# ESTEEM

> **NIH NIH K01** · DUKE UNIVERSITY · 2024 · $159,276

## Abstract

PROJECT SUMMARY
Globally, gay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by HIV
and common mental illnesses, including depression and anxiety. The mental health of GBMSM is directly
affected by chronic exposure to sexual minority stressors, those that uniquely impact sexual minority individuals
via prejudice events, such as enacted stigma and violence, as well as anticipated and internalized stigma and
concealment of one’s sexual orientation. Behavioral interventions that address the multiple mental and sexual
health problems caused by chronic exposure to sexual minority stress among GBMSM are urgently needed. The
goal of this Career Development Award is to expand the candidate’s skillset and prepare him to conduct
independent research on scalable behavioral interventions that integrate mental health and HIV services for
sexual minority individuals in low- and middle-income countries (LMIC). Through a combination of didactic and
applied training and mentorship from leading experts, the candidate will develop expertise in 1) the systematic
adaptation of evidence-based interventions (EBI); 2) implementation science tools for identifying and evaluating
implementation strategies; 3) theory and analysis of mechanisms of change for mental health interventions; and
4) leading culturally appropriate intervention research in LMIC. The candidate will apply the knowledge and skills
gained through this training to conduct a pilot randomized control trial (RCT) in collaboration with Colectivo
Amigos contra el SIDA (CAS), a GBMSM-serving community clinic in Guatemala City with whom he has
extensively collaborated. Specifically, the candidate will adapt the ESTEEM (Effective Skills to Empower
Effective Men) intervention to target pre-exposure prophylaxis (PrEP) uptake for the Guatemalan context and to
identify implementation strategies (Aim 1). ESTEEM is a skills-building Cognitive Behavioral Therapy (CBT)
intervention that was designed to reduce GBMSM’s co-occurring health risks by addressing the underlying
cognitive, affective, and behavioral pathways through which minority stress impairs health; it is effective at
improving mental health and HIV-related behaviors among GBMSM in the US and China. He will then pilot the
adapted intervention with 80 GBMSM to assess preliminary effectiveness on depression, anxiety, and PrEP
uptake, and explore mechanisms of change (Aim 2). Finally, he will assess acceptability, feasibility, and fidelity
of the adapted intervention and implementation strategies for future scale-up in other community clinic settings.
Findings from this research will inform the development of an R01 proposal for a hybrid type 1 implementation-
effectiveness trial to examine effectiveness and implementation sustainability of the scaled-up, adapted
intervention. Together, the training, research, and collaborations outlined in the award will support the testing of
a scalable mental health intervention with t...

## Key facts

- **NIH application ID:** 10839007
- **Project number:** 1K01MH134676-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Dirk Alexander Davis
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $159,276
- **Award type:** 1
- **Project period:** 2024-04-20 → 2024-09-22

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10839007

## Citation

> US National Institutes of Health, RePORTER application 10839007, ESTEEM (1K01MH134676-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10839007. Licensed CC0.

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