eHealth HIV Prevention Studies

Sabina Hirshfield, PhD, Principal Research Scientist, Department of Medicine, and Visiting Associate Professor in Downstate’s STAR Program, is conducting the following eHealth HIV prevention studies.

The NIDA funded study entitled “Supporting Treatment Adherence for Resilience and Thriving (START): A mHealth intervention to improve ART adherence for HIV-positive stimulant-using men” (Hirshfield, Co-PI) will test the efficacy of Supporting Treatment Adherence for Resilience and Thriving (START). START is a national mHealth intervention that will integrate two theoretically grounded, evidence-based behavioral interventions. The goal of START is to reach stimulant-using MSM, both inside and outside of major urban centers, to develop a scalable, efficacious, mHealth approach to optimize adherence to antiretroviral medications, regardless of whether men are seeking formal substance use treatment. This two-arm randomized controlled trial of a 6-month mHealth intervention for 350 HIV+ substance using MSM (SUMSM) seeks to improve viral load suppression at 6 months and determine whether any gains are maintained at month 12. If effective, START is scalable to reach a broader population of HIV+ SUMSM and may be adapted to clinic- and community-based settings.  

The NIMHD funded study entitled “Increasing Engagement and Improving HIV Care Outcomes via Stigma Reduction in an Online Social Networking Intervention among Racially Diverse Young MSM and Transgender Women” (Hirshfield, Co-I) will: 1) test whether an online intervention that promotes user-generated content and engagement to address intersectional stigma is associated with improvements in the HIV prevention and care continuum (HIV testing, antiretroviral adherence, viral suppression) as compared to an information-only control arm; 2) explore whether user engagement, as measured by quantitative and qualitative paradata, mediates the intervention’s stigma- and HIV care-related outcomes; and, 3) examine how changes in intersectional stigma and improvements across the HIV care continuum vary between the researcher-driven vs. peer-driven social network intervention conditions.

The NIAID funded study entitled “Understanding Viral Suppression for Newly Diagnosed HIV+ Men to Inform Implementation of TasP/U=U” (Hirshfield, Co-I) examines TasP and U=U messaging, a necessary component of the strategy to end the HIV epidemic. The study aims to address these issues with two studies grounded in the Social Ecological Model (SEM) to simultaneously examine both VL suppression and implementation barriers surrounding U=U from multiple levels of influence. Study 1 will involve longitudinally following 250 newly diagnosed SMM, capitalizing on an existing cohort tracking HIV seroconversion, to examine predictors of durable VL suppression as well as any potential risks associated with implementing U=U. In Study 2, we will use focus groups conducted three times over five years to inform implementation of U=U messaging.