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Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM

Award Number: R01MD013501
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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The literature reveals that hypertension (HTN) is considerably higher among HIV-positive individuals than HIV-negative individuals. However, the systemic/individual determinants (including behavioral, clinical, macro- social, and psychosocial factors) for this health co-morbidity is not fully understood in the literature. To fill these scientific gaps, we propose to use a longitudinal design to systematically examine a systemic/individual approach -- modeling after the NIMHD’s “Minority Health and Health Disparities Research Framework” -- to examine and elucidate the multiple determinants of HTN observed in two ethnic-sexual men who have sex with men (MSM) living with HIV/AIDS. To that end, we will address three specific aims and hypotheses: Aim 1: To examine the association of macro-social determinants (i.e., homophobia, racial/ethnic discrimination), behavioral risk factors (e.g., substance misuse), and psychosocial factors (e.g., stress) with HTN among a cohort of African American or AA (200 AA in Philadelphia) and Asian Pacific Americans or APA (200 APA in Honolulu) MSM living with HIV -- We hypothesize that greater exposure to homophobia and racial/ethnic discrimination is associated with a greater prevalence of HTN among HIV-positive MSM. Aim 2: To determine the underlying systemic/individual determinants which account for the relationship between inflammation and HTN over time, given common forms of hypertension have been postulated to be immune mediated -- We hypothesize that the greater exposure to homophobia and racial/ethnic discrimination is associated with dysregulation of pro-inflammatory cytokines (D-dimer, hsCRP, IL-6, IL-8, MCP-1, P-selectin), where they mediate HTN among these men. Aims 3: To examine whether associations between these factors and health outcomes are moderated by coping and social support -- We hypothesize that greater social support would mitigate HTN among these men. This is the first study that uses systemic/individual and multi-disciplinary approaches to examine the impact of multiple determinants on HTN co-morbidity over time among AA and APA MSM living with HIV. Our multi-disciplinary team with expertise in HIV prevention science, clinical HIV medicine, ethnic-sexual MSM, and chronic diseases are uniquely positioned to address risk and protective factors of multiple influences of HTN co-morbidity over time among AA and APA MSM with HIV. By conceptually and empirically testing novel hypotheses, we will provide evidence of etiology and validated tools and measures that advance our understanding of mechanisms of disparities in HIV-related co-morbidities. Findings from this longitudinal observational study will inform the management of HIV and its HTN co-morbidity as a chronic disease, especially among the two disparity groups of MSM (AA and APA) who continue to bear the burden of health disparities. This study is guided by NIMHD’s conceptual framework to address multiple influences of health disparities on HTN comorbidity among HIV-positive MSM disparity populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2022 ( Subtotal = $649,694 )
2022	2022	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	001	5	4/26/2022	NON-COMPETING CONTINUATION	$64,971
2022	2022	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	000	5	2/7/2022	NON-COMPETING CONTINUATION	$584,723
														Subtotal = $649,694

Issue Date FY: 2021 ( Subtotal = $656,773 )
2021	2021	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	002	4	3/11/2021	NON-COMPETING CONTINUATION	$65,678
2021	2021	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	001	4	2/10/2021	NON-COMPETING CONTINUATION	$591,095
2021	2020	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	000	3	12/10/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $656,773

Issue Date FY: 2020 ( Subtotal = $664,225 )
2020	2020	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	000	3	2/6/2020	NON-COMPETING CONTINUATION	$664,225
2020	2019	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	001	2	3/18/2020	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $664,225

Issue Date FY: 2019 ( Subtotal = $828,205 )
2019	2019	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	004	2	8/26/2019	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$406,820
2019	2019	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	001	2	4/8/2019	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$703,205
2019	2019	FLORIDA STATE UNIVERSITY	874 TRADITIONS WAY	TALLAHASSEE	FL	32306	LEON	USA	Minority Health and Health Disparities Research	005	2	9/24/2019	SUPPLEMENT FOR EXPANSION	$125,000
2019	2018	UNIVERSITY OF HAWAII SYSTEMS	2425 CAMPUS RD SINCLAIR RM 1	HONOLULU	HI	96822	HONOLULU	USA	Minority Health and Health Disparities Research	002	1	6/17/2019	NEW	$0
2019	2018	UNIVERSITY OF HAWAII SYSTEMS	2425 CAMPUS RD SINCLAIR RM 1	HONOLULU	HI	96822	HONOLULU	USA	Minority Health and Health Disparities Research	000	1	11/14/2018	NEW	$0
2019	2018	UNIVERSITY OF HAWAII SYSTEMS	2425 CAMPUS RD SINCLAIR RM 1	HONOLULU	HI	96822	HONOLULU	USA	Minority Health and Health Disparities Research	003	1	8/26/2019	NEW	-$406,820
														Subtotal = $828,205

Issue Date FY: 2018 ( Subtotal = $716,625 )
2018	2018	UNIVERSITY OF HAWAII SYSTEMS	2425 CAMPUS RD SINCLAIR RM 1	HONOLULU	HI	96822	HONOLULU	USA	Minority Health and Health Disparities Research	001	1	9/20/2018	NEW	$0
2018	2018	UNIVERSITY OF HAWAII SYSTEMS	2425 CAMPUS RD SINCLAIR RM 1	HONOLULU	HI	96822	HONOLULU	USA	Minority Health and Health Disparities Research	000	1	8/16/2018	NEW	$716,625
														Subtotal = $716,625

Grand Total All Awards = $3,515,522

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Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM

Award Number: R01MD013501

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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