HIV remains a critical global public health issue and a significant threat to global health security after having claimed more than 40 million lives, according to the World Health Organization. The stark reality is that one in five of the more than one million people living with HIV in the U.S. is unaware of his or her infection, the U.S. Department of Veterans Affairs reported.
Even amid recent strides to end HIV, the most concerning aspects about the treatment of the virus include the wide disparities among Black and Latino Americans. According to the Centers for Disease Control and Prevention, approximately 13% of Black Americans with HIV still do not know their status. Additionally, Black and Latino Americans are less likely to be virally suppressed than adults from other racial groups who have HIV.
One of significant factors related to HIV disease management is smoking status, as smoking negatively impacts HIV treatment, and people with HIV are more likely to smoke relative to the general population. In a dedicated effort to help those who are coping with the chronic disease of HIV/AIDS, University of Houston's RESTORE Lab researcher Lorra Garey and her team are collaborating on the development of a mobile intervention for Black American smokers who are infected with HIV.
Chronic and stigmatized diseases, such as HIV, are associated with a lot of different life stressors. Within communities of color, these stressors are on top of daily life stressors experienced because of being a person of color, including microaggressions, racism and discrimination. The combination of these things makes disease and stress management more challenging within these groups, which, in part, is likely to lead to substance use to cope."
Lorra Garey, Resaercher, University of Houston
Garey's research initiative was awarded a nearly $1.3 million Notice of Special Interest (NOSI) grant by the National Institute on Drug Abuse as a supplemental award under the existing award for the HEALTH Center for Addictions and Cancer Prevention, led by principal investigator Ezemenari Obasi. The research project is entitled, "A Fully Automated and Culturally Adapted Health Intervention for Smoking Cessation Among Black Smokers with HIV."
"It is so important that we start moving more towards an individualistic approach to understand health and intervention. It is more of a precision medicine perspective," Garey said. "We're looking at the individual and what they bring to the table – using their current skills to build upon and provide them the most effective treatment for them we can."
The RESTORE team is currently recruiting 72 people who are HIV positive. Garey is also collaborating with St. Hope Foundation and Thomas Street. She explained that her team is building upon the research materials from the Mobile Anxiety Sensitivity Program for smoking (MASP) mobile smoking cessation intervention.
"We are modifying materials (from the MASP app) to incorporate psychoeducation about HIV, being a smoker and how it affects mood, the risks of poor health outcomes and considering these complicated interconnected factors," Garey said. "We're also partnering with other people on this grant who have HIV expertise. We are drawing from their experience to make sure that this intervention is acceptable, empirically-supported and appropriate for our target population."
Garey emphasized that it was an honor to have NIDA's support to pursue the initiative.
"I appreciated that NIDA thought this was worth exploring," Garey said. "Ultimately, it's about what we can do to improve the overall well-being and quality of life for those who are HIV positive. With this app, we are hopeful that people will learn new skills – to manage stress, anxiety, depression and negative moods that will assist with them quitting smoking and help them improve their quality of life and well-being."
The app also features real-time interventions and motivational messages that will help with HIV symptom management.
"If they quit smoking, that can translate into better HIV symptom management outcomes. It's like a cascading positive effect," Garey said. "If we can tackle this, we can move on to other things. How do we get over smoking as a way to cope with life stressors? That's such a big thing."
Garey added that she's looking forward to collaborating with the community through this research initiative and exploring how her work can make a positive impact in the community.
"I'm really excited to work with this community because there's a lot of stigma around being HIV positive," Garey said. "I think it's definitely improved, but it's still very present. Folks who are dealing with a chronic disease such as HIV deserve specialized care, attention and 'to be seen.' I am excited to be an advocate for this work, be involved in it, and try to help the community as best as I can."