UG3AI176853

Limited Interaction Cohort to Identify Determinants of Viral Suppression in MSM and Transfeminine Individuals Living with HIV: A Multilevel Approach - Abstract

For people living with HIV (PLWH), achieving and maintaining viral suppression has critical benefits for their health and for reducing the risk of transmitting HIV to others. Viral suppression is thus a critical cornerstone of the US program to end HIV. However, over a third of people in the US living with HIV do not have a suppressed viral load.

Some groups, including younger people and Black people, have lower levels of viral suppression. Although transfeminine people (TFP) have shown rates of viral suppression comparable to other groups, there is ample evidence that they experience a multitude of barriers to sustaining viral suppression, including multiple forms of stigma and structural barriers to accessing culturally appropriate care.

In addition, there are wide racial disparities in HIV care among transgender communities, with Black TFP experiencing some of the lowest levels of viral suppression. A deep understanding is required of the circumstances that surround gaining, sustaining, or losing viral suppression.

Most research to date has focused on individual factors associated with viral suppression status. This approach is limited in that it restricts the consideration of the causes of lack of viral suppression to individual characteristics or behaviors, and misses the broader contexts – stigma, discrimination, lack of health coverage, distance to healthcare providers, and structural racism – that shape the risk of PLWH for losing viral suppression.

Further, understanding these multilevel predictors of loss of viral suppression is required to develop interventions that are responsive to the circumstances that shape risks for remaining or becoming unsuppressed. Thus, we propose to enroll and follow a cohort of PLWH – both MSM and TFP – to observe the patterns of gaining, sustaining, or losing viral suppression, and to develop information that can be used to inform the development of new interventions to support ongoing engagement in HIV care and viral suppression.

Drawing on over a decade of experience in recruiting and retaining sexual and gender minority people in limited-interaction research studies, we will develop nuanced data about the unique factors that shape viral suppression or lack thereof in different critical groups, including Black MSM and TFP, and younger MSM, that are inequitably impacted by lack of viral suppression.

Emory University

TO ASSIST PUBLIC AND PRIVATE NONPROFIT INSTITUTIONS AND INDIVIDUALS TO ESTABLISH, EXPAND AND IMPROVE BIOMEDICAL RESEARCH AND RESEARCH TRAINING IN INFECTIOUS DISEASES AND RELATED AREAS, TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS. TO ASSIST PUBLIC, PRIVATE AND COMMERCIAL INSTITUTIONS TO CONDUCT DEVELOPMENTAL RESEARCH, TO PRODUCE AND TEST RESEARCH MATERIALS, TO PROVIDE RESEARCH SERVICES AS REQUIRED BY THE AGENCY FOR PROGRAMS IN INFECTIOUS DISEASES, AND CONTROLLING DISEASE CAUSED BY INFECTIOUS OR PARASITIC AGENTS, ALLERGIC AND IMMUNOLOGIC DISEASES AND RELATED AREAS. PROJECTS RANGE FROM STUDIES OF MICROBIAL PHYSIOLOGY AND ANTIGENIC STRUCTURE TO COLLABORATIVE TRIALS OF EXPERIMENTAL DRUGS AND VACCINES, MECHANISMS OF RESISTANCE TO ANTIBIOTICS AS WELL AS RESEARCH DEALING WITH EPIDEMIOLOGICAL OBSERVATIONS IN HOSPITALIZED PATIENTS OR COMMUNITY POPULATIONS AND PROGRESS IN ALLERGIC AND IMMUNOLOGIC DISEASES. BECAUSE OF THIS DUAL FOCUS, THE PROGRAM ENCOMPASSES BOTH BASIC RESEARCH AND CLINICAL RESEARCH. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM EXPANDS AND IMPROVES PRIVATE SECTOR PARTICIPATION IN BIOMEDICAL RESEARCH. THE SBIR PROGRAM INTENDS TO INCREASE AND FACILITATE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATES AND FOSTERS SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. RESEARCH CAREER DEVELOPMENT AWARDS SUPPORT THE DEVELOPMENT OF SCIENTISTS DURING THE FORMATIVE STAGES OF THEIR CAREERS. INDIVIDUAL NATIONAL RESEARCH SERVICE AWARDS (NRSAS) ARE MADE DIRECTLY TO APPROVE APPLICANTS FOR RESEARCH TRAINING IN SPECIFIED BIOMEDICAL SHORTAGE AREAS. IN ADDITION, INSTITUTIONAL NATIONAL RESEARCH SERVICE AWARDS ARE MADE TO ENABLE INSTITUTIONS TO SELECT AND MAKE AWARDS TO INDIVIDUALS TO RECEIVE TRAINING UNDER THE AEGIS OF THEIR INSTITUTIONAL PROGRAM.

93.855 - Allergy and Infectious Diseases Research

National Institute of Allergy and Infectious Diseases (NIAID) [HHS - NIH]

Atlanta, Georgia 30322 United States

Single Zip Code

Limited Interaction Targeted Epidemiology: Viral Suppression (LITE-VS) (UG3/UH3 Clinical Trial Optional) (RFA-AI-22-024)

Termination This cooperative agreement was reported as terminated by the Department of Government Efficiency (DOGE) in July 2025. See All
Amendment Since initial award the End Date has been shortened from 04/30/25 to 03/21/25 and the total obligations have increased 57% from $2,510,861 to $3,953,069.