LGBTQ+

Advocacy, Research & Health Welcome to the UCLA Center for
ABOUT

Our
Vision

ABOUT US

The UCLA Center for LGBTQ+ Advocacy, Research & Health, or C-LARAH (LARAH is derived from the Latin word “hilaris,” meaning cheerful) is dedicated to improving the health and well-being of sexual and gender minorities.  We are committed to sharing our expertise in public health, including epidemiological methods, developing and testing bio-behavioral interventions, education and research training, program design and analysis, health policy initiatives and implementation science.

We work directly with members of the LGBTQ+ community and are able to draw upon expansive local and national relationships with state and local public health departments, academic researchers, healthcare providers, community-based organizations, consumer groups, advocacy foundations, and funding agencies.

Our familiarity and experience working with the LGBTQ+ community and allied organizations well-equips us to inform policymakers of the most effectual ways to reach members of this historically marginalized population and how to serve them holistically through all social determinants of health and justice.

Mission Statement

To maintain an interdisciplinary, research-driven, evidence-based platform used to carry out public policy initiatives that improve the health and social well-being of sexual and gender minorities. We engage our local and national community, as well as global partners, through cross-culturally informed scholarship, advanced academic training, and civic advocacy. We are deeply invested in intercultural competence and the importance of intersectionality of identities and lived experience; we are committed to conducting research to advance LGBTQ+ racial/ethnic health disparities.

DR. MATTHEW J. MIMIAGA

DIRECTOR’S MESSAGE

“Sexual and gender minorities experience significant health disparities as a result of myriad overlapping social-ecological, cultural, and political factors. Research findings by our team and others show that LGBTQ+ populations have a higher prevalence and incidence of life-threatening physical conditions, mental health problems, substance use, and chronic and infectious disease risk. Despite recent advances to civil rights protections, LGBTQ+ individuals continue to experience elevated rates of stigma, discrimination and violence. They are disproportionately represented among homeless people—often a result of estrangement from their families—and face significant barriers to accessing health care, prevention and treatment services. Now is the time for academic institutions to bolster the unwavering efforts at progress made by the LGBTQ+ movement. We must bridge health, research, and training measures to curtail socioeconomic inequities and close the health disparity gap. We have spent the past four decades advocating for LGBTQ+ rights—indeed, for their basic humanity—and we must continue to demand accountability in shaping and enforcing policies that best serve our community. It is extremely rewarding to be involved in work that improves the lives of historically marginalized members of society. I’m excited about the impact C-LARAH has had and will continue to have in training future generations of scientists interested in conducting LGBTQ+ public health and clinical research and ensuring that all sexual and gender minorities, and particularly those of us who are trans, racial/ethnic minorities and living with HIV, belong everywhere and can live openly and authentically, and be healthy.”

PEOPLE

The
Team

  • CENTER FACULTY, STAFF & STUDENTS
  • UCLA Affiliates
  • Main Collaborators
Matthew Mimiaga, ScD, MPH, MA

Matthew Mimiaga, ScD, MPH, MA

Center Director, Professor
CENTER FACULTY, STAFF & STUDENTS Faculty
Lisa Kuhns, PhD, MPH

Lisa Kuhns, PhD, MPH

Associate Professor
Main Collaborators
Eun Kwak

Eun Kwak

Research Coordinator
CENTER FACULTY, STAFF & STUDENTS Staff
Jaclyn White-Hughto, PhD, MPH

Jaclyn White-Hughto, PhD, MPH

Assistant Professor
Main Collaborators
Katie Biello, PhD, MPH

Katie Biello, PhD, MPH

Associate Professor
Main Collaborators
Roger Detels, MD, MS

Roger Detels, MD, MS

Distinguished Research Professor of Epidemiology
UCLA Affiliates
Robert Garofolo, MD, MPH

Robert Garofolo, MD, MPH

Professor
Main Collaborators
Steven Safren, PhD

Steven Safren, PhD

Professor
Main Collaborators
Sung-Jae Lee, PhD, MPH

Sung-Jae Lee, PhD, MPH

Professor-in-Residence
UCLA Affiliates
Carlos Santos, PhD, MEd

Carlos Santos, PhD, MEd

Associate Professor
UCLA Affiliates
Gifty Ntim, MD

Gifty Ntim, MD

Physician
UCLA Affiliates
Ayako Miyashita Ochoa, JD

Ayako Miyashita Ochoa, JD

Adjunct Faculty of Social Welfare
UCLA Affiliates
Chandra Ford, PhD, MPH, MLIS

Chandra Ford, PhD, MPH, MLIS

Professor of Community Health Sciences
UCLA Affiliates
Dallas Swendeman, PhD, MPH

Dallas Swendeman, PhD, MPH

Associate Professor In-Residence
UCLA Affiliates
Amy Ritterbusch, PhD

Amy Ritterbusch, PhD

Assistant Professor
UCLA Affiliates
Janet Pregler, MD

Janet Pregler, MD

Director
UCLA Affiliates
Jessica Bernacki, PhD

Jessica Bernacki, PhD

Psychologist
UCLA Affiliates
Amy Weimer, MD

Amy Weimer, MD

Physician
UCLA Affiliates
Ronald Brooks, PhD

Ronald Brooks, PhD

Assistant Professor
UCLA Affiliates
Ilan Meyer, PhD

Ilan Meyer, PhD

Distinguished Senior Scholar of Public Policy
UCLA Affiliates
Gladys Ng, MD, MPH

Gladys Ng, MD, MPH

Assistant Clinical Professor
UCLA Affiliates
Ian Holloway, PhD, LCSW, MPH

Ian Holloway, PhD, LCSW, MPH

Professor of Social Welfare
UCLA Affiliates
Bianca D.M. Wilson, PhD

Bianca D.M. Wilson, PhD

Senior Scholar of Public Policy
UCLA Affiliates
Elizabeth Ollen, PhD, MA

Elizabeth Ollen, PhD, MA

Clinical Psychologist
UCLA Affiliates
Brandon Ito, MD, MPH

Brandon Ito, MD, MPH

Assistant Clinical Professor
UCLA Affiliates
Andy Cofino, MA

Andy Cofino, MA

Director
UCLA Affiliates
Jennifer Olson, MBA

Jennifer Olson, MBA

Project Director
CENTER FACULTY, STAFF & STUDENTS Staff
Liz Lopez, MA

Liz Lopez, MA

Assistant Director
UCLA Affiliates
Keyanna Taylor, MPH

Keyanna Taylor, MPH

PhD student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
Yuhang Qian, MSc

Yuhang Qian, MSc

PhD student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
David Vargas Ayala

David Vargas Ayala

MPH student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
Candelaria Garcia

Candelaria Garcia

MPH student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
Jimmy Hua

Jimmy Hua

MPH student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
Hayden Mountcastle

Hayden Mountcastle

MPH student, Epidemiology, UCLA
CENTER FACULTY, STAFF & STUDENTS
Juan Solis

Juan Solis

MPH student, Community Health Sciences, UCLA
CENTER FACULTY, STAFF & STUDENTS
Marco Hidalgo, PhD

Marco Hidalgo, PhD

ASSOCIATE PROFESSOR AND LICENSED CLINICAL PSYCHOLOGIST
CENTER FACULTY, STAFF & STUDENTS
Charles Doran

Charles Doran

Administrative Specialist, MWCCS
CENTER FACULTY, STAFF & STUDENTS
John Oishi, MSPH

John Oishi, MSPH

Project Director, MWCCS
CENTER FACULTY, STAFF & STUDENTS
Daniel Cheng, BS

Daniel Cheng, BS

Study Coordinator, MWCCS
CENTER FACULTY, STAFF & STUDENTS
Maxwell C. Hechter, MPH

Maxwell C. Hechter, MPH

Study Coordinator, MWCCS
CENTER FACULTY, STAFF & STUDENTS
Nicole Hadjioannou, MPH

Nicole Hadjioannou, MPH

Clinical Outcomes Follow-up Study Coordinator, MWCCS
CENTER FACULTY, STAFF & STUDENTS
Rey Soto

Rey Soto

Data Manager, MWCCS
CENTER FACULTY, STAFF & STUDENTS
Najib Aziz, MD

Najib Aziz, MD

Lab Supervisor/Co-I, MWCCS
CENTER FACULTY, STAFF & STUDENTS
RESEARCH

Our Projects

PrEPare for Work

PrEPare for Work

PrEPare for Work

Optimizing PrEP Uptake & Adherence Among MSW Using a 2-Stage Randomization Design, 2016-2020

MPI: Mimiaga, Biello & Chan

National Institute of Mental Health (R34MH110369-01 + diversity supplement)
we designed the “PrEPare for Work” package that includes two components: 1) peer-led strengths-based case management (SBCM) for PrEP uptake, and 2) a counseling and problem-solving PrEP adherence intervention that addresses individualized barriers to optimal use. We conducted a pilot RCT of “PrEPare for Work” using a two-stage randomization design. Stage 1: 106 MSW were equally randomized to receive either the peer-led SBCM or standard of care (i.e., passive referrals only) for engagement with our existing PrEP clinic. Stage 2: Those from stage 1 who initiated PrEP (n~44), regardless of stage 1 randomization condition, were equally randomized to either the “PrEPare for Work” adherence intervention or standard of care comparison condition.
Findings provide evidence of feasibility and acceptability, and demonstrate initial efficacy for PrEP uptake and adherence.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper: Under Review
Secondary Outcome Paper 1
Secondary Outcome Paper 2

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Selected Completed Studies
Project IMPACT

Project IMPACT

Project IMPACT

Name of Grant

Integrated behavioral activation and HIV risk reduction counseling for MSM with stimulant abuse

Funding Source

National Institute on Drug Abuse (R01DA042805-01A1)

Pls

Mimiaga and Safren

Background

Problematic stimulant (i.e., crystal methamphetamine [meth], cocaine, crack) use is a prevalent and treatment refractory problem in some men who have sex with men (MSM), and highly predictive of both condomless sex and HIV infection. This application builds off of our successful formative and pilot work and is designed to assess the efficacy, in a two-arm randomized controlled trial (RCT), of Project IMPACT—a behavioral intervention to reduce high-risk sex in MSM with stimulant use disorder who are at risk for HIV acquisition. The intervention incorporates risk reduction counseling with behavioral activation (BA) to help participants re-engage in enjoyable and meaningful life activities not involving drugs. Behavioral activation is an evidence-based, easy to administer, cognitive behavioral approach to treat depression and other problems that focuses on helping individuals reengage in activities that generate feelings of enjoyment (i.e., mastery and pleasure). We chose this strategy for MSM with stimulant use disorder because our formative work revealed that MSM who abuse stimulants report becoming unable to enjoy activities that they previously enjoyed as a result of ongoing stimulant use. This lack of enjoyment (i.e., anhedonia, one of the core symptoms of depression) in activities that do not involve stimulant use or sex contributes to the continued use of stimulants and potentially condomless sex (not protected by PrEP). We developed and openly field-tested this intervention in a NIDA-funded nonrandomized pilot (R03 DA023393), and, subsequently, conducted a NIDA-funded pilot RCT (R34 DA031028) of this intervention compared to a standard of care condition (SOC) and found it to be feasible, acceptable, and successful at reducing both condomless anal sex and stimulant use. The proposed efficacy trial is the next logical step in this program of research.

Conceptual Model

The conceptual model focuses on anhedonia—a loss of interest in previously enjoyed activities—as a consequence of continued stimulant use. Accordingly, for individuals with stimulant use disorder, drug use becomes the central means for obtaining enjoyment, and hence BA will augment HIV risk reduction counseling.

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Active Studies
PrEP N’ Shine

PrEP N’ Shine

PrEP N' Shine

Name of Grant

Developing and pilot testing an adaptive intervention to facilitate PrEP uptake and maximize PrEP adherence among at-risk transgender women.

Funding Source

National Institute of Mental Health (R34 MH122499-01A1)

Pls

Mimiaga and Biello

Background

PrEP has dramatically changed the promise of HIV prevention, particularly for transgender women (TGW) who are among the highest risk group for HIV in the U.S. While PrEP reduces HIV acquisition by >90% with adequate adherence, TGW face multiple transgender-specific barriers with PrEP access, uptake, adherence, and retention. The PIs have longstanding partnerships with community-based organizations that provide gender-affirming services to this group in Providence, RI and operate one of the first clinical PrEP programs in the U.S., led by our team at Miriam Hospital/Brown University.

Conceptual Model

The intervention package (“PrEP N’ Shine”) is based on over a decade of formative and programmatic work grounded in the social-cognitive and contextual realities of high-risk TGW, and as such, the conceptual model underlying the intervention draws on Empowerment Theory and Social Cognitive Theory. The “PrEP N’ Shine” package includes two separate but complementary interventions: 1) peer-led, strengths-based case management (SBCM) for PrEP linkage and uptake; and 2) a resource-efficient, adaptive “stepped-care” technology and counseling intervention to optimize PrEP adherence. “Stepped-care” is a healthcare delivery model in which the least resource intensive part of an intervention is delivered first, and only those who continue to have problems adhering to PrEP receive the more resource-intensive components.

Approach

Initially, we will continue to work with community members and a community advisory board to further inform the “PrEP N’ Shine” intervention (Aim 1a). Next, we will iteratively refine the intervention, in an open pilot trial with exit interviews, with up to 10 TGW to enhance participant acceptability, feasibility of study procedures, and finalize study protocols (Aim 1b). For Aim 2, we will conduct a pilot randomized controlled trial (RCT) of the “PrEP N’ Shine” intervention using a 2-stage randomization design: For Stage 1, we aim randomize 106 TGW who are candidates for PrEP to receive either the peer-led SBCM for PrEP linkage and uptake or standard of care (SOC; i.e., PrEP referrals only). For Stage 2, those from Stage 1 who initiate PrEP (n~44), regardless of their randomization condition, will then be equally re-randomized to either the resource-efficient, adaptive “stepped-care” intervention to optimize PrEP adherence (initially TGW in this arm will receive daily 2-way gender-affirming text message reminders, and then those continuing to have poor adherence will receive the 4 more intensive counseling sessions) or the SOC condition. Primary outcomes include PrEP linkage and uptake; PrEP adherence (both biomedical and self-report assessments); and retention in PrEP care.

Innovation

The “PrEP N’ Shine” intervention is highly scalable and sustainable in the real world, as it takes into account the “future of PrEP access,” while simultaneously 1) addressing the barriers surrounding access, 2) aiding in navigating linkage, and for those who need it, both insurance and free PrEP program options, and 3) reducing barriers to, and building skills to support, PrEP adherence (once TGW have access to PrEP).

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Active Studies
Positive STEPS

Positive STEPS

Positive STEPS

Name of Grant

Adaptive intervention strategies trial for strengthening adherence to antiretroviral HIV treatment among youth

Funding Source

National Institute of Nursing Research (1R01NR017098-01)

Pls

Mimiaga and Garofalo

Background

A significant and growing population of young people are acquiring and living with HIV in the US. An estimated >12,200 adolescents were diagnosed with HIV infection in 2010, a 22% increase since 2008(1). Although HIV can be managed with ongoing antiretroviral therapy (ART), exceptionally high levels of adherence are required. Our recently published systematic literature review found that of the 21 articles published that reported data on medication adherence in HIV infected adolescents, seven described pilot interventions to enhance medication adherence; and only two utilized education / counseling sessions to promote adherence skills-building – a component that has shown to be necessary to improving adherence among HIV-infected adults. To our knowledge, there are no demonstrated efficacious ART adherence interventions for HIV infected adolescents to date. This is particularly concerning given that overall rates of adherence among adolescents is generally suboptimal.

Overview of Proposal

This proposal is culmination of 6 years of formative work with this population, including conducting two pilot randomized controlled trials (RCT). The current study is to test the efficacy of a stepped-care “adaptive” ART adherence intervention (“Positive STEPS”) for HIV infected adolescents, ages 16 to 24. Stepped care is a healthcare delivery model in which the least resource intensive part of an intervention is delivered first, and only those who do not improve then receive the high intensity, more resource intensive part of an intervention.

Conceptual Model

The conceptual model is based on our formative work that led to the development of a theoretically-driven intervention curriculum (“Positive STEPS”), grounded in the social and contextual realities of HIV infected adolescents. Our intervention begins with 2-way daily text messaging aimed at improving ART adherence. For many adolescents (over 1/3 from our pilot RCT), text messaging is not sufficient to overcome the barriers to ART adherence. These individuals will then also receive the more intensive component based on general principles of cognitive-behavioral therapy. Informational, problem solving, and cognitive-behavioral “steps” are addressed over 5, in-person, intervention-counseling sessions (incorporating digital video vignettes that are specific to the adherence challenges faced by adolescents).

Overview of Research Plan

192 HIV infected adolescents, aged 16 to 24, and prescribed ART will be recruited in two major U.S. cities with excellent access to and research experience with the population. Participants will be equally randomized to: (1) “Positive STEPS” – a stepped care, adherence intervention with integrated technology and counseling; or (2) Standard of Care comparison group. Participants will be followed for one-year post-randomization. The primary outcomes are improvements in measures of ART adherence (i.e., Wisepill, HIV viral load, and self-report); secondary outcomes include improvements in CD4 cell count, HIV symptoms, and quality of life.

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Active Studies
MWCCS

MWCCS

MWCCS

Name of Grant

Los Angeles CRS for the MACS/WIHS combined cohort study

Funding Source

National Heart, Lung, and Blood Institute (U01 HL 146333)

Pls

Detels and Mimiaga

Background

The Multicenter AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WIHS) Combined Cohort Study (MACS/WIHS-CSS) is a collaborative research effort that aims to understand and reduce the impact of chronic health conditions—including heart, lung, blood, and sleep (HLBS) disorders—that affect people living with HIV. For decades, the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health (NIH), has supported the separate MACS and WIHS cohort studies. MACS was a study of gay and bisexual men, while WIHS was a study of women who had other risk factors for HIV. The Multicenter AIDS Cohort Study is the first (1984) and largest study specifically created to examine the natural history of AIDS. This study involves 7,000+ gay and bisexual men nationwide; the UCLA site is the largest. The study has produced ~1500 papers and contributed landmark findings on the epidemiology of HIV infection and the virologic, immunologic, psychosocial, clinical and neurologic aspects of the disease. In 2019, the NHLBI became the primary steward of the new MACS/WIHS-CSS. The Combined Cohort Study includes continuing participants from the earlier studies. We are also recruiting new participants with a special focus on hard-hit population groups, such as Black/African American and Hispanic/Latinx men and women and residents of southern states.

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Active Studies
Life Skills Mobile

Life Skills Mobile

Life Skills Mobile

Name of Grant

Digital, Limited Interaction Efficacy Trial of LifeSkills Mobile to Reduce HIV Incidence in Young Transgender Women

Funding Source

National Institute of Allergy and Infectious Diseases (1U01AI156875-01)

Pls

Mimiaga, Belzer, and Kuhns

Background

Young transgender women (YTW) have the highest HIV prevalence/incidence than any other risk group in the U.S. The repeated exposure to gender minority stigma compounded by the psychosocial challenges associated with social disadvantage and economic marginalization exacerbates disparities in HIV incidence and invalidates YTW’s gender identity. This can lead to behaviors (e.g., substance use, sex work, healthcare avoidance) that potentiate HIV acquisition risk. In order to decrease HIV incidence among YTW, an intervention needs to 1) address HIV risk as part of YTW’s life contexts; 2) be accessible and far-reaching such that the entire at-risk population can participate (e.g., rural areas) during a time most convenient for them; and 3) be highly sustainable with low associated costs to implement in real-world settings.

Conceptual Model

LifeSkills Mobile is an mHealth intervention to promote biobehavioral HIV prevention strategies based on empowerment theory and was developed using a community-based participatory research approach.

Overview of Study Design

We propose to conduct an RCT to assess the efficacy of the LifeSkills Mobile intervention in comparison to a standard of care (SOC) condition among 5,000 YTW recruited online. The primary outcome is reduction in incident HIV infections; a secondary outcome is total condomless anal/ vaginal sex acts occurring in the context of insufficient PrEP protection. At baseline and every 6 months through 48 months, enrolled participants will complete an online survey sent via a link to their mobile phone and will be mailed an OraQuick In-Home HIV Test kit . We will also estimate the total and incremental costs of the LifeSkills Mobile intervention relative to SOC, from healthcare sector and societal perspectives. Real World Applicability. Given inherent limitations to widespread dissemination of face-to-face, group-based interventions, LifeSkills Mobile extends the potential reach of the intervention via the development of a mobile version, and provides content on, and access to, current biobehavioral prevention technologies (e.g., PrEP).

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Active Studies
Fostering Resilience Among MSM in India

Fostering Resilience Among MSM in India

Fostering Resilience Among MSM in India

Fostering Resilience to Psychosocial and HIV Risk in Indian MSM, 2014-2021

MPI: Safren & Mimiaga

National Institute of Mental Health (R01MH100627-01A1)

This was a randomized controlled efficacy trial of an HIV risk reduction group and individual counseling intervention that uses principles of cognitive behavioral therapy and emphasizes the importance of self-acceptance among MSM in Chennai and Mumbai, India.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper
Protocol Paper
Secondary Outcome Paper 1
Secondary Outcome Paper 2
Secondary Outcome Paper 3

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Selected Completed Studies
PASSOS POSITIVOS

PASSOS POSITIVOS

PASSOS POSITIVOS

Name of Grant

Making universal, free-of-charge antiretroviral therapy work for sexual and gender minority youth in Brazil

Funding Source

National Institute of Mental Health (R34 MH126894-01)

Pls

Matthew Mimiaga and Katie Biello

Background

Sexual and gender minority (SGM) youth account for the largest number of incident HIV infections in Brazil. Although HIV can be managed with ongoing antiretroviral therapy (ART), exceptionally high levels of adherence are required. Brazil has implemented a comprehensive HIV treatment program with broad access to ART, but this program does not specifically address barriers to optimal ART adherence, particularly for SGM youth who experience many challenges taking their medication as prescribed.

Overview

This application seeks to develop and pilot test a theory-based, integrated technology and counseling intervention to improve ART adherence among HIV infected SGM youth (ages 15-24) in Rio de Janeiro, Brazil. The intervention aims to improve social support, self-efficacy for taking ART, and teach skills for problem-solving barriers to promote better adherence. To inform the content, structure, and format of the proposed intervention, the MPIs recently conducted focus groups with SGM youth (N = 18) and key informant interviews (N = 7) with medical providers and staff at local HIV service organizations working closely with SGM youth in Rio de Janeiro. Across focus groups and key informant interviews there was universal agreement that an intervention should capitalize on and enhance social support structures among SGM youth, and address their specific concerns, especially as related to the individual (e.g., ART side effects, mood, substance use), social (e.g., HIV/SGM stigma), and structural (e.g., clinic hours, transportation challenges) barriers that they regularly face.

Theoretical Model

The intervention is guided by Social Cognitive and Social Support Theories and is grounded in the social and contextual realities of SGM youth living with HIV in Brazil. Specifically, social support is emphasized and informational, problem-solving and cognitive-behavioral “steps” are addressed over 4-group adherence counseling sessions, which include short video vignettes that seek to normalize adherence challenges. In addition, daily tailored SMS text messages are delivered as part of the intervention to facilitate social-cognitive cues to take medications as prescribed.

Research Plan

Phase 1: Refine and enhance participant acceptability of the intervention and resolve any issues with intervention delivery/implementation; this will be achieved by convening and obtaining feedback from our youth community advisory board throughout this phase and subsequent phases; and by conducting an open-phase pilot with up to 12 SGM youth, with post-intervention exit interviews, as well as obtaining feedback from our youth community advisory board throughout this and subsequent phases. Phase 2: Examine, in a pilot randomized controlled trial, the feasibility, acceptability and potential impact of the proposed intervention among 72 SGM youth who will be equally randomized to the intervention or a time- and attention-matched control condition with standard of care. The outcomes are improved ART adherence (Wisepill, pharmacy assessment and self-report), retention in care and viral load suppression. Study assessments will be conducted at baseline, 3- and 6-months.sss

 

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Active Studies
Project LifeSkills

Project LifeSkills

Project LifeSkills
    1. HIV Prevention Intervention for Young Transgender Women, 2011-2016

      MPI: Garofalo & Mimiaga; Co-Is: Kuhns & Reisner

      National Institute of Mental Health (R01MH094323-01)

      Randomized clinical efficacy trial of Project LifeSkills, a group-delivered, behavioral HIV prevention intervention, vs standard of care conducted among 190 sexually active YTW between March 26, 2012, and August 15, 2016, at community-based locations in Boston, Massachusetts, and Chicago, Illinois, to reduce sexual risk for HIV acquisition or transmission.

      PUBLISHED SCIENTIFIC JOURNAL ARTICLES:

      Primary Outcome Paper
      Protocol Paper
      Administrative Supplement Paper
      Secondary Outcome Paper 1
      Secondary Outcome Paper 2
      Secondary Outcome Paper 3
      Secondary Outcome Paper 4
      Secondary Outcome Paper 5
      Secondary Outcome Paper 6
      Secondary Outcome Paper 7
      Secondary Outcome Paper 8
      Secondary Outcome Paper 9
      Secondary Outcome Paper 10
      Secondary Outcome Paper 11
      Secondary Outcome Paper 12
      Secondary Outcome Paper 13
      Secondary Outcome Paper 14


  1. Mobile Adaptation and Testing of a Uniquely Targeted HIV Intervention for Young Transgender Women, 2019-2020

    MPIs: Kuhns & Mimiaga

    National Institute of Mental Health (R56MH113684-01)

    The group-based LifeSkills intervention was adapted to a mobile app, LifeSkills Mobile, with input from an expert advisory group and feedback from YTW collected during user-centered design sessions. A beta version of the app was then tested in a usability evaluation using a think-aloud protocol with debriefing interviews, recordings of screen activity, and assessments of usability

    PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
    Primary Outcome Paper

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Selected Completed Studies
Project IMPACT

Project IMPACT

Project IMPACT
    1. Behavioral Activation and HIV Risk Reduction for MSM with Crystal Meth Abuse, 2011-2015

      PI: Mimiaga

      National Institute on Drug Abuse (R34DA031028-01)

      Findings provide further evidence of feasibility and acceptability, and demonstrate initial efficacy for reducing sexual risk for HIV and crystal methamphetamine use in a pilot RCT.

      PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
      Primary Outcome Paper
      Protocol Paper


  1. Behavioral Activation and HIV Risk Reduction for MSM with Crystal Meth Abuse, 2008-2010

    PI: Mimiaga

    National Institute on Drug Abuse (R03DA023393-01)

    Findings provide evidence of feasibility and acceptability, and demonstrate initial efficacy for reducing sexual risk for HIV and crystal methamphetamine use in an open pilot trial.

    PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
    Primary Outcome Paper

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Selected Completed Studies
Project REWARD

Project REWARD

Project REWARD

Sustaining Effects of Contingency Management on Stimulant Use In HIV-Infected Persons, 2011-2014

MPI: Mimiaga & Mitty

Harvard Center for AIDS Research Award

We developed and implemented a combined contingency management (CM) and behavioral activation intervention aimed at HIV-infected individuals who are engaged in HIV care and currently dependent on crack, cocaine, or methamphetamine. Findings provide evidence of feasibility and acceptability, and demonstrate initial efficacy for  improvements in ARV medication adherence.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:

Primary Outcome Paper

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Selected Completed Studies
Positive STEPS

Positive STEPS

Positive STEPS

Improving Antiretroviral Medication Adherence Among HIV-Infected Youth, 2011-2013
PI: Mimiaga
Harvard Center for AIDS Research Award
This study adapted the Life-Steps intervention designed by our group for HIV-infected adults to be responsive to the needs of HIV-infected adolescents. Following an intervention development phase involving qualitative interviews with 30 adolescents, we conducted an RCT pilot of the intervention among 30 HIV-infected adolescents.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper 1
Primary Outcome Paper 2
Secondary Outcome Paper
Protocol Paper
Description of the Intervention Paper

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Selected Completed Studies
Stronger Together

Stronger Together

Stronger Together

CVCTPlus: A Couples-Based Approach to Linkage to Care and ARV Adherence, 2013-2018

MPI: Mimiaga, Stephenson & Garofalo

National Institute of Child Health and Human Development (R01HD075655-01A1)

We conducted a randomized controlled efficacy trial of a behavioral intervention that included CVCT combined with dyadic adherence counseling (“CVCTPlus”) to improve linkage to care, retention in care, ART adherence and viral suppression among 250 (total N = 500) HIV serodiscordant male-male couples across Atlanta, Boston, and Chicago. Findings demonstrated efficacy for improving HIV care continuum outcomes.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper
Protocol Paper
Description of the Intervention Paper
Secondary Outcome Paper 1
Secondary Outcome Paper 2
Secondary Outcome Paper 3
Secondary Outcome Paper 4
Secondary Outcome Paper 5
Secondary Outcome Paper 6
Secondary Outcome Paper 7
Secondary Outcome Paper 8
Secondary Outcome Paper 9
Secondary Outcome Paper 10

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Selected Completed Studies
NEXUS Study

NEXUS Study

NEXUS Study
    1. HIV Risk for MSM Sex Workers: A Social, Sexual and Drug Network Simulation Study, 2013-2016

      MPI: Mimiaga & Biello

      National Institute on Drug Abuse (R21DA035113-01A1)

      This was a longitudinal epidemiological study of MSM sex worker networks in Massachusetts and Rhode Island to identify protective and risk factors that affect HIV transmission dynamics. Longitudinal data enhanced our understanding of how contemporary social, sexual, and drug abuse network characteristics contribute to increased HIV and STI spread among male sex workers.

      PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
      Primary Outcome Paper 1
      Primary Outcome Paper 2
      Primary Outcome Paper 3
      Secondary Outcome Paper 1
      Secondary Outcome Paper 2
      Secondary Outcome Paper 3
      Secondary Outcome Paper 4
      Secondary Outcome Paper 5


  1. HIV Risk Among Male Sex Workers in New England

    PI: Mimiaga

    The Fenway Institute, Fenway Health Seed Award

    This was a formative study to lay the groundwork for a larger network-based study of male sex workers.

    PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
    Primary Outcome Paper 1

    Primary Outcome Paper 2

    Primary Outcome Paper 3

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Selected Completed Studies
Inkwari: Umlazi, Durban, SA

Inkwari: Umlazi, Durban, SA

Inkwari: Umlazi, Durban, SA

Inkwari: An Emerging High-Risk Place Potentiating HIV Spread Among Young Adults in a Hyper-Endemic South African Setting, 2011-2014

PI: Mimiaga

Ragon Institute of MGH, MIT and Harvard Scholars Award

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper
Secondary Outcome Paper 1
Secondary Outcome Paper 1

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Selected Completed Studies
Whoonga: Recreational ARVs South Africa

Whoonga: Recreational ARVs South Africa

Whoonga: Recreational ARVs South Africa

Epidemiology of HIV Antiretroviral Exposure from Whoonga Use in South Africa, 2015-2018

MPI: Grelotti & Mimiaga

National Institute on Drug Abuse (R21DA039857-01)

Some people are exposed to HIV antiretroviral medication through recreational use. This emerging phenomenon poses a significant obstacle to efforts to address the global HIV pandemic. Any antiretroviral exposure from recreational use may increase rates of antiretroviral-resistant HIV strains. This and any diversion of antiretroviral medication for recreational use will increase the cost of delivering this life-saving care. The proposed research will document antiretroviral exposure from the use of whoonga, a drug cocktail in South Africa that may contain antiretroviral medication and illicit drugs. It will also inform future research to link recreational antiretroviral use to antiretroviral resistance among HIV-infected individuals who have yet to initiate HIV treatment, as well as promote the design of culturally appropriate interventions.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper
Formative Paper 1
Formative Paper 2
News Related Article

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Selected Completed Studies
Men’s Small Group Vietnam

Men’s Small Group Vietnam

Men’s Small Group Vietnam
  1. Sexual Health Needs of Male Sex Workers in Ho Chi Minh City, Vietnam, 2010-2012 MPI: Colby & Mimiaga
    Harvard Catalyst Pilot Grant (UL1RR025758-01)

    The aim of this study was to conduct formative research to better understand risk and protective factors for HIV/STI transmission among MSW in Ho Chi Minh City.


  2. Group Based HIV Prevention Intervention for MSW In Ho Chi Minh City, Vietnam 2013-2016

    MPI: Mimiaga & Colby

    Centers for Disease Control and Prevention – Vietnam

    This was a pilot trial of a group-based manualized HIV prevention intervention, focused on barriers to HIV risk reduction and problem solving/skills building. The intervention consisted of 4 group sessions facilitated by trained MSM peer health educators.

    PUBLISHED SCIENTIFIC JOURNAL ARTICLES:

    Primary Outcome Paper
    Formative Paper 1
    Formative Paper 2
    Formative Paper 3
    Formative Paper 4
    Formative Paper 5
    Formative Paper 6
    Formative Paper 7

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Selected Completed Studies
Testing Brief Messages

Testing Brief Messages

Testing Brief Messages

Testing Brief Messages for Black & Latino MSM: Emerging HIV Prevention Options, 2012-2015 

PI: Mimiaga

Centers for Disease Control and Prevention / National Center for HIV, Viral Hepatitis, STDs, and TB Prevention (U01PS0053307-01)

This study included Black and Latino MSM in three major US cities—Chicago, Fort Lauderdale, and Kansas City— with variation in HIV serostatus and sexual risk behavior. Brief health messages of biomedical (e.g., PrEP, PEP, ARVs for treatment) and behavioral (e.g., condoms, serosorting) HIV prevention options were created through extensive qualitative interviews, key informant interviews, and focus groups with these populations. These data were used to refine the messages per participant and expert feedback, and to ensure comprehension of information / health literacy, clarity, increase in knowledge, and potential to influence behaviors and attitudes. Through an iterative approach, the messages were further refined and finalized. The final phase tested the brief messages (delivered via text message) on health behavior change among 1500 Black and Latino MSM in the same three cities. The primary aim of this project was to assess changes in behaviors and attitudes, feasibility of message delivery, and acceptability of message content.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper
Secondary Outcome Paper 1
Secondary Outcome Paper 2
Secondary Outcome Paper 3
Secondary Outcome Paper 4
Secondary Outcome Paper 5
Secondary Outcome Paper 6
Secondary Outcome Paper 7

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Selected Completed Studies
Club Drugs & PrEP

Club Drugs & PrEP

Club Drugs & PrEP

Understanding PrEP Implementation Among Club Drug Using MSM, 2011-2014

MPI: Mimiaga & Mitty

National Institute of Mental Health (R21MH095535-01)

This study reports finding on PrEP implementation approached among club drug using MSM.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper 1
Primary Outcome Paper 2
Primary Outcome Paper 3

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Selected Completed Studies
mHealth Male Sex Workers India

mHealth Male Sex Workers India

mHealth Male Sex Workers India

Technology For HIV Prevention Among Vulnerable Men in India, 2011-2015
PI: Mimiaga
National Institute on Drug Abuse (R21DA03372-01)
We first conducted qualitative interviews and focus groups to inform the content, structure and format of an HIV risk reduction intervention for male sex workers in India. We then conducted an open pilot of the intervention and assessed initial feasibility and acceptability. Next, we conducted a pilot randomized controlled trial of a mobile phone delivered HIV prevention intervention among this group.

PUBLISHED SCIENTIFIC JOURNAL ARTICLES:
Primary Outcome Paper 1
Primary Outcome Paper 2
Secondary Outcome Paper

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Selected Completed Studies
PrEPare for Work

PrEPare for Work

PrEPare for Work

Name of Grant

Efficacy of a PrEP uptake & Adherence Intervention among male sex workers using a 2-stage randomization design

Funding Source

National Institute of Nursing Research (R01NR020227-01A1)

Pls

Katie Biello, Matthew Mimiaga, and Philip Chan

Background:

Male sex workers (MSWs), or men who exchange sex for money, goods, drugs, or other items of value with other men, are at exceptionally high risk for HIV infection. Pre-exposure prophylaxis (PrEP) is effective at reducing HIV acquisition among HIV uninfected individuals, but its efficacy is highly dependent on uptake and excellent adherence. However, uptake of and adherence to PrEP among those who might benefit the most from using PrEP, such as MSWs, remains suboptimal. A successful PrEP uptake and adherence package must be responsive and tailored to MSWs’ distinct psychosocial and contextual circumstances.

Overview of Proposal

The current proposal is a culmination of over 10 years of research with this population, including qualitative research, epidemiological assessments and programmatic work. These formative data led to an NIMH-funded R34 (MPIs: Biello, Mimiaga, Chan), which allowed our interdisciplinary team and community partners to collaborate on the development and pilot testing of a theory-based intervention— “PrEPare for Work”—to address 1) access to and uptake of PrEP at local PrEP clinics/providers via strengthbased case management using principles of motivational interviewing (e.g., focusing on values, strengths and change efforts, making reflective and empathetic statements), and 2) provide cognitive-behavioral therapyinformed PrEP adherence counseling (e.g., problem-solving skill-building) with personalized, daily text message reminders to optimize PrEP adherence among MSWs. The pilot RCT demonstrated the feasibility, acceptability and preliminary efficacy of “PrEPare for Work”.

Conceptual Model

The “PrEPare for Work” intervention is based on Social Cognitive Therapy (SCT), which specifies a core set of mechanisms that influence health behavior with a primary emphasis on self-regulation and self-reflection, including self-efficacy.

Overview of Study Design

We now propose to test the efficacy of the “PrEPare for Work” package in the Greater Providence area and in Los Angeles County using a two-stage randomization design. Stage 1: 500 MSW will be equally randomized to receive either the “PrEPare for Work Stage 1 intervention” (strength-based case management and facilitated PrEP linkage) or standard of care to evaluate successful PrEP uptake (verified by real-time tenofovir urinalysis; prescription data) within 2 months. Stage 2: those who initiate PrEP (n~156; ~55% from Stage 1 intervention arm and ~20% from Stage 1 SOC arm) will be equally re-randomized to the “PrEPare for Work Stage 2 intervention” (1-on-1 skills training, problem solving, and motivational interviewing adherence counseling and personalized, daily text messaging reminders) or SOC to assess PrEP adherence (tenofovir concentration in hair sample) and retention in PrEP care (appointments attended) over 12 months. We will also examine the degree to which improvements in PrEP uptake and adherence occur in the context of the conceptual mediators (e.g., PrEP motivation, self-efficacy) and moderators (e.g., race/ethnicity, substance use, perceived HIV risk) of the intervention. Intervention cost-effectiveness will be assessed.

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Active Studies
Fostering Resilience

Fostering Resilience

Fostering Resilience

Name of Grant

Fostering resilience to psychosocial and HIV risk in Indian MSM

Funding Source

National Institute of Mental Health (R01MH100627-01A1)

Pls

Mimiaga and Safren

Background

India has the world’s third largest HIV epidemic1, and given the population size, one of the largest, if not the largest, populations of men who have sex with men (MSM) in the world. MSM in India have an estimated seroprevalence of 14.7%. HIV prevention efforts for MSM in India are limited to condom distribution and HIV education, with no existing efficacy trials of interventions and therefore no evidenced based interventions this population. They are hidden, stigmatized, and face considerable psychosocial stressors, including pressure to marry, which increases the risk for HIV transmission to their wives. This proposal is the culmination of our ongoing, successful > 10-year community-based research collaboration with two NGOs dedicated to HIV prevention among MSM, Sahodaran (Chennai) and The Humsafar Trust (Mumbai), and investigators from the India Council of Medical Research (ICMR), National Institute for Research in Tuberculosis (NIRT) in Chennai. We have, in every phase of the development of this proposal (and throughout each of our preliminary studies), engaged the community in developing the research ideas, forming the program of research, designing / refining the studies, and disseminating the results to inform next-steps. Preliminary studies include: 1) documenting the exceptionally high rates of distress / mental health problems in MSM in Mumbai, 2) documenting, in Chennai, the high prevalence of HIV and sexual risk, and the important surrounding psychosocial context, 3) conducting a three-phased Indo-U.S. sponsored R21 including extensive formative work from CABs, focus groups with representative MSM, and key informant interviews to develop our self-acceptance based model of self-care in the context of pervasive stigma and discrimination facing Indian MSM. We field tested and then conducted a feasibility pilot RCT (with CAB feedback throughout) of the resulting intervention comparing it to HIV voluntary counseling and testing (VCT) alone. This field test and pilot RCT showed high participant acceptability and feasibility of study procedures, and success reducing HIV sexual risk behavior.

Design

MSM in Chennai and Mumbai will be randomized to either: 1) a self-acceptance based HIV sexual risk reduction intervention and HIV/STI VCT, or 2) HIV/STI VCT. Those randomized to the experimental intervention will receive 4 group sessions focused on building self-acceptance, social support and HIV risk reduction skills and 6 individual sessions focused on personalized HIV risk reduction plans and, as needed, prevention case management. Participants will be followed for one year, with STI incidence and HIV risk behavior as primary outcomes and psychosocial mediators secondary. Cost effectiveness of the intervention will be calculated compared to HIV/STI VCT alone, considering individual and public health benefits as well as downstream cost-savings due to infections averted.

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January 5, 2022
UCLA Fielding School Center for LGBTQ+ Advocacy, Research & Health Marks Its First Year
In its first year, the Fielding School’s UCLA Center for LGBTQ+ Advocacy, Research & Health (C-LARAH) has had impact across a spectrum of applied research and organizational work, focused on...
July 9, 2021
UCLA Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention
A team of researchers co-led by UCLA Fielding School of Public Health epidemiology professor Dr. Matthew Mimiaga has received more than $5.2 million in grants from the U.S. National Institutes...
December 17, 2020
UCLA Fielding School of Public Health Establishes Center to Focus on the Health, Safety and Well-being of LGBTQ Community
The UCLA Center for LGBTQ Advocacy, Research & Health (C-LARAH) is directed by Matthew Mimiaga, a Fielding School professor of epidemiology renowned for his research working with sexual and gender minorities at the...
February 19, 2021
The Persistent and Evolving HIV Epidemic in American Men Who Have Sex With Men
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the journal The Lancet on the ongoing HIV epidemic in this population, using...
March 9, 2021
Group led by UCLA professor awarded $8.8 million for HIV intervention using mobile app
A team of researchers co-led by UCLA Fielding School of Public Health epidemiology professor Matthew Mimiaga has received an $8.8 million grant from the National Institute of Allergy and Infectious Diseases...
March 17, 2021
Strengthening Resilience to Reduce HIV Risk in Indian MSM: a Multicity, Randomised, Clinical Efficacy Trial
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the April edition of the journal The Lancet on the HIV epidemic in...
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Research Therapist

Research Therapist

Under the direction of the Principal Investigator, the Research Intervention Counselor will provide manualized counseling to study participants enrolled in behavioral HIV prevention studies within the Center for LGBTQ Research, Advocacy, and Health (C-LARAH) at the Fielding School of Public Health.

Project Manager

Project Manager

Working closely with the Principal Investigator, the Project Manager assumes major responsibility for the operation, implementation, and data management of randomized control trials to test behavioral interventions targeted in three key areas.

Research Assistant

Research Assistant

Implementing recruitment and retention efforts that lead to study participation; Arranging and conducting studying visits with participants; Coordinating with other community partner recruitment sites; maintaining regulatory procedures and assisting in development of study materials.

Research Nurse

Recruitment Assistance

Assists in the recruitment and follow up of patients participating in a clinical research project (MWCCS). Assists in promoting, explaining, and implementing the study. Collects data and monitors patients’ research visits schedule, ensuring follow ups are conducted on time. Performs phlebotomy and other related functions as part of study requirements. BSN/RN in nursing required.

UCLA Fielding School of Public Health Establishes Center to Focus on the Health, Safety and Well-being of LGBTQ Community

UCLA Fielding School of Public Health Establishes Center to Focus on the Health, Safety and Well-being of LGBTQ Community

UCLA Fielding School of Public Health Establishes Center to Focus on the Health, Safety and Well-being of LGBTQ Community
The UCLA Center for LGBTQ Advocacy, Research & Health (C-LARAH) is directed by Matthew Mimiaga, a Fielding School professor of epidemiology renowned for his research working with sexual and gender minorities at the intersection of HIV, substance use and mental health
Date:
Thursday, December 17, 2020
Contact:
The UCLA Fielding School of Public Health has launched a new center to promote the health of sexual and gender minorities through research and partnerships with the LGBTQ community, community-based organizations, public health officials and policymakers in Los Angeles and beyond. The UCLA Center for LGBTQ Advocacy, Research & Health, or C-LARAH, will develop and implement evidence-based strategies that address both the physical and mental health needs of LGBTQ individuals while working closely with local, national and global partners. “Both here at home and around the world, LGBTQ populations have a higher prevalence and incidence of life-threatening physical conditions, mental health challenges, and certain chronic and infectious diseases, along with significant barriers in accessing and maintaining healthcare and treatment,” said the center’s director, Matthew Mimiaga, a professor of epidemiology widely known for his work with sexual and gender minorities. “C-LARAH and its partners will collaborate on research-informed ways to both reach members of this historically marginalized population and serve them holistically.” C-LARAH — larah is derived from the Latin “hilaris,” meaning cheerful — will also provide training and mentorship opportunities for graduate students and postdoctoral fellows to support the growing demand for public health research that benefits vulnerable sexual and gender minorities. The center’s plans include establishing a postdoctoral fellowship program and certificate program in LGBTQ health and awarding pilot funding to researchers so that they can generate initial data that can then be used in applications for larger government grants. Mimiaga, who was recently recruited to the Fielding School from Brown University, has worked for years with LGBTQ populations at the intersection of HIV, substance use and mental health and conducts research projects that span countries in Asia, Africa, Latin America and Eastern Europe. He has developed and tested psychosocial treatments for substance use disorder, as well as biobehavioral interventions aimed at decreasing HIV infection and transmission by encouraging the use of recommended antiretroviral medications. Mimiaga also has close ties to leading LGBTQ organizations in Los Angeles and nationwide, and with Los Angeles being home of one of the world’s largest LGBTQ populations, C-LARAH is particularly well situated to join forces with a slew of highly regarded local organizations that serve and advocate for sexual and gender minorities. One of those, The Trevor Project, a nonprofit which provides suicide prevention and crisis intervention services for LGBTQ youth, welcomes the advocacy resources and interdisciplinary health research expertise C-LARAH will bring to the LGBTQ community — both locally and beyond. “I’m excited for the UCLA Center for LGBTQ Advocacy, Research & Health to open its doors and help shape policies that directly impact the lives of LGBTQ young people,” said the organization’s CEO and executive director Amit Paley. “Limited LGBTQ-inclusive research, plus the lack of systematic data collection on LGBTQ communities, can make it even more difficult to address the unique mental health challenges of LGBTQ youth and the obstacles to care that they face. “The Trevor Project recognizes a clear need for greater investment in advocacy and research that can better inform public policies that support the needs of LGBTQ youth. We look forward to working with the center to educate policymakers, advocate for LGBTQ youth, and provide unique insight into their mental health.” In addition to the physical and mental health challenges they face, sexual and gender minorities are at greater risk of violence, victimization, discrimination and other substantial threats to their quality of life, making the new center’s holistic approach all the more important, according to Fielding School Dean Ron Brookmeyer. “For reasons that include historic and continuing discrimination and stigma, the LGBTQ population experiences unacceptable — and in many cases preventable — disparities in their physical and mental health compared with the overall population,” Brookmeyer said. “The UCLA Center for LGBTQ Advocacy, Research & Health will provide much-needed research, training, and policy support that can contribute to reducing or eliminating these disparities.” Mimiaga, who previously held faculty appointments at Brown and Harvard universities, has authored more than 350 peer-reviewed scientific journal articles, book chapters and commentaries in the area of HIV prevention and sexual and gender minority health. He has had a 20-year research partnership and is currently an affiliated senior research scientist with The Fenway Institute in Boston, an interdisciplinary center for research, education, training and policy development to optimize health for sexual and gender minorities and those affected by HIV. At UCLA, he will also contribute to the Multicenter AIDS Cohort Study, or MACS. Dr. Roger Detels, principal investigator of MACS and a distinguished professor of epidemiology at the Fielding School, has directed the study at UCLA since 1984. Since that time, more than 7,000 gay and bisexual men have been enrolled in the study, which has produced seminal findings on the epidemic.
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Press Release
The Persistent and Evolving HIV Epidemic in American Men Who Have Sex With Men

The Persistent and Evolving HIV Epidemic in American Men Who Have Sex With Men

The Persistent and Evolving HIV Epidemic in American Men Who Have Sex With Men
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the journal The Lancet on the ongoing HIV epidemic in this population, using a social-ecological perspective
Date:
Friday, February 19, 2021
Contact:
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the journal The Lancet on the ongoing HIV epidemic in this population, using a social-ecological perspective. Summary: Men who have sex with men (MSM) in the USA were the first population to be identified with AIDS and continue to be at very high risk of HIV acquisition. We did a systematic literature search to identify the factors that explain the reasons for the ongoing epidemic in this population, using a social-ecological perspective. Common features of the HIV epidemic in American MSM include role versatility and biological, individual, and social and structural factors. The high-prevalence networks of some racial and ethnic minority men are further concentrated because of assortativemixing, adverse life experiences (including high rates of incarceration), and avoidant behaviour because of negativeinteractions with the health-care system. Young MSM have additional risks for HIV because their impulse control is less developed and they are less familiar with serostatus and other risk mitigation discussions. They might benefit from prevention efforts that use digital technologies, which they often use to meet partners and obtain health-related information. Older MSM remain at risk of HIV and are the largest population of US residents with chronic HIV, requiring culturally responsive programmes that address longer-term comorbidities. Transgender MSM are an understudied population, but emerging data suggest that some are at great risk of HIV and require specifically tailored information on HIV prevention. In the current era of pre-exposure prophylaxis and the undetectable equals untransmittable campaign, training of health-care providers to create culturally competent programmes for all MSM is crucial, since the use of antiretrovirals is foundational to optimising HIV care and prevention. Effective control of the HIV epidemic among all American MSM will require scaling up programmes that address their common vulnerabilities, but are sufficiently nuanced to address the specific sociocultural, structural, and behavioural issues of diverse subgroups. Conclusions: Our review has identified several common factors that potentiate the HIV epidemic among all MSM in the USA, including biological vulnerability, unique network characteristics, and internalisation of societal stigma leading to behavioural syndemics, enhanced by the disinhibiting effects of substance use. Growing up in non-affirming environments has health consequences. However, our review has also established that diverse subgroups of MSM exist, with unique racial, ethnic, age- related, and gender identities and needs. Institutional racism and cultural insensitivity will potentiate the increasing disparities in HIV incidence and access to optimal treatment and prevention services. Interventions that can leverage advances in antiretroviral-based treatment and prevention to curtail the domestic epidemic in US MSM will need to attend to the common themes (eg, by integrating behavioural health services with biomedical interventions), but culturally tailored programmes need to be developed to address the specific drivers of HIV risk in the diverse but vulnerable subpopulations. Interventions will need to attend to structural issues, including racism, poverty, homophobia and transphobia, and understand how different age cohorts meet partners and access health information, by considering how to educate and engage MSM in the digital era. Although great progress has been made in recent years, almost half of people with HIV in the USA are not currently virally suppressed on highly active ART, and fewer than a quarter of MSM in the USA who might benefit from PrEP are using it. The disparities in accessing the benefits of therapeutic and preventive advances are particularly egregious for Black and Latino MSM, indicating that much more work remains to be done to develop effective, culturally congruent programmes to addresss these challenges. In the face of many adversities, MSM in the USA have shown resilience, but progress will not happen unless structural and societal issues (eg, racism, access to health insurance, culturally responsive care) are properly addressed.

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Group led by UCLA professor awarded $8.8 million for HIV intervention using mobile app

Group led by UCLA professor awarded $8.8 million for HIV intervention using mobile app

Group led by UCLA professor awarded $8.8 million for HIV intervention using mobile app
A team of researchers co-led by UCLA Fielding School of Public Health epidemiology professor Matthew Mimiaga has received an $8.8 million grant from the National Institute of Allergy and Infectious Diseases to conduct a nationwide study aimed at reducing the spread of HIV, the virus that causes AIDS, among young transgender women through the use of a mobile app.
The app, LifeSkills Mobile, allows high-risk women who are unable to participate in face-to-face interventions due to geographic and socioeconomic barriers to easily access comprehensive HIV prevention information and strategies through their mobile devices. The five-year project will gauge how well the mobile intervention improves health outcomes among its users. While past decades have seen significant advances in HIV research and treatment, the pandemic continues to outpace efforts to control it, and there is an urgent need for interventions among younger transgender women, whose infection rates are particularly high, said Mimiaga, director of the Fielding School’s UCLA Center for LGBTQ Advocacy, Research & Health, or C-LARAH. He is a principal investigator on the project, along with professors Lisa Kuhns of Northwestern University and Marvin Belzer of the University of Southern California. “The constant and unrelenting exposure to gender minority stigma, compounded by the psychosocial challenges associated with social disadvantage and economic marginalization, exacerbates disparities in HIV incidence among young transgender women,” Mimiaga said. “This can lead to behaviors such as substance use, sex work, health care avoidance and others that increase HIV acquisition risk.” It is estimated that 28% of transgender women have laboratory-confirmed HIV infection, and their odds of infection are 49-fold higher than adults of reproductive age as a whole. In a recent study conducted in Los Angeles, San Francisco and Miami, 12% of transgender women were found to have previously undiagnosed HIV infection, with the rate rising to 45% for those between the ages of 18 and 29. “For this study, we are partnering with transgender-specific organizations for maximum impact,” said Belzer, a professor of pediatrics and medicine at USC’s Keck School of Medicine and head of the adolescent medicine division at Children’s Hospital Los Angeles. “Given that this population is a high-risk group for HIV infection and face numerous transgender-specific barriers to consistent condom use and pre-exposure prophylaxis linkage and uptake, they represent a group in great need of effective strategies to decrease HIV incidence.” LifeSkills Mobile is a fully adapted version of a group intervention that is delivered in person, called Project LifeSkills, which has demonstrated efficacy in reducing HIV risk among this population. That work was led by Robert Garofalo, chief of The Potocsnak Family Division of Adolescent and Young Adult Medicine at the Anne & Robert H. Lurie Children’s Hospital of Chicago and professor of pediatrics at Northwestern University’s Feinberg School of Medicine, and Sari Reisner, an assistant professor of medicine at Harvard Medical School and director of transgender research at Brigham and Women’s Hospital in Boston. Mimiaga and Kuhns also worked on the original project, which was supported by the National Institute of Mental Health. Garofalo and Reisner, in turn, are also investigators on the LifeSkills Mobile project. “Project LifeSkills is currently the only ‘best evidence’ HIV risk-reduction intervention for young transgender women included among the Centers for Disease Control and Prevention’s compendium of evidence-based HIV interventions,” said Kuhns, associate director of the Center for Gender, Sexuality and HIV Prevention at Lurie Children’s Hospital. “The new funding has the potential to scale this intervention widely via mobile devices, extending access to many hard-to-reach and high-need young transgender women who experience barriers to participating in a face-to-face intervention.” The study will enroll 5,000 young transgender women ages 16 to 29 recruited online who will be split into three regional groups — eastern, central and western — depending on where in the U.S. they live, with each group administered by researchers from one of the three partner universities. The efficacy of the program will be assessed by comparing the incidence of HIV infection among participants over the course of the project to infections among individuals randomized to a standard-of-care condition. The benefit of the LifeSkills Mobile intervention, the researchers stress, is that it addresses HIV risk within the context of each participant’s life; it is accessible enough to reach at-risk participants, including those in rural areas, at times that are most convenient for them; and it is highly sustainable and low cost. The National Institute of Allergy and Infectious Diseases is part of the National Institutes of Health.
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Strengthening Resilience to Reduce HIV Risk in Indian MSM: a Multicity, Randomised, Clinical Efficacy Trial

Strengthening Resilience to Reduce HIV Risk in Indian MSM: a Multicity, Randomised, Clinical Efficacy Trial

Strengthening Resilience to Reduce HIV Risk in Indian MSM: a Multicity, Randomised, Clinical Efficacy Trial
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the April edition of the journal The Lancet on the HIV epidemic in this population, evaluating a resilience-based psychosocial intervention
Date:
Wednesday, March 17, 2021
Contact:
Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, co-authored a research piece in the April edition of the journal The Lancet on the HIV epidemic in this population, evaluating a resilience-based psychosocial intervention. Background Men who have sex with men (MSM) in India are extremely marginalised and stigmatised, and therefore experience immense psychosocial stress. As current HIV prevention interventions in India do not address mental health or resilience to these stressors, we aimed to evaluate a resilience-based psychosocial intervention in the context of HIV and sexually transmitted infection (STI) prevention. Methods We did a multicity, randomised, clinical efficacy trial in Chennai (governmental tuberculosis research institute) and Mumbai (non-governmental organisation for MSM), India. Inclusion criteria were MSM, aged 18 years or older, who were at risk of HIV acquisition or transmission, defined as having any of the following in the 4 months before screening: anal sex with four or more male partners (protected or unprotected), diagnosis of an STI, history of transactional sex activity, or condomless anal sex with a man who was of unknown HIV status or serodiscordant. Participants were required to speak English, Tamil (in Chennai), or Hindi (in Mumbai) fluently. Eligible individuals were randomly assigned (1:1) to either a resilience-based psychosocial HIV prevention intervention, consisting of group (four sessions) and individual (six sessions) counselling alongside HIV and STI voluntary counselling and testing, or a standard-of-care control comprising voluntary counselling and testing alone. The primary outcomes were number of condomless anal sex acts with male partners during the past month (at baseline and 4 months, 8 months, and 12 months after randomisation), and incident bacterial STIs (at 12 months after randomisation). Resilience-related mediators included self-esteem, self-acceptance, and depression. Recruitment is now closed. This trial is registered with ClinicalTrials.gov, NCT02556294. Findings Between Sept 4, 2015, and June 28, 2018, we enrolled 608 participants; 305 (50%) were assigned to the psychosocial intervention condition and 303 (50%) were assigned to the control condition. 510 (84%) of 608 men completed an assessment at 4 months after randomisation, 483 (79%) at 8 months, and 515 (85%) at 12 months. 512 (99%) of 515 men had STI data from the 12-month assessment. The intervention condition had a 56% larger reduction in condomless anal sex acts (95% CI 35–71; p<0·0001) from baseline to 4-month follow-up, 72% larger reduction (56–82; p<0·0001) from baseline to 8-month follow-up, and 72% larger reduction (53–83; p<0·0001) from baseline to 12-month follow-up, compared with the standard-of-care control condition (condition by time interaction; χ2=40·29, 3 df; p<0·0001). Improvements in self-esteem and depressive symptoms both mediated 9% of the intervention effect on condomless anal sex acts. Bacterial STI incidence did not differ between study conditions at 12-month follow-up. Interpretation A resilience-based psychosocial intervention for MSM at risk of HIV acquisition or transmission in India was efficacious in reducing condomless anal sex acts, with evidence for mediation effects in two key target resilience variables. HIV prevention programmes for MSM in India should address mental health resilience to augment reductions in the risk of sexually transmitted HIV. Funding National Institute of Mental Health.

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What We’ve Learned About Disease in the 40 Years Since the Discovery of HIV/AIDS at UCLA

What We’ve Learned About Disease in the 40 Years Since the Discovery of HIV/AIDS at UCLA

What We’ve Learned About Disease in the 40 Years Since the Discovery of HIV/AIDS at UCLA
UCLA Health interviewed Dr. Roger Detels, UCLA Fielding School of Public Health distinguished research professor of epidemiology and infectious diseases and director of the Multicenter AIDS Cohort Study (MACS), about what has been learned about the disease in the 40 years since the discovery of HIV/AIDS at UCLA
Date:
Thursday, June 3, 2021
Contact:
On June 5, 1981, a cluster of curious cases of Pneumocystis carinii (now P. jirovecii) pneumonia (PCP) in five previously healthy, gay men in Los Angeles was first described in the Morbidity and Mortality Weekly Report, a publication from the U.S. Centers for Disease Control and Prevention. Forty years after the discovery of the HIV/AIDS at UCLA, we at UCLA Health are reflecting on that epidemic as the world inches toward relief from COVID-19. “No one could possibly have imagined that this [discovery] was the beginning of a global epidemic involving tens of millions of people,” says Michael Gottlieb, MD, an assistant professor of medicine and clinical immunology and the principal investigator on the CDC’s 1981 report. by Jocelyn Apodaca Schlossberg

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Promoting Public Health for the LGBTQ Population

Promoting Public Health for the LGBTQ Population

Promoting Public Health for the LGBTQ Population
A new FSPH center will partner with community groups and policymakers to develop and implement evidence-based strategies that advance the physical and mental health of sexual and gender minorities.
From the highest court in the land to the court of public opinion, the last two decades have been marked by swift, fundamental progress, both in LGBTQ legal rights and in U.S. society’s embrace of the LGBTQ population. But barely more than 50 years after the uprising at New York City’s Stonewall Inn catalyzed the gay-rights movement, sexual and gender minorities remain at elevated risk of violence, victimization, discrimination, and other substantial threats to their quality of life. And amid the ongoing struggle for social and legal justice, LGBTQ individuals disproportionately face physical and mental health problems — often related to the historic and continuing trauma, discrimination, and stigma. “Both here at home and around the world, LGBTQ populations have a higher prevalence and incidence of life-threatening physical conditions, mental health challenges, and certain chronic and infectious diseases, along with significant barriers in accessing and maintaining healthcare and treatment,” says Dr. Matthew Mimiaga, a Fielding School professor of epidemiology widely known for his work with sexual and gender minorities. Under Mimiaga’s leadership, FSPH has established the UCLA Center for LGBTQ Advocacy, Research & Health, or C-LARAH, to promote the health of sexual and gender minorities through research, training, and partnerships with the LGBTQ community, community-based organizations, public health officials, and policymakers in Los Angeles and beyond. C-LARAH (larah is derived from the Latin “hilaris,” meaning cheerful — signifying health, well-being, resilience, and being a proud member of the LGBTQ community) develops and implements evidence-based strategies that address both the physical and mental health needs of LGBTQ individuals while working closely with its local, national, and global partners. Mimiaga, recently recruited to the Fielding School from Brown University, has worked for years with LGBTQ populations at the intersection of HIV, substance use, and mental health, and conducts research internationally in Asia, Africa, Latin America, and Eastern Europe, as well as in the U.S. He has developed and tested psychosocial treatments for substance use disorder, as well as biobehavioral interventions aimed at decreasing HIV acquisition and transmission by encouraging the use of recommended antiretroviral medications for both prevention and treatment. Mimiaga also has close ties to leading LGBTQ organizations in Los Angeles and nationwide, and with Los Angeles being home to one of the world’s largest LGBTQ populations, C-LARAH is particularly well situated to join forces with a slew of highly regarded local organizations that serve and advocate for sexual and gender minorities. One Los Angeles-based partner is The Trevor Project, a nonprofit organization that provides suicide-prevention and crisis-intervention services for LGBTQ youth. The organization’s CEO and executive director, Amit Paley, welcomes the advocacy resources and interdisciplinary research expertise C-LARAH will bring to the LGBTQ community.
Dr. Matthew Mimiaga, a professor of epidemiology widely known for his work with sexual and gender minorities, heads the new FSPH center.
“I’m excited for the UCLA Center for LGBTQ Advocacy, Research & Health to help shape policies that directly impact the lives of LGBTQ young people,” Paley says. “Limited LGBTQ-inclusive research, plus the lack of systematic data collection on LGBTQ communities, can make it even more difficult to address the unique mental health challenges of LGBTQ youth and the obstacles to care that they face. The Trevor Project recognizes a clear need for greater investment in advocacy and research that can better inform public policies that support the needs of LGBTQ youth. We look forward to working with the center to educate policymakers, advocate for LGBTQ youth, and provide unique insight into their mental health.” C-LARAH will provide training and mentorship opportunities for graduate students and postdoctoral fellows to support the growing demand for public health research that benefits vulnerable sexual and gender minorities. The center’s plans include establishing a postdoctoral fellowship program and a certificate program in LGBTQ health, as well as awarding pilot funding to researchers so that they can generate initial data that can then be used in applications for larger government and foundation grants. Mimiaga says financial support — through center and training program grants from the National Institutes of Health; federal and foundation-funded research grants; and private donor and endowment gifts — will be a key factor in the center’s success. In March, a team led by Mimiaga received an $8.8 million grant from the National Institute of Allergy and Infectious Diseases to conduct a nationwide study aimed at reducing the spread of HIV among young transgender women through the use of a mobile app. The app, LifeSkills Mobile, allows high-risk women who are unable to participate in face-to-face interventions due to geographic and socioeconomic barriers to easily access comprehensive HIV-prevention information and strategies For Mimiaga, the Fielding School appointment marks a return to the city where he was born and raised. He was initially drawn to research in HIV prevention after a close friend was diagnosed with HIV at age 16 in the early 1990s. “I saw his day-to-day struggles taking antiretroviral therapy, which had terrible side effects at the time,” Mimiaga recalls. “And I saw the stigma and discrimination he experienced from being HIV-positive and knew I wanted to be involved in work that addressed that.” In the years since, Mimiaga has built a reputation as a leading researcher in the areas of HIV prevention and sexual and gender minority health, working in both academic and community settings. He has authored more than 350 peer-reviewed scientific journal articles, book chapters, and commentaries as a faculty member at Brown and, prior to that, at Harvard. He has a 20-year research partnership and is currently an affiliated senior research scientist with The Fenway Institute in Boston, an interdisciplinary center for research, education, training, and policy development to optimize health for sexual and gender minorities and those affected by HIV.

“As a member of the LGBTQ community, I know what it’s like to experience discrimination and fear around my sexual identity. I look forward to the impact C-LARAH will have in training future generations of scientists interested in conducting LGBTQ public health research.” — Dr. Matthew Mimiaga

Much of Mimiaga’s research has involved assessing the efficacy of psychosocial and biobehavioral interventions designed to decrease HIV risk by addressing mental health problems such as depression and trauma, substance use disorder, and access to prevention programs and medical care, including the uptake and adherence to antiretroviral medications for treatment and prevention. Ongoing studies are focused on sexual and gender minority populations, some of which include transgender women; adolescents and young adults; gay, bisexual and other men who have sex with men; and street-based male sex workers and internet escorts. In addition, Mimiaga’s research has led to two novel HIV prevention interventions that are now part of the Centers for Disease Control and Prevention’s Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention. At the Fielding School, Mimiaga will also co-lead the Multicenter AIDS Cohort Study, or MACS. Dr. Roger Detels, principal investigator of MACS and an FSPH distinguished professor of epidemiology, has directed MACS at UCLA since 1984; in that time, more than 7,000 gay and bisexual men have been enrolled in the study, which has produced groundbreaking findings on the epidemic.
“As a member of the LGBTQ community, I know what it’s like to experience discrimination and fear around my sexual identity,” Mimiaga says. “It’s extremely rewarding to be involved in work that is making a difference in the lives of historically marginalized members of society. I look forward to the impact C-LARAH will have in training future generations of scientists interested in conducting LGBTQ public health research and holistically serving sexual and gender minorities through all social determinants of health and justice.” To donate to C-LARAH, please visit giving.ucla.edu/FSPHmag and select the FSPH UCLA Center for LGBTQ Advocacy, Research & Health.
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Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention

Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention

Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention
National Institutes of Health-funded projects are researching interventions to optimize uptake and adherence to antiretroviral medications Date: Thursday, July 8, 2021 Contact: Brad Smith, Senior Public Relations Officer
A team of researchers co-led by UCLA Fielding School of Public Health epidemiology professor Dr. Matthew Mimiaga has received more than $5.2 million in grants from the U.S. National Institutes of Health (NIH) to develop and test interventions in the U.S. and Brazil. The projects, funded by three separate NIH grants, all have the goal of reducing the spread of HIV, the virus that causes AIDS, through the use of antiretroviral medications for HIV primary (PrEP) and secondary (ART) prevention among sexual and gender minority groups. “Whether used as PrEP for HIV negative individuals or as ART treatment as prevention for those living with HIV, antiretroviral medications are highly effective at reducing HIV acquisition and transmission, but its efficacy is highly dependent on uptake and excellent adherence,” said Mimiaga, director of the UCLA Center for LGBTQ Advocacy, Research & Health. “However, sexual and gender minority groups face specific barriers to PrEP and ART access, uptake, adherence, and retention in care. Because of this, we are testing interventions that are culturally-tailored to address the lived realities and barriers among these vulnerable groups.” The grants, announced by the NIH this month, will study the use of a variety of techniques – personalized, daily text message reminders; video vignettes; peer navigation; and individual and group counseling – to facilitate access and adherence to antiretroviral medications among those who would benefit the most from its use. These grants will be implemented in Los Angeles County; Providence, RI; Boston, MA; and Rio de Janeiro, Brazil. This will give the researchers a wide variety of data on how these approaches work for different populations, ranging from LGBTQ adolescents, ages 15-24, to transgender women, and men who engage in transactional sex with other men. Dr. Katie Biello, a Brown University behavioral and social sciences and epidemiology professor, will co-lead this work with Mimiaga. “Our goal is to develop HIV prevention interventions that are highly scalable and sustainable in the real world,” Biello said. “As such, this work takes into account the future of PrEP and ART access, while simultaneously addressing the barriers surrounding access, aiding in navigating linkage to PrEP and ART care programs, and reducing barriers to, and building skills to support, medication adherence.”

The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 631 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.
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UCLA Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention

UCLA Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention

UCLA Fielding School Professor’s Team Awarded more than $5.2 Million in Grants for HIV Prevention
National Institutes of Health-funded projects are researching interventions to optimize uptake and adherence to antiretroviral medications
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Date: 
Thursday, July 8, 2021
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A team of researchers co-led by UCLA Fielding School of Public Health epidemiology professor Dr. Matthew Mimiaga has received more than $5.2 million in grants from the U.S. National Institutes of Health (NIH) to develop and test interventions in the U.S. and Brazil.
The projects, funded by three separate NIH grants, all have the goal of reducing the spread of HIV, the virus that causes AIDS, through the use of antiretroviral medications for HIV primary (PrEP) and secondary (ART) prevention among sexual and gender minority groups.
“Whether used as PrEP for HIV negative individuals or as ART treatment as prevention for those living with HIV, antiretroviral medications are highly effective at reducing HIV acquisition and transmission, but its efficacy is highly dependent on uptake and excellent adherence,” said Mimiaga, director of the UCLA Center for LGBTQ Advocacy, Research & Health. “However, sexual and gender minority groups face specific barriers to PrEP and ART access, uptake, adherence, and retention in care. Because of this, we are testing interventions that are culturally-tailored to address the lived realities and barriers among these vulnerable groups.”
The grants, announced by the NIH this month, will study the use of a variety of techniques – personalized, daily text message reminders; video vignettes; peer navigation; and individual and group counseling – to facilitate access and adherence to antiretroviral medications among those who would benefit the most from its use. These grants will be implemented in Los Angeles County; Providence, RI; Boston, MA; and Rio de Janeiro, Brazil.
This will give the researchers a wide variety of data on how these approaches work for different populations, ranging from LGBTQ adolescents, ages 15-24, to transgender women, and men who engage in transactional sex with other men. Dr. Katie Biello, a Brown University behavioral and social sciences and epidemiology professor, will co-lead this work with Mimiaga.
“Our goal is to develop HIV prevention interventions that are highly scalable and sustainable in the real world,” Biello said. “As such, this work takes into account the future of PrEP and ART access, while simultaneously addressing the barriers surrounding access, aiding in navigating linkage to PrEP and ART care programs, and reducing barriers to, and building skills to support, medication adherence.”
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UCLA Fielding School Center for LGBTQ+ Advocacy, Research & Health Marks Its First Year

UCLA Fielding School Center for LGBTQ+ Advocacy, Research & Health Marks Its First Year

UCLA Fielding School Center for LGBTQ+ Advocacy, Research & Health Marks Its First Year
In its first year, the Fielding School’s UCLA Center for LGBTQ+ Advocacy, Research & Health (C-LARAH) has had impact across a spectrum of applied research and organizational work, focused on increasing equity for an underserved community
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Date:
Wednesday, January 5, 2022
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Brad Smith, Senior Public Relations Officer

Opening the UCLA Fielding School of Public Health's newest research center, dedicated to the mission of improving the health and social well-being of sexual and gender minorities, would be a challenging task at any time. For Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology, founding, organizing, and leading the new UCLA Center for LGBTQ+ Advocacy, Research & Health (C-LARAH), which officially opened its doors in December of 2020, opening the center in the middle of a global pandemic was just part of the job.
“COVID-19 has definitely made every task we’ve accomplished, in terms of organizing, research, and student and community service, more demanding, but what better time than now?” said Mimiaga, who serves as director of C-LARAH. “This is the time for academic institutions to bolster the progress made by the LGBTQ+ movement; we must bridge health, research, and training measures to reduce inequities and close the health disparity gap … and ‘challenging times’ certainly help focus on what is important.”
By any standard, the team of faculty, staff, and students led by Mimiaga, who also serves as a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA, has met and exceeded those challenges. In 12 months, even as they worked through the day-to-day needs of organizing the center, the team has:
  • Published 38 new scientific journal publications and five book chapters, which can be reviewed here. The findings were published in journals that include The Lancet, The Lancet Global Health, Drug and Alcohol Dependence, AIDS and Behavior, Journal of the International AIDS Society, Journal of AIDS, and AIDS;
  • Collaborated with 37 UCLA graduate students, affiliated post-doctoral researchers, and staff, along with 20 faculty affiliates;
  • Received nearly $8.6 million in federal research funding from five different U.S. National Institutes of Health entities in FY 2021 (>$50 million for all project years for current grants combined); and
  • Built a website for the new center that spotlights C-LARAH’s research program.
In 2020-21, C-LARAH’s research has focused on improving health disparities and health equity among LGBTQ+ communities, including epidemiological cohort studies; developing and testing interventions to decrease sexual risk in HIV primary and secondary prevention; and biobehavioral interventions to enhance uptake and adherence for both HIV treatment (ART) and prevention (PrEP/PEP). The team has also researched psychosocial treatments for stimulant use disorder and concurrent HIV risk, and opioid use disorder and adherence to medication-assisted treatment; infectious disease and psychiatric epidemiology; and global health research within several resource constrained countries.
In addition to research in the United States, C-LARAH has ongoing global public health research globally focused on HIV primary and secondary prevention. Currently, these include projects in Brazil, India, Nigeria, and Vietnam; and recently completd projects in Ecuador, Peru, South Africa, Thailand, and Zambia.
“I’m very proud of the team we’ve assembled, including our UCLA staff, students, and faculty-affilliates and our research partners in the U.S. and globally,” Mimiaga said. “And I am very excited about the impact C-LARAH has had and will continue to have in training future generations of scientists interested in conducting LGBTQ+ public health and clinical research, and ensuring that all sexual and gender minorities can live openly and authentically, and be healthy.”
For more information, see “Promoting Public Health for the LGBTQ Population” from the most recent edition of UCLA Public Health magazine.
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