CHIBPS

In the United States, Sexual and Gender Minority (e.g., LGBTQ) individuals experience a preponderance of health disparities. These health challenges are predicated on the chronic marginalization and discrimination, some of which are state sanctioned, experienced by the population, and are coupled with a healthcare workforce that is inadequately prepared to effectively address the specific health needs of the population. The myriad health challenges faced by SGM individuals are magnified due to hardships in accessing adequate and competent healthcare that serves the unique needs of this population. Contributing factors to inadequate care include overall lack of provider knowledge on healthcare needs, history of stigmatizing experiences in the healthcare setting, and discomfort around discussing sexual orientation and/or sexual behaviors. Because of these conditions, 18% SGM Americans avoid receiving healthcare in fear of being discriminated or treated poorly. In light of the COVID-19 pandemic, these disparities have been amplified with emerging reports suggesting that SGM individuals may be particularly vulnerable to the effects of the virus. While increasing access to the COVID-19 vaccine is critical to inoculation efforts, there is widespread vaccine hesitancy among adults in the United States, particularly among African American and Hispanic individuals. There is limited information on vaccination attitudes and hesitation among SGM communities, and most of what is available is focused specifically on Human Papillomavirus (HPV)-vaccination uptake. As such, the proposed study seeks to expand knowledge on overall vaccine hesitancy (including COVID-19) and the role of medical mistrust in vaccine uptake among SGM adults in New Jersey. 

The purpose of this study is to better understand the thoughts about and experiences with the COVID-19 vaccine among people who are living with human immunodeficiency virus (HIV) in the United States. In particular, we hope to understand why people who are living with HIV may or may not choose to get the COVID-19 vaccine, if they have access to the COVID-19 vaccine, as well as their sources of information about the COVID-19 vaccine. Learn more: Click here to learn more about this study and see if you are eligible to participate.

The purpose of the research is to determine the burden of SARS-CoV-2 (the virus that causes COVID-19) in Essex County. Using robust methods, we will sample 1150 persons to determine SARS-CoV-2 prevalence in the population. We will adopt a venue-based sampling (VBS) approach to reach the general population for testing for SARS-CoV-2 antibodies while collecting symptom and underlying condition data from a diverse sample of the population. Recruitment for this cross-sectional survey and cohort will follow the methodology of VBS as used by the CDC for National HIV Behavioral Surveillance. As a universe of venue-day-time (VDT) periods where the population can be found, we are proposing grocery stores as a sampling frame.

This ancillary study of HPV and HSV-1 and -2 infection seeks to (1) to detect cases of oral and anal HPV infection through site-specific PCR testing and clinically significant HPV subtype through serotyping and to estimate HPV persistence and clearance rates; (2) to identify uptake and completion of HPV vaccination via a combination of self-reported vaccination history in addition to New York State HPV vaccine registry verification; (3) to determine the prevalence and incidence of HSV-1 and HSV-2 by serology; (4) to estimate HIV risk among YMSM with and without HSV-1 and/or HSV-2 and to assess whether HSV infection explains racial/ethnic disparities in HIV risk; and (5) to determine the extent to which biological, behavioral, psychosocial and social/structural factors explain the likelihood of (a) oral/anal HPV infection, broadly and infection of HPV 6, 11, 16, and 18, specifically; (b) HPV vaccination uptake, (c) HSV-1 and HSV-2 infection, and (d) co-infections of HIV, HSV, and/or HPV. A number of participants will be randomly selected for qualitative interviews to obtain information on knowledge regarding and experiences with HPV and HPV vaccination.

The purpose of this mixed-methods research study is to explore how transgender adults in New Jersey experience healthcare related to human papillomavirus (HPV). The information from this project will allow us to better understand the barriers and facilitators to transgender individuals’ engagement with HPV-related healthcare, and will inform development of interventions to increase uptake of HPV-related cancer prevention through screening and vaccination. The specific aims of this study are to: 1) assess barriers and facilitators to HPV prevention and care through qualitative interviews; 2) describe state of HPV prevention, care, knowledge, and risk factors through quantitative surveys; and 3) identify demographic, psychosocial, behavioral, and transition-related correlates of HPV prevention, care, knowledge, and risk through quantitative surveys.

The purpose of the research is to determine the burden of SARS-CoV-2 (the virus that causes COVID-19) in Essex County. Using robust methods, we will sample 1150 persons to determine SARS-CoV-2 prevalence in the population. We will adopt a venue-based sampling (VBS) approach to reach the general population for testing for SARS-CoV-2 antibodies while collecting symptom and underlying condition data from a diverse sample of the population. Recruitment for this cross-sectional survey and cohort will follow the methodology of VBS as used by the CDC for National HIV Behavioral Surveillance. As a universe of venue-day-time (VDT) periods where the population can be found, we are proposing grocery stores as a sampling frame.

The purpose of this study was to describe syndemic production and sexual health among a total of 100 18–25-year-old racially/ethnically and economically diverse men who have sex with men and transgender women in Newark and surrounding areas. Syndemics are the related behaviors of sexual risk-taking, illicit drug use, and mental health burden affecting vulnerable populations. We will examine how these behaviors develop through baseline and additional assessments and describe the patterns of risk as well as the factors which predispose the development of these patterns.

Map and Expand is a partnership between CHIBPS and Garden State Equality, with the goal of improving our understanding of how healthcare needs are being met among the lesbian, gay, bisexual, and transgender (LGBT) population of New Jersey. The information from this project will allow us to improve health outcomes, identify unmet health needs of LGBT people, and increase accessibility to affirming care through improved communication and understanding among healthcare providers and their patients. The study’s specific aims are (1) to understand the attitudes, knowledge, and experiences of healthcare providers in New Jersey in serving LGBT clients; (2) to describe the extent of LGBT-affirming practices (e.g., inclusive intake forms, trainings provided for staff) at health care organizations in New Jersey; and (3) to create a map that will allow LGBT New Jersey residents to locate LGBT-affirming providers across the state.

People living with HIV/AIDS (PLWHA) experience health disparities related to the stigma, social isolation, and overall compromised health. Among the PLWHA population, the older adults experience increased complexity in health disparities because of the aging process, healthcare treatment, psychosocial and structural conditions. The aging population living with HIV show exhibit resilience as they experience intersectional problems. Resilience is a major factor related to how older PLWHA overcome health-related issues.
A focus of the project was to understand resilience as a buffer for the processes of three major stressors of the aging and HIV population. HIV and HIV therapy, aging process, psychosocial and structural states are buffered through resilience to affect the health paradigm. The theoretical model helped analyze the how physical, mental, and social health are affected in the older adults living with HIV. Interviews were conducted to qualitatively evaluate how resilience is exhibited in older adults with HIV. The resilience and health paradigm model guided the conversation to understand how negative health outcomes are affected by multi-factor stressors. The qualitative insight of the older adults in the interviews brought valuable data to identify key concepts within the resilience model. Personal examination of resilience within older PLWHA brought key elements of how elderly sexual and gender minorities with HIV can be empowered.

This mixed-methods study sought to understand how young sexual minority men (YSMM) think about and make decisions around PrEP and PrEP use. Although PrEP is an effective method of HIV prevention, many YSMM do not use it. Previous studies have suggested that slow uptake is related to structural drivers, such as healthcare access (e.g., lack of health insurance, lack of access to prescribing providers), as well as issues related to stigma and mistrust of providers and/or the healthcare system. Exploring sexual and other health-related beliefs, perceptions, and experiences will help inform programming and interventions aimed at increasing PrEP use among this population.

The proposed research study aims to understand the social and biological mechanisms linking adult attachment insecurity and daily substance use among YSMM ages 23-26 years old. The goal of this study is to inform the creation of attachment based substance use prevention interventions that will ultimately decrease the high rates of substance use among YSMM.

This longitudinal study followed the development of syndemics in a cohort of urban HIV-negative young men who have sex with men and trans women in New York City as they transitioned from adolescence into young adulthood, and applied, tested, and further developed a theory of syndemic production to understand the development of both maladaptive and adaptive behavioral outcomes.

Description: Older (50+) people living with HIV/AIDS (PLWHA) experience increased mental (e.g. depression, stress, anxiety, substance use, etc.) and psychosocial burdens (e.g. ageism, homophobia/homonegatvitiy, diminished social capital and social support, and social isolation, etc.) that exacerbates their physical health (e.g. HIV and HIV-related conditions, other chronic, etc.) and, in turn, diminishes their overall health. These multiple health states comprising overall health are interrelated and influenced by HIV therapies, the aging process, and psychosocial and structural conditions. To ensure the overall health and well-being of older PLWHA, we must attend to HIV and HIV-related conditions as well as mental health, psychosocial burdens and the physical conditions that affect aging adults.
One understudied area of focus is the understanding how resilience may serve to buffer the effects that HIV/HIV therapies, aging, and social/structural conditions have on health. Resilience is operationalized as a trait or characteristic that equips individuals with the ability to buffer against stressful life events and maintain their overall health/well-being. This project aims to evaluate a theoretical model that delineates the role of resilience in relation to the overall health/well-being (mental, physical and social) of older adults living with HIV and against the aforementioned stressors that impact overall health.

This project seeks to investigate spatial mobility across neighborhoods as well as relationships between Global Positioning System (GPS)-defined activity space neighborhoods and HIV risk among young men who have sex with men (MSM) in the New York City metropolitan area, through the use of innovative methodological approaches including real-time geospatial methods and geo-located Twitter posts. We will randomly enroll 250 young MSM in the NIH-funded P18 Cohort Study in the proposed study to address the aims of the research. Eligibility requirements include report having had sex with another male in the past 6 months; HIV-seronegative; self-report no restrictions to usual physical activity; and willingness to complete a two-week GPS protocol. Participants will wear the GPS device following protocols we have used in our previous feasibility research projects. Findings from the proposed research will impact HIV prevention intervention activities. First, this research will inform specific neighborhood-level policy interventions. For example, increasing community efforts to combat lesbian, gay, bisexual and transgender (LGBT) hate crime neighborhood rates through increased local police attention in high-crime locations may be an HIV prevention intervention. Second, given that we will know the travel patterns of young MSM, we can identify geographic locations for HIV testing/prevention interventions, which is an advancement of the literature as such interventions are not often spatially targeted. Finally, this research will also facilitate identifying geographic locations for recruiting young MSM in research studies (an improved method of venue-based sampling), in this understudied group.

The purpose of this pilot study is to learn more about the experiences of Arab men who have sex with men (MSM) in the United States; to survey and measure encounters with racism, ethnic and/or religious based discrimination and homophobia; and to find whether these experiences are associated with sexual risk behavior. Several research studies have shown associations between racial and ethnic discrimination, homophobia and sexual risk among other racial ethnic minority MSM in the U.S. However these associations have not yet been explored among Arab MSM. This pilot study seeks to shed light on a sorely understudied population.

Description: This ancillary study of HPV and HSV-1 and -2 infection as part of the P18 Cohort Study of racially/ethnically and socioeconomically diverse YMSM seek to (1) to detect cases of oral and anal HPV infection through site-specific PCR testing and clinically significant HPV subtype through serotyping and to estimate HPV persistence and clearance rates; (2) to identify uptake and completion of HPV vaccination via a combination of self-reported vaccination history in addition to New York State HPV vaccine registry verification; (3) to determine the prevalence and incidence of HSV-1 and HSV-2 by serology; (4) to estimate HIV risk among YMSM with and without HSV-1 and/or HSV-2 and to assess whether HSV infection explains racial/ethnic disparities in HIV risk; and (5) to determine the extent to which biological, behavioral, psychosocial and social/structural factors explain the likelihood of (a) oral/anal HPV infection, broadly and infection of HPV 6, 11, 16, and 18, specifically; (b) HPV vaccination uptake, (c) HSV-1 and HSV-2 infection, and (d) co-infections of HIV, HSV, and/or HPV.

This mixed-methods study seeks to more fully explicate the dynamics associated with accessing care among YMSM. We will (1) identify the extent to which YMSM have access to health care facilities that serve the LGBT population; (2) disentangle the roles that sexual orientation and sexual behavior may play in preventing the access of consistent and appropriate care for YMSM; (3) delineate the patterns by which YMSM transition from healthcare from adolescence to young adulthood and pre and post coming out.

This mixed-methods study seeks to more fully explicate the dynamics associated with accessing care among YWSW. We will (1) identify the extent to which YWSW have access to health care facilities that serve the LGBT population; (2) disentangle the roles that sexual orientation and sexual behavior may play in preventing the access of consistent and appropriate care for YWSW; (3) delineate the patterns by which YWSW transition from healthcare from adolescence to young adulthood and pre and post coming out.

In the aftermath of traumatic events, including mass shootings, people in communities that were geographically close to the event often experience symptoms of trauma. However, the recent shooting in Orlando, FL, appears to have been motivated, at least in part, by hatred towards lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) people. As such, experiences of trauma among people in the LGBTQ community may extend far beyond the geographic confines of the Greater Orlando area. To assess this hypothesis, a brief Internet survey assessing collective trauma (i.e., trauma experienced by an entire community) will be advertised on LGBTQ email listservs and Facebook pages. LGBTQ people will be invited to complete the survey, which includes items intended to assess experiences of collective trauma and resilience in the face of such atrocities.

As a chronic relapsing condition, drug use is a major risk factor for HIV infection and lower access to HIV medications. Identifying factors associated with sustained cessation can contribute meaningfully to HIV prevention and treatment. The purpose of this case-control study is to characterize the individual and neighborhood-level determinants of initial and sustained cessation of heroin use among persons who report a history of chronic heroin use within economically disadvantaged, predominantly racial/ethnic minority neighborhoods in New York City. Data are sparse on the prognostic indicators and course of sustained heroin cessation, particularly in street-recruited samples. Likewise, while cessation makes sense in terms of parenteral HIV prevention, heroin dulls libido, and little is known about levels of sexual risk following heroin cessation short or long term. This study seeks to isolate potentially modifiable factors to assist the overall goal of sustained abstinence if not risk reduction. Key to this study is our recognition of cessation as not only an outcome, but also a possible exposure associated with sexual risk behavior.

The purpose of this qualitative study was to elucidate how consensual non-monogamous (e.g. open, polyamorous, monogamish, etc.) relationships relate to HIV/STI risk. The study aimed to describe different types of CNM relationships among large sample of urban YMSM, assess how different CNM relationship structures relate to sex risk, elucidate how partners in CNM relationships perceive their own risk for HIV/STIs, communicate about extradyadic sex, and negotiate sex practices.

To characterize the extent to which the HIV care cascade is achieved for key, at-risk populations in Accra, Ghana.

This pilot study will provide an assessment of the feasibility of using real-time geospatial methods to explore spatial contexts of substance use and HIV risk in YMSM.

To conduct a pilot study to determine the logistics and feasibility of examining the prevalence and correlates of a range of psychiatric and neurocognitive health states among older, HIV+ adults.

The purpose of this pilot study is to understand the influence of social network-level factors on sexual- and drug use-related risk behaviors associated with sexually transmitted infection(STIs) (including N. Gonorrhoeae, Chlamydia T., and HIV) among Black, Latino and White young men who have sex with men (YMSM). The growing epidemic of these sexually transmitted infections among YMSM combined with the persistence of stark racial/ethnic disparities in STIs within this population underscores the need for novel research examining the interactions between broader cultural and social dynamics with the structure and characteristics of the social networks of YMSM. Given the paucity of empirical research on the relationship between these contextual influences and individual level sexual- and drug use -related risk behaviors as well as STI rates, the specific aims of this exploratory, pilot study are to (1) explore the relationship between social network structural characteristics and normative influences with sexual- and drug use-related risk behaviors among Black, Latino and White YMSM; and (2) examine the relationship between social network structural characteristics and N. Gonorrhoeae, Chlamydia T., and HIV outcomes among Black, Latino and White YMSM.

Project VIVA (Venue-Intensive Vaccines for Adults) Harlem is a quasi-experimental project involving a multilevel community participatory intervention that is designed to improve influenza vaccination rates among adults aged 50 and older living in East and Central Harlem through a community-based participatory research approach. The Project VIVA Harlem team includes academic researchers from the UCSF School of Nursing, NYU’s Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), and the New York Academy of Medicine’s Center for Urban Epidemiologic Studies along with community partners from Palladia, Inc. Working closely with the New York City Department of Health and Mental Hygiene, we address both seasonal and pandemic H1N1 vaccination needs by developing health education approaches as well as providing or identifying opportunities for vaccination in non-traditional settings including pharmacies and community-based organizations.

This mixed methods research project will utilize a cross-sectional survey and a qualitative interview to explore the ways in which individual psychological, developmental, and contextual processes impact HIV-positive men over 50’s lived experiences, risk behaviors, life perspectives and journeys. Study aims are to (1) determine the antecedents of and associations between illicit substance use, sexual risk taking, and cognitive ability among illicit drug users and non illicit drug users, (2) explore the resiliencies or adaptive behaviors utilized in this population, and (3) develop a qualitative understanding of the aging process and related quality-of-life issues among these HIV-positive men ages 50 and over.

This project, in collaboration with the New York City Department of Health & Mental Hygiene, was a mixed-methods investigation to better understand the recent increase in HIV incidence in young men who have sex with men (YMSM) in New York City. We also seek to develop and test HIV prevention messages tailored to this population. Project DESIRE will 1) document the patterns of sexual risk-taking behavior in a racially and ethnically diverse sample of YMSM in NYC, 2) develop a qualitative understanding of sexual risk-taking in this population, and 3) determine the effectiveness of HIV prevention messages as well as the needs of YMSM with regard to prevention messaging.

The goal of this project is to work with the LGBT Community Center of New York City to conduct a comprehensive evaluation of the methamphetamine education and treatment program and to conduct an analysis of LGBT addiction services in New York State.

By 2015, 50% of all HIV-positive individuals in the USA will be 50 and over, with a substantial proportion of these being gay and bisexual men. We would like to determine if this population of Black, Latino and white gay and bisexual men (ages 50-59 years old), who are long term survivors of HIV, and are living in New York City, has any health problems that can be addressed by a change of lifestyle. The study will entail a quantitative analysis of computerized surveys, and a qualitative analysis of interviews. We would seek to explore how they see themselves in terms of their weight and body image. In addition, we would like to see how active or inactive they are, their nutritional status and its association with their overall health. Our ultimate goal would be to determine how to design and implement a wellbeing help plan for this population in order to improve their overall health.

The goal of this project was to conduct a mixed-method, community-centered study to develop a holistic understanding of methamphetamine abuse and associated risk taking among gay, bisexual, and heterosexually-identified Black MSM in New York City.

This project was a collaboration between Harlem United and CHIBPS-NYU. The goals of the project are to compare the efficacy of three strategies for identifying and testing previously-undiagnosed, 18-64 year old, African American MSM; to conduct a cost/resource analysis to evaluate the relative cost of identifying each previously undiagnosed, HIV-positive African American MSM for each of these strategies; and to determine the key variables associated with barriers to HIV testing in African American MSM, which will contextualize the cost efficacy of each recruitment strategy.

The goal of this study was to develop a better understanding of the health behaviors of heterosexually-identified 18-25 year olds and the correlates between individual and person-level characteristics and these behaviors. More specifically, the focus of this study was to collect data on the sexual behaviors and drug use patterns of heterosexually-identified 18-25 year olds in New York City.

This evaluation research project documented and assessed the effectiveness of case management services delivered by AIDS service organizations to women living with HIV/AIDS in New York City.

This pilot study, funded under the umbrella of the Mind Body Center at New York University’s Medical School, which considers the interaction of the mind and body, and seeks to foster an academic environment to conduct further research in this arena, sought to bring together three areas of study: addiction research, neural imagine, and social cognitive theory. Various data collection modalities were used including: social cognitive tasks, calendar-based methods to assess levels of drug use, clinical assessments of addiction, computer administered self-reports, and biological measures of stress; in addition to neural imaging to elucidate the relations of interest in a cohort of 45 gay/bisexual men. The specific aims of the investigation were: 1) To assess the relation between methamphetamine use and life stress, with regard to both social cognition and executive functions in emergent adults; 2) To assess differences in structure and the connectivity of neural pathways (e.g. prefrontal cortical structures, medical temporal lobe structures) associated with stress and methamphetamine use in emergent adults; and 3) To determine the relations between structural integrity/connectivity in key neural pathways with regard to both social cognition and executing functions in methamphetamine using emergent adults.

This study examined the sexual and substance use behaviors of men who have sex with men (MSM) that attend New York City gyms. The purpose of the study was to assess the variety of reported sexual behaviors and drug use patterns, in addition to overall health seeking and health risks in this population of men. As previous studies of these phenomena in the lives of MSM had focused recruiting in “gay social venues,” this study sought to explore these patterns in a separate subset of MSM in New York City.

This study sought to understand the phenomenon of “barebacking,” the practice of intentional unprotected anal intercourse among gay and bisexual men, nested within life history methodologies. As such, we sought to (1) examine the meanings and definitions that men ascribe to intentional unsafe sex and differentiate these attitudes from “unintentional unsafe sex” (relapse); (2) assess attitudinal and social/contextual antecedents associated with the barebacking behaviors of gay/bisexual men; (3) measure drug and alcohol use and mental health co-factors in this group of men. In addition, we sought to understand the overall developmental trajectories of gay and bisexual men over time.

The purpose of this study was to examine the relations between various psychosocial, religious, and spirituality variables in the lives of LGBT persons, specifically as they related to HIV risk-taking behaviors, substance use, and coming out experiences.

Project RADAR was a 1-year study, in collaboration with the New York University School of Medicine, which examined the extent to which some gay men believed they were resistant to HIV infection, and whether these perceptions of resistance to HIV infection were concordant with individuals’ histories of risks or immunologic characteristics.

This study examined the use of five party drugs popular among many gay and bisexual men: ketamine, methylenedioxymethamphetamine (ecstasy), crystal methamphetamine (Tina, crystal, ice), cocaine, and gamma-hydroxybutyrate (GHB). Investigators sought to understand how social contexts of party drug use interact with men’s psychological factors to influence sexual risk-taking. As drug use patterns change over time, BUMPS followed 450 men for one-year to study how their drug use evolved. The project recruited participants from gay clubs, bars, public sex environments, community agencies, and Internet chat rooms.

This study followed 400 men for one year and examined how participants’ drug use/ abuse, experience with medication side effects, and life events affected adherence to highly active antiretroviral therapy (HAART) regimes containing protease inhibitors (PIs), as well as explored the sex and drug risk behaviors of study participants. The underlying purpose of the investigation was to help community agencies design and implement effective medication adherence interventions. The study recruited participants from gay venues, drug treatment programs, and AIDS service organizations using active and passive recruitment strategies.

This two-year study was CHIBPS’ first examination of crystal methamphetamine use in New York City among gay and bisexual men. It was also one of the first studies on the subject in New York at all. Investigators explored the context and culture of methamphetamine use among HIV negative and HIV positive gay and bisexual men in NYC. Project TINA also assessed the psychological, sociological, and behavioral correlates of use of this substance as well as the relationship of use to HIV-related sexual risk taking among those surveyed.

The major goal of this project was to conduct a randomized clinical trial of a six session group behavioral intervention aimed at reducing unsafe sex with HIV negative and serostatus unknown partners among HIV+ gay/bisexual men. The intervention was derived from information obtained via Project SUMS.

A survey of the sexual behaviors of HIV-positive MSM in two urban HIV epicenters (New York City and San Francisco) conducted to provide information for the development of a behavioral intervention for HIV-positive gay and bisexual men that would reduce the risk for HIV transmission and promote serostatus disclosure. The objectives of the project were (a) to compare the feasibility of recruiting self-identified HIV-positive MSM from three community settings; (b) to describe serostatus disclosure and sex practices of HIV-positive MSM; (c) to identify factors that help or hinder serostatus disclosure and the maintenance of safer sex practices; and (d) to elicit ideas regarding risk-reduction interventions for HIV-positive MSM.