R01DA056235

Structural Influences on Methamphetamine Use Among Black Gay and Bisexual Men in Atlanta - Project Summary

Emerging data demonstrates a rise in methamphetamine (meth) use among Black gay, bisexual, and other men who have sex with men (GBMSM). Meth is associated with myriad physical and social harms and has the potential to exacerbate existing health inequities impacting Black GBMSM. Existing meth prevention and treatment interventions do not address the unique social position of Black GBMSM or the related health impacts of structural racism and discrimination (SRD).

Based on our preliminary studies, we hypothesize that four forms of SRD are likely to influence meth use among Black GBMSM: housing discrimination, gentrification, racial and income segregation, and discriminatory LGBT community climate. Additionally, we posit that these forms of SRD operate through housing instability and inadequate service access to increase the risk for meth use among Black GBMSM.

The goal of this project is to generate knowledge that will inform the design of multi-level, culturally congruent structural approaches to prevent meth use and associated harms among Black GBMSM. Our study will be based in Atlanta, Georgia - an ideal setting to examine these questions given the cultural significance for Black Americans, large population of Black GBMSM, and recent SRD-related demographic shifts.

Drawing on the risk environment framework as its theoretical foundation, this study will pursue three specific aims:

1. To examine the impacts of census-tract level measures of SRD on housing instability, service access, and meth use among Black GBMSM in Atlanta.
2. To elicit narratives of meth use, housing instability, service access, and SRD among Black GBMSM.
3. To examine systems of structural influence and develop qualitative causal maps linking various forms of SRD, service access, housing, and meth use among Black GBMSM.

For the first aim, we will recruit N=300 Black GBMSM into a longitudinal cohort study and conduct serial surveys every 6 months over a two-year follow-up period. Additional location and meth use data will be obtained monthly using ecological momentary assessment technology. Individual survey responses will be linked to geolocated census-tract level measures of SRD and service access.

For the second aim, we will conduct a longitudinal qualitative study including in-depth interviews and walking ethnographies with N=40 cohort participants to gather insights on their experiences with SRD, housing, service access, and meth use.

For the third aim, we will use a community-based system dynamics approach to convene a group model building workshop with key stakeholders (N=25), which will lead directly to the development of causal maps that will inform structural interventions.

The proposed research is highly significant because of its potential to inform effective structural strategies for preventing meth use and ameliorating meth-related harms among Black GBMSM.

Emory University

TO SUPPORT BASIC, CLINICAL, TRANSLATIONAL, AND IMPLEMENTATION RESEARCH IN THE FIELD OF SUBSTANCE USE. TO DEVELOP NEW KNOWLEDGE AND APPROACHES FOR THE PREVENTION, DIAGNOSIS, AND TREATMENT OF DRUG USE, MISUSE, AND ADDICTION, DRUG OVERDOSE, AND RELATED HEALTH OUTCOME, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT; INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT; AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) LEGISTLATION IS INTENDED TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT; AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

Atlanta, Georgia 30322 United States

Single Zip Code

Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities (R01 Clinical Trial Optional) (RFA-MD-21-004)

Termination This project grant was reported on the Department of Government Efficiency (DOGE) partial or complete termation list as of its last report October 2025. See All
Amendment Since initial award the total obligations have increased 379% from $724,152 to $3,471,034.