# Health disparities, stress pathways, and stress-related comorbidities among MSM living with HIV

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $1,285,395

## Abstract

Project Summary
Stress is associated with HIV risk behaviors, immune dysregulation, and among people living
with HIV (PLWH) it has been associated with viral load and disease progression. The goal of
this study is to better understand the mechanisms of stress and stress-related comorbidities and
how they exacerbate HIV-related health disparities among HIV-infected Black men who have
sex with men (BMSM). Studies in many parts of the US suggest that BMSM often live or spend
much of their time in impoverished neighborhoods where physical and social disorders (e.g.,
physical decay, violence, discrimination) are clustered. These socio-structural factors can be
conceptualized as chronic and acute stressors and may promote other stressors that lead to
HIV-related outcomes. While much of the literature on minority stress has focused on major
discriminatory events, this proposed study will examine microaggressions. We will
comprehensively assess chronic, acute, and daily psychosocial stressors that are particularly
relevant to MSM, especially BMSM. Moreover, we will use measures of hypothalamic–pituitary–
adrenal (HPA) axis responses, sympathetic nervous system (SNS), and inflammatory
biomarkers to identify specific stress pathways among HIV-infected BMSM and White MSM
(WMSM) that can be targeted in future interventions. We aim to provide an extension of minority
stress theory by utilizing intensive longitudinal protocols to assess daily discriminatory events
and other stressors, and to explore the association with HIV-related behaviors and physiological
outcomes. Built upon the evidence of feasibility and acceptability from our previous research,
this aim will be accomplished by using ecological momentary assessment (EMA) of stressors
and stress, Medication Event Monitoring System (MEMS), and home-based testing for cortisol.
We propose a longitudinal study of 450 HIV-infected BMSM and WMSM who have common
stress-related comorbidities (e.g., cardiovascular disease, depression, substance abuse)
assessed at baseline, 6, 12, 18, and 24 months. Participants will provide 9 days of smartphone-
based EMA and MEMS for ART medication adherence every 6 months for 24 months. Every 6
months, we will collect stress and immune function biomarkers.

## Key facts

- **NIH application ID:** 10364643
- **Project number:** 5R01MD013495-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CARL A LATKIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,285,395
- **Award type:** 5
- **Project period:** 2018-09-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10364643

## Citation

> US National Institutes of Health, RePORTER application 10364643, Health disparities, stress pathways, and stress-related comorbidities among MSM living with HIV (5R01MD013495-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10364643. Licensed CC0.

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