Center for AIDS Intervention Research (CAIR) Current Research Projects

Principal Investigators: Jeffrey Kelly, PhD, and Yuri Amirkhanian, PhD

Funded by the National Institute of Nursing Research (R01-NR017574)

PrEP use remains very low in mid-sized cities across the nation, especially among African American MSM who may be hidden in the community and hard to reach through conventional PrEP awareness campaigns. This research will employ a social network approach for both reaching racial minority MSM in the community and delivering an intervention in which peer network leaders are taught and enlisted to increase awareness, correct misconceptions, reduce stigma, and increase benefit perception and positive attitudes of their network members toward PrEP.

Principal Investigators: Jennifer Walsh, PhD, and Andrew Petroll, MD, MS

Funded by the National Institute for Nursing Research (R56-NR019443-01)

People living with HIV (PLH) in rural areas face unique challenges to maintaining good health and suffer from greater morbidity and mortality than non-rural PLH. This health disparity is not well understood, but is significant, since more than 55,000 PLH in the US live in rural areas.  When compared to younger PLH, older PLH (age 50+) may face additional challenges to maintaining their health and wellbeing, including social isolation, waning long-term motivation to stay engaged in treatment, decreasing cognitive abilities, and many others. This project aims to create and pilot test an optimized intervention for rural older PLH living in seven states in the southern USA.

Project Thrive Home Page

Principal Investigator: Alan Nyitray, PhD

Funded by the National Cancer Institute (R01-CA232892)

Even though expert opinion recommends annual digital ano-rectal exams for detection of anal cancer tumors among men having sex with men (MSM), the procedure is severely underutilized by clinicians and it is not known how to increase utilization. This is problematic in the context of an extremely high incidence of anal cancer among MSM, no proven treatment for anal precancerous lesions, and lack of screening infrastructure for detecting pre-cancerous lesions. The long-term goal of this study is to decrease morbidity and mortality from anal cancer by increasing detection of anal canal tumors through self- or partner-palpation of the anal canal.

Principal Investigator: Laura Glasman, PhD

Funded by the National Institute of Mental Health (R01-MH017574)

In the United States, Latino men who have sex with men and transwomen (LMSMT) are disproportionately affected by HIV.  LMSMT have the highest HIV incidence after African Americans, and 21% remain unaware of their HIV infection, despite improvements in HIV detection in most populations. Despite the many strategies to increase HIV testing, few have promoted regular HIV testing and even fewer have addressed the needs of LMSMT outside large urban centers of the US, such as the midsized Midwestern cities. To advance high-impact prevention among LMSMT in midsized Midwestern cities, this study will conduct a full evaluation of Latinos Unidos por sus Amigos (LUPAA 2), a social network intervention shown to be promising to encourage regular HIV testing and prevention, including risk reduction and pre-exposure prophylaxis (PrEP).

Principal Investigator: Steven A. John, PhD, MPH

Funded by The National Institute of Mental Health (K01-MH118939)

 An Information-Motivation-Behavioral Skills-guided mHealth intervention to increase HIV self-testing and post-test PrEP uptake has large public health implications for reducing HIV incidence among young men who have sex with men, offering participant confidentiality and scaling of an efficient intervention. Despite the promise of this type of theoretically-guided intervention, little is known about the independent effects of each Information-Motivation-Behavioral Skills (IMB) model construct on HIV self-testing and PrEP uptake. Empirical evidence on condom use suggests some IMB model constructs are more important. As such, we propose an mHealth intervention using a factorial randomized experimental design of the IMB model using pilot intervention components tailored by formative mixed-methods research with young men who have sex with men nationwide. Findings from our study will also inform other ongoing IMB-guided studies attempting to increase biomedical prevention uptake by identifying the most important IMB components for uptake, supporting efficiency and scalability nationwide.

Principal Investigator: Alan Nyitray, PhD

Funded by the National Cancer Institute (R01-CA215403)

Persistent anal human papillomavirus infection is the primary cause of anal cancer, a common cancer among men having sex with men (MSM). Annual anal cancer screening is standard of care for HIV+ MSM and recommended by expert opinion for HIV- MSM. But, most HIV+ and HIV- MSM do not screen. Since home-based self-sampling increases rates of cervical cancer screening and self-sampling is acceptable to MSM, it is important to investigate home-based screening for anal cancer among MSM. Our long-term goal is to reduce morbidity and mortality by discovering barriers and challenges to annual anal cancer screening among MSM.

Principal Investigator: Jennifer Walsh, PhD

Funded by the National Institute of Mental Health (R01-MH115764)

To this point, there has been limited PrEP (Pre-exposure prophylaxis) research with young Black MSM. We know very little about the frequency of PrEP termination, gaps in PrEP use, or lapses in prevention-effective adherence among young Black MSM, or about short- and long-term changes in use and adherence for these men. Additionally, it is unclear how changes in PrEP relate to changes in other sexual health and risk behaviors and outcomes, such as number of partners, condom use, serosorting, and STI diagnosis. We also lack information about how use and adherence among young Black MSM may be impacted by structural and psychosocial barriers to PrEP, including issues with health care access, insurance, and providers; low socioeconomic status (SES) and instability in employment, transportation, and housing; poor mental health; substance use; and stigma and negative social norms related to PrEP. Similarly, it is unclear how use and adherence may be influenced by partner and relationship factors, such as the introduction of new partners, the development of committed relationships, perceptions of partner risk, and intimate partner violence (IPV). Studies are necessary to determine which factors are the most important predictors of lapses in PrEP use and adherence for young Black MSM.

Principal Investigator: Katherine Quinn, PhD

Funded by the National Institute for Mental Health (R21-MH122010)

HIV infection and poor engagement and retention in care continue to be an ongoing public health crisis among young Black men who have sex with men (YBMSM). YBMSM are also disproportionately affected by the prevalence of various forms of violence that have been shown to have widespread effects on public health. This project is examining the interplay between these two intersecting public health concerns and has the potential to prolong the quality of life for YBMSM by identifying the pathways through which experience of violence contributes to disparities in HIV treatment outcomes.

Principal Investigator: Carol L. Galletly, JD, PhD

Funded by the National Institute on Minority Health and Health Disparities (R01-MD011573)

Along with disproportionate rates of HIV infection, Hispanic immigrants are affected by three important drivers of the US HIV epidemic: disordered alcohol and drug use, intimate partner violence, and reduced rates of HIV testing. This study addresses the knowledge gap. Law and policy scans, key informant interviews, and structured focus groups with Hispanic immigrants living in four US metropolitan areas will be conducted to explore immigrants' experiences with legal barriers and to identify the immigration-related concerns, beliefs, and misconceptions that influence their service utilization.

Principal Investigators: Yuri A. Amirkhanian, PhD, and Jeffrey A. Kelly, PhD

Funded by the National Institute of Mental Health (R01-MH113555) and the Russian Academy of Sciences

Social support is a main determinant of medical care adherence. The intervention to be tested in this research will directly build peer social supports for medical care attendance and adherence. Most prior adherence interventions have involved only clinic-based counseling provided to individual patients. The planned approach is unique because it will extend beyond individual patient counseling to also strengthen social supports for care in the daily lives of PLH.

The approach to be tested is novel because it will intervene with groups of friends who are all HIV+ to strengthen mutual norms, skills, problem-solving, and social supports for entering, remaining, and adhering to HIV medical care. HIV infection is often clustered within social networks of persons who know one another, share the same exposure risks, and face similar care and adherence barriers. The intervention to be tested is aimed at increasing mutual social supports among PLH to help one another attend and adhere to HIV medical care, a promising approach not previously tested.

Principal Investigator: Michelle R. Broaddus, PhD

Funded by the Advancing a Healthier Wisconsin (AHW) Endowment

The Healthier Wisconsin Partnership Program (HWPP) seeks to improve the behavioral health in Wisconsin communities--a person's mental well-being, their ability to function in everyday life, and their concept of self. An Academic Partner Team of CAIR faculty and staff works with 10 selected community coalitions spanning the state of Wisconsin to develop and implement strategies designed to improve some facet of each community's behavioral health. This collaborative effort also seeks sustainability by building the capacity of local communities to continue to serve and improve the behavioral health of their residents.

Principal Investigator: Katherine Quinn, PhD

Funded by The National Institute of Mental Health (K01-MH112412)

Young Black men who have sex with men (YBMSM) continue to be disproportionately affected by HIV and pre-exposure prophylaxis (PrEP) may be an essential part of combination prevention strategies to curb these disparities Stigma may be a limiting factor in the success of PrEP for YBMSM and this research will examine how intersectional stigma experienced by YBMSM may influence PrEP knowledge and uptake. This study examines the factors that shape YBMSM's engagement with PrEP and findings from the study will inform a tailored PrEP intervention for YBMSM.