# Optimizing Study Design to Test a Community-level Intervention to Reduce Intersectional Stigma and Increase HIV Testing and Prevention among African-American/Black MSM

> **NIH NIH R34** · CITY COLLEGE OF NEW YORK · 2020 · $241,541

## Abstract

ABSTRACT
Increasing access to and uptake of consistent HIV testing and biomedical prevention is critical to ending the
epidemic in the United States (US) among gay, bisexual and other men who have sex with other men (MSM)1.
This is particularly true for urban, African-American or Black MSM, who are disproportionately affected by
HIV/AIDS in the US2-4 and would thus benefit from consistent testing, which is the gateway to treatment and
prevention. NYC is the metropolitan area in the US with the largest number of newly diagnosed HIV infections
among MSM and 89-94% of all people living with HIV/AIDS (PLWHA) in the US reside in urban areas. HIV
stigma, PrEP/PEP stigma and homophobia are key barriers to HIV testing and prevention. Intersectional HIV-
related stigmas and homophobia may be especially significant barriers to HIV testing and prevention among
African-American/Black MSM, who test less often and are more likely to live with undiagnosed HIV/AIDS
compared with white MSM. Few interventions have been developed and tested to reduce intersectional HIV
stigmas and homophobia simultaneously or at the community level, particularly for African-American/Black MSM.
One exception, designed and evaluated by study team leads is CHHANGE (Challenge HIV/AIDS Stigma &
Homophobia and Gain Empowerment), a community-level, theory-based, anti-stigma and -homophobia
intervention designed for African-American urban neighborhoods with high HIV prevalence. Here we propose to
adapt this community-level intervention to include a focus on reducing PrEP/PEP and testing stigmas, as well
as racism, to increase testing and PrEP/PEP uptake among African-American MSM living in urban areas. In
Phase 1, we will use group model building, a systems science method, to identify causal pathways and other
features of multiple levels of the community environment to inform the adaptation of CHHANGE. In Phase 2, we
will adapt the intervention applying principles of design thinking and results will be concept tested. In this phase
we will also identify optimal study design features for a large-scale trial of the resultant community-level
intervention. In Phase 3, we will pilot test the intervention, including aspects of the optimized study design, in a
matched-community approach. The final result will be an intervention to reduce intersectional HIV, PrEP/PEP,
testing stigmas and homophobia, in the context of racism, and the planning required to test the intervention using
a rigorous design at scale. Results will fill a gap in the prevention science evidence base around interventions to
increase HIV testing and PrEP/PEP use among populations most at risk for HIV.

## Key facts

- **NIH application ID:** 9990853
- **Project number:** 5R34MH121295-02
- **Recipient organization:** CITY COLLEGE OF NEW YORK
- **Principal Investigator:** Victoria Frye
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $241,541
- **Award type:** 5
- **Project period:** 2019-08-07 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990853

## Citation

> US National Institutes of Health, RePORTER application 9990853, Optimizing Study Design to Test a Community-level Intervention to Reduce Intersectional Stigma and Increase HIV Testing and Prevention among African-American/Black MSM (5R34MH121295-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9990853. Licensed CC0.

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