In this competing renewal, we propose to continue the largest cohort study of young men who have sex with men (YMSM) ever conducted. The RADAR study was launched in 2014 to provide critical insights into risk and protective factors for HIV and drug use, and to identify facilitators and barriers to the implementation of an effective strategy to end the epidemic. RADAR is reflective of the US HIV epidemic; it focuses on the ages with the highest HIV incidence, has exceptional representation of minority HIV disparity groups (38% black, 30% Latino), and is located in Chicago, an urban epicenter of the HIV and drug epidemics (i.e., Cook County was 4th in HIV incidence-2017). During our initial grant period, we were extremely productive in recruitment (N>1,200), retention (>80%), scientific outputs (40+ publications), training future scholars, and serving as a platform for innovative research (25+ connected studies; 7 concepts via NIDA C3PNO consortium). YMSM account for nearly 70% of all new HIV diagnoses among adolescents and young adults each year in the U.S. While all other risk groups have declining incidence, dramatic increases continue among YMSM of color. In an era of evolving prevention and treatment options, YMSM still show insufficient PrEP utilization and fall off the HIV care cascade at high rates. Substance use and minority stressors, with associated social, structural, and biological processes, are key factors that drive disparities. In response to RFA-DA-20-005 we propose a sophisticated multilevel research design, in which we will enhance the cohort in 2020 with 300 new 16-20 year olds and continue to follow existing cohort members. In this renewal, we will answer critical new questions about the HIV and substance use epidemics in YMSM.
First (Aim 1), we will keep a pulse on emerging trends in drug use, HIV risk/preventive behaviors, and care continuum engagement. We will chart YMSM developmental trajectories of drug use into adulthood, with a novel focus on how use trajectories and transitions are associated with drug consequences. Further, enrollment of multiple samples of 16-20 year olds (2008, 2011, 2015, 2020) allows us to disentangle historical (e.g., advent of PrEP; marijuana legalization) and developmental changes in substance use, HIV risk and care.
Next (Aim 2), we will continue to enroll cohort members? new serious partners. We will extend our prior work by longitudinally examining the key role that dyadic processes play in the development of substance use problems and HIV risk behaviors and transmission among coupled YMSM.
Third (Aim 3), we will build on our provocative findings of high levels of systemic inflammation in the RADAR cohort regardless of HIV status by collecting pathogenic biomarkers of substance use to begin forecasting later-life morbidities for HIV+ and HIV- YMSM. Finally (Aim 4), RADAR will continue to add specimens and data to our well-characterized biobehavioral repository to provide a platform for high-impact science. RADAR is a unique multilevel and longitudinal study of diverse YMSM?its continuation will provide critical data to inform strategies to end the HIV epidemic.

Public Health Relevance

Young men who have sex with men (YMSM) are the largest HIV transmission group in the U.S. and are the only group were rates of diagnoses are increasing. Non-injection drug use is an important risk factor for HIV infection in this group. The objective of this proposal is to sustain and enhance a large and innovative cohort of YMSM and their serious sexual partners in order to delineate multilevel influences on HIV and substance use. This cohort will serve as a strong resource platform for a wide range of future innovative research efforts and will inform implementation and optimization of HIV and drug abuse interventions for YMSM.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DA036939-07
Application #
10128420
Study Section
Special Emphasis Panel (ZDA1)
Program Officer
Hartsock, Peter
Project Start
2014-04-15
Project End
2025-01-31
Budget Start
2021-02-01
Budget End
2022-01-31
Support Year
7
Fiscal Year
2021
Total Cost
Indirect Cost
Name
Northwestern University at Chicago
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611
Mustanski, Brian; Ryan, Daniel T; Hayford, Christina et al. (2018) Geographic and Individual Associations with PrEP Stigma: Results from the RADAR Cohort of Diverse Young Men Who have Sex with Men and Transgender Women. AIDS Behav 22:3044-3056
Newcomb, Michael E; Moran, Kevin; Feinstein, Brian A et al. (2018) Pre-Exposure Prophylaxis (PrEP) Use and Condomless Anal Sex: Evidence of Risk Compensation in a Cohort of Young Men Who Have Sex with Men. J Acquir Immune Defic Syndr 77:358-364
Phillips 2nd, Gregory; Johnson, Amy K; Adames, Christian N et al. (2018) Meningitis Vaccination, Knowledge, and Awareness Among YMSM in Chicago. Health Educ Behav 45:607-615
Janulis, Patrick; Feinstein, Brian A; Phillips 2nd, Gregory et al. (2018) Sexual Partner Typologies and the Association Between Drug Use and Sexual Risk Behavior Among Young Men Who Have Sex With Men. Arch Sex Behav 47:259-271
Phillips 2nd, Gregory; Birkett, Michelle; Salamanca, Paul et al. (2018) Interplay of Race and Criminal Justice Involvement on Sexual Behaviors of Young Men Who Have Sex With Men. J Adolesc Health 63:197-204
Morgan, Ethan; Moran, Kevin; Ryan, Daniel T et al. (2018) Threefold Increase in PrEP Uptake Over Time with High Adherence Among Young Men Who Have Sex With Men in Chicago. AIDS Behav 22:3637-3644
Whitton, Sarah W; Dyar, Christina; Newcomb, Michael E et al. (2018) Romantic involvement: A protective factor for psychological health in racially-diverse young sexual minorities. J Abnorm Psychol 127:265-275
Puckett, Jae A; Feinstein, Brian A; Newcomb, Michael E et al. (2018) Trajectories of Internalized Heterosexism among Young Men Who have Sex with Men. J Youth Adolesc 47:872-889
Morgan, Ethan; Taylor, Harry E; Ryan, Daniel Timothy et al. (2018) Systemic inflammation is elevated among both HIV-uninfected and -infected young men who have sex with men. AIDS :
Feinstein, Brian A; McConnell, Elizabeth; Dyar, Christina et al. (2018) Minority stress and relationship functioning among young male same-sex couples: An examination of actor-partner interdependence models. J Consult Clin Psychol 86:416-426

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