# Piloting an App-Based Just-in-Time Adaptive Ecological Momentary Intervention to Reduce Substance Use among HIV-Positive Sexual MinorityMen

> **NIH NIH R34** · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · 2022 · $263,775

## Abstract

ABSTRACT
In the United States (U.S.), sexual minority men (SMM) are disproportionately affected by HIV compared to
the general population. For this population, intersectional sexual minority and HIV-related stress add to
general life stressors to increase health risks. Research demonstrates a bidirectional association between
psychosocial stress and physiological HIV progression, including CD4 decline and increased viral load.
However, stress is not only associated with HIV progression, it is also linked to transmission risk behaviors
(TRB), such as medication non-adherence and substance use. Substance use is a particularly important risk
factor for HIV transmission. In addition to injection drug use risk, recreational use is associated with sexual
TRB and increased risk for HIV among SMM. As such, interventions which target stress responses may be
particularly useful for HIV risk reduction among substance using SMM (SUSMM) living with HIV (LWH).
Positive affect and mindfulness-based interventions have shown promise in reducing stress across various
populations living with chronic illness, including HIV. However, despite the fact SMM represent a majority of
the U.S. HIV+ population and SUSMM in particular experience prominent, unique stressors, few studies have
examined these interventions and their potential health benefits for SUSMM-LWH. This R34 application builds
on our pilot work in the areas of positive affect induction and mindfulness as potential intervention approaches
to improve HIV-related health outcomes among SMM-LWH. In our proof-of-concept pilot (n=22), we adapted
an integrative positive affect and mindfulness intervention for mobile app delivery. Our pilot findings suggest
the mobile app is an acceptable and feasible delivery platform for SMM-LWH. However, SUSMM-LWH
experience unique stressors (e.g. substance use stigma), and experience additional barriers to intervention.
While the in-person version of this intervention demonstrated efficacy in a randomized control trial with
SUSMM-LWH, we have yet to assess acceptability and feasibility for delivering it via mobile app with this
population. We propose to first pilot our existing app-based intervention with a sample of SUSMM-LWH to
gather community feedback, which will be used to tailor the app design and intervention content for the target
population. In Phase 2, we will pilot a factorial optimization trial to assess acceptability and feasibility of two
additional features that may enhance our just-in-time-adaptive ecological momentary intervention (EMI) design
and delivery: (1) random craving prompts throughout the day in addition to a fixed, once-daily survey and (2) a
smart watch in addition to our phone-based EMI. Data from this formative pilot will inform the development of
subsequent research grant application to conduct a larger factorial optimization trail to assess how each of
these new features (and their combination) impact the effectiveness of our intervention. This ...

## Key facts

- **NIH application ID:** 10793250
- **Project number:** 7R34DA053999-04
- **Recipient organization:** RUTGERS BIOMEDICAL AND HEALTH SCIENCES
- **Principal Investigator:** Brett M Millar
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $263,775
- **Award type:** 7
- **Project period:** 2021-09-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10793250

## Citation

> US National Institutes of Health, RePORTER application 10793250, Piloting an App-Based Just-in-Time Adaptive Ecological Momentary Intervention to Reduce Substance Use among HIV-Positive Sexual MinorityMen (7R34DA053999-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10793250. Licensed CC0.

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