Research Microscope Lab

Center for AIDS Intervention Research (CAIR)

Current Research Projects

At any one time, CAIR has several projects in the field, ranging from local projects in Milwaukee to large international projects around the world.

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Increasing PrEP Use in High-Risk Social Networks of African-American MSM in Underserved Low-Uptake Cities

Principal Investigators: Jeffrey Kelly, PhD, and Yuri Amirkhanian, PhD

Funded by the National Institute of Nursing Research (R01-NR017574)

PrEP use remains very low in mid-sized cities across the nation, especially among African American MSM who may be hidden in the community and hard to reach through conventional PrEP awareness campaigns. This research will employ a social network approach for both reaching racial minority MSM in the community and delivering an intervention in which peer network leaders are taught and enlisted to increase awareness, correct misconceptions, reduce stigma, and increase benefit perception and positive attitudes of their network members toward PrEP.

Comparison of Supportive Housing Models for HIV+ and At-Risk Chronically Homeless

Principal Investigator: Julia Dickson-Gomez, PhD

Funded by the National Institute on Drug Abuse (R01-DA038085)

The link between homelessness or housing instability and HIV is clear and indisputable, particularly among those with long or frequent episodes of homelessness who are also likely to suffer from substance use disorders and serious mental illness. Supportive housing—permanent, subsidized housing with supportive services—has been offered as a structural intervention to reduce HIV infection rates and improve health outcomes of HIV-positive persons. The SHOP project uses qualitative and quantitative data to characterize and compare the effectiveness of different types of supportive housing programs on residents’ sexual and injection risk, substance use, ART/treatment adherence, and housing stability, and it evaluates the economic efficiency of at least 20 different supportive housing programs serving over 2000 chronically homeless individuals.

Perceived Immigration Laws' Impact on Hispanic Immigrants' HIV Health Behavior

Principal Investigator: Carol L. Galletly, JD, PhD

Funded by the National Institute on Minority Health and Health Disparities (R01-MD011573)

Along with disproportionate rates of HIV infection, Hispanic immigrants are affected by three important drivers of the US HIV epidemic: disordered alcohol and drug use, intimate partner violence, and reduced rates of HIV testing. This study addresses the knowledge gap. Law and policy scans, key informant interviews, and structured focus groups with Hispanic immigrants living in four US metropolitan areas will be conducted to explore immigrants' experiences with legal barriers and to identify the immigration-related concerns, beliefs, and misconceptions that influence their service utilization.

Longitudinal Predictors of PrEP Use and Adherence Among Young Black MSM

Principal Investigator: Jennifer Walsh, PhD

Funded by the National Institute of Mental Health (R01-MH115764)

To this point, there has been limited PrEP (Pre-exposure prophylaxis) research with young Black MSM. We know very little about the frequency of PrEP termination, gaps in PrEP use, or lapses in prevention-effective adherence among young Black MSM, or about short- and long-term changes in use and adherence for these men. Additionally, it is unclear how changes in PrEP relate to changes in other sexual health and risk behaviors and outcomes, such as number of partners, condom use, serosorting, and STI diagnosis. We also lack information about how use and adherence among young Black MSM may be impacted by structural and psychosocial barriers to PrEP, including issues with health care access, insurance, and providers; low socioeconomic status (SES) and instability in employment, transportation, and housing; poor mental health; substance use; and stigma and negative social norms related to PrEP. Similarly, it is unclear how use and adherence may be influenced by partner and relationship factors, such as the introduction of new partners, the development of committed relationships, perceptions of partner risk, and intimate partner violence (IPV). Studies are necessary to determine which factors are the most important predictors of lapses in PrEP use and adherence for young Black MSM.

Community Intervention for HIV Testing & Care Linkage Among Young MSM in Bulgaria

Principal Investigators: Jeffrey A. Kelly, PhD, and Yuri A. Amirkhanian, PhD

Funded by the National Institute for Child Health and Human Development (R01-HD085833)

Throughout the world, young MSM are disproportionately burdened by HIV infection. Young MSM in low- and middle-income countries often do not seek out HIV testing, are unaware of their HIV+ status, and do not receive early medical care, compromising their health and contributing to downstream disease incidence. This situation is of great concern in post-socialist countries of Eastern Europe, with the stigma of HIV/AIDS and same-sex behavior, ever-increasing HIV epidemics, and the health needs of young MSM rarely acknowledged or addressed. This study, being conducted in Sofia, Bulgaria, seeks to conduct in-depth interviews with young MSM ages 16 to 20 and other key informants to gain an understanding of factors related to HIV testing and barriers and facilitators of testing and medical care. In a second phase of the study, a network intervention to increase regular HIV testing and care linkage among young MSM will be tested.

Social Network Intervention to Engage Community PLH to Enter HIV Medical Care

Principal Investigators: Yuri A. Amirkhanian, PhD, and Jeffrey A. Kelly, PhD

Funded by the National Institute of Mental Health (R01-MH113555) and the Russian Academy of Sciences

Social support is a main determinant of medical care adherence. The intervention to be tested in this research will directly build peer social supports for medical care attendance and adherence. Most prior adherence interventions have involved only clinic-based counseling provided to individual patients. The planned approach is unique because it will extend beyond individual patient counseling to also strengthen social supports for care in the daily lives of PLH.

The approach to be tested is novel because it will intervene with groups of friends who are all HIV+ to strengthen mutual norms, skills, problem-solving, and social supports for entering, remaining, and adhering to HIV medical care. HIV infection is often clustered within social networks of persons who know one another, share the same exposure risks, and face similar care and adherence barriers. The intervention to be tested is aimed at increasing mutual social supports among PLH to help one another attend and adhere to HIV medical care, a promising approach not previously tested.

Social Network Intervention to Engage Out-of-Care PLH into Treatment

Principal Investigators: Yuri A. Amirkhanian, PhD, and Jeffrey A. Kelly, PhD

Funded by The National Institute of Mental Health (R01-MH098729)

Most current approaches for improving care linkage are based on case management, and most adherence interventions studied to date rely on clinic-based, individual-level counseling. The field needs new approaches that can also reach PLH who are not in care and that can strengthen norms among PLH in the community to enter or re-enter, remain, and adhere to treatment. This project develops an intervention that extends beyond current counseling paradigms by strengthening treatment-related norms, motivations, and collective self-efficacy within social networks of PLH in the community. It also trains leaders of the PLH social networks to encourage their personally-known HIV-positive friends to enter and adhere to care.

Healthier Wisconsin Strategic Initiative to Improve Behavioral Health

Principal Investigator: Michelle R. Broaddus, PhD

Funded by the Advancing a Healthier Wisconsin (AHW) Endowment

The Healthier Wisconsin Partnership Program (HWPP) seeks to improve the behavioral health in Wisconsin communities--a person's mental well-being, their ability to function in everyday life, and their concept of self. An Academic Partner Team of CAIR faculty and staff works with 10 selected community coalitions spanning the state of Wisconsin to develop and implement strategies designed to improve some facet of each community's behavioral health. This collaborative effort also seeks sustainability by building the capacity of local communities to continue to serve and improve the behavioral health of their residents.

The Effects of Intersecting Stigmas on PrEP Outcomes for Young Black MSM (Your Health, Your Voice)

Principal Investigator: Katherine Quinn, PhD

Funded by The National Institute of Mental Health (K01-MH112412)

Young Black men who have sex with men (YBMSM) continue to be disproportionately affected by HIV and pre-exposure prophylaxis (PrEP) may be an essential part of combination prevention strategies to curb these disparities Stigma may be a limiting factor in the success of PrEP for YBMSM and this research will examine how intersectional stigma experienced by YBMSM may influence PrEP knowledge and uptake. This study examines the factors that shape YBMSM's engagement with PrEP and findings from the study will inform a tailored PrEP intervention for YBMSM.