The Fenway Institute is one of the preeminent LGBTQIA+ health and HIV research organizations in the world. What makes The Fenway Institute unique is our staff and our community-based research setting. Each day, our team demonstrates that the best way to equitable, ethical, and inclusive science is to do it in community.
We are always looking for community members who want to make a difference in LGBTQI+ health and wellness by participating in research. A list of studies that are currently recruiting is posted online. If you are interested in learning more, or want to find out if you may be eligible to participate, please fill out this form or contact us directly at 617.927.6450.
Here are some highlights of recent research published by Faculty and staff at The Fenway Institute.
AJPM Focus
Pre-exposure prophylaxis (PrEP) use among transgender women in the U.S. has not reached levels capable of changing the trajectory of the HIV epidemic due to number of barriers. This study analyzed data collected from transgender women not living with HIV in eastern and southern U.S. in 2020-2022 and found that transgender women may prefer long-acting injectable PrEP to daily oral PrEP for HIV prevention. Increasing availability and access to long-acting injectable PrEP may improve PrEP uptake in transgender women, particularly in combination with other interventions designed to reduce barriers to accessing the medication.
AIDS Patient Care and STDs
Telehealth Interventions to Improve HIV Care Continuum Outcomes: A Narrative Review
In 2022, only 76% of the 1.02 million people in the U.S. with an HIV diagnosis received any HIV medical care, and only 65% had reached viral suppression on their most recent viral load test. To end the domestic HIV epidemic, we need to expand and improve access to HIV care, adherence to antiretroviral therapy (ART), retention in care, and viral suppression. Interventions that leverage telehealth technologies have the potential to do this. This study looked at 23 different telehealth interventions, with texting and videoconferencing being the most common. These interventions were reported as acceptable and feasible, with several improving antiretroviral therapy adherence. Further research is recommended to fully leverage the potential of telehealth for ending the HIV epidemic in the U.S.
Current Opinion in HIV and AIDS
Why is roll-out of long-acting PrEP agents so slow?
Injectable cabotegravir for HIV preexposure prophylaxis (PrEP) is effective, yet global implementation has been slow. This reviews factors which have contributed to the delayed roll-out of this medication, including:
- Global cabotegravir PrEP implementation delays are largely driven by a lack of medication availability and access
- The medication is not available outside of research studies in Africa and Asia
- The process towards generic medication production is lengthy, keeping costs high
- In the U.S., the medication is costly even with insurance and the process for health centers to acquire and administer cabotegravir is complex, leading to implementation delays
Injectable cabotegravir PrEP has not fulfilled its potential to be an alternative for those who have trouble adhering to a daily PrEP pill regimen. Lessons learned regarding cabotegravir can inform the rollout of future HIV prevention long-acting agents.
JAIDS
In 2022, the largest number of new U.S. HIV infections occurred among people aged 25–34 years. Those aged 13–24 years accounted for 20% of new infections and of every 100 youths aged 13–24 years diagnosed with HIV in 2021, only 55% were retained in HIV care, and 35% had unsuppressed viral loads.
This five-year study found that a stepped care, behavioral and technology-based intervention for adolescents living with HIV improved antiretroviral therapy adherence by more than 30 percent and improved their viral load suppression by 74 percent over common standards of care. Read more on the UCLA blog.
Journal of Racial and Ethnic Health Disparities
To effectively address HIV infection in Black men who have sex with men (MSM), experiences of discrimination and HIV need to be examined from the perspective of strength and resilience and not just risk. Fostering a strong connection with one’s sociocultural identities may increase individuals’ ability to cope with discrimination and has been related to positive health outcomes. Researchers have coined the term positive intersectionality to refer to this effect.
An analysis of Black MSM through the lens of positive intersectionality revealed novel insights into psychosocial factors and PrEP outcomes for Black MSM. Individuals with high levels of positive intersectionality tended to have better outcomes related to mental and emotional health and social well-being. In contrast, findings on PrEP adherence suggest that motivations for PrEP engagement in Black MSM are complex and may reflect intricate mechanisms that require further research.
Taken together, the findings have implications for future research and intervention development by underscoring the importance of resilience and building on the strengths of Black MSM to promote healing and positive health outcomes.
AIDS Education and Prevention: An Interdisciplinary Journal
Syndemics describes the clustering of social factors, behavioral risks, and diseases that can lead to negative health outcomes for vulnerable populations. In the field of HIV prevention and care, most studies of HIV syndemic problems are do not differentiate by HIV transmission groups and rarely focus on people living with HIV. This study looked at sexually active heterosexual men (HM), heterosexual women (HW), and men who have sex with men (MSM) living with HIV in Brazil, Thailand, and Zambia.
Overall, syndemic problems were associated with lower anti-retroviral medication (ART) adherence over time, but this differed across sexual transmission categories. For HM and HW, those with 2 or 3+ syndemic problems had lower odds of ART adherence than those with none. However, for MSM, the association between syndemic scores and ART adherence was not significant. While syndemic problems generally predicted poorer ART adherence, the association appears nuanced across subgroups.