CURRENT FUNDED RESEARCH PROJECTS
Impact of harm reduction care in HIV clinical settings on stigma and health outcomes for PLWH who use drugs
MPI: Emma Sophia Kay, PhD & Mary Hawk, DrPH
National Institutes of Health/National Institute on Drug Abuse
People living with HIV (PLWH) who use drugs experience significant health disparities including lower rates of retention in HIV care and higher rates of unsuppressed viral load, resulting in secondary infections and increased mortality. The study will used mixed methods to explore (a) providers’ attitudes towards working with PLWH who use drugs as well as their preparedness for delivering harm reduction care; (b) patients’ experiences of stigma in healthcare settings, viewed from an intersectionality framework; and (c) the extent to which structural and relational harm reduction care buffer the effects of stigma in HIV primary care settings, contributing to improved clinical outcomes. The study will also use these findings to inform the development of an intervention to operationalize harm reduction in healthcare settings, using stakeholder-engaged and human-centered design approaches, presenting a novel path to reducing HIV health inequities for PLWH who use drugs.
Harnessing the Power of Social Network Support to Improve Retention in Care and Viral Suppression among Young Black Men in Chicago and Alabama: A Hybrid Type I Effectiveness-Implementation Trial of Project nGage
MPI: Alida Bouris, PhD & D. Scott Batey, PhD
National Institutes of Health/National Institute of Mental Health
The goal of this R01 is to conduct a Hybrid Type I effectiveness-implementation randomized controlled trial of Project nGage, an evidence-based, flexible, and tailored intervention designed to harness social network support to improve retention in care and viral suppression for HIV-positive young Black MSM (YBMSM) age 18-35. The study will be conducted in Chicago, IL and Alabama, two sites prioritized in the national Ending the HIV Epidemic Plan. Project nGage holds remarkable potential for improving Continuum of Care outcomes through its novel focus on recruiting, informing, and motivating naturally existing social support network members and, thus, benefitting public health by decreasing the risk of onwards HIV transmission and increasing the number of YBMSM retained in HIV care.
Birmingham Homelessness and HIV Testing (B-HOT)
PI: Sarah Tucker, PhD
UAB Center for the Study of Community Health Community Health Scholars Pilot Grant Program
Given that people experiencing homelessness are at increased risk for HIV and people living with HIV (PLWH) who are homeless are more likely to experience suboptimal HIV health outcomes than PLWH who are not homeless, it is imperative to increase HIV testing and linkage to HIV primary care for this vulnerable population. Yet, the rate of HIV incidence among the homeless in the US at large, in the state of Alabama, or locally (Birmingham/Jefferson County), is not well known. Leveraging the strong community-based relationships in Jefferson County, AL that our study team has established, this proposed demonstration project, Birmingham HOmelessness and HIV Testing, or B-HOT, seeks to increase HIV testing and explore barriers to HIV care among homeless adults living in Birmingham, AL and surrounding areas in Jefferson County using a CBPR approach.
CHAMPS: A randomized trial of a Community Health Worker intervention for persons living with HIV in two high priority settings
MPIs: Rebecca Schnall, PhD & D. Scott Batey, PhD
National Institutes of Health/National Institute of Nursing Research
Given the limited time of clinicians, the fragmented condition of the United States health care and insurance system, and the challenges inherent in the lives of poor or stigmatized groups, a community health worker (CHW) delivered intervention holds promise for addressing some of these ongoing challenges in persons living with HIV. This study in response to RFA-NR-20-002 will strengthen a CHW intervention by capitalizing on our existing mobile health approach to improve antiretroviral therapy adherence and viral suppression in persons living with HIV in two high-priority settings.
Ending the HIV Epidemic: Addressing HIV Health and Homelessness (AH3)
PI: Anne Rygiel
UAB 1917 Clinic/Center for AIDS Research Ending HIV in Alabama Community Funding
This project, Ending the HIV Epidemic: Addressing HIV Health and Homelessness (AH3), is designed to help end the HIV epidemic and achieve the 90-90-90 initiative in AL by increasing HIV testing and outreach and linkage to care for the local homeless population in Jefferson County, AL, both for the newly and previously diagnosed. New HIV services supported through this award will be purposefully integrated into emergency sheltering at The Firehouse Shelter, to include access to specialized, in-house case management and participation in Antiretroviral Treatment Access Study (ARTAS), a Centers for Disease Control and Prevention (CDC)-recognized evidence-based linkage to care (LTC) intervention provided by Birmingham AIDS Outreach.
Impact of Representative Payee Services on ART Adherence Among Marginalized People Living with HIV/AIDS
Study PI: Mary Hawk, DrPH
Site PI: D. Scott Batey, PhD
National Institutes of Health/National Institute of Mental Health/Birmingham AIDS Outreach
In this study, we hypothesize that, by helping clients to pay their rent and other bills on time, housing stability improves and financial stress decreases. By reducing the cognitive burden of living with chronic financial stress and frequent threats of housing loss, clients can devote more time and attention to medical appointments and medication adherence. Ultimately, we believe that this program improves clients’ self-efficacy for health behaviors, retention in care, medication adherence, CD4 counts, and viral loads. Through this work, we are conducting a randomized controlled trial to test the effect of Client-Centered Representative Payee on antiretroviral medication adherence and viral load among persons living with HIV who are economically disadvantaged and unstably housed.
Increasing equitable access to health care and influencing health policy for LGBTQ people in Alabama
Co-PIs: Tina Kempin Reuter, PhD & Emma Sophia Kay, PhD
UAB Lister Hill Center’s Pilot Grants for Health Policy Research
Research suggests limited knowledge of LGBTQ best-practices among healthcare providers and a need to include clinical competency LGBTQ-specific training in medical curricula. This study is a collaborative effort between the UAB Institute for Human Rights, the UAB Department of Social Work, and Birmingham AIDS Outreach (BAO) to (1) assess access to and experiences with the health care system among LGBTQ people in Alabama, (2) evaluate Alabama physicians’ experience with and attitudes towards LGBTQ patients, and, based on Aims 1 and 2, (3) offer suggestions and policy recommendations for increasing access to health care, well-being, and equity for this population in an effort to advance health outcomes and counter health disparities of the LGBTQ community in Alabama.
Adapting and Pilot Testing a Behavioral Intervention to Incorporate Advances in HIV Prevention for Black Young MSM in Alabama
PI: Henna Budhwani, PhD, MPH
National Institutes of Health/National Institute of Mental Health/Birmingham AIDS Outreach
This project will adapt and test a behavioral intervention to promote HIV rapid testing in the community, deliver culturally appropriate prevention education, offer sociostructural supports, and refer eligible participants for pre-exposure prophylaxis (PrEP). Aim 1 is to elucidate experiences, beliefs, and predictors related to delivery and utilization of HIV testing and prevention services by black YMSM using qualitative research methods, namely in-depth interviews with HIV outreach staff, focus groups with black YMSM, and in-depth interviews with members of key sub-groups to inform the adaptation of the Brothers Saving Brothers (BSB) intervention. Aim 2 is to adapt the BSB intervention to include two HIV prevention tools (rapid testing and PrEP), to address structural barriers, and to be acceptable to black YMSM in Alabama. Aim 3 is to conduct a hybrid type 1 effectiveness-implementation pilot study of the adapted intervention.
A Multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the South
Co-PIs: Lisa Hightow-Weidman, MD and Henna Budhwani, PhD, MPH
National Institutes of Health/National Institute of Minority Health Disparities (NIMHD)
Digital Health Interventions (DHIs) can reach large numbers of African American (AA)-Young Adults (YA) regardless of geographic location and empower them to make informed decisions about their health using a familiar modality that YAs value and trust. This study applies a community- based participatory research (CBPR) approach to assess multi-level factors identified within the NIMHD Research Framework and adapt and test Tough Talks to address COVID vaccine hesitancy (VH), Tough Talks-COVID (TT-C). Primary effectiveness outcomes are COVID vaccine uptake and series completion. We leverage our existing infrastructure to meaningfully engage with southern AA-YA communities, working to dismantle inequitable research relationships and medical mistrust to increase COVID vaccine uptake.
A Pragmatic Clinical Trial of MyPEEPS Mobile to Improve HIV Prevention Behaviors in Diverse Adolescent MSM
Study PI: Rebecca Schnall, PhD
Site PI: Michael Mugavero, MD
National Institutes of Health/Columbia University
This subcontract from Columbia utilizes partnerships with local community sites and provide assistance with recruitment strategies for the Birmingham cohort, to recruit participants into an HIV prevention intervention for at-risk populations using a mobile platform.
Conducting the preparation phase of a Multiphase Optimization Strategy (MOST) to develop a modular HIV prevention and PrEP intervention for sexual and gender minority adolescents and parents: “Hey, Friend”
Co-PIs: Henna Budhwani, PhD, MPH and Tina Simpson, MD, MPH
Merck, Sharp, and Dohme (Merck and Co., Inc)
We conduct the preparation phase of a multiphase optimization strategy (MOST) to develop a culturally appropriate modular HIV prevention mHealth intervention, targeting behavior change related to HIV testing, HIV prevention knowledge, and pre-exposure prophylaxis (PrEP) uptake for sexual and gender minority (SGM) adolescents, that can be seamlessly integrated into the existing school and community environments across the Deep South. We will assess stakeholders’ knowledge, sentiments, and beliefs related to HIV risk, HIV stigma, and HIV prevention including preferences related to modality of PrEP and PrEP acceptability. We will use these data to inform the development of intervention modules targeting SGM adolescents and their parents or guardians. After intervention modules have been finalized, we will assess each module’s acceptability, feasibility, and “clinical signal” of effectiveness.
Older Persons with HIV Who are Caregivers: Unrecognized Gap in HIV Research
PI: Yookyong Lee, PhD
University of Alabama at Birmingham (UAB) College of Arts and Sciences
While older persons with HIV (PWH, aged 50+) advance in age with various challenges and concerns, they may also become a caregiver of their elderly parents, sibling, spouse/partner, other family members, or friends. Little attention has been given to the overlap between older PWH and their caregiving responsibilities. This study seeks to qualitatively explore older caregivers with HIV’s lived experiences as a caregiver (e.g., adjustment to the caregiving role, caregiving responsibilities, support systems, resilience, stigma, caregiving outcomes), how their caregiving experiences affect HIV health and other health issues (e.g., self-care, medication adherence), and their own perceptions on how to help them (e.g., needs assessment) in sustained antiretroviral therapy (ART) and viral suppression (VS) in accordance with a specific focus on 90-90-90 outcomes.