A Spotlight on our Research Team Efforts
In this e-newsletter, we share the extraordinary work of our research staff
In this issue
  1. Director's Message
  2. Featured Research Staff Publications
  3. Laying Foundations of Trust. Moving Towards Health Equity Town Hall Video Series
  4. Announcements
Marguerita Lightfoot, PhD - Director's Message
This newsletter features recent publications from our research coordinators (RCs) and statisticians/data analysts that make important contributions to the goal of ending the HIV epidemic.

For the last 10 years, I have been proud to lead the University of California San Francisco's Center for AIDS Prevention Studies and Prevention Research Center. HIV research is a team effort, which requires knowledge and skills from a diverse group of individuals, including principal investigators (PIs), research coordinators, statisticians/data analysts, and other investigators – all essential members of the research process.

UCSF’s Pride Values, specifically “diversity," create an environment of equity and inclusion with opportunities for everyone to reach their potential.

The expertise, efforts, and contributions of RCs (e.g., coordinating and executing day-to-day tasks of multiple clinical research studies, acting as an intermediary, overseeing data and specimen management, managing and reporting on study milestones) and statisticians (i.e., managing, analyzing, and communicating complex data in a clear and concise manner) in no small way help to drive and maintain CAPS’ impactful research agenda.

RCs and statisticians/data analysts have taken the lead writing peer review articles, serving as first authors, while others have had the opportunity to be second authors, making significant contributions to scientific publications. CAPS is excited to honor them and feature their publications in this newsletter. It is our intention that the research will pique/further pique your interest and add to your understanding of:

  1. Pre-Exposure Prophylaxis (PrEP) optimization efforts.
  2. The role of integrated HIV/drug prevention implementation in addressing HIV risk, amphetamine-type stimulant use, and structural realities (poverty, unemployment) faced by female sex/entertainment workers in Cambodia.
  3. Mobile health applications for engagement in HIV care and medication adherence in youth and young adults living with HIV.
  4. The DriSti intervention and its use to reduce HIV stigma in health settings in India.
  5. The use of a mHealth app intervention to improve care-engagement outcomes among Black sexual-minority male couples living with HIV. 

We highly regard all of CAPS’ RCs and statisticians/research data analysts for their unwavering commitment and contribution to HIV science and the research process.
Featured Staff Publications: Implementing Innovative Research and HIV Programming
Kristen Ming
Improving the HIV PrEP continuum of care using an intervention for healthcare providers: a stepped-wedge study protocol.

Kristen Ming, I Shrestha, A Vazquez, James Wendelborn, V Jimenez, N Lisha, Tor Neilands, H Scott, A Liu A, Wayne Steward, Mallory Johnson, Parya Saberi.

Pre-exposure prophylaxis (PrEP) has been demonstrated to be a highly effective method for preventing HIV; however, many individuals with PrEP indications are not receiving PrEP. Primary care settings provide an opportunity to offer PrEP to a wide range of patients. In this paper, we describe the PrEP-Optimization Intervention (PrEP-OI), which includes a PrEP Coordinator and a web-based panel management tool (called PrEP-Rx), and is targeted at healthcare providers (HCPs) to increase PrEP uptake and persistence among those at risk for acquiring HIV. The PrEP-OI study was initiated by Parya Saberi and colleagues in 2018 to examine the impact of the PrEP intervention through a stepped-wedge design among 10 primary care clinical sites in the San Francisco Department of Public Health. The results of this study can provide valuable insight into methods to reduce the burden of PrEP care on HCPs and improve the PrEP continuum of care.
Ellen Stein (L)
Protocol of a cluster-randomized stepped-wedge trial of behavioral interventions targeting amphetamine-type stimulant use and sexual risk among female entertainment and sex workers in Cambodia
 
Kimberly Page, Ellen S Stein, Adam W Carrico, Jennifer L Evans, Muth Sokunny, Ean Nil, Song Ngak, Chhit Sophal, Charles McCulloch, Lisa Maher

In this NIDA-funded study, we developed a multi-level intervention for female sex/entertainment workers (FSEW) in 10 Cambodian provinces. Cambodia Integrated HIV/Drug Prevention Implementation (CIPI) aimed to reduce HIV risk, amphetamine-type stimulant (ATS) use, and address structural realities (poverty, lack of employment) faced by many Cambodian women. Using a step wedge trial design, we tested the impact of the CIPI multi-level sequentially-delivered intervention. After baseline assessment of 1,198 FESW, those with ATS use disorder were assigned to a 12-week contingency management program (CCT) followed by a 4-week behavioral aftercare group (CCT+AC). At six months all ATS-abstinent participants were offered a financial literacy microenterprise (ME) opportunity. Outcomes assessed in 600 FESW at each 6-, 12- and 18-month follow-up visits included the number of recent sex partners, ATS toxicology results, and economic well-being. Relative to baseline FESW had (1) fewer sexual partners at all follow-up assessments with a 50% decrease at 12-months; (2) 60% lower odds of being ATS toxicology-positive 6-months, and continued but non-significant reductions at 12- and 18-months; and (3) improvements in economic well-being indicators at 12- and 18-months.
WYZ: a pilot study protocol for designing and developing a mobile health application for engagement in HIV care and medication adherence in youth and young adults living with HIV.

Xavier A. Erguera, Mallory O. Johnson, Torsten B. Neilands, Theodore Ruel, Beth Berrean, Sean Thomas, Parya Saberi

The goal of the WYZ study was to 1) build on formative work and develop a mobile health application for engagement in HIV care and medication adherence in youth and young adults living with HIV and 2) conduct a pilot study to evaluate its acceptability and feasibility. This paper describes the development of WYZ, a tailor-made mobile health application, and the innovative methodology developed to evaluate the acceptability and feasibility of this mHealth intervention. The study concept and design were developed by Dr. Parya Saberi (principal investigator) and colleagues. Xavier Erguera (clinical research coordinator) prepared the study protocols for publication. The paper 1) summarizes and critiques current mHealth intervention evaluation practices, 2) advances the rigor of mHealth application evaluation by publishing ahead of the clinical thresholds for determining acceptability and feasibility, and 3) attempts to move beyond self-report and simplified user analytics (e.g, page views) is proposing to calculate composite scores for measuring user engagement with the mobile health intervention.
Else Heylen

L Srinivasan, Elsa Heylen, T Raj, L Nyblade, D Devadass,M Pereira, Maria Ekstrand

HIV stigma in health settings acts as a significant barrier to care. The DriSti intervention targeted key stigma drivers, including instrumental stigma, symbolic stigma, transmission misconceptions, and blame to reduce stigma and discrimination among nursing students and ward staff, via two sessions with videos and interactive exercises on a computer tablet and one interactive face-to-face group session. Its efficacy was tested in a cluster-randomized trial in south India. Twelve-month outcome analyses of the nursing student subsample showed a significant reduction among intervention participants in endorsement of coercive policies and the number of situations in which they intended to discriminate against PLWH. Mediation analysis revealed the effects of the intervention on these outcomes were partially mediated by reductions in key stigma drivers including instrumental stigma, blame, symbolic stigma, and transmission misconceptions. The CDC has selected DriSti for inclusion in its Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention.
Hyunjin Cindy Kim
Study protocol: a pilot randomized waitlist-controlled trial of a dyadic mobile health intervention for Black sexual-minority male couples with HIV in the U.S.

Hyunjin Cindy Kim, Lance M Pollack, Parya Saberi, Torsten B Neilands, Emily Arnold, Darius J Bright, Robert W Williams III, Susan M Kegeles, Judy Y Tan
 
Being in a primary relationship is generally associated with more successful HIV care engagement across various populations. However, among Black sexual-minority men, the association between primary-relationship status and HIV-related outcomes is inconsistent across the HIV care continuum. Given the ubiquity of mobile technology access and use among racial/ethnic minority communities, leveraging mobile technology for HIV care engagement appears a promising intervention strategy. This paper outlines the protocol of the LetSync study, a pilot randomized controlled trial of a mHealth app intervention to improve care-engagement outcomes among Black sexual-minority male couples living with HIV. The study concept and design were developed by Dr. Judy Tan (Principal Investigator) and colleagues. Cindy Kim (Clinical Research Coordinator) prepared the study protocols for publication.

Laying Foundations of Trust: Moving Towards Health Equity. Town Hall Series.

Earlier in 2021 the UCSF CAPS/PRC hosted a 4-part UCSF CAPS/PRC Town Hall series exploring core social and behavioral aspects of trust and engagement with public health measures in relation to the COVID-19 pandemic. The series highlighted lessons from HIV work to stimulate programmatic and research agendas that promote health equity.
The Legacy of Racism and Earning Trust in Medicine a discussion feat Yolonda Wilson, Ph.D. - Session 1

The Legacy of Racism and Earning Trust in Medicine. This conversation sets a historical and contemporary view of medical mistrust and trustworthiness, particularly in the Black community, and identifies strategies for addressing and building trust in our HIV and COVID-19 work.

Yolonda Wilson, Ph.D., Associate Professor, Departments of Health Care Ethics, Philosophy, and African American Studies, St. Louis University, St. Louis, MO.

Be sure to like, share, and subscribe YouTube channel.
Community Engagement: Representation and Respect feat. Michele Andrasik, Ph.D. and Tina Hoff (Greater than COVID-19) - Session 2

On competent engagement and representation of communities of color in HIV and COVID research, practice, and communications. The discussion in this session focuses on competent engagement and representation of communities of color in HIV and COVID research, practice, and communications.

Michele Andrasik, Ph.D., Fred Hutchinson Vaccine and Infectious Disease Division, Professor at the University of Washington, and Tina Hoff Senior Vice President of Social Impact Media at the Kaiser Family Foundation. Greater than COVID.

Be sure to like, share, and subscribe. YouTube channel.
Risk and Decision Making in a Climate of Uncertainty feat. Dolores Albarracín, Ph.D. and Shawnika Hull, Ph.D. - Session 3

On how people understand risk (related to both acquisition and transmission) and how we make decisions about public and personal health-related behaviors (HIV- and COVID-related), particularly in the context of uncertainty, changing information, and misinformation. We examine tools at our disposal to address these challenges.

Dolores Albarracín is a renowned scholar in the fields of psychology, business, and medicine in the areas of attitudes, communication, and behavior. Dr. Albarracín received her Ph.D. in Psychology from the University of Illinois.
Shawnika Hull’s earned her Ph.D. in Communication at the University of Pennsylvania and was accepted in 2019 as a participant in the CAPS Visiting Professor Program.

Be sure to like, share, and subscribe YouTube channel.
Of Hesitancy and Harm Reduction. feat Bisola Ojikutu, MD, MPH, and Gregg Gonsalves, Ph.D. - Session 4

On the need to “reach people where they are” with respect to the promotion of public health guidance, for example, by understanding vaccine hesitancy as it relates to medical mistrust, and by engaging the debate between public health absolutism and harm reduction in the COVID context.

Bisola Ojikutu, MD, MPH, Associate Director of the Bio-behavioral and Community Sciences Core within the Harvard University Center for AIDS Research (HU CFAR), and Director of the CFAR Community-Engaged Research Program.
Gregg Gonsalves, Ph.D., is an expert in policy modeling on infectious disease and substance use, as well as the intersection of public policy and health equity. His research focuses on the use of quantitative models for improving the response to epidemic diseases.

Be sure to like, share, and subscribe YouTube channel.
ANNOUNCEMENTS
Mallory Johnson
A national search to hire for Dr. Marguerita Lightfoot’s position as chief of the Division of Prevention Science (DPS) was launched this summer. In the meantime, it is exciting that Dr. Mallory Johnson has agreed to assume the role of interim chief of the DPS. Mallory’s many years with UCSF working with the Center for AIDS Prevention Studies (CAPS) have focused on improving HIV treatment outcomes through patient empowerment, resulting in more than 150 peer-reviewed articles and several teaching and mentoring awards. In addition to Mallory’s new role as interim chief of DPS, he is also co-director of CAPS and director of the CAPS Developmental Core. He is looking forward to supporting DPS faculty and staff to continue the division’s impactful work to help end the HIV epidemic.
Dr. Marguerita Lightfoot proudly served as Director of the UCSF Center for AIDS Prevention Studies (CAPS) for the past 10 years and the Prevention Research Center (PRC) for the past seven years. Under her leadership, both Centers have been very effective in engaging the community and producing impactful research and outcomes that in no small way will help to end the HIV epidemic. It is with sadness and joy that we announce Marguerita’s departure from UCSF, as she has accepted an opportunity to serve as the Associate Dean of Research at the OHSU-PSU School of Public Health in Portland, Oregon. Her CAPS and PRC family wish her much success in the next chapter of her career.

As the new Directors of CAPS and the PRC, we are excited for the opportunity to continue Marguerita’s legacy and to put our own individual imprints on the important work that ensues. 
Jae Sevelius (L) and Greg Rebchook (R)
Jae Sevelius, Director of CAPS | Greg Rebchook, Director of PRC
UCSF is responding to the outbreak of the respiratory illness COVID-19. This website provides regularly updated information for the UCSF community. https://coronavirus.ucsf.edu/
HIV and COVID-19. Here you will find guidance and resources prepared by leading HIV organizations: https://prevention.ucsf.edu/COVID19 
Are you working to prevent HIV in your community?

We are home to 101 prevention scientists, researchers, and staff who conduct high-impact HIV prevention science. We also provide Technical Assistance in the use of HIV science.
  • Consult with one of our researchers
  • Review program materials
  • Targeted review of grant proposals and surveys
  • Assistance in facilitating research and community partnerships
  • Consultations on intervention curricula
  • Review assessments and measurement tools
  • Share stories of those living with HIV through the Positive Project
The mission of Center for AIDS Prevention Studies is to end the HIV epidemic and associated health and social disparities by conducting high impact HIV prevention science and building capacity among researchers and communities to effectively address HIV. Project #: 2P30MH062246
The mission of the UCSF Prevention Research Center is to maintain an interdependent network of community, academic, and public health partners to design and implement prevention research aimed at answering significant and innovative HIV research questions and promoting the wide use of practices proven to promote health for those infected and affected by HIV. Project #: 5U48DP004998