# A behavioral intervention for Black men who have sex with men and live with HIV to address intersectional stigma and improve antiretroviral therapy adherence

> **NIH NIH K01** · COLUMBIA UNIV NEW YORK MORNINGSIDE · 2022 · $175,157

## Abstract

7. 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. The candidate seeks training and research experience to desi
gn and pilot test a technology-enhanced,
culturally-sensitive EBI for BMSM/LWH to address sporadic and sustained non-adherence.
Through this K01
Award, he will accomplish the following Training Goals (TGs): TG1. To develop skills in behavioral intervention
research; TG2. To gain skills in qualitative research methods; TG3. To acquire proficiency in the assessment
and interpretation of biomarkers of ART adherence and chronic inflammation. These TGs coupled with the
candidate’s expertise in quantitative methods, biopsychosocial stigma models, and clinical psychology will
barriers to ART adherence faced by
due to intersectional stigma and strategies to counter these barriers through
RA2. Design a technology-enhanced, culturally-sensitive EBI addressing intersectional
stigma-related barriers to ART adherence for BMSM/LWH;
enable him to achieve the following Research Aims (RAs): RA1. Identify
BMSM/LWH in-depth interviews
with ~30 BMSM/LWH;
RA3. Evaluate the feasibility, acceptability, and effect
size estimates of the EBI (RA2) through a pilot RCT with 60 BMSM/LWH.
The EBI
(RA2)
will combine ARemind
with the
Effective Skills to Empower Effective Men (ESTEEM) intervention’s strategies. Because these strategies
focus on sexual orientation stigma, the candidate will adapt them for BMSM/LWH to address intersectional
stigma-related barriers to ART adherence. Participants randomized to the experimental arm will receive the
EBI
(RA2). Participants in the control arm will receive ARemind only. The primary outcome is ART adherence based
on self-report, Medication Event Monitoring System devices, and hair ART levels. The secondary outcomes are
viral suppression and chronic inflammation. The...

## Key facts

- **NIH application ID:** 10432133
- **Project number:** 5K01MH125724-02
- **Recipient organization:** COLUMBIA UNIV NEW YORK MORNINGSIDE
- **Principal Investigator:** Andrea Norcini Pala
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $175,157
- **Award type:** 5
- **Project period:** 2021-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10432133

## Citation

> US National Institutes of Health, RePORTER application 10432133, A behavioral intervention for Black men who have sex with men and live with HIV to address intersectional stigma and improve antiretroviral therapy adherence (5K01MH125724-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10432133. Licensed CC0.

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