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.

Public Health Relevance

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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01DA039030-02
Application #
9031756
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Aklin, Will
Project Start
2015-04-01
Project End
2019-03-31
Budget Start
2016-04-01
Budget End
2017-03-31
Support Year
2
Fiscal Year
2016
Total Cost
Indirect Cost
Name
Hunter College
Department
Type
Organized Research Units
DUNS #
620127915
City
New York
State
NY
Country
United States
Zip Code
10065
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Rendina, H Jonathon; Millar, Brett M; Parsons, Jeffrey T (2018) The critical role of internalized HIV-related stigma in the daily negative affective experiences of HIV-positive gay and bisexual men. J Affect Disord 227:289-297
Rendina, H Jonathon; López-Matos, Jonathan; Wang, Katie et al. (2018) The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale. J Sex Res :1-12
Gurung, Sitaji; Ventuneac, Ana; Rendina, H Jonathon et al. (2018) Prevalence of Military Sexual Trauma and Sexual Orientation Discrimination Among Lesbian, Gay, Bisexual, and Transgender Military Personnel: a Descriptive Study. Sex Res Social Policy 15:74-82
Whitfield, Thomas H F; Rendina, H Jonathon; Grov, Christian et al. (2018) Viewing Sexually Explicit Media and Its Association with Mental Health Among Gay and Bisexual Men Across the U.S. Arch Sex Behav 47:1163-1172
Rendina, H Jonathon; Millar, Brett M; Parsons, Jeffrey T (2018) Situational HIV stigma and stimulant use: A day-level autoregressive cross-lagged path model among HIV-positive gay and bisexual men. Addict Behav 83:109-115
Grov, Christian; Rendina, H Jonathon; John, Steven A et al. (2018) Determining the Roles that Club Drugs, Marijuana, and Heavy Drinking Play in PrEP Medication Adherence Among Gay and Bisexual Men: Implications for Treatment and Research. AIDS Behav :
Rendina, H Jonathon; Millar, Brett M; Dash, Genevieve et al. (2018) The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men. Ann Behav Med 52:380-392
Whitfield, Thomas H F; John, Steven A; Rendina, H Jonathon et al. (2018) Why I Quit Pre-Exposure Prophylaxis (PrEP)? A Mixed-Method Study Exploring Reasons for PrEP Discontinuation and Potential Re-initiation Among Gay and Bisexual Men. AIDS Behav 22:3566-3575
Rendina, H Jonathon; Parsons, Jeffrey T (2018) Factors associated with perceived accuracy of the Undetectable = Untransmittable slogan among men who have sex with men: Implications for messaging scale-up and implementation. J Int AIDS Soc 21:

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