# The role of resilience in addressing racial disparities in adverse HIV-related outcomes

> **NIH NIH R01** · BROWN UNIVERSITY · 2020 · $559,735

## Abstract

Project Summary/Abstract
 In the United States (U.S.), African Americans/Blacks (AAs) are the racial/ethnic group most adversely
impacted by the HIV epidemic. As such, one of the goals of the White House National HIV/AIDS Strategy is to
permanently reduce long-standing health disparities in HIV disease. Lower HIV clinic attendance and
suboptimal antiretroviral therapy (ART) use (i.e., initiation, modification, and adherence) by AAs are likely the
main mediators of continually worse HIV virologic responses among AAs compared to Caucasians. However,
despite the development and implementation of interventions targeting many known individual-level risk and
protective factors for clinic attendance and ART use, substantial racial disparities remain. Persistent disparities
may be due, in part, to the adverse conditions that characterize the high risk neighborhood environments (e.g.,
socioeconomic deprivation and violence) in which HIV+ AAs disproportionately reside. However, despite such
adversities some AAs demonstrate resilience (i.e., displaying positive behaviors/outcomes despite adversity)
which may be critical to reducing persistent racial disparities. Compared to the risk environment, individual,
interpersonal, and neighborhood resilience represent novel and more malleable intervention targets for
reducing persistent disparities. Unfortunately, resilience remains understudied in the HIV literature, perhaps
due to the absence of a reliable and valid resilience measure for HIV+ adults that captures all resilience
components. The objective of the proposed research is to develop a reliable and valid measure of individual,
interpersonal, and neighborhood resilience; to document its psychometric properties; and to assess
longitudinally whether higher resilience facilitates positive HIV outcomes among HIV+ AAs by the level of the
risk environment. Data on HIV+ AAs enrolled in the UNC CFAR HIV Clinical Cohort and the UAB 1917 Clinic
Cohort will be used for the proposed study. Specifically, this study aims to (1) use advanced concept mapping,
which is a mixed methods approach, to generate items that capture all components of resilience; (2) perform
psychometric testing of concept mapping items to create a reliable and valid resilience measure that includes
all components of resilience; (3a) examine whether resilience and non-resilience individual-level factors (e.g.,
alcohol/drug use, mental illness, and health insurance) are prospectively associated with HIV outcomes (e.g.,
clinic attendance, ART adherence, and virologic suppression) by the level of the neighborhood risk
environment; and (3b) assess for interactions between resilience and non-resilience individual-level factors by
the level of the risk environment. This study responds to the critical need to develop a multi-component
resilience measure for HIV+ adults and to establish whether resilience facilitates positive HIV outcomes among
HIV+ AAs. Our important findings may lead to the development a...

## Key facts

- **NIH application ID:** 9936346
- **Project number:** 5R01MH112386-04
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Chanelle Je'net Howe
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $559,735
- **Award type:** 5
- **Project period:** 2017-08-25 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9936346

## Citation

> US National Institutes of Health, RePORTER application 9936346, The role of resilience in addressing racial disparities in adverse HIV-related outcomes (5R01MH112386-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9936346. Licensed CC0.

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