Lisa B Hightow-Weidman

Research topics

Matched from this investigator's NIH project titles and abstracts.

• Depression
• Health Disparities in Mental Health
• Child and Adolescent Development
• Decision Making and Reward

Active NIH awards

• RP7 Impact

  5UM2HD111102-03

  NICHD · FY 2025 · $1.1M

  Stimulant drug (e.g., crystal methamphetamine, cocaine, ecstasy, MDMA) use is a substantial public health problem among young gay, bisexual and other men who have sex with men (YGBMSM) in the United States (US). Stimulant use is associated with increased engagement in sexual risk behaviors and decreased use of HIV prevention and treatment services, and as such leads to increased HIV acquisition/transmission. There are currently no evidence-based interventions to reduce stimulant use and concurrent HIV risk among YGBMSM; in response to this urgent need and building of over a decade of NIH-funded formative and pilot research, the proposed hybrid type 2 effectiveness-implementation trial is designed to assess the effectiveness and implementation strategies of Project IMPACT—a HIV status neutral, modular behavioral intervention to reduce HIV risk in YGBMSM who use stimulants in the context of high-risk sex. The intervention incorporates HIV risk reduction counseling (including supporting PrEP and ART use) with behavioral activation (BA)—an evidence-based, easy to administer, cognitive behavioral approach to treat depression that focuses on helping individuals re-engage in activities that generate feelings of enjoyment. Our conceptual model posits that BA will re-engage YGBMSM in pleasurable non-drug use activities that will serve as a natural reinforcement for functional behavior, improve depressed mood when not on stimulants by experiencing increases in pleasure, and decrease overall distress so that YGBMSM who use stimulants can better benefit from HIV risk reduction counseling. The initial pilot trials of Project IMPACT resulted in significant reductions in sexual risk, stimulant use and depressive symptoms. Research Plan Overview: By harnessing the resources, geographic and site diversity, and multidisciplinary expertise of the Adolescent Trials Network (ATN), the current proposal aims to efficiently and rigorously prepare Project IMPACT for rapid translation into real-world practice. Following the RE-AIM Framework, we will test the reach and effectiveness of Project IMPACT (compared to an enhanced Standard of Care condition) in a two-arm, multi-site and multi-format (i.e., in-person and virtual) randomized controlled trial of 360 cisgender YGBMSM who use stimulants in the context of high-risk sex. Participants will be followed for 12 months, and primary outcomes include number of condomless anal sex acts while not protected by PrEP (HIV- YGBMSM) or while not virally suppressed (HIV+ YGBMSM) and stimulant use (via urinalysis). We will also test our multi-faceted implementation strategy by assessing adoption/ accessibility and implementation using mixed-methods assessments that describe and examine characteristics of successful implementation (including differences by intervention delivery format). Finally, we will assess the feasibility of maintenance and sustainment of Project IMPACT by using the well-established CEPAC-AYA model to project its cost effectiveness on HIV transmissions, QALYs, and per person lifetime costs.

• RP7 Impact

  3UM2HD111102-02S1

  NICHD · FY 2024 · $795K

  Stimulant drug (e.g., crystal methamphetamine, cocaine, ecstasy, MDMA) use is a substantial public health problem among young gay, bisexual and other men who have sex with men (YGBMSM) in the United States (US). Stimulant use is associated with increased engagement in sexual risk behaviors and decreased use of HIV prevention and treatment services, and as such leads to increased HIV acquisition/transmission. There are currently no evidence-based interventions to reduce stimulant use and concurrent HIV risk among YGBMSM; in response to this urgent need and building of over a decade of NIH-funded formative and pilot research, the proposed hybrid type 2 effectiveness-implementation trial is designed to assess the effectiveness and implementation strategies of Project IMPACT—a HIV status neutral, modular behavioral intervention to reduce HIV risk in YGBMSM who use stimulants in the context of high-risk sex. The intervention incorporates HIV risk reduction counseling (including supporting PrEP and ART use) with behavioral activation (BA)—an evidence-based, easy to administer, cognitive behavioral approach to treat depression that focuses on helping individuals re-engage in activities that generate feelings of enjoyment. Our conceptual model posits that BA will re-engage YGBMSM in pleasurable non-drug use activities that will serve as a natural reinforcement for functional behavior, improve depressed mood when not on stimulants by experiencing increases in pleasure, and decrease overall distress so that YGBMSM who use stimulants can better benefit from HIV risk reduction counseling. The initial pilot trials of Project IMPACT resulted in significant reductions in sexual risk, stimulant use and depressive symptoms. Research Plan Overview: By harnessing the resources, geographic and site diversity, and multidisciplinary expertise of the Adolescent Trials Network (ATN), the current proposal aims to efficiently and rigorously prepare Project IMPACT for rapid translation into real-world practice. Following the RE-AIM Framework, we will test the reach and effectiveness of Project IMPACT (compared to an enhanced Standard of Care condition) in a two-arm, multi-site and multi-format (i.e., in-person and virtual) randomized controlled trial of 360 cisgender YGBMSM who use stimulants in the context of high-risk sex. Participants will be followed for 12 months, and primary outcomes include number of condomless anal sex acts while not protected by PrEP (HIV- YGBMSM) or while not virally suppressed (HIV+ YGBMSM) and stimulant use (via urinalysis). We will also test our multi-faceted implementation strategy by assessing adoption/ accessibility and implementation using mixed-methods assessments that describe and examine characteristics of successful implementation (including differences by intervention delivery format). Finally, we will assess the feasibility of maintenance and sustainment of Project IMPACT by using the well-established CEPAC-AYA model to project its cost effectiveness on HIV transmissions, QALYs, and per person lifetime costs.

• Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) Scientific Leadership Center

  5UM2HD111102-02

  NICHD · FY 2024 · $592K

  Adolescents and young adults (AYA) under the age of 25 in the United States (US) are the least likely of all age groups to: 1) know their HIV status, 2) initiate PrEP if HIV-negative even when indicated, 3) take medication as prescribed, attend medical appointments, and be virally suppressed if living with HIV. Persistent rates of new infections among US youth indicate that evidence-based and integrated approaches to increase the uptake and use of effective biomedical prevention and treatment products are required. Adolescence and young adulthood are challenging developmental periods, with significant physical, neurocognitive, emotional, and social changes. While multiple vulnerabilities and complex community factors drive the HIV epidemic among youth, these developmental periods are also characterized by opportunities for growth, achievement, and resilience. HIV research networks must be broad in agenda, go beyond traditional clinical sites and individual level interventions and address the multi-faceted, multi-level barriers that have thwarted HIV prevention and care progress among AYA. The newly envisioned Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) is a multi- component collaborative research enterprise focused on the reduction of new HIV infections among AYA in the US as well as improvements across the HIV continuum of care for youth living with HIV. Such a large-scale, complex clinical research program demands high productivity and strong contributions from each essential component. Our proposed overall network structure is conceptualized as a well-oiled machine with interdependent structures working together seamlessly to achieve the mission of the ATN. The Scientific Leadership Center (SLC) will bring all elements together and ensure that they function collaboratively, effectively, and efficiently with the Operations and Collaboration Center (OCC), NIH, and the overall network. The ATN has identified five high priority research areas to address the substantial and disproportionate gaps in the health outcomes of AYA across the HIV prevention and care continuum. With this application, we include seven highly innovative and impactful clinical trials led by talented multi-disciplinary teams, addressing all five priority research areas, spanning key populations of youth, multiple socioecological systems, and a variety of regulatory phases. We are also poised to accept emerging research opportunities as the field of prevention and treatment science advances. Communities will be situated at the center of the ATN’s work because community ownership, engagement, and connectedness are critical for successful research implementation. Drs. Hightow-Weidman and Hosek are uniquely qualified as MPIs to lead the SLC. Both have worked in the field of adolescent HIV prevention and treatment for the entirety of their careers and have worked collaboratively within the ATN for >16 years, giving them clear insight on how best to make this new iteration successful. Our overall vision for a redesigned and robust ATN is one that not only anticipates and plans for ongoing evolution in the HIV field and an emerging scientific agenda but one with a renewed focus on the most impactful science and priority areas.

• RP4 LEAP

  1UM2HD111102-01

  NICHD · FY 2023 · $11M

  ABSTRACT In the United States (US), transgender and gender diverse (TGD) youth have high rates of new HIV diagnoses, with Black, Latinx, and other TGD youth of color representing the majority of these cases. The HIV prevention and care continua emphasize the need to reduce HIV transmission risk via regular HIV testing, consistent condom use, and linkages to HIV prevention and care, such as pre-exposure prophylaxis (PrEP) among HIV- negative individuals and antiretroviral therapy (ART) and viral suppression among people living with HIV. However, there are inequities at each step of these continua among TGD youth of color. TGD youth of color experience intersectional oppression that results in unmet gender affirmation, legal, and economic needs, which have been linked to inequities in HIV prevention and continua outcomes. Building on formative work, this project seeks to test the effectiveness of the LEAP intervention, a HIV status-neutral intervention designed to address social determinants of health to reduce sexual risk behaviors, increase HIV prevention uptake (PrEP use), and treatment outcomes (viral suppression). LEAP will harness the resources, geographic diversity, and multidisciplinary expertise of the Adolescent Trials Network for HIV/AIDS Interventions (ATN) to provide gender-affirming individualized HIV prevention and treatment peer support, address health-harming legal needs, and improve educational and employment outcomes for translation into real-world practice. We propose a hybrid type 1 effectiveness-implementation study focused on testing the effectiveness of LEAP and secondarily conducting a prospective implementation process evaluation. HIV risk will be assessed using a composite indicator of risk, which is a binary HIV risk indicator of validated measures of sexual risk behavior, as well as self-reported and biomarkers of HIV status, PrEP use, and viral suppression. We will recruit and randomize 250 TGD youth of color from five different ATN Site Consortiums (stratified by site, HIV status, and gender), following participants for 12 months and collecting biological (i.e., HIV status, PrEP use, or viral load) and behavioral data. Findings will provide critical insights into the effectiveness of an urgently needed multicomponent intervention designed to address unmet gender affirmation, legal, and economic needs to reduce HIV inequities among TGD youth of color.

• Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN)Scientific Leadership Center; ADMIN SUPPLEMENT

  3UM2HD111102-01S1

  NICHD · FY 2023 · $2.0M

  The scientific rationale for this supplement is to support the Adolescent Medicine Trials Network for HIV Interventions (ATN) mission and overall aims. These supplemental funds are needed to cover unanticipated costs that were not budgeted in either the original Scientific Leadership Center (SLC) application (RFA-HD-23- 020) or the Operations and Collaborations Center (OCC) application (RFA-HD-23-021) but are critical to the successful execution of the ATN goals. All funds requested support core needs and gaps identified through collaborative consultation with members of the SLC, OCC and NIH and are for activities that are within the scope of the originally reviewed and awarded application. Based on our detailed review of the parent RFAs, we anticipated that all of these activities would have been included in the application put forth by the OCC. However, now that the network has launched, we have found that these critical gaps exist and re-budgeting from the prime award to cover these costs is not an option because all the awarded funds are obligated. Specific Aim 1: Advance a rigorous and innovative research agenda to end the HIV epidemic among adolescents and young adults (ages 13-24) in the US by establishing a robust ATN infrastructure that prioritizes and implements high-impact research. The administrative supplement will support research gaps in current ATN agenda, specifically addressing HIV prevention and care needs among youth impacted by alcohol use and aligning one of the currently supported protocols with a collaborative protocol in the HIV Prevention Trials Network (HPTN). Further, the supplement supports important aspects of successful research implementation, including enrollment and retention of participants through social media and eConsent and critical aspects of monitoring participant safety and pharmacovigilance. Specific Aim 2: Facilitate internal communication and external collaborations and idea exchange to optimize alignment with NIH priorities, address emergent opportunities and maximize network productivity and resources. The administrative supplement will support successful implementation and dissemination of ATN protocols. While the OCC is developing the ATN website, they do not have the capacity or expertise to create any recruitment/dissemination materials to be displayed on the website nor have they planned for any dissemination activities at the site level. Specific Aim 3: Develop and nurture partnerships that will ensure community and youth input at all stages of conceptualization, design, implementation, and interpretation of the research. The administrative supplement will support adequate representation of youth within the ATN. The Subject Matter Research Consultants (SMRC) are a core facet of the ATN and are being deeply embedded into all aspects of the project including as members of protocol teams, scientific leadership groups, and Communication and Dissemination Hub where they will provide ongoing consultation.

Earlier awards

• A multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the SouthFY 2024 · $693K
• A multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the SouthFY 2023 · $748K