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Multilevel Racism & Discrimination and PrEP Outcomes Among Black SMM in the Southeastern U.S.

Award Number: R01MH130166
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/08/2022
PERIOD OF PERFORMANCE END DATE: 03/12/2025

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Multilevel Racism & Discrimination and PrEP Outcomes Among Black SMM in the Southeastern U.S. - PROJECT SUMMARY Inequities in health manifest as a result of systemic minority stressors and social injustices. Racism and discrimination are salient minority stressors and social injustices for Black sexual minority men (SMM) because Black SMM anticipate and experience discrimination at different ecological levels (intrapersonal, interpersonal, and community) due to their interconnected identities (e.g., race, sexual minority status, HIV status). These multiple exposures concomitantly contribute to increased HIV vulnerability among Black MSM: 1 in 2 Black SMM will be diagnosed with HIV in their lifetime, compared to 1 in 11 for White MSM, if current trends remain unchanged. There is increasing interest in understanding an individual's ability to adapt to or resist life's adversities or stressful events (i.e., minority strengths framework). Thus, an integrated minority social-structural stress and minority strengths theory model will be tested in the proposed application to delineate the multilevel discrimination predictors of HIV prevention outcomes, and understand how resilience moderates these associations. First, we hypothesize that greater anticipation and experiences of discrimination are predictive of infrequent testing for sexually transmitted infections, including HIV, and lower pre-exposure prophylaxis (PrEP) use, retention in care, PrEP adherence, and PrEP protection over a 36-month follow-up period among Black MSM in the Deep South. Next, we hypothesize that differing levels of resilience will moderate the associations between discrimination and HIV prevention. Finally, we will conduct qualitative focus groups with social mapping to validate the quantitative results in Aims 1&2 and to identify and/or adapt effective social-structural and/or strengths-based interventions to mitigate the effect of SRD on PrEP outcomes among Black SMM. Three integrated specific aims are proposed to test these hypotheses. In Specific Aim 1, to evaluate the relationships between SRD factors and PrEP continuum outcomes among Black SMM in two Southeastern U.S. cities over a 36-month follow-up period, using multilevel modeling techniques. In Specific Aim 2, to determine the moderating effects of resiliency factors on the relationships between SRD factors and PrEP continuum outcomes among Black SMM in two Southeastern U.S. cities through moderation analyses. And finally, in Specific Aim 3, to a. gain contextually-grounded explanations of the quantitative results via focus groups; b. “geo-narratives” of the geographical landscape of Black SMM using social mapping; and c. synthesize the quantitative and qualitative results via data triangulation methods. Broadly, this research will enhance our understanding of how SRD discrimination contributes to inequities in HIV and provide insight into three long-standing questions in the field of HIV epidemiology: (1) minority stress mechanisms that contribute to HIV prevention outcomes, (2) intrapersonal traits that buffer the associations of minority stressors with HIV prevention, and (3) identification and/or adaptation of social- structural or strengths-based interventions to mitigate HIV among Black SMM.


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 = -$49,194 )
2025	2024	US HELPING US-PEOPLE INTO LIVING, INC	3636 GEORGIA AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	3	3/14/2025	TERMINATION	$0
2025	2024	US HELPING US-PEOPLE INTO LIVING, INC	3636 GEORGIA AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	001	3	7/16/2025	TERMINATION	-$49,194
														Subtotal = -$49,194

Issue Date FY: 2024 ( Subtotal = $601,194 )
2024	2024	US HELPING US-PEOPLE INTO LIVING, INC	3636 GEORGIA AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	3	7/2/2024	NON-COMPETING CONTINUATION	$601,194
														Subtotal = $601,194

Issue Date FY: 2023 ( Subtotal = $613,194 )
2023	2023	US HELPING US-PEOPLE INTO LIVING, INC	3636 GEORGIA AVE NW	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	2	8/3/2023	NON-COMPETING CONTINUATION	$613,194
														Subtotal = $613,194

Issue Date FY: 2022 ( Subtotal = $618,699 )
2022	2022	US HELPING US-PEOPLE INTO LIVING, INC	3636 GEORGIA AVE NW STE B2	WASHINGTON	DC	20010	DISTRICT OF COLUMBIA	USA	Mental Health Research Grants	000	1	9/8/2022	NEW	$618,699
														Subtotal = $618,699

Grand Total All Awards = $1,783,893

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Multilevel Racism & Discrimination and PrEP Outcomes Among Black SMM in the Southeastern U.S.

Award Number: R01MH130166

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/08/2022

PERIOD OF PERFORMANCE END DATE: 03/12/2025

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