Nathan Grant Smith - US grants

PROJECT SUMMARY/ABSTRACT Young gay and bisexual men are disproportionately affected by HIV, accounting for the majority of new HIV cases among youth. Young gay and bisexual men face specific challenges that increase their risk for HIV transmission. These challenges include the stress associated with having a stigmatized non-heterosexual identity and the negative health outcomes associated with this stress, including alcohol and drug use, condomless sex, and poor mental health. There is a need to develop and test interventions that target these specific risk factors in order to prevent HIV transmission among young gay and bisexual men. The purpose of the proposed project is to conduct a pilot randomized controlled trial of a novel, theory-based primary HIV- prevention intervention. This intervention, entitled Project PRIDE (Promoting Resilience In Discriminatory Environments), consists of 8 sessions and is delivered to young gay and bisexual men aged 18-25. Project PRIDE focuses on the development of adaptive coping strategies to deal with gay/bisexual-related stress in order to reduce alcohol and drug use, condomless sex, and mental health problems. The specific aims of the proposed project are to (1) randomize 123 racially/ethnically-diverse, HIV-negative young gay and bisexual men to one of two conditions: either the intervention condition, which will receive Project PRIDE immediately, or the wait-list control condition, which will wait approximately 5 months before receiving Project PRIDE, and (2) test the feasibility of obtaining biological measures of stress, drug use, and HIV and other sexually transmitted infections (STIs; i.e., syphilis, gonorrhea, and chlamydia), including saliva samples to assess the stress hormone cortisol, urine samples to assess drug use, and urine/blood/oral swabs to assess HIV and other STIs. To meet these aims, we will recruit participants in Houston, TX, through a health services agency and through study advertisements targeted to venues, both physical and virtual, frequented by young gay and bisexual men. Eligible participants will complete self-report measures, including sexual behavior, mental health, and coping, among others, in addition to biological measures. The effects of the intervention will be examined immediately after the conclusion of Project PRIDE and again 3 months later in both the intervention condition and the wait-list control condition. Study results will be used to inform a subsequent NIH application to test the efficacy of a large-scale randomized controlled trial in reducing condomless sex, drug and alcohol use, and negative mental health outcomes among young gay and bisexual men. Moreover, the results have important implications for public health and have the potential to reduce drug use, mental health problems, and HIV risk among a population at high risk for negative health outcomes.