# Southwest Health Equity Research Collaborative

> **NIH NIH U54** · NORTHERN ARIZONA UNIVERSITY · 2021 · $749,752

## Abstract

PROJECT SUMMARY
In the U.S., incidence rates of HIV and sexually transmitted infections (STIs) are disproportionately high among
gay, bisexual, and other men who have sex with men—referred to herein as sexual minority men (SMM)—
compared to men who have sex with women only.1,2 Roughly 10% of HIV incidence is attributable to increased
transmission due to untreated STIs among SMM,3 64% of syphilis cases occur among SMM,4 and SMM
residing in Ending the HIV Epidemic (EHE) priority jurisdictions have nearly 50% greater odds of STIs
compared to those residing elsewhere.5 Oklahoma is an EHE priority rural state with above average yearly
cases of chlamydia and ranks in the top 10 for gonorrhea and syphilis infections nationwide. Within these
Oklahoma communities, those under the age of 24 account for a quarter of new HIV, chlamydia, and
gonorrhea infections. Less than 28% of rural Oklahomans have received an HIV test during their lifetime and
only 5.7% during the past year, the lowest testing rate among the EHE states.6 Similar to their SMM peers,
rural American Indian (AI) men have seen an increase in HIV incidence—where the AI men now account for
9.3% of new infections in Oklahoma compared to 7.8% in 2016.7-9 AI men and SMM living in rural areas of the
U.S. are less likely to receive HIV prevention messaging, engage in routine testing, identify HIV testing
resources, or receive comprehensive education as compared to their urban counterparts. Rural SMM and AI
men in Oklahoma experience many barriers to HIV and STI testing, including worries about HIV-related stigma,
low perceptions of risk, difficulty communicating with healthcare providers, and confidentiality concerns,10-15
requiring expansion of prevention and screening services. Our proposed research will specifically focus on two
EHE pillars: diagnose (i.e., HIV screening) and prevent (i.e., increase condom use; adoption of Pre-Exposure
Prophylaxis). Our specific aims are as follows: AIM 1 – To refine our preliminary intervention strategy in
partnership with a Community Advisory Board (CAB) and rural peer mentors. In a 4-month formative
phase, we will partner with a CAB to finalize Ending the HIV Epidemic in Rural Oklahoma (e-HERO)
components to be included in an initial intervention prototype. AIM 2 – To assess feasibility, acceptability,
and preliminary impact of the e-HERO intervention. We will pilot and evaluate the finalized intervention in
rural Oklahoma using a randomized control trial design to mimic a future statewide implementation. We will
recruit rural SMM (n = 100) and AI men (n = 100) between 17-29 years of age. We will use RE-AIM19 to guide
the evaluation, which will entail conducting a convergent mixed-method analysis of surveys (SMM and AI
men), HIV/STI testing records, and exit interviews to assess feasibility, acceptability, and preliminary impact of
the intervention.

## Key facts

- **NIH application ID:** 10457777
- **Project number:** 3U54MD012388-05S2
- **Recipient organization:** NORTHERN ARIZONA UNIVERSITY
- **Principal Investigator:** Julie A. Baldwin
- **Activity code:** U54 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $749,752
- **Award type:** 3
- **Project period:** 2021-09-01 → 2022-09-19

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10457777

## Citation

> US National Institutes of Health, RePORTER application 10457777, Southwest Health Equity Research Collaborative (3U54MD012388-05S2). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10457777. Licensed CC0.

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