Miller School, CUNY Collaborate on $3.9 Million Study on HIV Risk and Meth Use in Gay Men

Researchers at the University of Miami Miller School of Medicine and City University of New York Graduate School of Public Health and Health Policy (CUNY SPH) have been awarded an initial $3.9 million grant over two years by the National Institute of Allergy and Infectious Diseases (NIAID), with the goal of transforming HIV prevention in sexual minority men (SMM) while addressing the resurging methamphetamine epidemic.

Supported by NIAID’s LITE-2 initiative, the study was developed in response to patterns of sexualized drug use, including meth, that are 20 times more prevalent among SMM (i.e., gay, bisexual and other men who have sex with men) than heterosexual men. Expanded efforts to address meth use are essential to ending the HIV epidemic in the United States, as 1 in 3 new infections among SMM report recent meth use.

“We are thrilled to have received a LITE-2 award from NIAID,” said Adam Carrico, Ph.D., professor of public health sciences at the Miller School, who will serve as the Miller School’s MPI for the study and work in collaboration with CUNY SPH Professor Christian Grov. “This project represents the culmination of over 20 years of research by Dr. Grov and myself to address the role of meth as a pernicious, resurgent driver of the HIV/AIDS epidemic.”

“We have known for decades that meth use contributes to behavioral disinhibition, which puts people at greater risk for HIV, but now we will also answer questions related to whether meth use increases biological vulnerability,” says Dr. Grov. “This could point us toward the development of novel biomedical interventions targeting rectal immune function.”

The researchers plan to enroll 5,000 SMM across the United States into a cohort study. Assuming the team can meet a series of milestones during the first two years of the study, they will become eligible for up to three more years of funding.

Studying HIV

The LITE-2 study builds off the previous LITE-1 study findings that highlight the urgent need to focus on the multi-level mechanisms through which meth use drives HIV incidence.

Dr. Carrico and his team will be leading two efforts that build off a national cohort examining multi-level determinants of the intertwining epidemics of meth use and HIV in SMM across the U.S. The first will test how to respond with scalable telehealth motivational enhancement interventions to support PrEP use in SMM who use meth by enrolling more than 800 participants from across the U.S. in a trial. The second seeks to determine why meth use is linked to HIV risk by examining if meth-induced alterations in rectal immune function amplify biological vulnerability to HIV.

Dr. Grov will collaborate with Dr. Carrico’s team to conduct a case-cohort analysis to determine whether meth-associated alterations in rectal cytokines/chemokines explain heightened risk for HIV seroconversion among meth users. This work will be performed in partnership with Jennifer Manuzak, Ph.D., a mucosal immunologist at Tulane University.

Transformative Platform

Both research teams are eager to begin the study with the goal of building a platform for potentially transformative approaches to HIV prevention with SMM who use meth.

Findings from the study will guide subsequent efforts to develop multi-level intervention strategies targeting the intersection of meth and HIV risk, test the implementation of scalable, telehealth motivational interventions to optimize PrEP use if they demonstrate efficacy, and identify key alterations in rectal immune function that could be targeted by novel biomedical strategies to prevent HIV.

“We hope the LITE-2 initiative will guide geographically targeted, bio-behavioral public health approaches to address meth use as a resurgent driver of the HIV epidemic in SMM,” Dr. Carrico said.

Tags: CUNY, Dr. Adam Carrico, gay health, HIV/AIDS research, Miller School of Medicine, National Institute of Allergy and Infectious Diseases