUCCESSFULLY CONDUCT THE STUDY. ALL SENIOR PERSONNEL ARE OF LATIN AMERICAN DESCENT, FULLY BILINGUAL (SPANISH AND ENGLISH), AND THREE OF THEM ARE WOMEN. THE PROPOSED STUDY IS STRONGLY ALIGNED WITH NIH UNITED INITIATIVE OF FOSTERING RACIAL EQUITY AND INCLUSION IN BIOMEDICAL RESEARCH AND IS RESPONSIVE TO PRIORITY AREAS OF MULTIPLE NIH INSTITUTES AND CENTERS, SUCH NIMHD, NIMH, AND THE OFFICE OF AIDS RESEARCH.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_U01MH136574_7529/

ASST_NON_K23MH132475_7529

Department of Health and Human Services

National Institutes of Health

TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE

TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE

ACCELERATING EQUITABLE PREP DELIVERY FOR BLACK ADULTS IN PRIMARY CARE SETTINGS: DEVELOPMENT AND TESTING OF A PRACTICE-LEVEL MULTIFACETED IMPLEMENTATION STRATEGY - PROJECT SUMMARY/ABSTRACT SUBSTANTIAL MEASURES MUST BE TAKEN IN THE UNITED STATES TO RECTIFY THE MARKED INEQUITIES IN HIV PRE-EXPOSURE PROPHYLAXIS (PREP) OUTCOMES AMONG BLACK ADULTS. PREP IMPLEMENTATION AMONG BLACK POPULATIONS IS UNDERMINED BY INDIVIDUAL, INTERPERSONAL, AND STRUCTURAL BARRIERS ROOTED IN STIGMA, RACISM, HETEROSEXISM, AND SEXISM. IMPROVING PREP PROVISION HAS BECOME IMPERATIVE AS NOVEL MODALITIES EMERGE. THERE IS AN URGENT NEED TO DEVELOP IMPLEMENTATION STRATEGIES THAT ACCELERATE EQUITABLE PREP DELIVERY. THE GOAL OF THIS K23 IS TO FACILITATE DR. WATSON’S LONG-TERM GOAL TO BECOME AN INDEPENDENT INVESTIGATOR FOCUSED ON THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES TO ACHIEVE EQUITABLE HIV PREVENTION OUTCOMES AMONG BLACK POPULATIONS. THE PROPOSED K23 WILL FOCUS ON DESIGNING AND TESTING A MULTIFACETED IMPLEMENTATION STRATEGY TO SUPPORT PREP PROVISION FOR BLACK PRIMARY CARE PATIENTS, GROUNDED IN AN ADAPTED CONCEPTUAL FRAMEWORK THAT INCLUDES CONSTRUCTS FROM THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR) AND BANDURA’S SOCIAL COGNITIVE THEORY. DR. WATSON’S PROPOSED RESEARCH PLAN WILL CONSIST OF TRAINING OBJECTIVES IN (1) QUALITATIVE RESEARCH, (2) BEHAVIORAL AND SOCIAL SCIENCE RESEARCH (BSSR), (3) COMMUNITY-ENGAGED RESEARCH, AND (4) IMPLEMENTATION SCIENCE. WITH A FOCUS ON EQUITY-CENTERED APPLICATIONS WITHIN IMPLEMENTATION SCIENCE AND COMMUNITY-ENGAGED RESEARCH, SHE REQUIRES FURTHER TRAINING IN QUALITATIVE RESEARCH, BSSR, AND TRIAL DESIGN TO DEVELOP AND PILOT AN IMPLEMENTATION STRATEGY TO INCREASE LOCAL PREP PROVISION CAPACITY. THESE TRAINING OBJECTIVES WILL BE ACHIEVED THROUGH MENTORSHIP FROM AN EXEMPLARY MULTIDISCIPLINARY MENTORSHIP TEAM, COMPLEMENTARY RESEARCH AIMS, PROFESSIONAL DEVELOPMENT ACTIVITIES, AND COURSEWORK. SPECIFICALLY, SHE PLANS TO: (AIM 1) IDENTIFY KEY PROVIDER-, PRACTICE-, AND COMMUNITY-LEVEL CFIR- BASED DETERMINANTS OF LOCAL PREP DELIVERY; (AIM 2) DEVELOP A THEORY-INFORMED MULTIFACETED IMPLEMENTATION STRATEGY THAT FOLLOWS A DESTIGMATIZING SEXUAL HEALTH FRAMEWORK TO ACCELERATE EQUITABLE PREP DELIVERY FOR ADULT BLACK PRIMARY CARE PATIENTS; (AIM 3) CONDUCT A 12-MONTH TWO-ARM PILOT TRIAL TO EVALUATE IMPLEMENTATION STRATEGY FEASIBILITY AND ACCEPTABILITY AT FOUR MEDICAL PRACTICES THAT PROVIDE PRIMARY CARE SERVICES. THE RESULTS OF THIS STUDY WILL BE IMPORTANT FOR THE FIELD OF IMPLEMENTATION SCIENCE AS IT FOCUSES ON FACILITATING THEORY- INFORMED BEHAVIOR CHANGES AMONG PROVIDERS AND PRACTICE LEADERSHIP TO ACCELERATE EQUITABLE PREP PROVISION FOR BLACK PRIMARY CARE PATIENTS. FINDINGS FROM THE PILOT WILL INFORM THE DESIGN AND SUBMISSION OF AN R01 APPLICATION FOR A HYBRID EFFECTIVENESS-IMPLEMENTATION TRIAL OF THE IMPLEMENTATION STRATEGY IN YEAR 4. THE PROPOSAL WILL FORM A STRONG FOUNDATION FOR DR. WATSON’S CONTINUED DEVELOPMENT TOWARD AN INDEPENDENTLY FUNDED RESEARCH CAREER AS AN IMPLEMENTATION SCIENTIST INVESTED IN THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES TO ACHIEVE EQUITABLE HIV PREVENTION CARE OUTCOMES AMONG BLACK ADULTS IN THE U.S.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K23MH132475_7529/

ASST_NON_UG3DA058304_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

DEVELOPING A U.S. NATIONAL COHORT TO IMPROVE VIROLOGIC SUPPRESSION AMONG STIMULANT-USING MEN LIVING WITH HIV. - PROJECT SUMMARY/ ABSTRACT A RESURGENT STIMULANT EPIDEMIC AMONG SEXUAL MINORITY MEN/MEN WHO HAVE SEX WITH MEN, INCLUDING THOSE LIVING WITH HIV, COULD COMPROMISE THE U.S. ENDING THE HIV EPIDEMIC GOALS BY INTERFERING WITH HIV CARE ENGAGEMENT, ADHERENCE, AND VIROLOGIC SUPPRESSION AMONG SEXUAL MINORITY MEN LIVING WITH HIV. PROMINENT MULTI-LEVEL BARRIERS INTERFERE WITH HIV VIROLOGIC SUPPRESSION AMONG SEXUAL MINORITY MEN LIVING WITH HIV, PARTICULARLY AMONG THOSE WHO USE STIMULANTS. WE WILL DIGITALLY RECRUIT AT LEAST 1,000 SEXUAL MINORITY MEN LIVING WITH HIV, OF WHOM AT LEAST 40% WILL IDENTIFY AS BLACK/AFRICAN-AMERICAN AND AT LEAST 70% WILL HAVE ACTIVE STIMULANT USE TO IDENTIFY MULTI-LEVEL DETERMINANTS OF HIV CARE ENGAGEMENT, ADHERENCE, AND VIROLOGIC SUPPRESSION AMONG SEXUAL MINORITY MEN LIVING WITH HIV, WITH AND WITHOUT STIMULANT USE. GUIDED BY THE SOCIAL ECOLOGICAL MODEL, WE WILL INVESTIGATE NETWORK FACTORS (HIV STATUS, STIMULANT USE), GEOSPATIAL DETERMINANTS (BACKGROUND STIMULANT USE PREVALENCE, EHE REGION), AND OTHER STRUCTURAL FACTORS (INTERSECTIONAL STIGMA, STRUCTURAL RACISM) THAT AFFECT VIROLOGIC SUPPRESSION (AIM 1). AFTER RECRUITMENT MILESTONES ARE MET, WE WILL PERFORM A NESTED RANDOMIZED CLINICAL TRIAL TO TEST A MULTI-COMPONENT INTERVENTION TO IMPROVE VIROLOGIC SUPPRESSION, ADHERENCE, POSITIVE AFFECT, AND STIMULANT USE AMONG SEXUAL MINORITY MEN LIVING WITH HIV WHO USE STIMULANTS (N=300). THE INTERVENTION, KNOWN AS RESTART, WILL COMBINE AN EVIDENCE-BASED POSITIVE AFFECT INTERVENTION DELIVERED THROUGH A SMARTPHONE APP AND USE OF URINE POINT-OF- CARE TESTING TO PERFORM ADHERENCE SELF-MONITORING, WITH MOTIVATIONAL MESSAGES TO IMPROVE OR MAINTAIN ADHERENCE DELIVERED VIA THE RESTART APP (AIM 2). IN AIM 3 OF THE PROPOSAL, WE WILL ASSESS THE IMPACT OF RESTART ON INCREMENTAL COST PER PERSON ON VIROLOGIC SUPPRESSION AND OPTIMAL ANTIRETROVIRAL THERAPY ADHERENCE MEASURED VIA HAIR TENOFOVIR LEVELS. BY THIS HIGH-IMPACT STUDY’S END, WE WILL HAVE IDENTIFIED MULTI-LEVEL DETERMINANTS OF THE TREATMENT CONTINUUM AMONG DIGITALLY-RECRUITED SEXUAL MINORITY MEN LIVING WITH HIV, INCLUDING AMONG THOSE WHO USE STIMULANTS; AND THE IMPACT OF A MULTI-COMPONENT RESTART MHEALTH INTERVENTION USING NOVEL POINT-OF-CARE ADHERENCE SELF- MONITORING ON HIV VIROLOGIC SUPPRESSION, ADHERENCE, AND COST AMONG A KEY UNDERSERVED POPULATION.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_UG3DA058304_7529/

ASST_NON_UG3AI176853_7529

Department of Health and Human Services

National Institutes of Health

EMORY UNIVERSITY

EMORY UNIVERSITY

LIMITED INTERACTION COHORT TO IDENTIFY DETERMINANTS OF VIRAL SUPPRESSION IN MSM AND TRANSFEMININE INDIVIDUALS LIVING WITH HIV: A MULTILEVEL APPROACH - ABSTRACT FOR PEOPLE LIVING WITH HIV (PLWH), ACHIEVING AND MAINTAINING VIRAL SUPPRESSION HAS CRITICAL BENEFITS FOR THEIR HEALTH AND FOR REDUCING THE RISK OF TRANSMITTING HIV TO OTHERS. VIRAL SUPPRESSION IS THUS A CRITICAL CORNERSTONE OF THE US PROGRAM TO END HIV. HOWEVER, OVER A THIRD OF PEOPLE IN THE US LIVING WITH HIV DO NOT HAVE A SUPPRESSED VIRAL LOAD. SOME GROUPS, INCLUDING YOUNGER PEOPLE AND BLACK PEOPLE, HAVE LOWER LEVELS OF VIRAL SUPPRESSION. ALTHOUGH TRANSFEMININE PEOPLE (TFP) HAVE SHOWN RATES OF VIRAL SUPPRESSION COMPARABLE TO OTHER GROUPS, THERE IS AMPLE EVIDENCE THAT THEY EXPERIENCE A MULTITUDE OF BARRIERS TO SUSTAINING VIRAL SUPPRESSION, INCLUDING MULTIPLE FORMS OF STIGMA AND STRUCTURAL BARRIERS TO ACCESSING CULTURALLY APPROPRIATE CARE. IN ADDITION, THERE ARE WIDE RACIAL DISPARITIES IN HIV CARE AMONG TRANSGENDER COMMUNITIES, WITH BLACK TFP EXPERIENCING SOME OF THE LOWEST LEVELS OF VIRAL SUPPRESSION. A DEEP UNDERSTANDING IF REQUIRED OF THE CIRCUMSTANCES THAT SURROUND GAINING, SUSTAINING OR LOSING VIRAL SUPPRESSION. MOST RESEARCH TO DATE HAS FOCUSED ON INDIVIDUAL FACTORS ASSOCIATED WITH VIRAL SUPPRESSION STATUS. THIS APPROACH IS LIMITED IN THAT IT RESTRICTS THE CONSIDERATION OF THE CAUSES OF LACK OF VIRAL SUPPRESSION TO INDIVIDUAL CHARACTERISTICS OR BEHAVIORS, AND MISSES THE BROADER CONTEXTS – STIGMA, DISCRIMINATION, LACK OF HEALTH COVERAGE, DISTANCE TO HEALTHCARE PROVIDERS, AND STRUCTURAL RACISM – THAT SHAPE THE RISK OF PLWH FOR LOSING VIRAL SUPPRESSION. FURTHER, UNDERSTANDING THESE MULTILEVEL PREDICATORS OF LOSS OF VIRAL SUPPRESSION IS REQUIRED TO DEVELOP INTERVENTIONS THAT ARE RESPONSIVE TO THE CIRCUMSTANCES THAT SHAPE RISKS FOR REMAINING OR BECOMING UNSUPPRESSED. THUS, WE PROPOSE TO ENROLL AND FOLLOW A COHORT OF PLWH – BOTH MSM AND TFP – TO OBSERVE THE PATTERNS OF GAINING, SUSTAINING OR LOSING VIRAL SUPPRESSION, AND TO DEVELOP INFORMATION THAT CAN BE USED TO INFORM THE DEVELOPMENT OF NEW INTERVENTIONS TO SUPPORT ONGOING ENGAGEMENT IN HIV CARE AND VIRAL SUPPRESSION. DRAWING ON OVER A DECADE OF EXPERIENCE IN RECRUITING AND RETAINING SEXUAL AND GENDER MINORITY PEOPLE IN LIMITED- INTERACTION RESEARCH STUDIES, WE WILL DEVELOP NUANCED DATA ABOUT THE UNIQUE FACTORS THAT SHAPE VIRAL SUPPRESSION OR LACK THEREOF IN DIFFERENT CRITICAL GROUPS, INCLUDING BLACK MSM AND TFP, AND YOUNGER MSM, THAT ARE INEQUITABLY IMPACTED BY LACK OF VIRAL SUPPRESSION.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_UG3AI176853_7529/

ASST_NON_K01MH133504_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF MICHIGAN

REGENTS OF THE UNIVERSITY OF MICHIGAN

COMMUNITY-ENGAGED STRUCTURAL APPROACHES TO PREVENT VIOLENCE AND IMPROVE HIV PREVENTION AND CARE OUTCOMES AMONG TRANS WOMEN OF COLOR - PROJECT ABSTRACT THIS K01 APPLICATION TO NIMH WILL ENABLE A CONCENTRATED FOUR-YEAR INTENSIVE TRAINING AND MENTORED RESEARCH PROGRAM DESIGNED TO TRANSITION DR. SARAH PEITZMEIER FROM HER CURRENT OBSERVATIONAL RESEARCH FOCUS TO A NEW RESEARCH AGENDA DESIGNING AND EVALUATING STRUCTURAL INTERVENTIONS WITHIN A COMMUNITY-BASED PARTICIPATORY RESEARCH (CBPR) CONTEXT FOR INTEGRATED HIV AND VIOLENCE PREVENTION AND MENTAL HEALTH PROMOTION, IN PARTNERSHIP WITH TRANS WOMEN OF COLOR. DR. PEITZMEIER IS AN ASSISTANT PROFESSOR AT THE UNIVERSITY OF MICHIGAN SCHOOL OF NURSING AND SCHOOL OF PUBLIC HEALTH, WHICH HOUSES ONE OF THE OLDEST CBPR PARTNERSHIPS AND ACADEMIES NATIONALLY (THE DETROIT URBAN RESEARCH CENTER) AND IS A POWERHOUSE OF HIV INTERVENTION RESEARCH. RACISM, SEXISM, HIV STIGMA, CISGENDERISM, AND OTHER INTERLOCKING FORMS OF OPPRESSION GENERATE MUTUALLY REINFORCING STRUCTURAL VULNERABILITIES FOR TRANS WOMEN OF COLOR, INCLUDING GENDER-BASED VIOLENCE (GBV), POVERTY, HOMELESSNESS, AND SEX WORK. THESE STRUCTURAL VULNERABILITIES SYNERGISTICALLY INTERACT TO ELEVATE RISK OF HIV. HOWEVER, INTERVENTIONS TO ADDRESS THESE DEEPLY ENTRENCHED UPSTREAM STRUCTURAL DETERMINANTS OF HIV IN THIS POPULATION ARE LIMITED, WHICH IN TURN LIMITS THE EFFICACY OF DOWNSTREAM INDIVIDUAL BEHAVIORAL INTERVENTIONS WHILE THESE DETERMINANTS REMAIN INTACT. THE PROPOSED WORK WILL 1) IDENTIFY COMMUNITY PRIORITIES FOR A STRUCTURAL INTERVENTION FOR INTEGRATED HIV/GBV PREVENTION THROUGH FORMING A CBPR PARTNERSHIP WITH TRANS WOMEN OF COLOR AND SERVICE PROVIDERS IN DETROIT AND CONDUCTING AN ACTION-ORIENTED COMMUNITY DIAGNOSIS, 2) DEVELOP A GROUNDED THEORY OF HOW TRANS WOMEN'S PARTICIPATION IN A CASH-PLUS CASH TRANSFER INTERVENTION AFFECTS THEIR EXPERIENCE OF GBV, HIV-RELATED BEHAVIORS, AND MENTAL HEALTH, AND 3) COLLABORATIVELY DESIGN A STATUS-NEUTRAL INTERVENTION TO PROMOTE HIV PREVENTION AND CARE, REDUCE MENTAL HEALTH BURDEN, AND PREVENT GBV AGAINST TRANS WOMEN OF COLOR. THE RESEARCH WILL BE UNDERPINNED BY COURSEWORK IN CBPR, STRUCTURAL INTERVENTIONS, INTERVENTION TRIAL DESIGN, AND IMPLEMENTATION SCIENCE, AS WELL AS INVALUABLE MENTORED LEARNING EXPERIENCES OBSERVING THE IMPLEMENTATION AND EVALUATION OF DIVERSE STRUCTURAL INTERVENTIONS (DRS. DARBES, SHERMAN, GAMAREL, AND PETTIFOR) AND CBPR PARTNERSHIPS (GAMAREL, ISRAEL, BRUSH, RIVERA) FROM RENOWNED EXPERTS IN THE FIELD. OVERALL, THE RESEARCH WILL GENERATE RICH PRELIMINARY DATA, A FINALIZED INTERVENTION PROTOCOL, A CONCRETE STRATEGY FOR FUNDING AND IMPLEMENTING THE INTERVENTION, A PILOT HYBRID EFFICACY-IMPLEMENTATION TRIAL DESIGN FOR EVALUATING THE INTERVENTION, AND A STRONG CBPR PARTNERSHIP AS A FRUITFUL PLATFORM FOR DR. PEITZMEIER'S ONGOING RESEARCH AGENDA IN PARTNERSHIP WITH THIS COMMUNITY. BY SUPPORTING DIDACTIC AND FIELD-BASED LEARNING AND PROTECTED TIME FOR RESEARCH AND CBPR PARTNERSHIP BUILDING, A K01 WILL ADVANCE DR. PEITZMEIER'S CAREER PROGRESSION AS AN INDEPENDENT, COMMUNITY-BASED HIV INTERVENTION SCIENTIST FOCUSED ON STRUCTURAL DETERMINANTS OF HEALTH, LEADING TO BETTER HEALTH AND WELLBEING AMONG TRANS WOMEN OF COLOR, AN NIH PRIORITY POPULATION.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K01MH133504_7529/

ASST_NON_F31MH135787_7529

Department of Health and Human Services

National Institutes of Health

THE JOHNS HOPKINS UNIVERSITY

THE JOHNS HOPKINS UNIVERSITY

EXTENDING THE PREVENTION TOOLBOX: EXPLORING THE ACCEPTABILITY AND IMPACT OF LONG-ACTING INJECTABLE PREP AMONG MSM IN BALTIMORE: A PILOT STUDY - PROPOSAL SUMMARY THE INCIDENCE OF HIV IN BALTIMORE, MD IS AMONG THE HIGHEST IN THE US, WITH MEN WHO HAVE SEX WITH MEN (MSM) BEARING A DISPROPORTIONATE BURDEN OF THE DISEASE. AS WE ENTER THE “95-95-95” ERA OF THE JOINT UN PROGRAM ON HIV/AIDS (UNAIDS) FAST TRACK TARGETS, RESEARCH INTO INNOVATIVE APPROACHES THAT EXTEND THE PREVENTION TOOLBOX IS NEEDED. LONG-ACTING (LA) CABOTEGRAVIR (CAB) FOR HIV PRE-EXPOSURE PROPHYLAXIS (PREP) WAS RECENTLY APPROVED BY THE FDA BASED ON DATA THAT DEMONSTRATED SUPERIORITY TO TENOFOVIR DISOPROXIL FUMARATE (TDF)/EMTRICITABINE (FTC). LA PREP MAY HELP OVERCOME KEY CHALLENGES OF ORAL PREP BY INCREASING PREP USE/UPTAKE, PARTICULARLY AMONG KEY POPULATIONS, SUCH AS MSM. FURTHERMORE, MUCH RESEARCH HAS SHOWN THAT SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH (SSDOH), SUCH AS POVERTY, RACISM, ACCESS, HOMONEGATIVITY AND DISCRIMINATION AND INDIVIDUAL AND COMMUNITY-LEVEL FACTORS, SUCH AS STIGMA, KNOWLEDGE, AND PERCEPTION TOWARDS PREP SHAPE ACCESS AND UPTAKE OF PREP AMONG MSM INDIVIDUALS. STUDIES TO DATE HAVE EXPLORED THE ACCEPTABILITY OF LA PREP AS A HYPOTHETICAL OPTION AMONG MSM; HOWEVER, SINCE THE FDA APPROVAL OF LA CAB IN DECEMBER 2021, LITTLE IS KNOWN ABOUT PERCEPTIONS AND ACCEPTABILITY OF LA PREP IN HIGH-RISK MSM COMMUNITIES AND ITS RELATION TO SEXUAL NETWORK STRUCTURES (E.G., HOW DO THE PERCEPTIONS AND BEHAVIORS OF ONE’S CONTACTS INFLUENCE ONE’S OWN PERCEPTION OF LA PREP). FURTHER, EVEN AMONG THOSE ON ORAL PREP, LITTLE IS KNOWN ABOUT THE KNOWLEDGE, ACCEPTABILITY, AND PREFERENCE OF DAILY TENOFOVIR ALAFENAMIDE (TAF) VS. TDF-BASED REGIMENS AND FURTHER STILL, DAILY ORAL PREP VS. TDF/FTC 2-1-1 (ON-DEMAND) PREP, WHICH WAS NOT INCLUDED IN CDC GUIDELINES UNTIL 2021. THE APPLICANTS PROPOSED STUDY, EXTENDING THE PREVENTION TOOLBOX: EXPLORING THE ACCEPTABILITY AND IMPACT OF LONG-ACTING INJECTABLE PREP AMONG MSM IN BALTIMORE: A PILOT STUDY WILL ADDRESS THIS GAP. THIS STUDY WILL GATHER DATA ON COMMUNITY PREFERENCES FOR PREP CHOICES AMONG MSM IN BALTIMORE AND USE THIS INFORMATION TO INFORM MESSAGING AND SUPPORT MECHANISMS, AS WELL AS GENERATE DATA ON BEHAVIORS AND NETWORKS TO INFORM EPIDEMIOLOGICAL MODELS AND POLICIES TO REDUCE BARRIERS TO PREP. THIS WILL BE ACCOMPLISHED THROUGH THE FOLLOWING AIMS: AIM 1: TO USE THEMATIC ANALYSIS FROM THE PARENT STUDY FOCUS GROUP INTERVIEWS, TO REFINE A CROSS-SECTIONAL SURVEY INCLUDING A DCE MODULE FOR PREP PREFERENCES WITH RANDOM ALLOCATION OF ATTRIBUTES (I.E., COST, SIDE-EFFECTS, EFFECTIVENESS, INSURANCE COVERAGE ETC.) WITHIN EACH PREP CHOICE SET. AIM 2: TO CHARACTERIZE MSM SEXUAL NETWORKS IN BALTIMORE (N=500) TO DETERMINE THE IMPACT OF PREDISPOSING, ENABLING, AND PERCEIVED NEED FACTORS ON PREP USE/UPTAKE. AIM3: TO EVALUATE HOW SEXUAL NETWORK CHARACTERISTICS IMPACTS PREP USE/UPTAKE AND PREFERENCES AMONG MSM; H1: THE USE/UPTAKE OF PREP IS POSITIVELY ASSOCIATED WITH PREP USE WITHIN SEXUAL NETWORKS AND H2: PREP PREFERENCES, AS DETERMINED IN THE DCE ARE POSITIVELY ASSOCIATED WITH SEXUAL NETWORK PARTNER PREFERENCES. THIS INNOVATIVE STUDY BUILDS ON OVER MANY MONTHS OF PRELIMINARY WORK OF CONDUCTING FOCUS GROUPS AND QUAL DATA ANALYSIS FOR THE PARENT STUDY. IT ESTABLISHES A FOUNDATION FOR FUTURE STUDIES TO EVALUATE THE ROLE OF LA PREP IN MSM COMMUNITIES TO IMPLEMENT AN INFORMED PREP STRATEGY.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_F31MH135787_7529/

ASST_NON_H79TI085189_7522

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

HARLEM UNITED COMMUNITY AIDS CENTER INC

HARLEM UNITED COMMUNITY AIDS CENTER INC

SCREENING AND TESTING FOR RACIAL AND ETHNIC AT-RISK MINORITIES (STREAM) PROJECT - SUMMARY: HARLEM UNITED (HU) PROPOSES A PROJECT TO INCREASE ENGAGEMENT IN PREVENTATIVE CARE AS PART OF THE CONTINUUM OF CARE FOR INDIVIDUALS FROM RACIAL/ETHNIC MINORITY COMMUNITIES, PARTICULARLY THOSE LIVING WITH HIV/AIDS, OR AT RISK OF CONTRACTING HIV AND/OR VIRAL HEPATITIS. SERVICES WILL INCLUDE HIV/HCV/HBV TESTING, CASE MANAGEMENT, COUNSELING, AND LINKAGE TO CARE. THE PROJECT WILL CONDUCT 400 ANNUAL HIV TESTS; 300 HCV AND 100 HBV SCREENINGS PER YEAR; 200 BASELINE AND 160 FOLLOW-UP GPRA INTERVIEWS PER YEAR; AND 80 UNIQUE CLIENT ENROLLMENTS IN 1:1 COUNSELING SESSIONS WITH A BEHAVIORAL HEALTH SPECIALIST, FOR A TOTAL OF 960 SESSIONS HELD ANNUALLY. PROJECT NAME: SCREENING AND TESTING FOR RACIAL AND ETHNIC AT-RISK MINORITIES (STREAM) PROJECT TARGET POPULATIONS: HU WILL IMPLEMENT THE STREAM PROJECT TO OFFER SERVICES TO INDIVIDUALS, AGES 18 AND OVER, OF RACIAL AND ETHNIC MINORITIES WITH SUBSTANCE USE DISORDERS (SUD) AND/OR CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS (COD) LIVING WITH OR AT RISK FOR HIV AND/OR HEPATITIS. THIS UNDER-RESOURCED POPULATION EXPERIENCES DISPARITIES IN HEALTH CARE AND OUTCOMES DUE TO DIFFERENCES IN RACE, ETHNICITY, LANGUAGE, CULTURE, AND/OR SOCIOECONOMIC FACTORS. HU RECOGNIZES THE INTERSECTIONAL NATURE OF RACISM, TRANS AND HOMOPHOBIA, SEXISM, AND SOCIAL CLASSISM; WE THUS PROPOSE SERVING THE PRIORITY POPULATIONS OF BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC) WHO GRAPPLE WITH SUBSTANCE USE DISORDER (SUD), SERIOUS MENTAL ILLNESS (SMI), AND MULTIPLE CHRONIC INFECTIONS OR ILLNESSES (E.G., HIV, DIABETES). THESE COMMUNITIES HAVE BEEN OUR FOCUS FOR THE LAST 30 YEARS; AND IN 2021, THE MAJORITY OF HU CLIENTS IDENTIFIED AS BIPOC: 69% AS BLACK, 26% AS LATINO/A. STRATEGIES/INTERVENTIONS: HU’S STREAM PROJECT WILL ENTAIL AN EXPANSION OF HU’S PREEXISTING PREVENTION AND TESTING SERVICE DELIVERY MODEL, WITH AN INCREASE IN OUR TESTING CAPACITY, AS WELL AS THE ADDITION OF A BEHAVIORAL HEALTH SPECIALIST WHO CAN DEVELOP APPROPRIATE TREATMENT APPROACHES BY SCREENING AND ASSESSING CLIENTS INDIVIDUALLY. GIVEN THAT PEOPLE SERVED BY OUR PROJECT ARE ETHNIC AND RACIAL UNDERREPRESENTED INDIVIDUALS LIVING WITH SUD AND/OR COD, THESE SERVICES ARE INTEGRAL TO ACHIEVING INCREASED ENGAGEMENT AND BETTER HEALTH OUTCOMES AND EXPERIENCES FOR THEM. GOALS: THE PRIMARY GOAL OF HU’S PROJECT WILL BE TO INCREASE ENGAGEMENT IN CARE, AND THUS HELP CONTROL THE SPREAD OF CHRONIC INFECTIONS AND THE CONSEQUENCES OF SUCH INFECTIONS FOR RACIAL AND ETHNIC UNDERREPRESENTED INDIVIDUALS WITH SUD/COD WHO ARE AT RISK FOR OR LIVING WITH HIV/AIDS. THIS WILL BE ACHIEVED THROUGH AN INTEGRATED HARM REDUCTION APPROACH, ENCOMPASSING INCREASED HIV TESTING; INCREASED HCV/HBV SCREENING; CASE MANAGEMENT; 1:1 BEHAVIORAL HEALTH COUNSELING SESSIONS; MOTIVATIONAL INTERVIEWING AND INDIVIDUALIZED RECOVERY PLANS; AND BUILDING LASTING CONNECTIONS FOR OUR TARGET POPULATION TO TESTING, COUNSELING, AND HEALTH EDUCATION. OBJECTIVES: 1) CONDUCTING 5 DAYS/WEEK OUTREACH TO TEST 400/YEAR UNIQUE CLIENTS FOR HIV; 2) SCREENING 300/YEAR CLIENTS FOR HCV; 3) SCREENING 300/YEAR CLIENTS FOR HBV; 4) SERVING 1,900 UNDUPLICATED CLIENTS OVER THE 5-YEAR CONTRACT PERIOD (300 IN YEAR 1, 400 IN YEARS 2–5); 5) LINKING 100% OF HIV+ CLIENTS TO CASE MANAGEMENT SERVICES; 6) LINKING 100% OF CLIENTS WITH HCV/HBV TO TREATMENT AS WELL AS OTHER HU SERVICES; 7) LINKING 20/YEAR CLIENTS TO HEP A/B VACCINATION; 8) INVITING 100% OF CLIENTS CONSENTING TO TESTING TO PARTICIPATE IN GPRA INTERVIEWS; 9) CONDUCTING 360/YEAR GPRA INTERVIEWS (200 BASELINE, 160 FOLLOW-UP); 10) PERFORMING 200/YEAR INITIAL COD SCREENINGS TO DEVELOP APPROPRIATE TREATMENT OPTIONS FOR CLIENTS; 11) PROVIDING 80/YEAR UNIQUE CLIENTS 1:1 EVIDENCE-BASED SUD/COD TREATMENT/RECOVERY SUPPORT SERVICES USING MOTIVATIONAL INTERVIEWING TECHNIQUES; 12) LINKING 100% OF CLIENTS TO SUBSTANCE USE COUNSELING, SEEKING SAFETY COUNSELING, AND FDA-APPROVED MEDICATION FOR TREATMENT

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_H79TI085189_7522/

ASST_NON_H79TI085215_7522

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

VIA CARE COMMUNITY HEALTH CENTER

VIA CARE COMMUNITY HEALTH CENTER

VIA CARE CHICAS - VIA CARE COMMUNITY HEALTH CENTER'S CHICAS: MY LIFE, NUESTRO CAMINO PROGRAM IS AN INTEGRATED CULTURALLY COMPETENT TREATMENT RESPONSE TO SUBSTANCE USE DISORDERS AND/OR CO-OCCURRING MENTAL DISORDERS (SUD/COD) AMONG UNDERSERVED HIGH-RISK LATINAS (HRL) IN AND AROUND EAST LOS ANGELES NEIGHBORHOODS WHO ARE AT RISK OR LIVING WITH HIV/AIDS. (LOS ANGELES COUNTY IS ONE OF THE LOCALITIES HARDEST HIT BY THE HIV EPIDEMIC IN THE U.S) THE GOALS OF CHICAS ARE: (1) TO IMPROVE HEALTH, FUNCTIONING, AND STABILITY OF HRL THROUGH COLLABORATIVE, COMPREHENSIVE, TRAUMA-INFORMED, AND RECOVERY-BASED CLINICAL AND PEER SUPPORT SERVICES THAT ADDRESS BEHAVIORAL AND PHYSICAL HEALTH, AS WELL AS OTHER NEEDS DRIVEN BY SOCIAL DETERMINANTS OF HEALTH (SDOH) FACTORS; AND (2) TO REDUCE INFECTION AND TRANSMISSION RATES OF HIV AND VIRAL HEPATITIS (VH) AMONG HRL AND THEIR SEXUAL AND DRUG-USING PARTNERS. MORE THAN 50% OF CHICAS CLIENTS WILL BE JUSTICE-INVOLVED; 50% WILL BE IMMIGRANTS; 30% MONOLINGUAL SPANISH-SPEAKING; 5% TRANSGENDER OR NONBINARY; 20% LESBIAN OR BISEXUAL; 100% LOW-INCOME (UNDER 200% OF THE FPL); 25% UNHOUSED/HOUSING INSECURE; AND 20% WOMEN WHO INJECT DRUGS. HRL FROM EAST LA NEIGHBORHOODS EXPERIENCE DISPARITIES IN ACCESS, USE, AND OUTCOMES OF HEALTH CARE DUE TO A VARIETY OF SDOH FACTORS (E.G., HOUSING INSTABILITY, GENDER-BASED VIOLENCE, GANGS AND JUSTICE SYSTEM INVOLVEMENT, LANGUAGE, RACISM, IMMIGRATION STATUS, TRANS-/HOMOPHOBIA, STIGMA REGARDING SUD/COD AND HIV, THE CULTURE OF MACHISMO, ETC.). THERE IS A DEARTH OF CULTURALLY COMPETENT SUD/COD SERVICES INTEGRATED INTO PROGRAMS AND ORGANIZATIONS THAT SPECIFICALLY ADDRESS THE NEEDS OF WOMEN IN THE CATCHMENT AREA, ESPECIALLY THOSE WHO HAVE EXPERIENCED GENDER-BASED VIOLENCE AND PTSD. OBJECTIVES INCLUDE SCREENING FOR SUD/COD AND HIV/VH AND LINKING IMMEDIATELY AND SUCCESSFULLY INTO CARE COORDINATION SERVICES; ENSURING HIGH RATES OF RETENTION IN THE SEEKING SAFETY EBP AND CLINICAL SERVICES TO ADDRESS PTSD AND SUBSTANCE MISUSE; IMPROVING LINKAGE TO HIV CARE, PREP UPTAKE, AND TREATMENT/MEDICATION ADHERENCE AMONG HRL; SUCCESSFULLY LINKING HRL TO A MEDICAL HOME; AND IMPROVING MENTAL HEALTH AND DECREASING SUBSTANCE MISUSE, THEREBY INCREASING FUNCTIONING, SELF-EFFICACY, SOCIAL CONNECTION/INCLUSION, AND A SENSE OF HOPE FOR PARTICIPANTS. A TOTAL OF 350 UNDUPLICATED HRL WILL BE SERVED (50 IN YEAR 1 AND 75 IN EACH SUBSEQUENT YEAR) THROUGH THIS GRANT. ADDITIONALLY, 1,400 HRL AND THEIR PARTNERS WILL BE SCREENED FOR HIV, 840 SCREENED FOR SUD/COD, 420 WILL BE ENROLLED IN SEEKING SAFETY, AND 420 WILL RECEIVE CASE MANAGEMENT AND/OR RECOVERY SUPPORT SERVICES.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_H79TI085215_7522/

ASST_NON_R01NR020764_7529

Department of Health and Human Services

National Institutes of Health

TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE

TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE

IMPROVING THE ORGANIZATIONAL SOCIAL CONTEXT TO ADDRESS STRUCTURAL RACISM AND DISCRIMINATION: A RANDOMIZED CONTROLLED TRIAL TO REDUCE RACIAL DISPARITIES IN VIRAL SUPPRESSION AND RETENTION IN HIV CARE - ABSTRACT/ PROJECT SUMMARY: DESPITE THE WIDESPREAD USE OF EFFECTIVE ANTIRETROVIRAL THERAPY (ART), THE HIV EPIDEMIC CONTINUES TO IMPACT RACIAL AND ETHNIC MINORITY POPULATIONS DISPROPORTIONATELY. ALTHOUGH BLACK/AFRICAN AMERICAN PERSONS ACCOUNT FOR 13% OF THE U.S. POPULATION, THEY ACCOUNT FOR 41% OF NEW HIV DIAGNOSES AND EXPERIENCE THE LOWEST RATES OF RETENTION IN HIV CARE AND VIRAL SUPPRESSION (VS) COMPARED TO OTHER RACIAL/ETHNIC GROUPS. STRUCTURAL RACISM AND DISCRIMINATION (SRD) LIKELY CONTRIBUTE TO RACIAL DISPARITIES IN HIV OUTCOMES. ALTHOUGH THE OUTPATIENT SETTING IS A VITALLY IMPORTANT ASPECT OF CARE PROVISION FOR PLWH, THERE ARE LIMITED DATA ON THE IMPACT OF INTRA-ORGANIZATIONAL SRD ON HIV OUTCOMES. LONGITUDINAL ENGAGEMENT IN HIV CARE IS NEEDED FOR SUSTAINED VS, DECREASED COMMUNITY TRANSMISSION OF HIV. THE ORGANIZATIONAL SOCIAL CONTEXT (OSC) INCLUDES ORGANIZATIONAL CULTURE (ORGANIZATIONAL NORMS AND VALUES THAT DRIVE QUALITY OF CARE), ORGANIZATIONAL CLIMATE (PERCEPTION OF THE CULTURE AND HOW IT IMPACTS PERSONAL WELL-BEING), AND WORKERS' ATTITUDES. USING A RANDOMIZED CONTROLLED TRIAL, WE WILL IMPLEMENT ARC (ACCESSIBILITY, RESPONSIVENESS, CONTINUITY) TO IMPROVE ORGANIZATIONAL BEHAVIOR AND REDUCE RACIAL DISPARITIES IN HIV OUTCOMES FOR PLWH. ARC IS AN EVIDENCE-BASED INTERVENTION THAT USES THREE STRATEGIES (ARC PRINCIPLES, ARC COMPONENT TOOLS, AND ARC MENTAL MODELS) TO CREATE OSCS THAT SUPPORT THE IMPLEMENTATION OF INTERVENTIONS TO IMPROVE PATIENT OUTCOMES. CLINICS WILL BE RANDOMIZED TO ARC (N = 2) OR STANDARD OF CARE (SOC; N= 2). THOSE ASSIGNED TO ARC WILL ADDRESS SRD OCCURRING AT THE ORGANIZATIONAL LEVEL AFFECTING CARE, INCLUDING REFERRAL AND TREATMENT PATTERNS FOR PLWH. A PRE-IMPLEMENTATION PERIOD WILL BE FOLLOWED BY ARC AND ARC-ASSOCIATED IMPLEMENTATION STRATEGIES FOR 36 MONTHS AND THEN A 12-MONTH POST-IMPLEMENTATION PERIOD WHERE WE WILL CONTINUE TO MEASURE HIV OUTCOMES IN BOTH ARMS. WE WILL COMPARE HIV OUTCOMES, NAMELY VS AND RETENTION IN CARE, AND INTERMEDIATE OUTCOMES, SUCH AS LINKAGE TO MENTAL HEALTH TREATMENT AND STAFF TURN-OVER IN CLINICS ASSIGNED TO ARC AND SOC. WE WILL ALSO EVALUATE WHETHER INDIVIDUAL (SELF-EFFICACY, PERCEIVED DISCRIMINATION) AND ORGANIZATIONAL FACTORS (OSC AND COHESION OF OSC MEASURES) MEDIATE THE RELATIONSHIP BETWEEN ARC, INTERMEDIATE, AND HIV OUTCOMES. IN PREPARATION TO THE RCT, WE WILL EVALUATE BASELINE OSC MEASURES ACROSS 12 HIV CLINICS IN PHILADELPHIA AND DETERMINE ASPECTS OF THE OSC ASSOCIATED WITH VS AND RETENTION IN CARE IN A MULTI-LEVEL MODEL ADJUSTING FOR NEIGHBORHOOD SRD, PATIENT-LEVEL FACTORS, AND CLUSTERING OF PATIENTS NESTED IN CLINICS AND NEIGHBORHOODS. WE WILL THEN TEST THE EFFECTIVENESS OF ARC IN IMPROVING A PRIMARY OUTCOME OF VS AND SECONDARY OUTCOME OF RETENTION IN CARE AT THE END OF THE IMPLEMENTATION PERIOD. WE WILL EXAMINE THE ACCEPTABILITY, SUSTAINABILITY, AND COST OF IMPLEMENTING ARC IN OUTPATIENT HIV CARE. THIS RESEARCH WILL ADVANCE UNDERSTANDING OF THE IMPACT OF SRD ON HIV TREATMENT OUTCOMES AND HEALTH SERVICES RESEARCH AND THE IMPLEMENTATION OF A DISSEMINABLE EVIDENCE-BASED PRACTICE AIMED AT REDUCING SRD.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01NR020764_7529/

ASST_NON_R01AG077934_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

STRUCTURAL RACISM AND DISCRIMINATION IN OLDER MEN'S HEALTH INEQUITIES - ABSTRACT THE HEALTH AND WELL-BEING OF OLDER GAY MEN HAS BEEN GREATLY SHAPED BY STRUCTURAL FORCES, NAMELY DISCRIMINATION AND, FOR OLDER GAY MEN OF COLOR, RACISM. THEIR CONTEMPORARY HISTORY AND LIFE COURSE HAVE BEEN DEFINED BY EXODUS FROM HOSTILE ENVIRONMENTS AND THE FORMATION OF SUPPORTIVE COMMUNITIES. THE OVERALL GOAL OF THIS RESEARCH IS TO SHED LIGHT ON THE EXTENT AND THE MANNER IN WHICH STRUCTURAL RACISM AND DISCRIMINATION SHAPES OLDER GAY MEN’S HEALTH. THIS STUDY WILL ASSESS THE RELATIONSHIPS AMONG HEALTH, STIGMA, STRUCTURAL RACISM AND DISCRIMINATION, RESOURCES, AND BIOMARKERS OF HEALTH AND AGING IN OLDER GAY MEN OF FOUR RACIAL/ETHNIC GROUPS— AFRICAN AMERICAN, LATINX, ASIAN AMERICAN, AND WHITE— AND ACROSS HIV STATUS. THIS RESEARCH IS NEEDED BECAUSE OLDER GAY MEN’S HEALTH FARES WORSE THAN THAT OF THEIR HETEROSEXUAL COUNTERPARTS, THEIR EXPOSURE TO STRUCTURAL DISCRIMINATION IS HIGHER, AND THEY HAVE LESS ACCESS TO SUPPORTIVE RESOURCES THAN OLDER HETEROSEXUAL MEN. NOTABLY, 40 YEARS AFTER WE FIRST FACED HIV, WE CONTINUE TO LEARN ABOUT THE CONSEQUENCES OF HIV, INCLUDING AGING WITH HIV. GAY MEN COMPRISE THE MAJORITY OF OLDER PEOPLE LIVING WITH HIV. OLDER GAY MEN FACE UNIQUE HEALTH RISKS AND PROTECTIVE FACTORS, YET THEY CONSTITUTE A VERY DIVERSE AND COMPLEX POPULATION. WHAT WE KNOW ABOUT THEIR HEALTH COMES FROM MOSTLY WHITE, WELL-EDUCATED, AND CONVENIENT SAMPLES. HENCE, THE NEED TO COLLECT DATA FROM DIVERSE AND VALID SAMPLES. THIS IS A CROSS-SECTIONAL STUDY BASED ON SAN FRANCISCO BAY AREA. QUANTITATIVE AND QUALITATIVE DATA WILL BE COLLECTED FROM A SAMPLE OF 600 OLDER GAY MEN. WE WILL COLLECT STRUCTURAL, INDIVIDUAL, AND BIOLOGICAL DATA TO TEST HYPOTHESES REGARDING THE ASSOCIATIONS AMONG STRUCTURAL RACISM AND DISCRIMINATION, RESOURCES, AND HEALTH (E.G., MENTAL HEALTH, HIV RISK, COGNITIVE FUNCTION). OUR TEAM IS MULTIDISCIPLINARY AND INCLUDES OUR COMMUNITY PARTNER, THE ELIZABETH TAYLOR 50-PLUS NETWORK (OF THE SAN FRANCISCO AIDS FOUNDATION). THIS PROPOSAL IS IN RESPONSE TO NIH’S RFA UNDERSTANDING AND ADDRESSING THE IMPACT OF STRUCTURAL RACISM AND DISCRIMINATION ON MINORITY HEALTH AND HEALTH DISPARITIES. IT ADDRESSES THE OFFICE OF AIDS RESEARCH STRATEGIC PLAN OF TACKLING HIV COMORBIDITIES AND HEALTH DISPARITIES. THE DATA AND FINDINGS FROM THIS STUDY ARE INTENDED TO CONSTITUTE THE BASELINE FOR A LONGITUDINAL STUDY.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01AG077934_7529/

ASST_NON_R01MH130166_7529

Department of Health and Human Services

National Institutes of Health

US HELPING US-PEOPLE INTO LIVING, INC

US HELPING US-PEOPLE INTO LIVING, INC

DISTRICT OF COLUMBIA

MULTILEVEL RACISM & DISCRIMINATION AND PREP OUTCOMES AMONG BLACK SMM IN THE SOUTHEASTERN U.S. - PROJECT SUMMARY INEQUITIES IN HEALTH MANIFEST AS A RESULT OF SYSTEMIC MINORITY STRESSORS AND SOCIAL INJUSTICES. RACISM AND DISCRIMINATION ARE SALIENT MINORITY STRESSORS AND SOCIAL INJUSTICES FOR BLACK SEXUAL MINORITY MEN (SMM) BECAUSE BLACK SMM ANTICIPATE AND EXPERIENCE DISCRIMINATION AT DIFFERENT ECOLOGICAL LEVELS (INTRAPERSONAL, INTERPERSONAL, AND COMMUNITY) DUE TO THEIR INTERCONNECTED IDENTITIES (E.G., RACE, SEXUAL MINORITY STATUS, HIV STATUS). THESE MULTIPLE EXPOSURES CONCOMITANTLY CONTRIBUTE TO INCREASED HIV VULNERABILITY AMONG BLACK MSM: 1 IN 2 BLACK SMM WILL BE DIAGNOSED WITH HIV IN THEIR LIFETIME, COMPARED TO 1 IN 11 FOR WHITE MSM, IF CURRENT TRENDS REMAIN UNCHANGED. THERE IS INCREASING INTEREST IN UNDERSTANDING AN INDIVIDUAL'S ABILITY TO ADAPT TO OR RESIST LIFE'S ADVERSITIES OR STRESSFUL EVENTS (I.E., MINORITY STRENGTHS FRAMEWORK). THUS, AN INTEGRATED MINORITY SOCIAL-STRUCTURAL STRESS AND MINORITY STRENGTHS THEORY MODEL WILL BE TESTED IN THE PROPOSED APPLICATION TO DELINEATE THE MULTILEVEL DISCRIMINATION PREDICTORS OF HIV PREVENTION OUTCOMES, AND UNDERSTAND HOW RESILIENCE MODERATES THESE ASSOCIATIONS. FIRST, WE HYPOTHESIZE THAT GREATER ANTICIPATION AND EXPERIENCES OF DISCRIMINATION ARE PREDICTIVE OF INFREQUENT TESTING FOR SEXUALLY TRANSMITTED INFECTIONS, INCLUDING HIV, AND LOWER PRE-EXPOSURE PROPHYLAXIS (PREP) USE, RETENTION IN CARE, PREP ADHERENCE, AND PREP PROTECTION OVER A 36-MONTH FOLLOW-UP PERIOD AMONG BLACK MSM IN THE DEEP SOUTH. NEXT, WE HYPOTHESIZE THAT DIFFERING LEVELS OF RESILIENCE WILL MODERATE THE ASSOCIATIONS BETWEEN DISCRIMINATION AND HIV PREVENTION. FINALLY, WE WILL CONDUCT QUALITATIVE FOCUS GROUPS WITH SOCIAL MAPPING TO VALIDATE THE QUANTITATIVE RESULTS IN AIMS 1&2 AND TO IDENTIFY AND/OR ADAPT EFFECTIVE SOCIAL-STRUCTURAL AND/OR STRENGTHS-BASED INTERVENTIONS TO MITIGATE THE EFFECT OF SRD ON PREP OUTCOMES AMONG BLACK SMM. THREE INTEGRATED SPECIFIC AIMS ARE PROPOSED TO TEST THESE HYPOTHESES. IN SPECIFIC AIM 1, TO EVALUATE THE RELATIONSHIPS BETWEEN SRD FACTORS AND PREP CONTINUUM OUTCOMES AMONG BLACK SMM IN TWO SOUTHEASTERN U.S. CITIES OVER A 36-MONTH FOLLOW-UP PERIOD, USING MULTILEVEL MODELING TECHNIQUES. IN SPECIFIC AIM 2, TO DETERMINE THE MODERATING EFFECTS OF RESILIENCY FACTORS ON THE RELATIONSHIPS BETWEEN SRD FACTORS AND PREP CONTINUUM OUTCOMES AMONG BLACK SMM IN TWO SOUTHEASTERN U.S. CITIES THROUGH MODERATION ANALYSES. AND FINALLY, IN SPECIFIC AIM 3, TO A. GAIN CONTEXTUALLY-GROUNDED EXPLANATIONS OF THE QUANTITATIVE RESULTS VIA FOCUS GROUPS; B. “GEO-NARRATIVES” OF THE GEOGRAPHICAL LANDSCAPE OF BLACK SMM USING SOCIAL MAPPING; AND C. SYNTHESIZE THE QUANTITATIVE AND QUALITATIVE RESULTS VIA DATA TRIANGULATION METHODS. BROADLY, THIS RESEARCH WILL ENHANCE OUR UNDERSTANDING OF HOW SRD DISCRIMINATION CONTRIBUTES TO INEQUITIES IN HIV AND PROVIDE INSIGHT INTO THREE LONG-STANDING QUESTIONS IN THE FIELD OF HIV EPIDEMIOLOGY: (1) MINORITY STRESS MECHANISMS THAT CONTRIBUTE TO HIV PREVENTION OUTCOMES, (2) INTRAPERSONAL TRAITS THAT BUFFER THE ASSOCIATIONS OF MINORITY STRESSORS WITH HIV PREVENTION, AND (3) IDENTIFICATION AND/OR ADAPTATION OF SOCIAL- STRUCTURAL OR STRENGTHS-BASED INTERVENTIONS TO MITIGATE HIV AMONG BLACK SMM.

NOT RECOVERY ACT

NONPROFIT WITHOUT 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MH130166_7529/

ASST_NON_R01AG076383_7529

Department of Health and Human Services

National Institutes of Health

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

VASCULAR CONTRIBUTIONS TO HIV-ASSOCIATED NEUROCOGNITIVE DISORDERS (HAND) - PROJECT SUMMARY/ABSTRACT: AS PEOPLE WITH HIV (PWH) AGE, CHRONIC COMORBIDITIES SUCH AS CEREBROVASCULAR DISEASE AND POORER COGNITION BECOME MORE PREVALENT. THERE EXIST A DISPARITY IN THE RATES OF CEREBROVASCULAR DISEASE AND DEMENTIA AMONG PWH. POSSIBLE CONTRIBUTING FACTORS INCLUDE DISPROPORTIONATE PREVALENCE OF VASCULAR RISK FACTORS SUCH AS HYPERTENSION, DIABETES, DYSLIPIDEMIA AND SMOKING IN PWH. ADDITIONALLY, THE SOCIOECONOMIC CONTEXT OF PWH (THAT INCLUDES BUT IS NOT LIMITED TO HOMOPHOBIA, STRUCTURAL RACISM AND SOCIETAL STIGMA) MAY TRANSLATE IN STRESSORS THAT MAY CONTRIBUTE TO POORER VASCULAR HEALTH. IN THIS PROPOSAL, WE ATTEMPT TO FILL IN THE KNOWLEDGE GAP OF HOW VASCULAR RISK FACTORS AND SOCIOECONOMIC STRESSORS MAY AFFECT CEREBROVASCULAR DISEASE AND COGNITION IN PWH. WE PROPOSE THAT SOLUBLE BLOOD BIOMARKERS OF ENDOTHELIAL ACTIVATION SUCH AS VASCULAR CELL ADHESION MOLECULE-1 (VCAM-1), INTERCELLULAR ADHESION MOLECULE-1 (ICAM-1), AND TUMOR NECROSIS FACTOR ALPHA (TNFA), ARE KEY MEDIATORS OF THESE RELATIONSHIPS, AND MORE IMPORTANTLY, THEY COULD BE THERAPEUTIC TARGETS. IN AIM 1, WE HYPOTHESIZE THAT UNCONTROLLED VASCULAR RISK FACTORS AND SOCIOECONOMIC STRESSORS INTERACT WITH HIV TO RELATE TO INCREASED LEVELS OF BLOOD BIOMARKERS OF ENDOTHELIAL ACTIVATION COMPARED TO AGE-, SEX-, AND ETHNICITY-MATCHED UNINFECTED CONTROLS. IN AIM 2, WE PROPOSE THAT DISPARITIES IN HIV-RELATED CEREBROVASCULAR DISEASE COMPARED TO UNINFECTED CONTROLS ARE MEDIATED BY INCREASED LEVELS OF BLOOD BIOMARKERS OF ENDOTHELIAL ACTIVATION. IN AIM 3, WE HYPOTHESIZE THAT DISPARITIES IN MRI-BASED NEURODEGENERATION AND COGNITION IN PWH COMPARED TO MATCHED UNINFECTED CONTROLS ARE MEDIATED BY INCREASED LEVELS OF BLOOD BIOMARKERS OF ENDOTHELIAL ACTIVATION AND MRI- BASED CEREBROVASCULAR DISEASE. TO CONFIRM THE CENTRAL ROLE OF ENDOTHELIAL ACTIVATORS OVER OTHER INFLAMMATORY MOLECULES, WE WILL CARRY OUT CONFIRMATORY ANALYSES USING FIVE MODELS THAT INCLUDE LASSO WITHOUT INTERACTION TERMS, LASSO WITH INTERACTION TERMS, RF, XGBOOST AND MODEL AVERAGE. WITH THE EXECUTION OF THESE AIMS, WE WILL PRODUCE RIGOROUS SCIENTIFIC EVIDENCE SUPPORTING THE UNIQUE PHYSIOPATHOLOGY OF HIV-RELATED CEREBROVASCULAR DISEASE AND NEURODEGENERACION. FURTHERMORE, BY ESTABLISHING ENDOTHELIAL ACTIVATION AS A KEY PATHWAY IN MEDIATING HIV-RELATED DISPARITIES IN CEREBROVASCULAR DISEASE AND NEURODEGENERATION, WE WILL PROVIDE PRELIMINARY SUPPORT TO TEST WHETHER MODIFICATION OF THESE INFLAMMATORY PATHWAYS (E.G. TNFA BLOCKADE) MAY PROVE BENEFICIAL IN PWH OR IN CERTAIN SUBGROUPS TO BE IDENTIFIED IN THIS STUDY.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01AG076383_7529/

ASST_NON_R01NR020583_7529

Department of Health and Human Services

National Institutes of Health

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

ENDING THE HIV EPIDEMIC WITH EQUITY: AN ALL-FACILITY INTERVENTION TO REDUCE STRUCTURAL RACISM AND DISCRIMINATION AND ITS IMPACT ON PATIENT AND HEALTHCARE STAFF WELLBEING - PROJECT SUMMARY THE SCOPE OF THIS STUDY IS TO ENGAGE RYAN WHITE HIV/AIDS PROGRAM (RWHAP) FUNDED ORGANIZATIONS IN ENDING THE HIV EPIDEMIC (ETHE) AREAS IN THE SOUTH/EAST US TO CO-DEVELOP CONTEXT-RESPONSIVE PROGRAMS UTILIZING EVI- DENCE-INFORMED INTERVENTIONS TO REDUCE STRUCTURAL RACISM AND DISCRIMINATION (SRD) AGAINST BLACK, INDIGENOUS, PEOPLE OF COLOR (BIPOC) LIVING WITH HIV (PLH) AND BIPOC HEALTHCARE WORKERS. SRD DIRECTLY IMPACTS ACCESS TO AND UPTAKE OF HEALTHCARE FOR BIPOC, INCLUDING ENGAGEMENT IN HIV SERVICES ACROSS THE CONTINUUM OF PREVENTION AND CARE. THE PROPOSED INTERVENTION, TITLED TRANSCENDS, DRAWS ON THE EVIDENCE-BASED HEALTH POLICY PLUS (HP+) ‘TOTAL’ FACILITY HIV STIGMA-REDUCTION INTERVENTION AND CONTACT THEORY, WHICH HAVE DEMONSTRATED EFFICACY IN REDUCING RACE-RELATED INTERGROUP PREJUDICE. TRANSCENDS TARGETS THE CLINICS’ ORGANIZATIONAL (E.G., ANTI-RACIST AND DIVERSITY, EQUITY AND INCLUSION [DEI] POLICIES) AND SYSTEMS (E.G., STAFF ATTITUDES/BEHAVIORS) LEVELS TO AFFECT PATIENT (E.G., EXPERIENCED AND PERCEIVED DISCRIMINATION, HIV CARE, MENTAL HEALTH) OUTCOMES AND STAFF (E.G., JOB SATISFACTION) WELLBEING, AT THE INDIVIDUAL LEVEL. IN AIM 1, WE WILL RIGOROUSLY SELECT 6 CLINICS FROM ETHE AREAS EVI- DENCING FULL COMMITMENT TO DISMANTLING SRD (MOS 3-9). IN AIM 2, AFTER A BASELINE ASSESSMENT (N=180; MOS 11-12), WE WILL CONDUCT A STEPPED WEDGE CLUSTER RANDOMIZED TRIAL OF THE SRD REDUCTION INTERVENTION. AT EACH OF THE 3 STEPS, TWO RANDOMIZED CLINICS WILL RECEIVE TRANSCENDS. THE INTERVENTION WILL SUPPORT CLINICS TO 1) IDENTI- FY/CREATE ORGANIZATIONAL-LEVEL ANTI-RACIST POLICIES AND PRACTICES (E.G., CLEAR DEFINITIONS OF RACIST BEHAVIOR, ADE- QUATE TRAINING AND MONITORING SYSTEMS, AND PROMPT RESPONSES FOR CONSTRUCTIVE REDRESS) TO REDUCE SRD AND INCREASE RACE-BASED EQUITY FOR BIPOC PATIENTS AND PROVIDER/STAFF, AND 2) DELIVER RACE-SPECIFIC TRAININGS TO ALL STAFF (E.G., HISTORY OF SRD, HEALTH CONSEQUENCES OF BIAS AND DISCRIMINATION, CULTURAL HUMILITY, INTERSECTIONAL DIS- CRIMINATION AT THE CONFLUENCE OF RACE, ETHNICITY, SEXUALITY AND GENDER). EACH CLUSTER WILL RECEIVE THE INTERVENTION FOR 6 MOS, STARTING WITH CLUSTER GROUP 1 (MOS 13-18), FOLLOWED BY CLUSTER GROUPS 2 (MOS 19-24) AND 3 (MOS 25-30). IN AIM 3, WE WILL EVALUATE MULTI-LEVEL OUTCOMES USING THE CFIR, INCLUDING WITHIN THE ORGANIZATION (PRI- MARY OUTCOME OF SRD INDEX – RATINGS OF MISSION/VISION STATEMENTS, ANTI-RACIST POLICY, WORKFORCE DIVERSITY, EQUI- TY AND INCLUSION [DEI], CLINIC ENVIRONMENT), SYSTEMS (SECONDARY OUTCOMES OF PROVIDER/STAFF ATTITUDES; BEHAVIOR; DEI INDICATORS), AND INDIVIDUAL PATIENT LEVEL (TERTIARY OUTCOMES OF CLINIC-LEVEL HIV INDICATORS, REPORTS OF DISCRIMI- NATION, MEDICAL DISTRUST, ANXIETY, DEPRESSION, AND TRAUMA) OUTCOMES. ASSESSMENTS WILL TAKE PLACE EVERY 6 MONTHS, WITH THE CLINICS RANDOMIZED TO THE SECOND OR THIRD STEP HAVING MULTIPLE ASSESSMENTS BEFORE THE INTER- VENTION (WITH FINAL DATA COLLECTION BEING IN MONTH 49). BIPOC PATIENTS AT THE CLINICS WILL BE SURVEYED AT EACH AS- SESSMENT (N=2,100). FINDINGS WILL YIELD A MANUAL FOR IMPLEMENTING TOTAL-FACILITY SRD-REDUCTION PROCESSES AND CONTENT (MOS 52-60). OTHER RWHAP-FUNDED CLINICS AND FACILITIES SERVING MARGINALIZED GROUPS MAY BE ABLE TO ADOPT THIS MANUALIZED, YET HIGHLY ADAPTABLE INTERVENTION PACKET TO SUPPORT BIPOC.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01NR020583_7529/

ASST_NON_H79SP082826_7522

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

HARLEM UNITED COMMUNITY AIDS CENTER INC

HARLEM UNITED COMMUNITY AIDS CENTER INC

STREET MEDICINE & HARM REDUCTION (SMHR) PROJECT - SUMMARY. HARLEM UNITED (HU) PROPOSES A PROJECT TO STRENGTHEN HARM REDUCTION PROGRAMS AS PART OF THE CONTINUUM OF CARE FOR INDIVIDUALS FROM RACIAL/ETHNIC MINORITY COMMUNITIES, PARTICULARLY THOSE WITH OR AT RISK OF DEVELOPING SUBSTANCE USE DISORDERS. SERVICES WILL INCLUDE STREET-BASED MEDICINE, OVERDOSE PREVENTION EDUCATION, AND LINKAGE TO CARE. THE PROJECT WILL CONDUCT 300 MONTHLY FIELD ENCOUNTERS AND 204 MONTHLY FIELD REFERRALS, ESTABLISH 144 MONTHLY LINKAGES, AND SERVE 9,600 PEOPLE OVER THREE YEARS. PROJECT NAME. STREET MEDICINE & HARM REDUCTION (SMHR) PROJECT TARGET POPULATIONS. HU WILL IMPLEMENT THE SMHR PROJECT TO OFFER SERVICES TO INDIVIDUALS IN RACIAL/ETHNIC MINORITY COMMUNITIES. RECOGNIZING THE INTERSECTIONAL NATURE OF RACISM, TRANS AND HOMOPHOBIA, SEXISM, AND SOCIOECONOMIC DISCRIMINATION, WE WILL SERVE THE PRIORITY POPULATIONS OF BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC), AS WELL AS LGBTQ+ IDENTIFYING INDIVIDUALS, WHO GRAPPLE WITH SUBSTANCE USE DISORDER (SUD), SERIOUS MENTAL ILLNESS (SMI), MULTIPLE CHRONIC INFECTIONS (E.G., HIV), DISPROPORTIONATE POVERTY, HOMELESSNESS, AND INTIMATE PARTNER VIOLENCE (IPV). THESE COMMUNITIES HAVE BEEN OUR FOCUS FOR THE LAST 30 YEARS; AND IN 2021, THE MAJORITY OF HU CLIENTS IDENTIFIED AS BIPOC: 69% AS BLACK, 26% AS LATINO/A. ADDITIONALLY, OF THOSE OPTING TO DISCLOSE THEIR SEXUAL ORIENTATION IN 2021, 27% OF HU CLIENTS IDENTIFIED AS LGBTQ+. STRATEGIES/INTERVENTIONS. HU’S SMHR PROJECT WILL ENTAIL AN EXPANSION OF HU’S PREEXISTING HARM REDUCTION SERVICE DELIVERY MODEL, WITH THE ADDITION OF A NURSE PRACTITIONER WHO CAN INCORPORATE STREET-BASED MEDICINE AND FACILITATE OUR USE OF INNOVATIVE APPROACHES (I.E., LOW THRESHOLD BUPRENORPHINE INDUCTION, WOUND CARE, BLOOD PRESSURES SCREENINGS, VACCINE ADMINISTRATION, AND A COMMUNITY ADVISORY BOARD EXCLUSIVE TO PEOPLE WHO USE DRUGS) IN THE PROPOSED PROJECT. GIVEN THAT MANY PEOPLE SERVED BY OUR PROJECT ARE STREET HOMELESS PEOPLE OF COLOR, THESE NON-TRADITIONAL SERVICES ARE INTEGRAL TO ACHIEVING BETTER HEALTH OUTCOMES AND EXPERIENCES FOR OUR CLIENTS. GOALS. THE PRIMARY GOAL OF HU’S PROJECT WILL BE TO HELP CONTROL THE SPREAD OF CHRONIC INFECTIONS AND THE CONSEQUENCES OF SUCH INFECTIONS FOR BIPOC, AS WELL AS LGBTQ+ INDIVIDUALS WITH, OR AT RISK OF DEVELOPING SUD THROUGH OUR SYRINGE EXCHANGE PROGRAM AND TESTING; ENHANCE OVERDOSE PREVENTION ACTIVITIES; OFFER TRAININGS ON ADMINISTRATION METHODS AND DISTRIBUTE OPIOID OVERDOSE REVERSAL MEDICATION TO INDIVIDUALS AT RISK OF OVERDOSE, AS WELL AS OTHER COMMUNITY MEMBERS; REMOVE BARRIERS TO CARE BY PROVIDING STREET-BASED MEDICAL CARE TO TARGET POPULATION; AND BUILD CONNECTIONS FOR OUR TARGET POPULATION TO OVERDOSE EDUCATION, COUNSELING, AND HEALTH EDUCATION. OBJECTIVES. 1) 3 DAYS/WEEK OUTREACH CONDUCTED TO ENCOUNTER 300/MONTH INDIVIDUALS (3,600 ANNUAL) AND REFER 204/MONTH INDIVIDUALS TO SUPPORT SERVICES (2,448 ANNUAL); 2) 144/MONTH LINKAGES (INDIVIDUAL ENGAGEMENTS WITH ANY SUPPORT SERVICE) TO SUPPORT SERVICES (1728 ANNUAL); 3) 22/MONTH BASELINE GPRA INTERVIEWS CONDUCTED (264 ANNUAL) AND AT LEAST 18/MONTH FOLLOW-UP GPRA INTERVIEWS TO BE CONDUCTED AT MONTH 6 (216 ANNUAL), FOR MINIMUM 80% FOLLOW-UP RATE; 4) 60/MONTH BLOOD PRESSURE SCREENINGS/WOUND CARE, 2/MONTH BUPRENORPHINE INDUCTIONS, 18/MONTH FLU VACCINES AND 2/QUARTER HPV VACCINES ADMINISTERED; 5) 1000 FENTANYL STRIPS AND 120 NARCAN KITS DISTRIBUTED ANNUALLY; 6) 360 NARCAN TRAININGS CONDUCTED ANNUALLY; 7) 8/MONTH INDIVIDUALS SCREENED FOR HIV, 6/MONTH FOR HCV, WITH 25,000/YEAR SYRINGES DISTRIBUTED; 8) TO DOCUMENT AND PROVIDE ANNUAL REPORTS ON OD REVERSALS; 9) 4 ANNUAL MEETINGS (1/QUARTER) FOR TWO SEPARATE CABS: A DRUG USERS UNION (DUU) CAB FOR PEOPLE WHO USE DRUGS AND A NEIGHBORHOOD CAB FOR KEY COMMUNITY MEMBERS AND SERVICE PROVIDERS; 10) 1 STREET-BASED (DISTRIBUTION OF MARKETING MATERIALS DURING OUTREACH) AND 2 SOCIAL MEDIA-BASED (PSA POSTS ACROSS HU’S PLATFORMS) ANNUAL CAMPAIGNS ON HOW TO IDENTIFY/REVERSE AN

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_H79SP082826_7522/

ASST_NON_R34MH130207_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF MICHIGAN

REGENTS OF THE UNIVERSITY OF MICHIGAN

STRENGTHENING COMMUNITY RESPONSES TO ECONOMIC VULNERABILITY AND HIV INEQUITIES - ABSTRACT IN THE UNITED STATES, TRANSGENDER WOMEN OF COLOR (`TRANS WOMEN OF COLOR') EXPERIENCE CYCLICAL, INTERLOCKING SYSTEMS OF STRUCTURAL AND INSTITUTIONAL OPPRESSION ROOTED IN RACISM AND TRANSPHOBIA, WHICH FUEL ECONOMIC VULNERABILITY. TOGETHER, CYCLES OF INTERSECTING RACISM, TRANSPHOBIA, AND ECONOMIC VULNERABILITY CREATE CONDITIONS THAT GIVE RISE TO EXTREME HIV INEQUITIES AMONG TRANS WOMEN OF COLOR. MICROECONOMIC INTERVENTIONS – DESIGNED TO IMPROVE FINANCIAL STANDING BY INCREASING INCOME GENERATION AND ACCESS TO FINANCIAL RESOURCES THROUGH ENTREPRENEURSHIP, CASH TRANSFERS, AND TRAINING — HAVE THE POTENTIAL TO ADDRESS STRUCTURAL FACTORS UNDERLYING HIV RISK. OVER THE PAST FEW YEARS, SEVERAL TRANS-LED ORGANIZATIONS, INCLUDING THE TRANS SISTAS OF COLOR PROJECT, HAVE INTEGRATED MICROECONOMIC STRATEGIES, SPECIFICALLY EMERGENCY ASSISTANCE (I.E., UNCONDITIONAL CASH GRANTS) INTO THEIR PROGRAMMING. BUILDING ON OUR FORMATIVE WORK IN DETROIT, THIS PROJECT SEEKS TO ADAPT AND EXAMINE THE ACCEPTABILITY AND FEASIBILITY OF AN ENHANCED MICROECONOMIC INTERVENTION DESIGNED TO ADDRESS HIV PREVENTION AND CARE CONTINUA OUTCOMES. THE ENHANCED MICROECONOMIC INTERVENTION BUILDS ON OUR COMMUNITY PARTNER'S EXISTING MICROECONOMIC INTERVENTIONS, WHICH INCLUDES: (1) AN EMERGENCY ASSISTANCE; AND (2) PEER AND LEGAL SUPPORT TO OBTAIN LEGAL GENDER AFFIRMATION (I.E., LEGAL NAME AND GENDER MARKERS ON IDENTIFICATION DOCUMENTS). THE EXISTING INTERVENTION WILL BE ENHANCED TO INCLUDE (1) WEEKLY EDUCATIONAL SESSIONS ON ECONOMIC EMPOWERMENT (I.E., JOB ACQUISITION, INCOME GENERATION THROUGH MICRO-BUSINESS, AND FINANCIAL LITERACY) AND HIV PREVENTION AND CARE; (2) EMPLOYMENT-FOCUSED MENTORING; (3) WEEKLY SOCIAL MEDIA POSTS OF JOB OPENINGS IN DETROIT; AND (4) AN UNCONDITIONAL GRANT ($1,200) FOR USE TOWARDS ACQUIRING SELF-LED OR FORMAL EMPLOYMENT. OUR COMMUNITY ADVISORY BOARD COMPOSED OF TRANS WOMEN OF COLOR WILL PROVIDE ONGOING CONSULTATION. THE PROPOSED RESEARCH PLAN IS DIRECTLY IN LINE WITH THE PRIORITIZATION OF SEXUAL AND GENDER MINORITY COMMUNITIES FOR HEALTH DISPARITIES RESEARCH AND THE ENDING THE HIV EPIDEMIC (EHE) INITIATIVE, AS WELL AS NIH PRIORITY AREAS FOR REDUCING HIV INCIDENCE. FINDINGS WILL PROVIDE THE NECESSARY GROUNDWORK TO EXAMINE INTERVENTION EFFICACY AND IMPLEMENTATION PROCESSES IN A FUTURE, LARGE-SCALE TRIAL.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R34MH130207_7529/

ASST_NON_R21MH130268_7529

Department of Health and Human Services

National Institutes of Health

RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.

RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC.

EFFECTS OF OVERLAPPING PANDEMICS ON COPING AND BEHAVIORAL HEALTH AMONG YOUNG ADULTS AFFECTED BY HIV (EPOCH-HIV) - THE COVID-19 PANDEMIC HAS DRAMATICALLY DISRUPTED EVERYDAY LIFE FOR MANY YOUNG PEOPLE, INCLUDING YOUNG ADULTS WHO HAVE GROWN UP WITH PERINATALLY-ACQUIRED HIV (YAPHIV). YAPHIV WERE VULNERABLE TO POOR HEALTH OUTCOMES (MENTAL ILLNESS, SUBSTANCE USE, LOW RATES OF VIRAL SUPPRESSION) BEFORE THE PANDEMIC DUE TO THE MULTIFACETED IMPACT OF HIV, RACISM, AND POVERTY. YA WHO WERE PERINATALLY HIV-EXPOSED, BUT UNINFECTED (YAPHEU) HAVE GROWN UP IN SIMILAR VULNERABLE COMMUNITIES, BUT OFTEN WITHOUT THE SAME ACCESS TO SERVICES AS YAPHIV. IN THIS R21, WE WILL EXAMINE THE EFFECTS OF THE COVID-19 PANDEMIC ON COPING AND BEHAVIORAL HEALTH AMONG YOUNG ADULTS AFFECTED BY HIV (EPOCH-HIV) IN ORDER TO INFORM CARE AND INTERVENTIONS THAT ADDRESS BEHAVIORAL HEALTH PROBLEMS AND HIV TREATMENT AND PREVENTION FOR BLACK AND LATINX YA AFFECTED BY HIV. LEVERAGING RESOURCES FROM A LONGITUDINAL COHORT OF YAPHIV AND YAPHEU (CASAH; R01-MH69133), AND OUR COLLABORATION WITH THE NORTHEAST/CARIBBEAN AIDS EDUCATION AND TRAINING CENTER (NECA AETC), WE WILL INFORM THE TAILORING OF BEHAVIORAL AND PHYSICAL HEALTH SERVICES TO MEET THE NEEDS OF YA AFFECTED BY HIV IN AN ERA OF OVERLAPPING HIV AND COVID-19 PANDEMICS. CASAH HAS COLLECTED EXTENSIVE PSYCHOSOCIAL, PSYCHIATRIC, AND BEHAVIORAL DATA ON YAPHIV AND YAPHEU, AND HEALTH OUTCOMES (INCLUDING HIV OUTCOMES) FROM 2003 (N=340; MEAN AGE 12 YEARS) TO THE PRESENT (MEAN AGE 27 YEARS). TO ACHIEVE EPOCH-HIV’S AIMS, WE WILL USE LATENT CLASS ANALYSIS (LCA) (AIM 1) TO IDENTIFY PANDEMIC EXPERIENCE TYPOLOGIES (I.E., HIGHLY AFFECTED, MODERATELY AFFECTED, MINIMALLY AFFECTED) BASED ON PANDEMIC-RELATED CHANGES TO PSYCHOSOCIAL FACTORS (E.G., JOB/HOUSING LOSS, TRAUMA). WE WILL THEN EXPLORE RISK AND PROTECTIVE FACTORS FOR THESE TYPOLOGIES (E.G., RACE/ETHNICITY, GENDER, PHIV STATUS, SOCIAL SUPPORT) AS WELL AS THE RELATIONSHIP BETWEEN PANDEMIC EXPERIENCE TYPOLOGIES AND THE FOLLOWING OUTCOMES: (A) BEHAVIORAL HEALTH (I.E., MENTAL HEALTH, SUBSTANCE USE), (B) VACCINE AND BOOSTER UPTAKE, C) PHYSICAL HEALTH (E.G., BODY MASS INDEX, HEALTH CARE VISITS), AND (D) YAPHIV VIRAL SUPPRESSION. SAMPLING FROM PARTICIPANTS IN EACH OF THESE TYPOLOGIES, WE WILL QUALITATIVELY EXAMINE LIVED EXPERIENCES BEFORE AND DURING THE COVID-19 PANDEMIC (AIM 2), TO IDENTIFY AREAS FOR MODIFICATION IN (A) BEHAVIORAL HEALTH (B) VACCINE AND BOOSTER UPTAKE, AND (C) PHYSICAL HEALTH, AND (D) YAPHIV CARE. OUR MULTIDISCIPLINARY TEAM HAS EXPERTISE IN INFECTIOUS DISEASES, COVID-19, MENTAL HEALTH, YA, PERINATAL HIV, QUALITATIVE METHODS, MHEALTH, STRUCTURAL RACISM, TRAUMA, AND PSYCHOSOCIAL AND BEHAVIORAL INTERVENTION DEVELOPMENT, AND TOGETHER ARE UNIQUELY POSITIONED TO CONDUCT THIS WORK. PUBLIC HEALTH IMPACT: EPOCH WILL USE RIGOROUS AND INNOVATIVE METHODS TO IDENTIFY AND BEGIN TO ADDRESS HOW THE COVID-19 PANDEMIC AFFECTED THE BEHAVIORAL AND PHYSICAL HEALTH AND CARE FOR OF YA AFFECTED BY HIV. OUR PARTNERSHIP WITH NECA AETC AND LEADERS IN HEALTH SERVICES WILL ENABLE US TO REACH PROVIDERS AND RAPIDLY DISSEMINATE FINDINGS AND INFORM THE TAILORING OF SERVICES TO ADDRESS THE NIH OAR PRIORITIES OF: 1) REDUCING HEALTH DISPARITIES IN HIV INCIDENCE AND TREATMENT OUTCOMES, 2) ADDRESSING HIV CO-MORBIDITIES, 3) MAKING A SUBSTANTIVE RESEARCH-TO-PRACTICE CLINICAL IMPACT.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R21MH130268_7529/

ASST_NON_R01DA056265_7529

Department of Health and Human Services

National Institutes of Health

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

REGENTS OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, THE

THE IMPACT OF RACISM ON TRAJECTORIES OF SUBSTANCE USE, MENTAL HEALTH AND LEGAL SYSTEM CONTACT FROM ADOLESCENCE TO YOUNG ADULTHOOD - PROJECT SUMMARY DATA CONSISTENTLY DEMONSTRATE ALARMING RACIAL DISPARITIES AMONG YOUTH AND ADULTS IMPACTED BY THE LEGAL SYSTEM, AND MULTIPLE STUDIES HAVE DOCUMENTED THAT JUSTICE-IMPACTED YOUTH HAVE SUBSTANTIALLY HIGHER RATES OF PSYCHIATRIC NEEDS, SUBSTANCE USE AND HIV/STI RISK BEHAVIORS THAN YOUTH WHO HAVE NOT HAD JUVENILE LEGAL SYSTEM CONTACT. HOWEVER, RESEARCH ELUCIDATING THE IMPACT OF STRUCTURAL, CULTURAL AND INDIVIDUAL RACISM ON THE HEALTH AND LEGAL OUTCOMES AND DISPARITIES OF JUSTICE-IMPACTED ETHNORACIAL MINORITIZED YOUTH AND FAMILIES IS NASCENT. THIS STUDY WILL ADVANCE THE SCIENCE IN STRUCTURAL RACISM AND DISCRIMINATION (SRD) AND ITS INFLUENCE ON PUBLIC HEALTH AND LEGAL INEQUITIES BY LEVERAGING AN EXISTING STATEWIDE LONGITUDINAL DATASET FROM PROJECT EPICC AS WELL AS FOLLOWING UP WITH 300 PREVIOUSLY ENROLLED YOUTH AND CAREGIVERS (N=300 DYADS OR 600 PARTICIPANTS TOTAL) TO CONDUCT ONCE ANNUAL FOLLOW-UP ASSESSMENTS AND LIFE COURSE INTERVIEWS. INFORMED BY ECODEVELOPMENTAL THEORY, PROJECT EPICC FOLLOWED 401 YOUTH AND AN INVOLVED CAREGIVER (55% ETHNORACIAL MINORITIZED YOUTH) FOR TWO YEARS STARTING FROM THE TIME OF FIRST EVER YOUTH CONTACT WITH THE JUVENILE LEGAL SYSTEM. DATA ARE AVAILABLE ON THE LONGITUDINAL TRAJECTORIES OF SUBSTANCE USE, PSYCHIATRIC SYMPTOMS, HIV/STI RISK BEHAVIORS AND RECIDIVISM AND THE MULTIPLE CONTRIBUTING RISK AND PROTECTIVE INFLUENCES (INDIVIDUAL, FAMILY AND EXTRAFAMILIAL) ON YOUTH TRAJECTORIES. PROJECT EPICC-2 WILL EXPAND THE ECODEVELOPMENTAL FRAMEWORK TO STUDY THE LONGITUDINAL IMPACT OF STRUCTURAL RACISM AND DISCRIMINATION ON TRAJECTORIES OF ETHNORACIAL MINORITIZED YOUTH’S SUBSTANCE USE, PSYCHIATRIC, SEXUAL AND REPRODUCTIVE HEALTH AND LEGAL OUTCOMES DURING ADOLESCENCE AND INTO YOUNG ADULTHOOD. USING STATEWIDE ADMINISTRATIVE DATA, WE WILL EXPAND ORIGINAL PRIMARY OUTCOMES TO INCLUDE SUBSTANCE USE AND PSYCHIATRIC SERVICES UTILIZATION TO UNDERSTANDING MORE ABOUT DIRECT INFLUENCE OF STRUCTURAL RACISM AND DISCRIMINATION ON JUSTICE-IMPACTED YOUNG ADULT HEALTHCARE SERVICES ACCESS AND EQUITY. ANNUAL LIFE COURSE INTERVIEWS WITH A STRATIFIED RANDOM SUBSAMPLE OF 50 YOUNG ADULTS AND 50 CAREGIVERS WILL PROVIDE A MORE NUANCED QUALITATIVE AND CONTEXTUAL UNDERSTANDING OF THE IMPACT OF STRUCTURAL RACISM ON ADOLESCENT, YOUNG ADULT AND FAMILY EXPERIENCES AND TRAJECTORIES. EPICC-2 WILL LEVERAGE AN EXISTING LONGITUDINAL DATASET, PRE-EXISTING RELATIONSHIPS WITH A LARGE SAMPLE OF JUSTICE-IMPACTED FAMILIES, AN ECODEVELOPMENTAL AND INTERSECTIONAL (RACE, ETHNICITY, SEX, GENDER, SOCIOECONOMIC STATUS) FRAMEWORK, AN INTERGENERATIONAL APPROACH AND AN ACCOMPLISHED MULTIDISCIPLINARY STUDY TEAM TO ANSWER CRITICALLY IMPORTANT QUESTIONS IN THE FIELD OF ADOLESCENT AND YOUNG ADULT HEALTH DISPARITIES.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA056265_7529/

ASST_NON_T32MH130247_7529

Department of Health and Human Services

National Institutes of Health

GEORGE WASHINGTON UNIVERSITY (THE)

GEORGE WASHINGTON UNIVERSITY (THE)

DISTRICT OF COLUMBIA

TRAINING PROGRAM IN APPROACHES TO ADDRESS SOCIAL-STRUCTURAL FACTORS RELATED TO HIV INTERSECTIONALLY (TASHI) - PROJECT SUMMARY FOUR DECADES INTO THE GLOBAL HIV PANDEMIC, HIV/AIDS REMAINS A PRESSING PUBLIC HEALTH CHALLENGE CONTRIBUTING TO ALMOST 1 MILLION DEATHS PER YEAR. HIGHLY EFFICACIOUS BIOMEDICAL INTERVENTIONS HAVE EMERGED, INCLUDING MULTIPLE MODALITIES OF LONG-ACTING ANTI-RETROVIRAL (ART)-BASED TREATMENT AND PREVENTION. HOWEVER, NOT ALL PEOPLE HAVE EQUAL ACCESS TO THESE LIFESAVING TECHNOLOGIES. MANY OF THE SAME SOCIAL-STRUCTURAL DETERMINANTS (E.G. STRUCTURAL RACISM, GENDER-BASED VIOLENCE, INTERSECTIONAL STIGMA AND DISCRIMINATION) THAT HAVE HISTORICALLY CONSTRAINED HIV PROTECTIVE BEHAVIORS, LIMIT THE POTENTIAL FOR PEOPLE AND COMMUNITIES AT THE MOST MARGINALIZED INTERSECTIONS OF RACE, ETHNICITY, GENDER, SOCIOECONOMIC STATUS, AND SEXUAL AND GENDER MINORITY STATUS, TO BENEFIT FROM THE REAL-WORLD IMPACT OF THESE NEW TECHNOLOGIES. ALTHOUGH THERE IS INCREASING ATTENTION IN THE FIELD TO THE ROLE OF SOCIAL-STRUCTURAL FACTORS ON PREVENTION AND TREATMENT, SUBSTANTIAL GAPS EXIST ABOUT HOW BEST TO CONCEPTUALIZE, RESEARCH, AND DEVELOP EFFECTIVE INTERVENTIONS TO ADDRESS THE INFLUENCE OF POWER STRUCTURES AND SYSTEMS ON HIV PREVENTION, TREATMENT AND CARE OUTCOMES, INCLUDING FROM AN INTERSECTIONAL LENS. THE PROPOSED PREDOCTORAL TRAINING PROGRAM IN APPROACHES TO ADDRESS SOCIAL-STRUCTURAL FACTORS RELATED TO HIV INTERSECTIONALLY (TASHI) WILL PREPARE THE NEXT GENERATION OF COMMUNITY-ENGAGED RESEARCHERS TO RIGOROUSLY STUDY AND STRATEGICALLY INTERVENE ON THESE DETERMINANTS TO PROMOTE HEALTH EQUITY AND TO END THE HIV EPIDEMIC. THE PROGRAM WILL LEVERAGE THE MULTI-FACETED STRENGTHS OF THE DEPARTMENTS OF PREVENTION AND COMMUNITY HEALTH (PCH) AND PSYCHOLOGICAL AND BRAIN SCIENCES (PBS) AT THE GEORGE WASHINGTON UNIVERSITY (GW) MILKEN INSTITUTE SCHOOL OF PUBLIC HEALTH (SPH) AND THE COLLEGE OF ARTS AND SCIENCES (CCAS), RESPECTIVELY, AS WELL AS THE GW INTERSECTIONALITY RESEARCH INSTITUTE (IRI), THE SPH’S DEPARTMENT OF EPIDEMIOLOGY AND THE GW SCHOOL OF MEDICINE’S DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL SCIENCES. PRE-DOCTORAL TRAINEES WILL UNDERTAKE A RIGOROUS PROGRAM OF COURSEWORK INCLUDING A SOLID FOUNDATION IN CRITICAL THEORETICAL FRAMEWORKS (E.G., CRITICAL RACE THEORY, INTERSECTIONALITY), MULTIPLE RESEARCH METHODOLOGIES (E.G., COMMUNITY-BASED PARTICIPATORY RESEARCH, MIXED METHODS), AND SOCIAL-STRUCTURAL AND MULTI-LEVEL INTERVENTION DEVELOPMENT AND EVALUATION. TRAINEES WILL PARTICIPATE IN CROSS-CUTTING AND INTEGRATIVE ACTIVITIES INCLUDING A MONTHLY SEMINAR SERIES, MENTORED RESEARCH PROJECTS, AND COMMUNITY AND STAKEHOLDER ENGAGEMENT ROUNDS. TRAINEES WILL BE SUPPORTED BY A GROUP OF 18 PROGRAM FACULTY MEMBERS WITH EXPERTISE IN THE SOCIAL, STRUCTURAL AND INTERSECTIONAL ASPECTS OF HIV AND RELATED HEALTH OUTCOMES. PROPOSED CO-PROGRAM DIRECTORS, DR. LISA BOWLEG AND DR. DEANNA KERRIGAN, ARE RECOGNIZED LEADERS IN THE U.S. AND GLOBAL HIV RESPONSE AND BOTH ARE EXECUTIVE COMMITTEE MEMBERS OF THE DISTRICT OF COLUMBIA CENTER FOR AIDS RESEARCH (DC CFAR), WHICH WILL SERVE AS A FOUNDATIONAL PLATFORM FOR TASHI.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_T32MH130247_7529/

ASST_NON_UG3AI169655_7529

Department of Health and Human Services

National Institutes of Health

GEORGE WASHINGTON UNIVERSITY (THE)

GEORGE WASHINGTON UNIVERSITY (THE)

DISTRICT OF COLUMBIA

MULTILEVEL STRATEGIES TO UNDERSTAND AND MODIFY THE ROLE OF STRUCTURAL AND ENVIRONMENTAL CONTEXT ON HIV INEQUITIES FOR SEXUAL AND GENDER MINORITIES OF COLOR - PROJECT SUMMARY/ABSTRACT BLACK, LATINO/A/E/X, AND MULTIRACIAL (BLM) SEXUAL AND GENDER MINORITIES WHO HAVE SEX WITH MEN (SGMSM) IN THE U.S. CONTINUE TO EXPERIENCE A HIGH AND DISPROPORTIONATE BURDEN OF HIV, PARTICULARLY YOUNGER BLM SGMSM FOR WHOM HIV INCIDENCE CONTINUES TO RISE DESPITE ADVANCES IN HIV PREVENTION. EVIDENCE SUGGESTS THAT DIFFERENCES IN INDIVIDUAL RISK BEHAVIORS DO NOT ACCOUNT FOR HIV INEQUITIES, AND UNDERSCORE THE NEED TO MOVE BEYOND MODELS OF INDIVIDUAL-LEVEL RISK FACTORS TO IDENTIFY AND INTERVENE UPON THE SOCIO-STRUCTURAL FACTORS THAT CREATE AND MAINTAIN INEQUITABLE RISK ENVIRONMENTS. HOWEVER, MUCH OF THE RESEARCH TO DATE IS LIMITED IN SCOPE AND FOCUSES INDIVIDUAL-LEVEL RISK OR ON CROSS-SECTIONAL HIV PREVALENCE, WHICH LIMITS THE ABILITY TO TREAT SOCIO- STRUCTURAL FACTORS AS DYNAMIC OR TO INVESTIGATE THE ENVIRONMENTS WITHIN WHICH RISK BEHAVIORS OCCUR. WE ARE SUBMITTING THIS APPLICATION IN RESPONSE TO RFA-AI-21-018 LIMITED INTERACTION TARGETED EPIDEMIOLOGY TO ADVANCE HIV PREVENTION (UG3/UH3). WE PROPOSE TO ENROLL A COHORT OF APPROXIMATELY 5,500 BLM SGMSM AGES 16 AND OLDER IN THE U.S. AND PUERTO RICO WHO ARE AT HIGH RISK FOR HIV INFECTION. WE WILL USE A COMBINED APPROACH TO RECRUITMENT (SEXUAL NETWORKING APPS, SOCIAL MEDIA, AND OTHER DIGITAL RECRUITMENT TECHNIQUES) THAT IS ADAPTIVE TO KNOWN SHIFTS IN DIGITAL TECHNOLOGY. PARTICIPANTS WILL COMPLETE A SURVEY AND HOME-BASED SAMPLING FOR LAB-BASED HIV TESTING AT ENROLLMENT AND ANNUALLY THEREAFTER FOR THREE YEARS AND AN ECOLOGICAL MOMENTARY ASSESSMENT (EMA) FOR SIX WEEKS AFTER ENROLLMENT. CONCORDANT WITH STUDY ENROLLMENT, WE WILL DEVELOP NOVEL METRICS TO QUANTIFY SOCIO-STRUCTURAL FACTORS (STATE-LEVEL POLICY AND SOCIAL CLIMATE INDICATORS) THAT CREATE INTERSECTIONAL OPPRESSION FOR BLM SGMSM, SPECIFICALLY STRUCTURAL RACISM, ANTI-LGBTQ STIGMA, AND RESTRICTIVE HIV-RELATED HEALTHCARE (AIM 1A). WE WILL SUBSEQUENTLY UTILIZE THE NEWLY DEVELOPED METRICS FROM AIM 1A ALONG WITH LOCAL SOCIO-STRUCTURAL FACTORS (LOCAL-LEVEL HIV PREVALENCE AND SOCIOECONOMIC INDICATORS) AND BASELINE AND EMA DATA TO TEST THE INEQUITABLE RISK ENVIRONMENTS HYPOTHESIS TO UNDERSTAND THE ROLE OF STATE AND LOCAL SOCIO- STRUCTURAL RISK FACTORS IN HIV RISK—THIS HYPOTHESIS WILL SPECIFICALLY TEST BOTH THE IMPACT OF SOCIO-STRUCTURAL FACTORS ON DAILY EXPOSURE TO INTERSECTIONAL STIGMA AND THE INTERACTION OF SOCIO-STRUCTURAL RISK WITH INDIVIDUAL BEHAVIORS ON UNDIAGNOSED HIV INFECTION AT BASELINE (AIM 2). THESE DATA WILL ALSO BE USED TO TEST A LONGITUDINAL MODEL OF MECHANISMS THROUGH WHICH STATE AND LOCAL SOCIO-STRUCTURAL FACTORS DIRECTLY AND INDIRECTLY INFLUENCE HIV SEROCONVERSION AND ACCESS TO EMERGING HIV PREVENTION TECHNOLOGIES (E.G., EMERGING PREP MODALITIES) (AIM 3). STUDY FINDINGS WILL BE SYSTEMATICALLY REVIEWED AND TRANSLATED INTO GUIDELINES FOR ENDING THE HIV EPIDEMIC- RELATED PUBLIC HEALTH POLICY AND COMMUNITY-LEVEL INTERVENTIONS TO REDUCE HIV INEQUITIES (AIM 1B). DEVELOPING AND TESTING A SOCIO-STRUCTURAL MODEL OF HIV RISK HAS STRONG POTENTIAL TO MOVE THE FIELD BEYOND INDIVIDUALLY- FOCUSED MODELS OF RISK AND IMPROVE THE NEXT GENERATION OF HIV PREVENTION INTERVENTIONS AIMED AT REDUCING DISPARITIES FOR THIS POPULATION.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_UG3AI169655_7529/

ASST_NON_UH3AI169655_7529

Department of Health and Human Services

National Institutes of Health

GEORGE WASHINGTON UNIVERSITY (THE)

GEORGE WASHINGTON UNIVERSITY (THE)

DISTRICT OF COLUMBIA

MULTILEVEL STRATEGIES TO UNDERSTAND AND MODIFY THE ROLE OF STRUCTURAL AND ENVIRONMENTAL CONTEXT ON HIV INEQUITIES FOR SEXUAL AND GENDER MINORITIES OF COLOR - PROJECT SUMMARY/ABSTRACT BLACK, LATINO/A/E/X, AND MULTIRACIAL (BLM) SEXUAL AND GENDER MINORITIES WHO HAVE SEX WITH MEN (SGMSM) IN THE U.S. CONTINUE TO EXPERIENCE A HIGH AND DISPROPORTIONATE BURDEN OF HIV, PARTICULARLY YOUNGER BLM SGMSM FOR WHOM HIV INCIDENCE CONTINUES TO RISE DESPITE ADVANCES IN HIV PREVENTION. EVIDENCE SUGGESTS THAT DIFFERENCES IN INDIVIDUAL RISK BEHAVIORS DO NOT ACCOUNT FOR HIV INEQUITIES, AND UNDERSCORE THE NEED TO MOVE BEYOND MODELS OF INDIVIDUAL-LEVEL RISK FACTORS TO IDENTIFY AND INTERVENE UPON THE SOCIO-STRUCTURAL FACTORS THAT CREATE AND MAINTAIN INEQUITABLE RISK ENVIRONMENTS. HOWEVER, MUCH OF THE RESEARCH TO DATE IS LIMITED IN SCOPE AND FOCUSES INDIVIDUAL-LEVEL RISK OR ON CROSS-SECTIONAL HIV PREVALENCE, WHICH LIMITS THE ABILITY TO TREAT SOCIO- STRUCTURAL FACTORS AS DYNAMIC OR TO INVESTIGATE THE ENVIRONMENTS WITHIN WHICH RISK BEHAVIORS OCCUR. WE ARE SUBMITTING THIS APPLICATION IN RESPONSE TO RFA-AI-21-018 LIMITED INTERACTION TARGETED EPIDEMIOLOGY TO ADVANCE HIV PREVENTION (UG3/UH3). WE PROPOSE TO ENROLL A COHORT OF APPROXIMATELY 5,500 BLM SGMSM AGES 16 AND OLDER IN THE U.S. AND PUERTO RICO WHO ARE AT HIGH RISK FOR HIV INFECTION. WE WILL USE A COMBINED APPROACH TO RECRUITMENT (SEXUAL NETWORKING APPS, SOCIAL MEDIA, AND OTHER DIGITAL RECRUITMENT TECHNIQUES) THAT IS ADAPTIVE TO KNOWN SHIFTS IN DIGITAL TECHNOLOGY. PARTICIPANTS WILL COMPLETE A SURVEY AND HOME-BASED SAMPLING FOR LAB-BASED HIV TESTING AT ENROLLMENT AND ANNUALLY THEREAFTER FOR THREE YEARS AND AN ECOLOGICAL MOMENTARY ASSESSMENT (EMA) FOR SIX WEEKS AFTER ENROLLMENT. CONCORDANT WITH STUDY ENROLLMENT, WE WILL DEVELOP NOVEL METRICS TO QUANTIFY SOCIO-STRUCTURAL FACTORS (STATE-LEVEL POLICY AND SOCIAL CLIMATE INDICATORS) THAT CREATE INTERSECTIONAL OPPRESSION FOR BLM SGMSM, SPECIFICALLY STRUCTURAL RACISM, ANTI-LGBTQ STIGMA, AND RESTRICTIVE HIV-RELATED HEALTHCARE (AIM 1A). WE WILL SUBSEQUENTLY UTILIZE THE NEWLY DEVELOPED METRICS FROM AIM 1A ALONG WITH LOCAL SOCIO-STRUCTURAL FACTORS (LOCAL-LEVEL HIV PREVALENCE AND SOCIOECONOMIC INDICATORS) AND BASELINE AND EMA DATA TO TEST THE INEQUITABLE RISK ENVIRONMENTS HYPOTHESIS TO UNDERSTAND THE ROLE OF STATE AND LOCAL SOCIO- STRUCTURAL RISK FACTORS IN HIV RISK—THIS HYPOTHESIS WILL SPECIFICALLY TEST BOTH THE IMPACT OF SOCIO-STRUCTURAL FACTORS ON DAILY EXPOSURE TO INTERSECTIONAL STIGMA AND THE INTERACTION OF SOCIO-STRUCTURAL RISK WITH INDIVIDUAL BEHAVIORS ON UNDIAGNOSED HIV INFECTION AT BASELINE (AIM 2). THESE DATA WILL ALSO BE USED TO TEST A LONGITUDINAL MODEL OF MECHANISMS THROUGH WHICH STATE AND LOCAL SOCIO-STRUCTURAL FACTORS DIRECTLY AND INDIRECTLY INFLUENCE HIV SEROCONVERSION AND ACCESS TO EMERGING HIV PREVENTION TECHNOLOGIES (E.G., EMERGING PREP MODALITIES) (AIM 3). STUDY FINDINGS WILL BE SYSTEMATICALLY REVIEWED AND TRANSLATED INTO GUIDELINES FOR ENDING THE HIV EPIDEMIC- RELATED PUBLIC HEALTH POLICY AND COMMUNITY-LEVEL INTERVENTIONS TO REDUCE HIV INEQUITIES (AIM 1B). DEVELOPING AND TESTING A SOCIO-STRUCTURAL MODEL OF HIV RISK HAS STRONG POTENTIAL TO MOVE THE FIELD BEYOND INDIVIDUALLY- FOCUSED MODELS OF RISK AND IMPROVE THE NEXT GENERATION OF HIV PREVENTION INTERVENTIONS AIMED AT REDUCING DISPARITIES FOR THIS POPULATION.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_UH3AI169655_7529/

ASST_NON_K01MD016346_7529

Department of Health and Human Services

National Institutes of Health

GEORGE MASON UNIVERSITY

GEORGE MASON UNIVERSITY

A COMMUNITY-BASED INTERVENTION TO INCREASE PREP INITIATION AMONG BLACK SEXUAL MINORITY MEN IN PRINCE GEORGE'S COUNTY, MARYLAND: REDUCING INTERNALIZED STIGMA AND INCREASING SOCIAL SUPPORT - ABSTRACT MY GOAL IN PURSUING A MENTORED RESEARCH CAREER DEVELOPMENT AWARD IS TO GAIN THE NECESSARY TRAINING, KNOWLEDGE, AND PRACTICAL EXPERIENCE NEEDED TO BECOME AN INDEPENDENT INVESTIGATOR FOCUSED ON IMPROVING ACCESS TO AND UTILIZATION OF PREP AMONG BLACK MEN WHO HAVE SEX WITH MEN (BSMM) THROUGH SOCIAL, PEER- BASED INTERVENTION RESEARCH. TO CONTINUE MY PROGRESS TOWARDS MY CAREER GOALS, I PROPOSE TO CONDUCT AN INTERVENTION FOCUSED ON INCREASING PREP ACCEPTABILITY THROUGH DEVELOPING AND MAINTAINING PEER SUPPORT AND RESILIENCE TO INTERSECTIONAL RACISM AND HOMOPHOBIA AMONG BSMM IN PRINCE GEORGE’S COUNTY, MD. DESPITE A CLEAR, WELL-DOCUMENTED NEED FOR GREATER UPTAKE OF PREP AMONG BSMM IN THIS COUNTY, PREP UPTAKE AMONG BSMM IN THIS SETTING REMAINS LOW, AND EXTANT LITERATURE SPECIFIC TO PREP USE IN THIS SETTING AND POPULATION IS EXTREMELY LIMITED. TO ADDRESS THIS NEED, I PROPOSE THE FOLLOWING: SPECIFIC AIMS: 1) UNDERSTAND PEER-PEER INTERACTIONS/EXCHANGES AND HIV PREVENTION COMMUNICATIONS AMONG BSMM THROUGH ETHNOGRAPHIC QUALITATIVE OBSERVATIONS (PARTICIPANT AND DIRECT) OF TWO ONGOING MPOWERMENT MODELS, 2) CONDUCT QUALITATIVE IN DEPTH INTERVIEWS TO INFORM DESIGNING AN INTERVENTION TO REDUCE INTERNALIZED RACISM, INTERNALIZED HOMOPHOBIA AND INCREASE PREP INITIATION AMONG BSMM IN PG COUNTY, AND 3) PILOT TEST A COMMUNITY-BASED INTERVENTION (130 PARTICIPANTS) TO REDUCE INTERNALIZED RACISM, INTERNALIZED HOMOPHOBIA, AND HIV STIGMA AND INCREASE SOCIAL SUPPORT AND PREP INITIATION AMONG BSMM IN PG COUNTY, BASED ON THE MPOWERMENT MODEL. IN ADDITION TO MY SPECIFIC AIMS, MY SPECIFIC CAREER DEVELOPMENT AIMS ARE THE FOLLOWING: 1) TO DEVELOP EXPERTISE IN THE ANALYSIS OF QUALITATIVE DATA, PARTICULARLY RELATED TO SOCIAL AND STRUCTURAL FACTORS, 2) TO DEVELOP EXPERTISE IN THE COLLECTION AND ANALYSIS OF NETWORK DATA COLLECTED VIA RESPONDENT DRIVEN SAMPLING, 3) TO GAIN EXPERIENCE IN THE DESIGN, CONDUCT, AND EVALUATION OF INTERVENTIONS AND 4) TO DEVELOP RESEARCH MANAGEMENT AND PROFESSIONAL DEVELOPMENT SKILLS NEEDED TO LEAD FUTURE INDEPENDENT RESEARCH PROJECTS. THE KNOWLEDGE AND EXPERIENCE GAINED FROM THE PROPOSED RESEARCH WILL PROVIDE ME THE SKILLSET NECESSARY TO SUCCESSFULLY COMPETE FOR R01 FUNDING TO CONDUCT A LARGER SCALE PEER-FOCUSED INTERVENTION TO PROMOTE PREP ACCEPTABILITY AND ADHERENCE AMONG BSMM. THE PROPOSAL MAKES SIGNIFICANT CONTRIBUTIONS TO THE FIELD IN SEVERAL WAYS, INCLUDING 1) IDENTIFYING BARRIERS TO PREP ACCEPTABILITY AMONG BSMM IN PRINCE GEORGE’S COUNTY, 2) QUALITATIVELY UNDERSTAND FACTORS THAT MAY IMPACT OBSERVED QUANTITATIVE ASSOCIATIONS BETWEEN BARRIERS AND PREP USE AND ACCEPTABILITY, AND 3) DEVELOPING AND EVALUATING AN MPOWERMENT INTERVENTION TO IMPROVE PREP USE AND ACCEPTABILITY IN THIS POPULATION. MY RIGOROUS EDUCATION, TRAINING, AND RESEARCH EXPERIENCE IN SOCIAL DETERMINANTS OF HIV/STI RISK, COLLABORATIONS WITH BSMM POPULATIONS AND ORGANIZATIONS, PROFICIENCY WITH QUANTITATIVE DATA ANALYSIS, AND THE EXPERTISE OF MY MULTIDISCIPLINARY RESEARCH TEAM, UNIQUELY PREPARES ME TO CONDUCT THE PROPOSED RESEARCH AND SIGNIFICANTLY CONTRIBUTE TO HIV PREVENTION SCIENCE.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K01MD016346_7529/

ASST_NON_K23MH126794_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF ALABAMA AT BIRMINGHAM

UNIVERSITY OF ALABAMA AT BIRMINGHAM

AMPLIFYING OUR VOICE: UNDERSTANDING HIV PREP PROMOTIONAL MESSAGING TO CREATEAUTHENTIC PREP CONTENT BY MEN WHO HAVE SEX WITH MEN IN THE DEEP SOUTH - 1 PROJECT SUMMARY/ABSTRACT: 2 THIS K23 AWARD WILL ALLOW RONNIE M. GRAVETT, MD, TO TRAIN UNDER MULTIDISCIPLINARY, EXPERT MENTORSHIP TO BECOME 3 AN INDEPENDENT PATIENT-ORIENTED OUTCOMES RESEARCHER DEDICATED TO IMPROVING THE HIV OUTCOMES AFFECTING SEXUAL 4 MINORITY PERSONS IN THE DEEP SOUTH. HIV DISPROPORTIONATELY AFFECTS MEN WHO HAVE SEX WITH MEN (MSM) IN THE 5 DEEP SOUTH, A REGION IN THE UNITED STATES WITH THE HIGHEST BURDEN OF NEW HIV DIAGNOSES. PRE-EXPOSURE 6 PROPHYLAXIS (PREP) EFFECTIVELY PREVENTS HIV ACQUISITION AMONG MSM, BUT THERE IS A SIGNIFICANT LAG IN PREP UPTAKE 7 AND PERSISTENCE IN THE DEEP SOUTH WHEN COMPARED TO OTHER REGIONS OF THE US. BARRIERS, SUCH AS SYSTEMIC RACISM, 8 STIGMA, AND HOMONEGATIVITY, PREVENT MSM FROM ADEQUATELY ACCESSING AND USING THIS EFFECTIVE STRATEGY. THE HIGH 9 BURDEN OF HIV AND INADEQUATE PREP UPTAKE ARE NIH PRIORITIES THAT NEED NOVEL STRATEGIES TO ADDRESS, SUCH AS 10 EMPOWERING AND EFFECTIVE PREP PROMOTIONAL STRATEGIES TO INCREASE PREP UPTAKE. YET, THERE IS A CRITICAL GAP IN 11 UNDERSTANDING HIV PREVENTION MESSAGING THAT IS INFORMED BY THE GREATER CONTEXT OF THE INTERSECTING IDENTITIES AND 12 KNOWN BARRIERS TO PREP UPTAKE AMONG MSM IN THE DEEP SOUTH. TO ADDRESS THIS GAP, THIS PROJECT WILL EXAMINE 13 PREFERENCES FOR PREP PROMOTIONAL MESSAGING IN ORDER TO CREATE AUTHENTIC AND INFORMATIVE PREP MESSAGES 14 THROUGH CROWDSOURCING, AN INNOVATIVE STRATEGY WHEREIN A GROUP SOLVES A COMMON PROBLEM AND THE SOLUTION IS 15 GIVEN BACK TO THE GROUP. INTEGRATING CONSTRUCTS OF ANDERSEN’S BEHAVIORAL MODEL OF HEALTHCARE UTILIZATION AND 16 COMMUNITY ENGAGEMENT INTO A HUMAN-CENTERED DESIGN MODEL WILL SERVE AS THE FRAMEWORK FOR THIS PROJECT. THIS 17 PROJECT WILL ADDRESS THE GAP THROUGH THE FOLLOWING SPECIFIC AIMS: 1) EXPLORE PREFERENCES FOR PREP MESSAGING 18 CONTENT AMONG MSM IN THE DEEP SOUTH THROUGH QUALITATIVE INTERVIEWS, 2) USING A DISCRETE CHOICE EXPERIMENT 19 (DCE), DEFINE THE PREFERRED ATTRIBUTES FOR PREP MESSAGING CONTENT TO INFORM THE FORMAT FOR THE CROWDSOURCING 20 OPEN CALL, AND 3) COMPARE MSM PREFERENCES FOR CROWDSOURCED SERVICES TO STANDARD SERVICES TO INFORM A DIGITAL 21 INTERVENTION DESIGNED TO INCREASE PREP UPTAKE AMONG MSM IN THE DEEP SOUTH. CROWDSOURCED CONTENT CREATED 22 DURING THIS PROJECT WILL BE COMPARED TO HEALTH AUTHORITY CONTENT TO SHOW THAT COMMUNITY-DERIVED CONTENT IS 23 PREFERRED BY MSM. THE TRAINING PLAN WILL COMBINE FORMAL COURSEWORK, INTENSIVE SEMINARS, AND EXPERT MENTORSHIP 24 FOCUSED ON THE FOLLOWING TOPICS: 1) QUANTITATIVE, QUALITATIVE, AND MIXED METHODOLOGIES, 2) DESIGN AND CONDUCT OF 25 DISCRETE CHOICE EXPERIMENTS, AND 3) CROWDSOURCING TO CREATE AUTHENTIC PREP PROMOTIONAL MESSAGING. THIS K23 26 AWARD WILL SUPPORT THE DEVELOPMENT OF AFFIRMING, EFFECTIVE CONTENT TO IMPROVE HIV PREVENTION STRATEGIES AMONG 27 MSM WHILE ALSO PROVIDING MENTORSHIP FROM RENOWNED CONTENT AND METHODOLOGICAL EXPERTS, STRUCTURED, 28 MULTIDISCIPLINARY TRAINING IN A COLLABORATIVE ENVIRONMENT, AND THE AVENUE FOR DR. GRAVETT TO DEVELOP INTO AN 29 INDEPENDENT PHYSICIAN INVESTIGATOR AND LEADING EXPERT IN HIV PREVENTION AMONG SEXUAL MINORITIES IN THE DEEP 30 SOUTH.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_K23MH126794_7529/

ASST_NON_R34MH129187_7529

Department of Health and Human Services

National Institutes of Health

EMORY UNIVERSITY

EMORY UNIVERSITY

BROTHERS BUILDING BROTHERS BY BREAKING BARRIERS (B6): A RESILIENCE-FOCUSED INTERVENTION FOR YOUNG BLACK GAY AND BISEXUAL MEN LIVING WITH HIV - PROJECT SUMMARY YOUNG BLACK GAY, BISEXUAL AND OTHER MEN WHO HAVE SEX WITH MEN (YB-GBMSM) ENCOUNTER MULTILEVEL BARRIERS TO ENGAGING IN HIV CARE, AS A DIRECT RESULT OF STRUCTURAL AND INTERPERSONAL RACISM, HOMONEGATIVITY AND HIV STIGMA. THESE BARRIERS LEAD TO HIV DISPARITIES IN WHICH YB-GBMSM HAVE HIGH HIV PREVALENCE AND INCIDENCE, BUT SUBOPTIMAL RATES OF ENGAGEMENT ACROSS THE HIV CARE CONTINUUM. RESILIENCE AT BOTH THE INDIVIDUAL AND COMMUNITY LEVELS CAN BUFFER THE DELETERIOUS EFFECTS OF STIGMA AND DISCRIMINATION ON HIV CARE ENGAGEMENT. WE HAVE PREVIOUSLY DEVELOPED A CULTURALLY-SPECIFIC RESILIENCE-BUILDING INTERVENTION FOR YB-GBMSM LIVING WITH HIV CALLED BROTHERS BUILDING BROTHERS BY BREAKING BARRIERS (B6). B6 SPECIFICALLY TARGETS INTERSECTIONAL IDENTITY AFFIRMATION (AN INDIVIDUAL-LEVEL RESILIENCE FACTOR) AND SOCIAL CAPITAL (A COMMUNITY-LEVEL RESILIENCE FACTOR) AS A STRATEGY FOR IMPROVING ENGAGEMENT IN HIV CARE. THE OBJECTIVE OF THIS R34 APPLICATION IS TO ADAPT B6, ORIGINALLY DEVELOPED AS AN IN-PERSON INTERVENTION, FOR TELEHEALTH DELIVERY WITHIN THE CONTEXT OF A COMMUNITY-BASED ORGANIZATION (CBO). THE RATIONALE FOR THE PROJECT IS THAT TELEHEALTH DELIVERY AND CBO PARTNERSHIP WILL REMOVE BARRIERS TO PARTICIPATION AND FACILITATE SCALABILITY AND SUSTAINABILITY. OUR STUDY WILL BE BASED IN ATLANTA, GEORGIA – AN HIV EPICENTER. THIS STUDY WILL PURSUE THREE SPECIFIC AIMS: (1) TO ADAPT B6 FOR TELEHEALTH DELIVERY, IN COLLABORATION WITH YB-GBMSM, COMMUNITY ADVISORS, AND SUBJECT MATTER EXPERTS; (2) TO CONDUCT A PILOT RANDOMIZED CONTROLLED TRIAL (RCT) TO EVALUATE FEASIBILITY AND ACCEPTABILITY OF TELE-B6 AMONG YB-GBMSM LIVING WITH HIV IN ATLANTA; AND (3) TO EVALUATE THE PROCESS OF IMPLEMENTING B6 WITHIN THE CONTEXT OF OUR PARTNER CBO. FOR THE FIRST AIM, WE WILL USE THE ADAPT-ITT FRAMEWORK TO CONVERT B6 FROM AN IN-PERSON TO A TELEHEALTH INTERVENTION (TELE-B6). FOR THE SECOND AIM, WE WILL TEST TELE-B6 WITH N=60 YB-GBMSM AND EXAMINE FEASIBILITY AND ACCEPTABILITY OF THE INTERVENTION. WE WILL ALSO EXPLORE INTERVENTION IMPACTS ON SOCIAL CAPITAL, IDENTITY AFFIRMATION, AND HIV CARE ENGAGEMENT. IN THE THIRD AIM, WE WILL UTILIZE THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH TO EXAMINE THE PROCESS OF IMPLEMENTING TELE-B6 WITHIN THE STRUCTURE OF OUR PARTNER CBO. THE PROPOSED RESEARCH IS HIGHLY SIGNIFICANT BECAUSE OF ITS POTENTIAL TO DEVELOP A CULTURALLY RELEVANT, SCALABLE INTERVENTION FOR YB-GBMSM, A GROUP WHO CONTINUES TO BE HEAVILY AND DISPROPORTIONATELY IMPACTED BY HIV.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R34MH129187_7529/

ASST_NON_NU62PS924666_7523

Department of Health and Human Services

Centers for Disease Control and Prevention

DISTRICT OF COLUMBIA

PACT - WE ARE UNITED - IN RESPONSE TO CDCS NOTICE OF FUNDING OPPORTUNITY ANNOUNCEMENT (NOFO), PARTNERING AND COMMUNICATING TOGETHER, AIDS UNITED (AU), IN PARTNERSHIP WITH THE NATIONAL LGBTQ TASK FORCE, THE BLACK WOMEN?S IMPERATIVE, THE COLLABORATIVE TO ADVANCE HEALTH SERVICES, FIJATE BIEN/MPACT GLOBAL ACTION FOR GAY MEN?S HEALTH AND RIGHTS, AND BUILDING HEALTHY ONLINE COMMUNITIES SUBMIT A PROPOSAL TO BRING HIV PREVENTION AND AWARENESS MESSAGING TO KEY PRIORITY POPULATIONS AND AREAS ACROSS THE U.S. THIS APPLICATION FOR PACT ? WE ARE UNITED - IS SUBMITTED UNDER CATEGORY A AND B OF THE FUNDING ANNOUNCEMENT TO SUPPORT THE DISSEMINATION OF CDC?S LET?S STOP HIV TOGETHER (TOGETHER) CAMPAIGN VIA THE USE OF DIGITAL AND SOCIAL MEDIA AND AT IN-PERSON AND VIRTUAL EVENTS. THE SCOPE OF STRATEGIES AND ACTIVITIES ARE DESIGNED TO REACH AND ENGAGE MSM, YOUNG MSM OF COLOR, TRANSGENDER WOMEN, HISPANIC/LATINX, AND COMMUNITIES IN SOUTHERN U.S. EVENTS ARE PLANNED TO TAKE PLACE IN TEN CRITICAL JURISDICTIONS IDENTIFIED BY THE ENDING THE HIV EPIDEMIC INITIATIVE (EHE) INCLUDING IN FLORIDA, GEORGIA, MISSOURI, MISSISSIPPI, NEW YORK, OHIO, SOUTH CAROLINA, TEXAS, WASHINGTON. D.C, AND PUERTO RICO. TODAY, WE HAVE REAL SOLUTIONS TO ADDRESS THE HIV EPIDEMIC IN THE US. YET, DESPITE ACCESS TO TREATMENT AND CARE, NEW ADVANCES IN TREATMENT, AND NEW PREVENTION MODALITIES SUCH AS PREP, 38,000 NEW HIV DIAGNOSES ARE REPORTED YEARLY WITH DISPROPORTIONATE IMPACT ON CERTAIN SECTORS OF THE POPULATION. SOME OF THE CHALLENGES TO HIV PREVENTION AND TREATMENT CAN BE DIRECTLY LINKED TO LACK OF ACCURATE AND CURRENT KNOWLEDGE ABOUT HIV AND THE IMPACT OF STIGMA. GAPS IN KNOWLEDGE ALONG WITH INTERNAL NEGATIVE ATTITUDES, BEHAVIORS, AND JUDGEMENTS TOWARDS PEOPLE LIVING WITH OR AT RISK FOR HIV ARE LINKED TO DISCOURAGING INDIVIDUALS FROM LEARNING THEIR HIV STATUS, ACCESSING TREATMENT, OR STAYING IN CARE. ADDITIONALLY, EXPERIENCES OF RACISM AND DISCRIMINATION ALSO CONTRIBUTE TO ADDITIONAL BARRIERS IN HEALTHCARE AND, OFTEN, ARE LINKED TO DISPARITIES ACCESSING IMPORTANT HIV PREVENTION TOOLS, INCLUDING PRESCRIPTION OF PREP.BUILDING UPON THE SUCCESSES OF THE CURRENT CDC FUNDED PACT PROGRAM (FORMERLY ACT AGAINST AIDS) THAT MOBILIZED NATIONAL AND LOCAL-BASED ORGANIZATIONS TO HELP DELIVER HIV INFORMATION AND RESOURCES TO LGBTQ COMMUNITIES, AU WILL ENGAGE A BROADER AND TARGETED NETWORK OF NATIONAL, REGIONAL, AND LOCAL ORGANIZATIONS TO CONTINUE DISSEMINATING THE TOGETHER CAMPAIGN MESSAGING. WORKING SIDE-BY-SIDE WITH THE PARTNERING ORGANIZATIONS, ALONG WITH A NETWORK OF ONLINE COMMUNITIES ? AND UTILIZING DIGITAL, SOCIAL MEDIA, AND EVENTS ? WE PROPOSE TO DISSEMINATE HIV INFORMATION AND RAISE AWARENESS ABOUT HIV PREVENTION AND TREATMENT OPTIONS TO SPECIFIC AREAS AND POPULATIONS DISPROPORTIONATELY IMPACTED BY HIV AND TO THEIR HEALTH CARE PROVIDERS. OUR PROPOSED PROGRAM WILL DISSEMINATE THE TOGETHER CAMPAIGN MESSAGES AND MATERIALS USING A COMPREHENSIVE COMMUNICATIONS PLAN TO INCLUDE TOGETHER-RELATED MESSAGES AND CONTENT IN SOCIAL MEDIA POSTS, BLOGS AND NEWSLETTERS, DIGITAL ARTICLES, AND SOCIAL MEDIA PLACEMENTS ACROSS VARIED PLATFORMS. FURTHERMORE, ACTIVITIES WILL ALSO INCLUDE TOGETHER DIGITAL AD PLACEMENTS AND STORIES GENERATED IN THE MEDIA, CAMPAIGN-RELATED MATERIAL DISTRIBUTION (MORE THAN 5000), AT LEAST 12 VIRTUAL AND 10 IN-PERSON EVENTS, CONTINUAL AD PLACEMENTS ON MSM DATING SITES, ENGAGEMENT OF NEW NATIONAL AND LOCAL PARTNERS, AND MUCH MORE. THESE EFFORTS AIM TO INCREASE UNDERSTANDING OF OPTIONS TO PROMOTE HIV TESTING, ENCOURAGE EARLY ENGAGEMENT IN AND ADHERENCE TO HIV TREATMENT, AND INCREASE THE USE OF EFFECTIVE PREVENTION TOOLS, INCLUDING PREP (AMONG OTHERS) TO REDUCE NEW HIV RATES AMONG OUR TARGET POPULATIONS

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_NU62PS924666_7523/

ASST_NON_DP2AI164315_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF CALIFORNIA IRVINE

UNIVERSITY OF CALIFORNIA IRVINE

ONE BALLROOM - ABSTRACT BLACK AND LATINO TRANS WOMEN AND MEN WHO HAVE SEX WITH MEN – OR SEXUAL AND GENDER MINORITIES OF COLOR (SGMOC) - ACCOUNT FOR AT LEAST HALF OF ALL NEW HIV INFECTIONS IN THE UNITED STATES (U.S.). AT THE SAME TIME THERE IS A SIGNIFICANT DISPARITY IN KNOWLEDGE OF, ACCESS TO AND UPTAKE OF PRE-EXPOSURE PROPHYLAXIS (PREP) AMONG SGMOC IS DISPROPORTIONATELY LOW COMPARED TO WHITE MSM AND TRANS WOMEN. NUMEROUS STUDIES HAVE ARTICULATED DISPARITIES IN HIV AMONG GROUPS UNDER THE SGMOC UMBRELLA. HOWEVER, MOST RESEARCH AGGREGATES EXPERIENCES BASED ON ONE AXIS OF STIGMA SUCH AS GAY OR TRANS IDENTITY. INTERSECTIONAL HIV STIGMA, OR STIGMA AS THE RESULT OF MULTIPLE, INTERSECTING MINORITY IDENTITIES, OFFER A COMPLEX LENS IN WHICH TO EXAMINE THE MULTIPLICATIVE EFFECT OF EXPERIENCING MORE THAN ONE AXIS OF STIGMA. SGMOC FACE STIGMA AS SEXUAL, GENDER AND RACIAL/ETHNIC MINORITIES. SGMOC WITH THESE INTERSECTING IDENTITIES FACE RACISM, SEXISM, TRANSPHOBIA AND A HOST OF OTHER STIGMAS THAT PUT THEM AT HIGH RISK OF HIV AND CREATE BARRIERS TO HIV PREVENTION. THIS STUDY WILL INCLUDE A 3-YEAR IN-DEPTH LONGITUDINAL QUALITATIVE PHASE, A 12-MONTH LONGITUDINAL SOCIAL EPIDEMIOLOGIC PHASE, AND AN INTENSIVE LONGITUDINAL ECOLOGICAL MOMENTARY ASSESSMENT PHASE. WE PROPOSE TO USE AN INNOVATIVE AND CULTURALLY RELEVANT SAMPLING STRATEGY OF WEB-BASED RESPONDENT DRIVEN SAMPLING (WEBRDS) TO RECRUIT AN ONLINE COHORT OF 900 SGMOC. THE ONLINE COHORT WILL COMPLETE 3 SURVEY ASSESSMENTS IN SIX-MONTH INTERVALS. THE 200 HIGHEST RISK COHORT PARTICIPANTS WILL PARTICIPATE IN EMA PHASE WITH TO MEASURE THE IMMEDIATE CONTEXT OF INTERSECTIONAL HIV STIGMA, HIV PREVENTION BEHAVIORS AND HIV RISK. THESE PARTICIPANTS WILL RECEIVE SHORT RANDOM ECOLOGICAL MOMENTARY ASSESSMENTS DAILY FOR 30 DAYS VIA A MOBILE HEALTH APPLICATION. NOT ONLY WILL THIS STUDY EXAMINE INTERSECTIONAL HIV STIGMA IN CONTEXT OF THE DAILY LIVES OF SGMOC, THE ECOLOGICAL MOMENTARY ASSESSMENT PHASE WILL ALSO INFORM FUTURE DEVELOPMENT OF A CONTEXT AWARE, ECOLOGICAL MOMENTARY INTERVENTION TO REDUCE INTERSECTIONAL HIV STIGMA AND OPTIMIZE THE HIV PREVENTION AND CARE CONTINUA.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_DP2AI164315_7529/

ASST_NON_R01HL160326_7529

Department of Health and Human Services

National Institutes of Health

RUTGERS THE STATE UNIVERSITY OF NEW JERSEY

RUTGERS THE STATE UNIVERSITY OF NEW JERSEY

STIGMA AND THE NON-COMMUNICABLE DISEASE SYNDEMIC IN AGING HIV POSITIVE AND HIV NEGATIVE MSM - ABSTRACT OVER THE NEXT DECADE, MORE THAN 70% OF PEOPLE LIVING WITH HIV (PWH) WILL BE OLDER THAN 50. THE INCREASING BURDEN OF THE NON-COMMUNICABLE DISEASES (NCDS) HYPERTENSION, DIABETES, AND DYSLIPIDEMIA HAS AL-READY BEGUN TO PRESENT KEY CHALLENGES TO EFFECTIVE HIV CARE AMONG AGING PLWH, INCLUDING SEXUAL MINORITY MEN (SMM). BECAUSE THESE NCDS OFTEN PRESENT TOGETHER AS COMORBID CONDITIONS, INTERACT WITH EACH OTHER ADVERSELY, AND ARE INFLECTED BY SOCIAL AND STRUCTURAL INEQUITIES, THEY MAY COMPRISE A SYNERGISTIC EPIDEMIC (SYNDEMIC). IN THE U.S., THERE ARE SUBSTANTIAL RACIAL, ETHNIC, AND SOCIOECONOMIC DISPARITIES IN THE PREVALENCE AND/OR CONTROL OF NCDS AND HIV. INTERSECTING STIGMAS, SUCH AS RACISM, CLASSISM, AND HOMOPHOBIA, MAY DRIVE THESE HEALTH DISPARITIES THROUGH DIRECT AND INDIRECT MECHANISMS. DIRECTLY, INTERSECTIONAL STIGMA IN HEALTHCARE SETTINGS MAY CONTRIBUTE TO HEALTHCARE AVOIDANCE, DECREASING SUCCESS RATES ALONG HIV AND NCD SYNDEMIC CONTINUA OF CARE DOMAINS OF RETENTION, TREATMENT, ADHERENCE, AND DISEASE CONTROL. INDIRECTLY, EXPERIENCING INTERSECTIONAL STIGMA MAY LEAD TO A PSYCHOSOCIAL SYNDEMIC OF STRESS, DEPRESSION, VIOLENCE, AND SUBSTANCE USE, THEREBY CONTRIBUTING TO HIV AND NCD INCIDENCE, PREVALENCE, AND POORER DISEASE CONTROL. VERY FEW IF ANY STUDIES HAVE PROSPECTIVELY ASSESSED THE CONTRIBUTION OF INTERSECTIONAL STIGMA TO SOCIAL DISPARITIES IN NCD SYNDEMIC INCIDENCE, PREVALENCE, AND CONTROL AMONG PWH; AND FEW IF ANY STUDIES HAVE RIGOROUSLY ASSESSED HOW THE PSYCHOSOCIAL SYNDEMIC MAY MEDIATE PATHWAYS BETWEEN SOCIAL POSITION AND SYNDEMIC NCD AND HIV OUTCOMES. COLLECTING DATA OVER A FOUR-YEAR PERIOD, WE WILL UTILIZE THE MACS/WIHS COMBINED COHORT STUDY, THE LONGEST-RUNNING COHORT STUDY OF HIV+ AND HIV- SMM IN THE U.S., TO ASSESS THE FOLLOWING SPECIFIC AIMS: 1) ASSESS RELATIONSHIPS BETWEEN SOCIAL POSITION, INTERSECTIONAL STIGMA, AND THE PSYCHOSOCIAL SYNDEMIC AMONG MIDDLE-AGED AND AGING HIV+ AND HIV- SMM; 2) ASSESS RELATIONSHIPS BETWEEN SOCIAL POSITION AND NCD SYNDEMIC INCIDENCE AND PREVALENCE; AND 3) ASSESS RELATIONSHIPS BETWEEN SOCIAL POSITION AND HIV AND NCD SYNDEMIC CONTINUA OF CARE OUTCOMES, MEDIATED BY INTERSECTIONAL STIGMA AND THE PSYCHOSOCIAL SYNDEMIC. OUR SCIENTIFIC PREMISE IS THAT MULTIPLY MARGINALIZED POPULATIONS EXPERIENCE DISPARITIES IN NCD SYNDEMIC INCIDENCE, PREVALENCE, AND CONTROL, WHICH ARE MEDIATED BY INTERSECTIONAL STIGMA AND THE PSYCHOSOCIAL SYNDEMIC. THE PROPOSED WORK WILL EXTEND INTERSECTIONAL STIGMA AND PSYCHOSOCIAL SYNDEMICS RESEARCH ON THE HIV CONTINUUM OF CARE TO THE NCD SYNDEMIC CONTINUUM OF CARE. THIS PROPOSAL ALIGNS WITH NIH HIGH PRIORITY AIDS RESEARCH AREAS OUTLINED IN NOT-OD-15-137 (“ADDRESSING THE IMPACT OF HIV-ASSOCIATED COMORBIDITIES”) AND WITH NHLBI RFA-HL-21-018, WHICH CALLS FOR MULTIFACTORIAL RESEARCH USING SYNDEMICS FRAMEWORKS TO CHARACTERIZE CLUSTERING OF HEART, LUNG, BLOOD, AND SLEEP CONDITIONS WITHIN PWH. THIS STUDY WILL PROVIDE CRITICAL DATA FOR INFORMING THE DEVELOPMENT OF INTEGRATED, MULTILEVEL INTERVENTIONS INTENDED TO REMEDIATE DISPARITIES IN NCD INCIDENCE, PREVALENCE, AND CONTROL AMONG MIDDLE-AGED AND AGING SMM, PARTICULARLY SMM OF COLOR AND PWH.

NOT RECOVERY ACT

PUBLIC/STATE CONTROLLED INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01HL160326_7529/

ASST_NON_T32MH128395_7529

Department of Health and Human Services

National Institutes of Health

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

THE TRUSTEES OF COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK

SOCIAL DETERMINANTS OF HIV - SOCIAL DETERMINANTS OF HEALTH (SDH) COMPRISE OVERLAPPING SOCIAL STRUCTURES AND ECONOMIC SYSTEMS THAT ACCOUNT FOR MOST HEALTH INEQUITIES. EXAMINING SDH MAY BE USEFUL IN IDENTIFYING AND MONITORING HIV-RELATED INEQUITIES, SUCH AS RACIAL AND GENDER DISPARITIES IN HIV TESTING, ENGAGEMENT IN CARE, AND TREATMENT. THIS PROPOSAL REQUESTS FUNDING FOR A PRE-DOCTORAL RESEARCH TRAINING PROGRAM TO ADDRESS SDH INCLUDING STRUCTURAL RACISM AND GENDER INEQUALITY, INTERSECTIONAL STIGMA, RESIDENTIAL SEGREGATION, AGING, AND MARGINALIZING STRUCTURES INFLUENCING HIV. COMBATTING THE ONGOING SYNDEMIC OF SDH, HIV, AFFILIATED CO-MORBIDITIES, AND OTHER POTENTIALLY OVERLAPPING INFECTIOUS DISEASES SUCH AS CORONAVIRUS, REQUIRES CUTTING EDGE PUBLIC HEALTH RESEARCH CONDUCTED BY SCIENTISTS OF THE HIGHEST CALIBER. THIS PRE-DOCTORAL PROGRAM WILL BE LOCATED IN THE DEPARTMENT OF SOCIOMEDICAL SCIENCES WITHIN COLUMBIA UNIVERSITY, MAILMAN SCHOOL OF PUBLIC HEALTH (MSPH). THE TRAINING PROGRAM WILL TAKE ADVANTAGE OF THE INTERDISCIPLINARY EXPERTISE ACROSS MSPH IN MENTORING EXPERIENCE AND EXPERTISE IN SDH AMONG PEOPLE AT RISK AND LIVING WITH HIV. WE ALSO PROPOSE TO COLLABORATE WITH FACULTY AT THE HIV CENTER ON CLINICAL AND BEHAVIORAL STUDIES AT COLUMBIA UNIVERSITY IRVING MEDICAL CENTER (CUIMC), THE INTERNATIONAL CENTER FOR AIDS CARE AND TREATMENT PROGRAM, AT MSPH, AND THE SOCIAL INTERVENTIONS GROUP AT THE COLUMBIA UNIVERSITY SCHOOL OF SOCIAL WORK. THIS WEALTH OF FACULTY HAVE OUTSTANDING RECORDS IN PUBLISHING, FUNDING, AND SUCCESSFULLY MENTORING TRAINEES. WE PROPOSE TO FUND TEN MSPH PRE-DOCTORAL FELLOWS. RECRUITMENT WILL BE FOCUSED SUCH THAT AT LEAST 50% OF FELLOWS ENROLLED WILL BE UNDER-REPRESENTED TRAINEES. ELIGIBLE TRAINEES ARE PRE-DOCTORAL STUDENTS ADMITTED TO COLUMBIA UNIVERSITY'S MSPH DEPARTMENTS OF SOCIOMEDICAL SCIENCES, BIOSTATISTICS, EPIDEMIOLOGY, AND POPULATION AND FAMILY HEALTH, AND COMMITTED TO UNDERSTANDING SOCIAL DETERMINANTS OF HIV. TRAINEES ARE REQUIRED TO COMPLETE IN THEIR PRIMARY DEPARTMENT, SPECIFIC THEORETICAL, METHODOLOGICAL, AND BIOSTATISTICAL PRE-DOCTORAL DEPARTMENT REQUIREMENTS. ALL FELLOWS WILL RECEIVE MENTORING AND CO-MENTORING AND WILL BE REQUIRED TO COMPLETE THE FOLLOWING TRAINING COMPONENTS: (1) A FACULTY-FELLOW SEMINAR THAT ALTERNATES HOSTING GUEST SPEAKERS DISCUSSING PROFESSIONAL DEVELOPMENT, STRUCTURAL INTERVENTIONS, SOCIAL POLICIES, COMMUNITY-ENGAGED RESEARCH, AND SOCIAL DETERMINANTS OF HIV, WITH A STUDENT-LED JOURNAL CLUB, (2) COURSEWORK ON SOCIAL AND ECONOMIC DETERMINANTS OF HEALTH, (3) COURSEWORK ON SOCIAL EPIDEMIOLOGY, (4) COURSEWORK ON HIV, (5) COURSEWORK ON MULTILEVEL MODELING, (6) ATTENDANCE IN HIV GRAND ROUNDS AT CUIMC, (7) A COURSE IN THE RESPONSIBLE CONDUCT OF RESEARCH, (8) GRANTSMANSHIP, (9) EXPERIENTIAL TRAINING TO HONE PUBLICATION, AND PRESENTATION SKILLS, AND (10) DOCTORAL RESEARCH ON THE SOCIAL DETERMINANTS OF HIV. THIS PRE-DOCTORAL PROGRAM AIMS TO PREPARE MSPH STUDENTS FOR RESEARCH AND TEACHING CAREERS THAT EXAMINE SHD, AND MARGINALIZING STRUCTURAL FACTORS THAT INFLUENCE HIV, NATIONALLY AND GLOBALLY.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_T32MH128395_7529/

ASST_NON_NU62PS924678_7523

Department of Health and Human Services

Centers for Disease Control and Prevention

SUTTER BAY HOSPITALS

SUTTER BAY HOSPITALS

ERADICATING RACISM AND STRIVING FOR EXCELLENCE IN HIV CARE (ERASE). - FOR 31 YEARS, EAST BAY AIDS CENTER (EBAC) HAS BEEN IMPROVING HEALTH OUTCOMES FOR PEOPLE LIVING WITH HIV AND THOSE AT-RISK, AS THE MOST COMPREHENSIVE SERVICE PROVIDER IN OAKLAND, CALIFORNIA. WITH PS21-2102 FUNDS, EBAC PROPOSES TO SCALE UP A SUCCESSFUL PILOT PROGRAM, ERADICATING RACISM AND STRIVING FOR EXCELLENCE IN HIV CARE (ERASE), THE FIRST PROGRAM IN THE REGION TO SPECIFICALLY FOCUS ON ADDRESSING STRUCTURAL BARRIERS BLACK MEN WHO HAVE SEX WITH MEN (BMSM) AGES 17+ FACE IN ACCESSING CARE. ERASE WILL USE A BOLD, INNOVATIVE APPROACH TO SERVICE DELIVERY, MOVING THE NEEDLE SIGNIFICANTLY IN REDUCING NEW INFECTIONS, INCREASING ACCESS TO CARE, AND PROMOTING HEALTH EQUITY FOR BMSM AND THEIR NETWORKS IN THE SAN FRANCISCO BAY AREA?S EAST BAY REGION.WEAVING TOGETHER A SET OF EVIDENCE-BASED, CULTURALLY-RESPONSIVE, AND CLIENT-CENTERED APPROACHES IN A ?STATUS-NEUTRAL? FRAMEWORK, EBAC ANTICIPATES PROVIDING 500 TESTS TO BMSM UNAWARE OF THEIR HIV STATUS, LINKING 75 BMSM TO HIV PREVENTION SERVICES (INCLUDING PREP AND NPEP), AND LINKING 75 BMSM TO ANTIRETROVIRAL HIV THERAPY EACH YEAR. ERASE?S CORE PROGRAM MODEL INCLUDES: INTENSIVE HIV AND HEALTH NAVIGATION SERVICES REGARDLESS OF HIV STATUS; MULTI-PRONGED TESTING STRATEGIES INCLUDING MOBILE, ON-SITE, AND INTEGRATED SCREENINGS; DEDICATED CASE MANAGEMENT AND SOCIAL WORK SERVICES TO CONNECT CLIENTS TO ALL AVAILABLE RESOURCES; A ?CLINIC WITHOUT WALLS? MODEL THAT REDUCES BARRIERS FOR BMSM; TARGETED COMMUNITY OUTREACH STRATEGIES; AND REGIONAL COLLABORATION AMONG PARTNERS IN THE LOCAL HIV PREVENTION ECOSYSTEM.EBAC WILL LEVERAGE EXTENSIVE EXISTING HEALTHCARE AND ADMINISTRATIVE INFRASTRUCTURE, INCLUDING IN-HOUSE CLINICAL SERVICES, A SPECIALTY PHARMACY, LABORATORY SERVICES, BENEFITS ENROLLMENT SPECIALISTS, MENTAL HEALTH AND SUBSTANCE USE SERVICES, HEALTH EDUCATION AND PREVENTATIVE SERVICES, URGENT CARE/EMERGENCY DEPARTMENT, PRIMARY AND SPECIALTY MEDICAL CARE, AND ANON-CALL PHYSICIAN, ALL UNDER ONE ROOF. WE WILL LEVERAGE EBAC ?S ONGOING ROLES AND RELATIONSHIPS WITH THE ALAMEDA COUNTY PUBLIC HEALTH DEPARTMENT, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, EAST BAY GETTING TO ZERO COALITION, FAMILY CARE NETWORK, AND OTHERS TO PROMOTE AN EFFECTIVE REGIONAL RESPONSE, WORKING STRATEGICALLY TO AUGMENT AND MAXIMIZE EXISTING PREVENTION AND TREATMENT EFFORTS.

NOT RECOVERY ACT

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_NU62PS924678_7523/

ASST_NON_R01DA054081_7529

Department of Health and Human Services

National Institutes of Health

NEW YORK UNIVERSITY

NEW YORK UNIVERSITY

ADVANCING KNOWLEDGE ON FACTORS THAT PROMOTE OR IMPEDE ENGAGEMENT ALONG THE HIV CARE CONTINUUM OVER TIME: A LONGITUDINAL MIXED METHODS STUDY OF BLACK AND LATINX YOUTH/EMERGING ADULTS LIVING WITH HIV - PROJECT SUMMARY: YOUNG PEOPLE LIVING WITH HIV (LWH) IN THE DEVELOPMENTAL PERIODS FROM ADOLESCENCE TO EMERGING ADULTHOOD (AGES 16-28 YEARS), WHICH WE REFER TO AS “YOUTH AND EMERGING ADULTS” (YEA), HAVE THE LOWEST RATES OF ENGAGEMENT ALONG THE HIV CARE CONTINUUM (HCC) OF ANY AGE GROUP. THIS POOR ENGAGEMENT IS MOST PRONOUNCED FOR AFRICAN AMERICAN/BLACK AND LATINX YEA-LWH, INCLUDING SEXUAL/GENDER MINORITIES, THOSE WHO USE ALCOHOL/DRUGS, AND INDIVIDUALS FROM LOW SOCIOECONOMIC STATUS BACKGROUNDS. YET, OUR KNOWLEDGE OF FACTORS THAT PROMOTE OR IMPEDE ENGAGEMENT ALONG THE HCC, AND HOW THEY OPERATE AND INTERPLAY OVER TIME, IS INSUFFICIENT, FOR BOTH LIMITED OCCURRENCE BEHAVIORS (E.G., HIV CARE APPOINTMENTS) AND REPEATED OCCURRENCE BEHAVIORS (E.G., ART ADHERENCE). THESE GAPS LIMIT INNOVATIONS TO POLICY AND HEALTH SERVICES. THE PROPOSED PROSPECTIVE LONGITUDINAL STUDY USES MIXED METHODS AND FOCUSES ON AFRICAN AMERICAN/BLACK AND LATINX YEA- LWH BOTH WITH AND WITHOUT VIRAL SUPPRESSION. THE STUDY USES QUANTITATIVE, QUALITATIVE, BIOMARKER (HIV VIRAL LOAD, DRUG USE), AND ECOLOGICAL MOMENTARY ASSESSMENT APPROACHES TO UNCOVER, DESCRIBE, AND BETTER UNDERSTAND FACTORS CONTRIBUTING TO TRAJECTORIES OF ENGAGEMENT ALONG THE HCC OVER TIME, WITH PRECISION, INCLUDING FROM YEA-LWH’S PERSPECTIVES. THE STUDY IS GROUNDED IN SOCIAL ACTION THEORY, A COMPREHENSIVE SOCIAL-COGNITIVE/ECOLOGICAL MODEL THAT ALLOWS FOR EXAMINATION OF CHANGES IN CONTEXTUAL INFLUENCES (E.G., ACTION CONTEXTS SUCH AS RACISM AND HOMOPHOBIA; SELF-REGULATORY RESOURCES SUCH AS SUBSTANCE USE), SELF-CHANGE PROCESSES (E.G., SOCIAL INTERACTION PROCESSES INCLUDING SOCIAL NETWORKS; MOTIVATIONAL APPRAISALS), AND ACTION STATES (E.G., ATTENDANCE AT HIV CARE APPOINTMENTS, SUBSTANCE USE TREATMENT [AS NEEDED], ART RE-INITIATION). THE STUDY’S PRIMARY OUTCOME IS HIV VIRAL SUPPRESSION (VS). TWO INTERCONNECTED AIMS ARE PROPOSED: TO DESCRIBE TRAJECTORIES OF ENGAGEMENT ALONG THE HCC (AIM 1), AND GUIDED BY SOCIAL ACTION THEORY, TO IDENTIFY, DESCRIBE, AND UNDERSTAND THE CONTEXTUAL INFLUENCES, SELF-CHANGE PROCESSES, AND ACTION STATES THAT IMPEDE OR SUPPORT THE BEHAVIORS THAT COMPRISE ENGAGEMENT ALONG THE HCC OVER TIME, INCLUDING YEA-LWH’S PERSPECTIVES ON THESE FACTORS (AIM 2). A YOUTH ADVISORY BOARD WILL BE JOINED BY SCIENTIFIC ADVISORS TO DEVELOP ACTIONABLE RECOMMENDATIONS BASED ON STUDY FINDINGS, WHICH WILL BE DISSEMINATED. PARTICIPANTS (N=270, HALF WITH HIV VS AND HALF NON-SUPPRESSED AT ENROLLMENT) WILL BE DIVERSE AFRICAN AMERICAN/BLACK OR LATINX BEHAVIORALLY INFECTED YEA-LWH RECRUITED IN NEW YORK CITY AND NEWARK, NJ USING A PROVEN HYBRID STRATEGY. WE WILL FOLLOW PARTICIPANTS PROSPECTIVELY FOR 18 MONTHS USING MIXED METHODS, COMBINING BASELINE AND FOLLOW-UP DATA (N ˜ 810 VIRAL LOAD OBSERVATIONS), TO ASSESS THE MULTIFACETED DOMAINS EXPECTED TO FACILITATE OR IMPEDE ENGAGEMENT ALONG THE HCC, AND YEA-LWH’S PERSPECTIVES ON THEIR CAUSES AND MEANINGS. THE RESEARCH TEAM IS EXPERT IN LONGITUDINAL MIXED METHODS STUDIES, HCC RESEARCH, AND AABL YEA. THE PROPOSED STUDY ALIGNS WITH NIH PRIORITIES AND WILL ADVANCE SOLUTIONS FOR THIS SERIOUS PUBLIC HEALTH PROBLEM.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01DA054081_7529/

ASST_NON_NU62PS924753_7523

Department of Health and Human Services

Centers for Disease Control and Prevention

MONTEFIORE MEDICAL CENTER

MONTEFIORE MEDICAL CENTER

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAMS FOR COMMUNITY-BASED ORGANIZATIONS - BACKGROUND: THE BRONX, THE POOREST BOROUGH IN NEW YORK CITY, (NYC) WITH A MEDIAN HOUSEHOLD INCOME OF $38,085, ACCORDING TO THE 2014-2018 US CENSUS. SELF-IDENTIFIED MEN WHO HAVE SEX WITH MEN (MSM) CONSTITUTED 71.4% OF NEW HIV DIAGNOSIS AMONG NEW YORK CITY MEN, IN 2018. THE LARGEST NUMBER WITHIN THIS GROUP ARE 20-39 YEARS OF AGE . TO REDUCE NEW HIV INFECTIONS, INCREASE ACCESS TO HEALTH CARE, AND REDUCE HEALTH DISPARITIES AMONG BRONX RESIDING BLACK AND LATINO MSM, OUR CDC-MODELED HIGH IMPACT HIV PREVENTION (HIP) PROGRAM WILL PROVIDE RAPID HIV TESTING IN COMMUNITY-SETTINGS, ON-SITE AT THE MONTEFIORE PREVENTION CENTER (MPC), AT OUR FEDERALLY QUALIFIED HEALTH CENTERS AND VIA SELF-TEST HOME KITS (MAILED OR PICKED UP). WE WILL IMMEDIATELY LINK PARTICIPANTS TO MEDICAL CARE AND, PREVENTION AND ESSENTIAL SERVICES (ESS) FOR HIV-POSITIVE AND MEN WHO HAVE SEX WITH MEN (MSM) AND TRANSGENDER AND/OR GENDER-NON-CONFORMING (TGNB), 13-49 YEARS OLD AND OF COLOR WITHIN THE STRUCTURE OF THE MONTEFIORE HIV PREVENTION PROGRAM, (MHPP). THE MHPP LOCATED IN THE MPC, HAS UTILIZED THEIR PROJECT SPACE TO PROVIDE INNOVATIVE APPROACHES (MOVIE NIGHT, CLOTHING DRIVES, FASHION SHOWS, ETC.) TO ENGAGE HARD TO REACH POPULATIONS. OUR TARGET POPULATIONS ARE BLACK AND HISPANIC/LATINX MSM AND TGNB, 13-49 YEARS OLD, RESIDENTS OF NORWOOD, CROTONA-TREMONT, FORDHAM-BRONX PARK, HIGHBRIDGE, MORRISANIA, MORRIS HEIGHTS, MELROSE, WEST FARMS, AND OTHER AREAS OF THE BRONX AND NYC WHERE MSM AND TGNB CONGREGATE. THE BRONX NEIGHBORHOODS MENTIONED HAVE THE HIGHEST NUMBER OF HIV DIAGNOSES, AND HIGH RATES OF POVERTY. BRONX-BASED MSM AND TGNB EXPERIENCE SOCIAL, CULTURAL, AND ECONOMIC BARRIERS TO PREVENTION, TREATMENT AND CARE, INCLUDING A LACK OF KNOWLEDGE OF HIV STATUS; AWARENESS OF RISK AND RISK REDUCTION STRATEGIES; NON-DISCLOSURE OF POSITIVE HIV STATUS; MINIMAL ACCESS TO HEALTH INSURANCE AND CARE; UNSTABLE HOUSING; HOMOPHOBIA; LIMITED EDUCATIONS; HIV AND SEXUAL ORIENTATION AND GENDER IDENTIFI CATION RELATED STIGMA; RACISM; FINANCIAL HARDSHIP; AND LACK OF FAMILY AND SOCIAL SUPPORT. THESE EXPERIENCES DE-PRIORITIZE HEALTH AND HEATH CARE AND PREVENT MSM FROM SEEKING AND ACCESSING SERVICES. OBJECTIVES: THE MONTEFIORE HIV PREVENTION PROGRAM (MHPP) PROPOSES THE DELIVERY OF HIGH-IMPACT HIV PREVENTION SERVICES, GOVERNED IN PART BY THE COMMUNITY ENGAGEMENT GROUP (CEG) WHO WILL INFORM THE PROGRAM AT VARIOUS LEVELS OF SERVICE DELIVERY FROM PROGRAM PROMOTION MESSAGING TO TARGETING VENUES FOR OUTREACH AND SO FORTH. PREVENTION SERVICES WILL ALIGN WITH THE GOALS OF THE NATIONAL ENDING THE EPIDEMIC (ETE) BY FOCUSING EFFORTS ON THE FOUR OUTLINED COMPONENTS: TESTING, TO IDENTIFY UNDIAGNOSED HIV + INDIVIDUALS; TREATMENT, TO FACILITATE VIRAL SUPPRESSION; PREVENTION, BY INITIATING PREP CARE FOR THOSE TESTING HIV NEGATIVE AND BY ACHIEVING VIRAL SUPPRESSION FOR HIV + INDIVIDUALS WHO ARE IMMEDIATELY LINKED TO CARE AND ESS, PROVIDED VIA STATUS-NEUTRAL NAVIGATION, IN COLLABORATION WITH THE BRONX COMMUNITY HEALTHCARE NETWORK?S COMMUNITY HEALTH WORKERS (CHW?S) TO ADDRESS SOCIAL DETERMINANTS OF HEALTH ; AND RESPOND, TO COLLABORATE WITH THE NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE, (DOHMH), TO COLLABORATE ON A COORDINATED PLAN FOR RESPONDING TO IDENTIFIED CLUSTER OUTBREAKS OF HIV DIAGNOSIS TO RAPIDLY DEPLOY TESTING STAFF AND IMMEDIATELY LINK THOSE TESTING POSITIVE TO HIV MEDIAL CARE AND THOSE TESTING NEGATIVE TO PREP AND NPEP WITHIN 72 HOURS.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_NU62PS924753_7523/

ASST_NON_NU62PS924746_7523

Department of Health and Human Services

Centers for Disease Control and Prevention

INSTITUTE FOR THE ADVANCEMENT OF MINORITY HEALTH

INSTITUTE FOR THE ADVANCEMENT OF MINORITY HEALTH

COMPREHENSIVE HIGH-IMPACT HIV PREVENTION PROGRAMS FOR COMMUNITY-BASED ORGANIZATIONS - DESPITE SIGNIFICANT ADVANCES IN DIAGNOSIS, CARE, AND PREVENTION, HIV/AIDS CONTINUES TO BE A PUBLIC HEALTH CRISIS IN THE UNITED STATES. THE SITUATION IS MOST ACUTE IN THE SOUTHERN U.S., WHICH EXPERIENCES THE GREATEST BURDEN OF NEW HIV INFECTION, ILLNESS, AND DEATHS OF ANY U.S. REGION. THE SOUTHERN U.S. ACCOUNTS FOR APPROXIMATELY 45% OF ALL PEOPLE LIVING WITH AN HIV DIAGNOSIS IN THE U.S. AND 51% OF ALL NEW HIV DIAGNOSES IN 2018 EVEN THOUGH THE REGION ONLY MAKES UP ONE-THIRD (38%) OF THE U.S. POPULATION.THE BURDEN OF HIV IN THE STATE IS DISPROPORTIONATELY HIGH FOR MEN WHO HAVE SEX WITH MEN (MSM). AMONG MEN WHOSE RISK FACTORS FOR HIV ARE KNOWN, 85 PERCENT OF MEN REPORTED HAVING MALE-TO-MALE SEXUAL CONTACT. IN 2017, THE BURDEN OF NEW HIV CASES WAS HIGHEST AMONG BLACK MALES AGED 20-24, WHILE YOUNG ADULTS AGED 20-29 REPRESENTED 43 PERCENT OF NEWLY DIAGNOSED CASES. AFRICAN AMERICAN WOMEN HAD THE SECOND-HIGHEST HIV INFECTION RATE IN THE STATE; THEREFORE, TESTING, PREVENTION, AND TREATMENT IS ESSENTIAL FOR THESE SPECIAL GROUPS. FACTORS THAT INFLUENCE THESE DISPARITIES INCLUDE LACK OF ACCESS TO HIV CARE AND PREVENTION SERVICES, LACK OF CULTURAL SENSITIVITY OF HEALTH CARE PROVIDERS, RACISM, STIGMA AND DISCRIMINATION.THE PURPOSE OF THE DELTA COMPREHENSIVE HIV PREVENTION (DCCHPP) PROGRAM IS TO REDUCE HIV/STD HEALTH DISPARITIES IN THE MISSISSIPPI BY TAKING A HOLISTIC APPROACH TO HIV PREVENTION AND TREATMENT THAT INCLUDES IDENTIFYING THOSE AT RISK FOR HIV, THOSE PERSONS WITH HIV AND LINKING THEM TO PREVENTION AND TREATMENT SERVICES, PROVIDING COMMUNITY OUTREACH AND EDUCATION, PROVIDING CULTURALLY SPECIFIC TRAINING TO LOCAL HEALTH CARE PROVIDERS AND ENHANCING SOCIAL SUPPORT SYSTEMS. THE TARGET GROUP FOR OF THIS PROGRAM WILL BE INDIVIDUALS BETWEEN THE AGES OF 18 AND 45 IN BOLIVAR, COAHOMA, SUNFLOWER AND WASHINGTON COUNTIES IN THE MISSISSIPPI DELTA.EXPECTED OUTCOMES FOR THE PROGRAM INCLUDE REDUCTION IN NEW HIV CASES; REDUCED PREVALENCE OF HIV/STDS; IMPROVED HEALTH OUTCOMES FOR PEOPLE DIAGNOSED WITH HIV, INCREASED ACCESS TO PREVENTION AND TREATMENT SERVICES.

NOT RECOVERY ACT

NONPROFIT WITH 501C3 IRS STATUS (OTHER THAN AN INSTITUTION OF HIGHER EDUCATION)

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_NU62PS924746_7523/

ASST_NON_R01MH121194_7529

Department of Health and Human Services

National Institutes of Health

UNIVERSITY OF MIAMI

UNIVERSITY OF MIAMI

MONITORING MICROAGGRESSIONS AND ADVERSITIES TO GENERATE INTERVENTIONS FOR CHANGE (MMAGIC) FOR BLACK WOMEN LIVING WITH HIV - BACKGROUND: BLACK WOMEN REPRESENT THE LARGEST GROUP OF WOMEN WITH HIV, BOTH NATIONALLY, AND LOCALLY IN MIAMI, A U.S. HIV EPICENTER; AND 40% ARE NOT VIRALLY SUPPRESSED. FURTHER, THEY LIVE AT THE INTERSECTION OF MULTIPLE MARGINALIZED IDENTITIES AND WITHIN SOCIAL STRUCTURES THAT TAKE A DAILY TOLL. MICROAGGRESSIONS ARE EVERY DAY AND SUBTLE INSULTS VIA COMMENTS, JOKES, AND BEHAVIORS THAT ARE DEMEANING TO A MARGINALIZED GROUP (E.G. BLACK INDIVIDUALS, WOMEN, PEOPLE LIVING WITH HIV, LGBTQ+). DESPITE THEIR FREQUENCY AND POTENTIAL IMPORTANCE, MICROAGGRESSIONS HAVE LARGELY BEEN IGNORED IN THE SCIENTIFIC LITERATURE ON BLACK WOMEN LIVING WITH HIV (BWLWH). ALSO, WHILE SCHOLARS ARE BEGINNING TO INVESTIGATE MACROAGGRESSIONS (DISCRIMINATION ACTS SUCH AS DENIAL OF HOUSING) AND TRAUMA/VIOLENCE AMONG WOMEN LIVING WITH HIV, THEY ARE OFTEN ONLY CAPTURED INFREQUENTLY (E.G. ANNUALLY) DESPITE THEIR RE-OCCURRING NATURE FOR THIS POPULATION. PRELIMINARY WORK. WE HAVE FURTHER DEMONSTRATED THE IMPORTANCE OF STUDYING MICROAGGRESSIONS AMONG BWLWH VIA AN R56 THAT SUPPORTED 1 YEAR OF RESEARCH THAT THIS 4-YEAR PROPOSAL WILL BUILD ON. WE ARE FINDING HIGH RATES OF MICROAGGRESSIONS IN BWLWH, AND HIGH RATES OF OTHER ADVERSITIES SUCH AS DISCRIMINATION (MACRO ACTS) AND REOCCURRING VIOLENCE. THESE FACTORS RELATE TO MENTAL HEALTH SYMPTOMS AND HEALTH BEHAVIORS, BUT ADDITIONAL DATA OVER TIME IS NEEDED TO UNDERSTAND THEIR RELATIONSHIP SPECIFICALLY TO VIRAL SUPPRESSION. ADDITIONALLY, WE ARE STARTING TO UNDERSTAND THE ROLE OF FACTORS SUCH AS RESILIENCE, COVID-19, AND THE CURRENT U.S. RACIAL CLIMATE. CONCEPTUAL MODEL: THE CONCEPTUAL MODEL FOR PROJECT MMAGIC (MONITORING MICROAGGRESSIONS AND ADVERSITIES TO GENERATE INTERVENTIONS FOR CHANGE) FOCUSES ON MICROAGGRESSIONS AND OTHER ADVERSITIES AS NEGATIVE PREDICTORS OF HIV VIRAL SUPPRESSION (MAIN OUTCOME) MEDIATED BY MENTAL HEALTH SYMPTOMS AND HEALTH BEHAVIORS (ART ADHERENCE AND ENGAGEMENT IN CARE). WE WILL LONGITUDINALLY EXAMINE BOTH POTENTIAL DIRECT EFFECTS AND MODERATION BY RESILIENCE FACTORS AT THE INDIVIDUAL (E.G. SELF-EFFICACY), INTERPERSONAL (E.G. SOCIAL SUPPORT), AND NEIGHBORHOOD LEVEL (E.G. COMMUNITY HEALTH CENTERS). BY ELUCIDATING THESE PATHWAYS TO VIRAL SUPPRESSION AMONG BWLWH AND HAVING ONGOING ENGAGEMENT WITH COMMUNITY PARTNERS, OUR FINDINGS WILL DIRECTLY INFORM INTERVENTIONS. THIS PROPOSAL IS PRECISELY ALIGNED WITH THE NIH HIV/AIDS (HIGH) RESEARCH PRIORITY FOR SUPPORTING RESEARCH TO REDUCE HEALTH DISPARITIES IN TREATMENT OUTCOMES OF THOSE LIVING WITH HIV. RESEARCH PLAN: 300 BWLWH WILL BE ENROLLED IN MIAMI (151 ENROLLED [4 LOST] VIA R56 GRANT), AND FOLLOWED OVER 4 YEARS. DATA WILL BE COLLECTED AT ASSESSMENT VISITS EVERY 3 MONTHS ON MICROAGGRESSIONS, DISCRIMINATION/MACROAGGRESSIONS, TRAUMA AND VIOLENCE, MENTAL HEALTH SYMPTOMS, MEDICATION ADHERENCE, ENGAGEMENT IN CARE, VIRAL SUPPRESSION, AND RESILIENCE FACTORS. GIVEN THE DAILY NATURE OF MICROAGGRESSIONS, WE WILL USE AN INNOVATIVE TEXT-MESSAGE ECOLOGICAL MOMENTARY ASSESSMENT METHODOLOGY SHOWN TO BE FEASIBLE (99% RESPONSE RATE) IN OUR R56. ANNUALLY, WE WILL GATHER INFORMATION (USING ZIP CODES) FROM PUBLIC DATA SOURCES ON NEIGHBORHOOD LEVEL RESILIENCE RESOURCES SUCH AS NUMBER AND DISTANCE TO COMMUNITY HEALTH CENTERS AND DOMESTIC VIOLENCE SHELTERS. IMPLICATIONS: THE PRESENT STUDY, OCCURRING IN THE CONTEXT OF BOTH COVID-19, AND HEIGHTEN VISIBILITY ON RACISM IN THE U.S. PRESENTS AN UNFORTUNATE YET UNMATCHED IMPORTANT OPPORTUNITY TO STUDY BWLWH IN AN HIV EPICENTER.

NOT RECOVERY ACT

PRIVATE INSTITUTION OF HIGHER EDUCATION

NON-AGGREGATE RECORD

https://www.usaspending.gov/award/ASST_NON_R01MH121194_7529/