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Research

Domestic Projects

Project iRaPID: Integrated rapid access to HIV prevention program for people who inject drugs

Sponsor: National Institutes of Health (NIH)
Mechanism: R21 (R21DA051934)
Period: 2020 – 2024
Role: Principal Investigator
DescriptionThe opioid epidemic in the United States, especially the rise in injection drug use, necessitates the need for novel strategies to reduce the risk of HIV infection in people who inject drugs (PWID). The proposed research aims to jump-start the HIV prevention cascade by developing and pilot-testing a nurse-delivered, integrated rapid access to HIV prevention program for PWID (iRaPID) program that incorporates same-day access to pre-exposure prophylaxis (PrEP) and opiate agonist therapy (OAT). Findings will inform the development of innovative and tailored primary HIV prevention strategies to address co-occurring sexual and drug risk behaviors and to enhance the HIV prevention gap in PWID amid the ongoing opioid crisis.

Project EPIC-P: Expanding pre-exposure prophylaxis (PrEP) implementation in communities of people who inject drugs and their risk network members

Sponsor: Gilead Sciences
Mechanism: Gilead Investigator Sponsored Research (IN-US-412-5629)
Period: 2019 – 2023
Role: Principal Investigator (PI)
Description: This is a non-randomized, open-label study designed to test the feasibility, acceptability, and preliminary efficacy of the EPIC-P intervention among high-risk people who inject drugs (PWID) with opioid dependence (N=100). Based on the IMB model for health behavior change, the EPIC-P is a biobehavioral intervention that incorporates: i) a biomedical component (i.e., Descovy prescription); ii) behavioral component (i.e., drug- and sex-related primary HIV prevention); and iii) mHealth strategy (i.e., text messaging PrEP reminders). This is the first study that is utilizing Descovy as an HIV prevention tool for HIV prevention among PWID.

Project SHADE: Smartphone Health Assessment for Digital Engagement

Sponsor: UConn CAHNR Pilot Award
Mechanism: NA
Period: 2023 – 2024
Role: Principal Investigator (PI)
Description: This project aims to assess the thoughts and attitudes of people who use drugs (PWUD) regarding health studies involving the collection of specific data linked to smartphones and smartwatches. This survey will assess the acceptability and feasibility of data collection from smartphones and smartwatches. The survey will collect information regarding how comfortable PWUD are when it comes to sharing this data.

Project SHIP: Smartwatch Health Innovation Program

Sponsor: UConn CAHNR Pilot Award
Mechanism: NA
Period: 2023 – 2024
Role: Principal Investigator (PI)
Description: This project aims to understand feasibility and acceptability of wearable smartwatch devices for passive data collection among people who use opioids. The purpose of this study is to explore the feasibility and acceptability of using wearable smartwatches for harm reduction among adult people who use drugs (PWUD). Participants will wear smartwatches and answer EMA surveys daily for 30 days.

Optimizing evidence-based HIV prevention targeting people who inject drugs on PrEP

Sponsor: National Institutes of Health (NIH)
Mechanism: R01 (R01DA055534)
Period: 2022 – 2027
Role: Co-Investigator (Co-I)
Description: A multiphase optimization strategy (MOST) will be used to conduct an optimization trial among people who inject drugs (PWID) and are newly enrolled on medication for opioid use disorder (MOUD). We will assess the impact and cost of four promising intervention components (Attention, Executive Functioning, Memory, and Information Processing). The components are designed to accommodate cognitive dysfunction such that participants can better process and utilize intervention content, thus leading to enhanced PrEP adherence and HIV risk reduction.

International Projects

Development & testing of a mobile application to enhance HIV prevention cascade in Malaysian MSM (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: R21/R33 (R21TW011665 / R33TW011665)
Period: 2020 – 2025
Role: Principal Investigator
Description: This project involves developing and prospectively testing the efficacy of a clinic-affiliated app (JomPrEP®) to deliver an integrated HIV prevention intervention that will promote HIV testing and linkage to pre-exposure prophylaxis (PrEP) and incorporates screening and support for underlying psychiatric and substance use disorder (P/SUD) among men who have sex with men (MSM) in Malaysia. Using a Type 1 Hybrid Implementation Science Trial, this project aims to evaluate the efficacy of the JomPrEP® app vs. treatment as usual (TAU) in Malaysian MSM for primary (HIV testing and PrEP uptake) and secondary (PrEP adherence and persistence) efficacy outcomes. Multi-level implementation outcomes will involve stakeholders’ perspective of the relative advantage of JomPrEP® app, adaptability, perceived design quality and packaging, compatibility in the Malaysian context, interest in sharing the app with others and readiness for implementation.

Training in mHealth prevention with MSM (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: K01 (K01DA051346)
Period: 2020 – 2025
Role: Principal Investigator
Description: The proposed research focuses on conducting two formative studies to overcome barriers along the HIV prevention cascade that now includes pre-exposure prophylaxis (PrEP) among Malaysian men who have sex with men (MSM). First, information about MSM’s preferences of various attributes of PrEP delivery programs, including segmentation of ATS-using MSM, will be assessed using a nationwide choice-based conjoint (CBC) online survey. Then, building on the first study, we will develop and test an mHealth-based intervention (smartphone app) to overcome barriers along the prevention continuum, including HIV testing, co-occurring sexual and drug risk behaviors and PrEP uptake among Malaysian MSM.

Integrated online-to-offline (O2O) model of care for HIV prevention and treatment among men who have sex with men (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: R34 (R34MH130233)
Period: 2022 – 2025
Role: Principal Investigator (MPI)
Description: The proposed research focuses on developing and testing a web-based platform, called Jom-TestPlus, that will incorporate HIV self-testing (HIVST) with real-time e-counseling (eHIVST) with online-to-offline (O2O) linkage to HIV prevention and treatment services while simultaneously co-addressing chemsex-related needs for men who have sex with men (MSM) in Malaysia. This model represents a potentially impactful strategy for reaching marginalized populations, like MSM, and allows immediate engagement in the post-test linkage process to prevention or treatment services.

Improving HIV testing and PrEP for transgender women through mHealth (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: R21 (R21AI157857)
Period: 2021 – 2023
Role: Principal Investigator (MPI)
Description: This research project focuses on developing and testing a clinic-affiliated app (MyLink2Care) to deliver an integrated HIV prevention intervention that incorporates tailored HIV prevention and gender-affirming care services to transgender women (TGW) in Malaysia. We expect that this project will lead to the development of an innovative and culturally tailored app that will address multilevel barriers to HIV testing and PrEP uptake in Malaysian TGW.

Digital Phenotyping-Pilot survey of MSM

Sponsor: UConn CAHNR Pilot Award
Mechanism: NA
Period: 2023 – 2024
Role: Principal Investigator (PI)
Description: This project intends to assess the thoughts and attitudes of men who have sex with men (MSM) about health studies involving the collection of specific data linked to smartphone use via an online pilot feasibility study in Malaysia. This concept enables quick participation in the post-test linking process to preventive or treatment facilities for substance use, psychological issues, and HIV/AIDS, making it a potentially effective technique for addressing vulnerable groups like MSM.

Strengthening the HIV care continuum for transgender women living with HIV in Malaysia

Sponsor: National Institutes of Health (NIH)
Mechanism: R21 (R21MH128114)
Period: 2022 – 2024
Role: Consultant
Description: This project aims to develop and evaluate the impact of a peer navigator program on HIV-positive transgender women’s engagement in the HIV care continuum by conducting qualitative assessments and a 6-month pilot feasibility study. Qualitative assessments will consist of one-on-one in-depth interviews with HIV-positive transgender women and HIV physicians with the goal of identifying the key facilitators and barriers to optimal HIV care engagement for transgender women. The pilot feasibility study will examine the impact of peer navigators on being linked to HIV care, initiating ART, and being retained in HIV care.

Gamification to enhance engagement in HIV prevention and co-morbid conditions in young men who have sex with men (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: R21 (R21AI167773)
Period: 2022 – 2024
Role: Consultant
Description: Young men who have sex with men (YMSM) have among the highest rates of HIV transmission of any group in Malaysia and are also one of the only groups that is seeing an increase in the rate of new HIV infections in Malaysia. The purpose of this proposal is to adapt and evaluate the feasibility and acceptability of a mHealth smartphone application that uses gamification to increase YMSM’s engagement in HIV prevention activities, including HIV testing and PrEP, in Malaysia. This project will provide important insight on how to improve HIV prevention in this vulnerable community and inform future innovative research efforts to optimize HIV outcomes.

Developing an artificial intelligence-based mHealth intervention to increase HIV testing in Malaysia

Sponsor: National Institutes of Health (NIH)
Mechanism: R21/R33 (R21TW011663 / R33TW011663)
Period: 2020 – 2025
Role: Consultant
Description: The proposed research will focus on developing a chatbot that using artificial intelligence to promote HIV testing among men who have sex with men (MSM) in Kuala Lumpur, Malaysia (My). Once developed and adequately tested, the new chatbot (named MyTestBot?) will be embedded into a social networking app selected by MSM to create an mHealth intervention to provide MSM with real-time HIV testing-related information, motivation, and behavioral skills. MyTestBot? will provide culturally tailored messages to promote HIV testing in MSM that does not rely on intensive human resources to develop and maintain.

Completed Projects

COVID-19 vaccine hesitancy among people living with HIV: A national survey (USA)

Period: 2020 – 2021
Role: Multiple Principal Investigator (MPI)
Description: Scaling up vaccination against COVID-19 is central to controlling the COVID-19 epidemic in the United States. Novel vaccines were developed rapidly but public concerns over safety and efficacy have resulted in heightened distrust and vaccine hesitancy. This is particularly concerning among people with HIV (PWH) who are at higher risk of developing a severe case of COVID-19 due to overlapping co-morbidities. This study’s aim is to identify and understand COVID-19 vaccine hesitancy in a sample of PWH in the U.S.

Examining ethical concerns in the context of app-based HIV prevention research with men who have sex with men in the Malaysian context (Malaysia)

Sponsor: National Institutes of Health (NIH)
Mechanism: R25 (R25DA031608)
Period: 2020 – 2021
Role: Subaward Principal Investigator (PI: Fisher)
Description: App-based platforms in mHealth are a promising strategy to increase access to effective biomedical preventions, like pre-exposure prophylaxis (PrEP). Little guidance is available to inform researchers about the ethical issues related to the use of app-based HIV prevention programs among MSM in Malaysia. Given the social, behavioral, and ethical issues surrounding the use of the mHealth platform, particularly in low- and middle-income countries (LMICs) such as Malaysia, we designed this study to assess attitudes toward the use of an app to link MSM to PrEP services and to examine perceived ethical issues related to its use among Malaysian MSM.

Methadone vs. Buprenorphine Therapy for opioid dependence: Diet and metabolic implications

Sponsor: Rutgers University
Mechanism: Busch Biomedical Grant Program
Period: 2018 – 2023
Role: Multiple Principal Investigator (MPI)
Description: This is a multi-site observational study that will utilize a prospective longitudinal cohort design to study the differential effects of methadone vs. buprenorphine maintenance therapy on dietary or metabolic outcomes (e.g., weight gain, glycemic control measures) among individuals with opioid dependence. This study will provide important insights into the role of sweet preference in influencing sugar intake and weight outcomes in OUD patients. This can aid in risk assessment and development of targeted dietary interventions to improve diet quality and prevent excess weight gain in this high-risk population.

Monkeypox 2022 outbreak survey: Understanding experiences with testing, treatment and vaccination among gay, bisexual, and other men who have sex with men

Sponsor: University of Connecticut
Mechanism: Pilot Award
Period: 2022 – 2023
Role: Multiple Principal Investigator (MPI)
Description: In this study, we will conduct a national online survey of adult gay, bisexual, and other men who have sex with men in the United States to explore attitudes and experiences related to the 2022 monkeypox outbreak. Specifically, the study will assess experiences with monkeypox exposure and infection, access and uptake of monkeypox treatment (if applicable). The study will also explore the knowledge of, and access to, the monkeypox vaccine, including vaccine availability in their geographic area, challenges associated with vaccine access, vaccine uptake, and vaccine completion (2-dose schedule). We will also explore participants’ experiences of stigma and/or discrimination in the delivery of testing, treatment, and care related to monkeypox infection and in the seeking and receipt of monkeypox vaccination.

Informing HIV and STI prevention among men who have sex with men (MSM) in Nepal

Sponsor: University of Connecticut
Mechanism: Pilot Award
Period: 2022 – 2023
Role: Principal Investigator
Description: We will conduct a bio-behavioral survey to study the prevalence and related risk factors for HIV and STIs among MSM in Nepal. The proposed study will obtain more recent and updated data regarding HIV infection and syphilis rates among MSM in Nepal, uptake in sexual health services, and risk factors (e.g., sexual risk behavior, substance use, stigma and discrimination, mental health, among others). This study will expand on the previously collected information to gain a better understanding of the current state of HIV and STI prevention among this vulnerable population.