# Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM

> **NIH NIH R01** · FLORIDA STATE UNIVERSITY · 2021 · $656,773

## Abstract

The literature reveals that hypertension (HTN) is considerably higher among HIV-positive individuals than
HIV-negative individuals. However, the systemic/individual determinants (including behavioral, clinical, macro-
social, and psychosocial factors) for this health co-morbidity is not fully understood in the literature. To fill
these scientific gaps, we propose to use a longitudinal design to systematically examine a systemic/individual
approach -- modeling after the NIMHD’s “Minority Health and Health Disparities Research Framework” -- to
examine and elucidate the multiple determinants of HTN observed in two ethnic-sexual men who have sex with
men (MSM) living with HIV/AIDS. To that end, we will address three specific aims and hypotheses: Aim 1: To
examine the association of macro-social determinants (i.e., homophobia, racial/ethnic discrimination),
behavioral risk factors (e.g., substance misuse), and psychosocial factors (e.g., stress) with HTN among a
cohort of African American or AA (200 AA in Philadelphia) and Asian Pacific Americans or APA (200 APA in
Honolulu) MSM living with HIV -- We hypothesize that greater exposure to homophobia and racial/ethnic
discrimination is associated with a greater prevalence of HTN among HIV-positive MSM. Aim 2: To determine
the underlying systemic/individual determinants which account for the relationship between inflammation and
HTN over time, given common forms of hypertension have been postulated to be immune mediated -- We
hypothesize that the greater exposure to homophobia and racial/ethnic discrimination is associated with
dysregulation of pro-inflammatory cytokines (D-dimer, hsCRP, IL-6, IL-8, MCP-1, P-selectin), where they
mediate HTN among these men. Aims 3: To examine whether associations between these factors and health
outcomes are moderated by coping and social support -- We hypothesize that greater social support would
mitigate HTN among these men. This is the first study that uses systemic/individual and multi-disciplinary
approaches to examine the impact of multiple determinants on HTN co-morbidity over time among AA and
APA MSM living with HIV. Our multi-disciplinary team with expertise in HIV prevention science, clinical HIV
medicine, ethnic-sexual MSM, and chronic diseases are uniquely positioned to address risk and protective
factors of multiple influences of HTN co-morbidity over time among AA and APA MSM with HIV. By
conceptually and empirically testing novel hypotheses, we will provide evidence of etiology and validated tools
and measures that advance our understanding of mechanisms of disparities in HIV-related co-morbidities.
Findings from this longitudinal observational study will inform the management of HIV and its HTN co-morbidity
as a chronic disease, especially among the two disparity groups of MSM (AA and APA) who continue to bear
the burden of health disparities. This study is guided by NIMHD’s conceptual framework to address multiple
influences of health disparities on HTN...

## Key facts

- **NIH application ID:** 10102145
- **Project number:** 5R01MD013501-04
- **Recipient organization:** FLORIDA STATE UNIVERSITY
- **Principal Investigator:** GRACE X. MA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $656,773
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10102145

## Citation

> US National Institutes of Health, RePORTER application 10102145, Unpacking the Mechanisms of Disparities for HIV-related Hypertension in African American and Asian Pacific American MSM (5R01MD013501-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10102145. Licensed CC0.

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