Gay and bisexual men (GBM) and other men who have sex with men (MSM) continue to be disproportionately affected by the HIV epidemic. Though minority stress models of health have been investigated for GBM in general, such models that incorporate the unique role of HIV-related stressors for HIV- positive GBM have yet to be tested. Research suggests that HIV-related stressors are associated with emotion regulation and health risk behaviors and that emotion regulation may be one path through which stressors impact behavioral outcomes. Moreover, neurocognitive functioning has been found to be associated with both emotion regulation and health risk behaviors (e.g., substance use, sexual risk, and medication non-adherence) as well as with the efficacy of behavioral interventions aimed at reducing health risk behavior. This Mentored Research Scientist Development Award (K01) will provide the candidate with the protected time, training, and resources necessary to carry out research aimed at applying a minority stress model to HIV-positive GBM. Specifically, the goal of this award is to test an HIV-related minority stress model of emotion regulation and health risk behavior among HIV-positive GBM and developing an intervention to target these minority stress and emotion regulation pathways. To accomplish these goals, the candidate requires training and mentorship in two areas: (1) the design of behavioral interventions and their translation to technology-based platforms; and (2) the theory and methods of behavioral and cognitive neuroscience. Training will be accomplished through a combination of didactic coursework, seminars, trainings, conferences, and mentored research projects. The overarching aims of these research projects are to: (1) conduct secondary data analyses to test an HIV-related minority stress model whereby HIV-related stressors lead to poorer emotion regulation which is associated with neurocognitive functioning and leads to health risk behavior and HIV-related health outcomes; (2) conduct a pilot study utilizing ecological momentary assessment (EMA) to develop a measure of situational (i.e., daily) HIV-related minority stressors and gather preliminary data on its association with neurocognitive functioning and daily experiences of emotion regulation difficulties, sexual risk behavior, substance use (i.e., alcohol and club drug use/abuse), and medication adherence; and (3) develop and pilot test for feasibility and acceptability an EMA-based behavioral intervention aimed at managing the impact of HIV-related minority stressors on emotion regulation, substance use, sexual risk behavior, medication adherence, and health outcomes. Together, these research projects will address novel questions about the role of HIV-related stressors in the health of HIV-positive GBM, provide modifiable targets for intervention, examine preliminary estimates of feasibility and acceptability of a mobile intervention to address these targets, and explore the role that neurocognitive functioning plays within the model. The training and research plan will allow the candidate to develop into an independent investigator focusing on creating innovative and high-impact interventions to address substance use, sexual risk, and HIV medication adherence for HIV-positive GBM.
Given the overwhelming burden of HIV infection for gay and bisexual men, novel interventions are needed that address their unique needs. This research is designed to test a minority stress model that incorporates HIV-specific stressors for HIV-positive gay and bisexual men. This model includes emotion regulation as the mediating pathway through which HIV-related stressors influence health risk behaviors (i.e., substance use, sexual risk, and medication non-adherence) as well as exploring the role that neurocognitive functioning plays in such associations. The goal of this research is to develop and pilot test a novel mobile intervention targeting these pathways in order to reduce health risk behavior for HIV-positive GBM.
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