Developing Internet-Delivered, Mindfulness-based Intervention to Reduce HIV Risk and Promote Mental and Sexual Health among Young Adult MSM

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PROJECT SUMMARY Young men who have sex with men (YMSM; age 18-24) are disproportionately burdened by HIV. Minority stress and its “downstream” effects in YMSM, including mental health issues, sexual risk behaviors, and suboptimal HIV testing, contribute to syndemic risks surrounding HIV. Mindfulness-based interventions (MBI), adapted for HIV prevention among YMSM and online-based delivery, could offer a transdiagnostic, innovative, and scalable method to address this public health issue. Consistent with NCCIH’s scientific priority in Disease Prevention and Health Promotion across Lifespan and NIH’s Strategic Plan to Advance Research on the Health of Sexual and Gender Minorities, the current project targets distressed, high HIV risk YMSM and aims to mobilize MBI for HIV prevention, to reduce minority stress and promote mental and HIV-related behavioral health. Specifically, this K23 will provide support for early phase, exploratory clinical trial by adapting mindfulness-based stress reduction (MBSR) and conducting a feasibility trial among YMSM. Candidate: Dr. Sun is a clinical scientist with a research background in HIV prevention and mental health concerning minority populations. In recent years, she has pursued clinical and research development in mindfulness. Building on her prior work, she is applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert in adapting and evaluating MBI to address HIV-related health disparities and an independent investigator capable of R01 funding. Mentoring: An excellent team of senior investigators serve as mentors on this proposal. Drs. Don Operario and Judson Brewer are co-primary mentors, who have complimentary expertise in HIV prevention for MSM and internet-based MBI for behavioral health. Three co-mentors bring expertise in internet-based HIV intervention with young adults (Dr. Larry Brown), mindfulness for population health (Dr. Eric Loucks), and stress physiology (Dr. Audrey Tyrka). Research: Guided by the ADAPT-ITT model, the proposed project aims to (1) adapt MBSR for distressed, high risk YMSM using focus groups with YMSM (n=30) and stakeholders (n=16), (2) refine the intervention protocol by administering adapted materials to distressed, high risk YMSM (n=18) via theatre testing, and (3) examine the feasibility and acceptability of the adapted iMBI for HIV prevention by randomizing 40 distressed, high-risk YMSM to the iMBI (n=20) and a waitlist condition (n=20). Primary outcomes are HIV testing and sexual risk behaviors. Secondary outcomes are stress biomarker (hair cortisol), psychological health, minority stress and coping. Trainings: Dr. Sun will receive tailored training in MBSR, intervention adaptation and implementation for YMSM, and a biopsychosocial-based understanding of stress through coursework, seminars, workshops, directed readings, and mentored research. Guided by an excellent mentorship team, these training and research experiences will establish the candidate’s career as an expert in HIV-related behavioral health through MBI. The candidate is institutionally supported by Brown University School of Public Health.