# Syndemics, the microbiome, and mucosal inflammation involved in HIV acquisition

> **NIH NIH F32** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2023 · $69,500

## Abstract

Project Summary/Abstract
Background. A Syndemic occurs when harmful social contexts (e.g., poverty and discrimination) fuel
interacting biological and psychological health conditions that increase risk for diseases such as HIV.
Syndemics of poor mental health, substance use, and trauma have shown relationships with sexual risk and
HIV seroconversion among women and sexual minority men (i.e., gay, bisexual, and other men who have sex
with men). However, there is a need for additional research on common biological pathways through which
Syndemics may impact the immune system to amplify risk of HIV acquisition in high priority populations. The
most likely route of HIV infection is through the rectal or cervicovaginal mucosa. Dysbiosis (non-optimal
microbiome composition) and local inflammation are associated with decreased mucosal immunological
capabilities, increasing the risk of HIV acquisition. Mental health, substance use, and risk behaviors have
shown separate relationships to dysbiosis and inflammation. However, no research has modeled these factors
together as a Syndemic and explored the Syndemic correlates of rectal or cervicovaginal dysbiosis and
characteristics of the vaginal/rectal environments associated with decreased mucosal immunity. Methods. This
F32 will involve two approaches: (1) conduct a sub-study that will add psychosocial Syndemic measures to an
ongoing R01 (5R01AI138718-02; PI: Alcaide)
investigating predictors of bacterial vaginosis among women to
examine the relationships among Syndemic factors (e.g., mental health, substance use, trauma) and vaginal
dysbiosis and (2) leverage existing 16S rRNA sequencing data from a recently completed study of 92 HIV-
negative sexual minority men in South Florida recruited in STI clinics to examine the relationship between
Syndemic conditions and rectal dysbiosis (AIDS Healthcare Foundation; PI: Carrico). Through both studies,
essential knowledge will be gained on the relevance of a dysbiotic microbiome as a common pathway
explaining how Syndemic processes could amplify HIV risk in priority populations. Training Plan. Through
hands-on training, didactics, and meetings with a multidisciplinary mentorship team (Carrico, Klatt, Alcaide,
and Safren), the applicant will gain training on psychoneuroimmunology in HIV prevention, with a focus on the
microbiome and mucosal immunology, and obtain exposure to sequencing-based bioinformatics analysis to
bridge the fields of clinical psychology and mucosal immunology. This F32 fellowship application will lay the
groundwork for a K23 proposal to develop and test bio-behavioral interventions targeting Syndemic conditions
to improve mental health, address dysbiosis of the microbiome, and improve mucosal immune functioning
relevant to HIV acquisition in high priority populations. Implications. Findings from this F32 research and
training plan represent an important first step towards an independent research program focusing on biological
mechanisms connect...

## Key facts

- **NIH application ID:** 10683382
- **Project number:** 5F32AI162229-03
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** Emily Mellissa Cherenack
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $69,500
- **Award type:** 5
- **Project period:** 2021-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10683382

## Citation

> US National Institutes of Health, RePORTER application 10683382, Syndemics, the microbiome, and mucosal inflammation involved in HIV acquisition (5F32AI162229-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10683382. Licensed CC0.

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