A behavioral intervention for Black men who have sex with men and live with HIV to address intersectional stigma and improve antiretroviral therapy adherence
July 2021 - June 2026
PI: Andrea Norcini Pala
Project Summary/Abstract
Intersectional stigma based on race, sexual orientation, and HIV-status reduces antiretroviral therapy (ART) adherence among Black men who have sex with men (BMSM) and live with HIV (LWH), a group heavily affected by the HIV epidemic in the US.
Low ART adherence is associated with a higher risk of virological failure as well as morbidity, mortality, and HIV transmission to HIV-negative partners. Evidence-based interventions (EBIs) for BMSM/LWH to address the ART adherence barriers due to intersectional stigma are still lacking.
Phone-based reminder systems like ARemind can increase ART adherence with a medium/high effect size, but their effect on viral suppression remains poorly understood. Reminder-based interventions address sporadic non-adherence or single missed ART doses due to forgetfulness that has minimal impact on viral suppression. They do not address sustained non-adherence resulting from social and structural factors including intersectional stigma.
Sustained non-adherence is a risk factor for virological failure. Sporadic and sustained non-adherence worsens HIV-induced chronic inflammation (e.g., high interleukin [IL]-6 levels), thereby increasing morbidity and mortality risk.
Dr. Norcini Pala aims to design a technology-enhanced, culturally-sensitive EBI for BMSM/LWH to address sporadic and sustained non-adherence. He will pilot test the intervention and collect preliminary data on its effect on ART adherence based on self-report, Medication Event Monitoring System devices, and hair ART levels as well as viral suppression and chronic inflammation.
Read more about the launch: New Research Study: Intersectional Stigma, HIV, & ART (ISHA)
