# Examining Social Determinants of Antiretroviral Adherence Trajectories among African American Adults with HIV

> **NIH NIH F31** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2024 · $41,316

## Abstract

PROJECT SUMMARY/ABSTRACT
Despite the scaling up of evidence-based interventions to End the HIV Epidemic (EHE) in the U.S., several
communities most affected by HIV lag behind the EHE goal of reducing HIV infections by 90% by 2030.
Black/African American (AA) people with HIV (PWH) account for a large proportion of HIV diagnoses in the
U.S. Specifically, AAs represented 42% of all new HIV diagnoses reported in 2019 despite comprising only
13% of the total United States population. Furthermore, AA PWH have poorer outcomes along the entire HIV
care continuum, including a greater number with undiagnosed HIV, poorer linkage to and retention in HIV care,
lower rates of receiving antiretroviral therapy (ART), lower ART adherence rates, and lower likelihood of
achieving viral suppression. While AA PWH with strong community cohesion report positive HIV outcomes
(e.g., high ART adherence, viral suppression), in regions where there is low community cohesion among AA
PWH, these individuals may be overlooked, despite the unique experience of having weaker community
cohesion. As such, it is imperative to focus research efforts on investigating psychosocial determinants of
health among AA PWH with low community cohesion. We have shown that high psychosocial resources
(e.g., resilience, personal mastery, social support) positively influences health outcomes such as medication
adherence, and physical and mental health-related quality of life. Nevertheless, these quantitative-based
studies may not account for the unique, individual experiences of AA PWH who lack strong community
cohesion. Assessing the relationships between psychosocial determinants of health, medication adherence, and
healthcare utilization is critical toward identifying AA PWH most at-risk for poor health outcomes. Accordingly, the
proposed F31 project will follow-up on an initial study of AA PWH in order to: 1) Characterize ART adherence
trajectories and their associations with HIV characteristics among AA PWH in an EHE jurisdiction with low AA
community cohesion; 2) Identify modifiable psychosocial determinants of health associated with ART
adherence trajectories among AA PWH in an EHE jurisdiction with low AA community cohesion; and 3)
Explore qualitative relationships between positive modifiable psychosocial determinants of health (e.g.,
resilience), ART adherence, and healthcare utilization among AA PWH in an EHE jurisdiction with low AA
community cohesion. The proposed research will use advanced qualitative and quantitative research methods
to examine these relationships. The opportunities afforded via this F31 mechanism will facilitate the applicant’s
professional development toward becoming an independent investigator dedicated to researching behavioral
medicine topics such as psychosocial determinants of health outcomes among diverse populations.

## Key facts

- **NIH application ID:** 10932129
- **Project number:** 5F31MH133506-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Vanessa Bianca Serrano
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $41,316
- **Award type:** 5
- **Project period:** 2023-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932129

## Citation

> US National Institutes of Health, RePORTER application 10932129, Examining Social Determinants of Antiretroviral Adherence Trajectories among African American Adults with HIV (5F31MH133506-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10932129. Licensed CC0.

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