# PS24-063, MARI:  Understanding Medical Mistrust to Inform Adaptation of an HIV Prevention Intervention for Latinx Sexual and Gender Minorities

> **NIH ALLCDC U01** · NORTHWESTERN UNIVERSITY · 2024 · $349,996

## Abstract

PROJECT SUMMARY
In 2021, a Centers for Disease Control and Prevention HIV surveillance report indicated that Latinx
communities accounted for 29% of new HIV diagnoses but comprised only 19% of the US population. In that
same year, male-to-male sexual contact accounted for 67% of all new HIV diagnoses. These disparities in HIV
cases have led to the designation of Latinx sexual and gender minority (LSGM) groups as priority populations
in the Ending the HIV Epidemic (EHE) Plans, both nationally and locally, and in the Getting to Zero-Illinois
Plan. Reasons for high HIV incidence and prevalence within LSGM communities are multifaceted and
compounded by intersecting sexual and ethnic/racial identities. As preliminary work by our team and others
has shown, lack of trust in health systems may reduce engagement and retention in HIV care and prevention
services, including uptake and adherence to HIV pre-exposure prophylaxis (PrEP). Moreover, social and
structural factors (e.g., racism, homophobia, stigma) may reinforce and perpetuate medical mistrust and
misinformation in LSGM communities. Unfortunately, little is known about the mechanisms of medical mistrust
and misinformation, particularly from the perspective of LSGM community members, and most research has
focused on individual-level behavioral interventions, thereby neglecting to target medical mistrust as a social
determinant of health. We believe that community- and structural-level interventions are needed to dismantle
medical mistrust and misinformation, and to improve the state of HIV prevention, particularly for engagement in
PrEP healthcare among LSGM. Leveraging our longstanding collaborations with local leaders in Latinx-
focused research and service provision, including partnerships with our local health department, the long-term
goal of this research is to prevent new HIV transmissions among LSGM by improving engagement in HIV
prevention services, including PrEP. To accomplish this goal, we propose the following mixed methods
research aims: 1) understand medical mistrust and misinformation and their impact on PrEP healthcare
engagement (i.e., PrEP Stages of Change) from the perspectives of LSGM, HIV healthcare providers, and
social service providers through interviews and a community-level survey; 2) utilize the ADAPT-ITT framework
to select and tailor a CDC-designated, evidence-based intervention (EBI) for LSGM with a focus on medical
mistrust, medical misinformation, and PrEP healthcare engagement using formative research, focus groups
with LSGM, input from our community advisory board (The Chicago Queer Latina/x/o Collaborative), and
feedback from expert consultants; and 3) conduct an implementation feasibility trial by leveraging
implementation science frameworks (e.g., CFIR) to optimize intervention delivery, assess the acceptability of
the adapted EBI for LSGM, and explore our capacity to collect preliminary outcomes using the RE-AIM
framework. This research is in alignment with the...

## Key facts

- **NIH application ID:** 11011067
- **Project number:** 1U01PS005281-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** GEORGE JESUS GREENE
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $349,996
- **Award type:** 1
- **Project period:** 2024-06-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11011067

## Citation

> US National Institutes of Health, RePORTER application 11011067, PS24-063, MARI:  Understanding Medical Mistrust to Inform Adaptation of an HIV Prevention Intervention for Latinx Sexual and Gender Minorities (1U01PS005281-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/11011067. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*