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Monitoring Microaggressions and Adversities to Generate Interventions for Change (MMAGIC) for Black Women Living with HIV

Award Number: R01MH121194
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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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.


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: 2025 ( Subtotal = $0 )
2025	2024	UNIVERSITY OF MIAMI	1320 SOUTH DIXIE HIGHWAY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	001	4	3/14/2025	NON-COMPETING CONTINUATION	$0
2025	2024	UNIVERSITY OF MIAMI	1320 SOUTH DIXIE HIGHWAY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	000	4	3/13/2025	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $714,934 )
2024	2024	UNIVERSITY OF MIAMI	1320 SOUTH DIXIE HIGHWAY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	001	4	1/26/2024	SUPPLEMENT FOR EXPANSION	$72,588
2024	2024	UNIVERSITY OF MIAMI	1320 SOUTH DIXIE HIGHWAY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	000	4	1/25/2024	NON-COMPETING CONTINUATION	$578,112
2024	2024	UNIVERSITY OF MIAMI	1320 SOUTH DIXIE HIGHWAY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	002	4	6/14/2024	NON-COMPETING CONTINUATION	$64,234
														Subtotal = $714,934

Issue Date FY: 2023 ( Subtotal = $732,955 )
2023	2023	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	001	3	3/27/2023	SUPPLEMENT FOR EXPANSION	$72,588
2023	2023	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	002	3	4/14/2023	SUPPLEMENT FOR EXPANSION	$0
2023	2023	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	000	3	2/2/2023	NON-COMPETING CONTINUATION	$660,367
														Subtotal = $732,955

Issue Date FY: 2022 ( Subtotal = $668,247 )
2022	2022	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	000	2	1/25/2022	NON-COMPETING CONTINUATION	$601,422
2022	2022	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	001	2	5/23/2022	NON-COMPETING CONTINUATION	$66,825
														Subtotal = $668,247

Issue Date FY: 2021 ( Subtotal = $825,627 )
2021	2021	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	001	1	4/27/2021	NEW	$0
2021	2021	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	000	1	3/19/2021	NEW	$676,574
2021	2021	UNIVERSITY OF MIAMI	1320 S DIXIE HWY STE 650	CORAL GABLES	FL	33146	MIAMI-DADE	USA	Mental Health Research Grants	002	1	9/15/2021	NEW	$149,053
														Subtotal = $825,627

Grand Total All Awards = $2,941,763

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Monitoring Microaggressions and Adversities to Generate Interventions for Change (MMAGIC) for Black Women Living with HIV

Award Number: R01MH121194

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

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