Multilevel Influences on Drug Use and HIV-Related Outcomes Among Men - Ongoing efforts in the U.S. to reduce rates of HIV infection rely on targeted prevention research among at-risk populations, such as men who have sex with other men (MSM), who account for 83% of new infections among men. Methamphetamine use is a significant factor in HIV seroconversion, and its increasing prevalence among MSM underscores the urgency to understand and address contributing factors. While methamphetamine use and its associated challenges are widely recognized, less is known about how contextual and interpersonal stress related to both drug use and sex behaviors influence methamphetamine use patterns and HIV risk among MSM. Consequently, current HIV prevention interventions may not fully address the converging impact of these multilevel stressors on the interpersonal, psychological, and biological processes that contribute to HIV risk in this population. This Mentored Research Scientist Development Award (K01) will support the exceptional candidate during his upcoming years of research and training, facilitating his transition toward research independence. The candidate’s proposed research aims to test a modified HIV prevention model examining the impact of contextual and network-level stress related to drug use and sex behaviors. This innovative research incorporates interpersonal, psychological, and biological processes influencing drug use and HIV risk among MSM. To accomplish these goals, the candidate requires training and expert mentorship in three crucial areas: 1) network science and network-related health factors, 2) inflammatory biomarkers of HIV risk, and 3) designing and testing multilevel prevention interventions. In addition to mentorship from leading experts in HIV prevention research, training will be accomplished through coursework, training institutes, working groups, scientific productivity, and career development activities. Training in these areas will be applied through several mentored research projects. The specific aims of the proposed research are to: 1) Determine the independent and joint influence of policy-level indicators related to drug use and sex behaviors on methamphetamine use and HIV-related behaviors among HIV-negative MSM in the U.S., 2) Assess network-level effects of interpersonal stress related to drug use and sex behaviors on methamphetamine use severity and HIV behavioral risk via emotion dysregulation and interpersonal support in HIV-negative MSM (A pilot study). 3) Examine the network- level effects of independent and combined interpersonal challenges related to drug use and sex behaviors on rectal inflammatory biomarkers (rectal cytokines) that may be linked to enhanced HIV biological risk. Aim 1 will be accomplished by analyzing data from five waves (2017-2022) of a cohort study of MSM. Aims 2 and 3 will be achieved by conducting a longitudinal pilot study of 200 MSM who use methamphetamine. This high-impact research will fill a crucial gap in HIV prevention and inform the development of a multilevel intervention for MSM who use methamphetamine, accelerating progress toward ending the HIV epidemic in the U.S.
