Study aims to improve HIV care for communities of color

Leo Wilton, professor of human development, is co-investigator on a $5.8-million, five-year grant that will help African American and Latino(a) populations living with HIV.

“HIV is a serious threat to communities of color. The field of public health has been at a crossroads in terms of developing culturally-congruent HIV prevention strategies for these communities,” Wilton said. “We need a multi-level approach to eliminate racial and ethnic inequities in healthcare, as there are structural, historical and cultural factors that impact communities of color receiving HIV primary care treatment.”

The study, funded by the National Institute on Drug Abuse (NIDA) — part of the National Institutes of Health — is geared to individuals living with HIV who are not taking antiretroviral therapy or regularly receiving HIV primary care. According to the grant, more than half of those living with HIV/AIDS in the U.S. are insufficiently engaged in HIV primary care and not taking antiretroviral therapy, and this demographic is mainly African Americans and Latinos.

Wilton said the research addresses gaps in the HIV healthcare continuum through the awareness that communities of color face a unique set of barriers. He said minority populations are less likely to seek primary care due to factors like mental health, substance use, patient-provider relationship, stigma and discrimination, medical distrust, poverty, and inadequate access to healthcare and treatment.

“This study addresses an urgent need for developing and implementing high-impact, culturally-informed prevention interventions that are available for communities of color,” Wilton said.

The study bases a key objective on existing biomedical levels for viral suppression of HIV. Previous research states that a very low level of HIV in the blood is important for the optimal health of people living with HIV or AIDS and reducing the risk of transmitting the HIV virus to others.

This study also employs “Multiphase Optimization Strategy” (MOST), a framework for developing interventions that are effective, efficient, scalable and cost-effective.

“HIV prevention research suggests that high-impact prevention services are cost effective in addressing the HIV epidemic among vulnerable populations. Our study aims to build the most cost-effective and efficient intervention model,” Wilton said. “Previous research has substantiated the efficacy of HIV prevention interventions, but there has been a void in evidenced-based prevention strategies that have been developed and implemented for communities of color.”

The collaborative research team for this study includes co-principal investigators Marya Gwadz of New York University (NYU) Rory Meyers College of Nursing and Linda Collins of Pennsylvania State University College of Health and Human Development. The study also includes co-investigators Charles Cleland and Noelle Leonard of NYU Meyers College of Nursing and Scott Braithwaite of NYU Langone School of Medicine.

About Leo Wilton

Wilton has developed extensive research expertise in the areas of health disparities and inequities (primary and secondary HIV prevention), community-based research and evaluation, and Black psychological development and mental health. He is a principal investigator of a National Institutes of Health-funded study. The focus of the study is to develop and test a brief intervention to increase uptake of consistent HIV self-testing among young Black men who have sex with men (MSM) and transgender women, aged 18-29, in New York City. This project aims to increase HIV self-testing and reduce sexual, alcohol and drug use risk among this highly impacted community. He is also a co-investigator of a study, funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), to develop and assess the effectiveness of an internet-based HIV testing intervention optimized for mobile devices for young Black MSM and transgender women in New York City.

Wilton received the Distinguished Contributions to Ethnic Minority Issues Award by Division 44 of the American Psychological Association. He was appointed to the NIH Director’s Council of Public Representatives and was also invited to the White House by the Office of National AIDS Policy to take part in a research meeting addressing the state of the AIDS epidemic among Black men in the U.S. He participated on an expert panel of the World Health Organization to review guidelines on HIV testing services and served on a panel to provide professional testimony to City Council in New York City in a public hearing to address the HIV-related health disparities among vulnerable populations in Black communities.