Project Description:
Transgender women (Persons born “male” with a female gender identity) have frequently been the target of violence, prejudice and discrimination. As a result, transgender women often develop poor coping skills that often lead to risk taking behaviors and poor self care.

Previous research has identified trangender women for being at HIV risk for infection or transmission of HIV due to risky sexual as well as drug injection behaviors (most often illegal hormones). This CDC funded project intends to develop and evaluate a “ground breaking intervention” for transgender women. Demonstrated effectiveness of interventions for transgender women is extremely limited and there are no current CDC evaluated interventions for this population. Hudson Pride Connections, in Jersey City, NJ. ( www.hudsonpride.org) which currently offers a support group for trans women collaborated with CHEST on this project.

The Lady Classified Project
Principal Investigator: Juline Koken , Ph.D.
Advisor: Jeffrey T. Parsons, Ph.D.

Project Description:
While the majority of research on female sex workers has focused on the mental and physical health risk factors associated with street based or trafficked sex workers, the Lady Classified Project sought to identify the ways in which independent (freelance) female escorts who advertise on the Internet work to maintain their health, safety, and happiness while maximizing their profit in this business. Specifically, this study used a mixed-methods approach (qualitative interviews as well as a survey) to identify the ways in independent female escorts cope with the stressors associated with performing sex work, manage the impact of sex work related stigma on their personal lives, negotiate safer sex with clients, and the linkages between demographic factors, coping styles, and level of work-related burnout. Data collection was completed in 2008; data analyses are ongoing. This project was conceived and carried out as Juline Koken’s dissertation research. Dr. Koken successfully defended her dissertation in Social-Personality Psychology at the CUNY Graduate Center in December of 2008. This study was funded through the Pilot Grant Program of the Hunter College Center for HIV/AIDS Educational Studies and Training (CHEST).

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Project Description:
This study sought to examine the use of "club drugs” [i.e., cocaine, LSD, GHB, ketamine (“K”), MDMA (“Ecstasy”), and methamphetamine (“Crystal”)] among male and female young adults (ages 18-29) in New York City (NYC). Using an ethnically-diverse sample of 400 gay/lesbian/bisexual and heterosexual young adult men and women, this longitudinal, prospective study, using qualitative and quantitative methods, had three aims: (1) to determine patterns of use, individual differences in use, and changes in club drug use among members of this population over the course of one year; (2) to determine the extent to which antecedent person factors, social context factors, and constructs associated with the Theory of Reasoned Action to explain differences in year-long club drug use trajectories of young adults in NYC; and (3) to better understand how patterns of club drug use impact sexual risk behaviors among young adults in NYC.

Project Description:
Project X-Factor/Project PnP was a series of studies targeting gay and bisexual men using "club drugs" and engaging in risky sex. The primary component of Project PnP tested the effectiveness of a brief intervention using motivational interviewing.  More than 300 men also participated in an initial survey called "Project X-Factor," while 150 participated in the PnP intervention. A supplement to PnP also assessed characteristics of the HIV virus among a subset of HIV-positive men using crystal meth. 

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Project Description:
Project PLUS involves the implementation and evaluation of a theory based intervention aimed at improving HIV medication adherence and a reduction in alcohol use among HIV-positive men and women with alcohol use disorders.  The intervention condition incorporates two treatment approaches: (1) individual Motivational Interviewing (MI) sessions, designed to motivate participants to adhere to their HIV medication regimen and reduce their alcohol use, and (2) Cognitive Behavioral Therapy (CBT) to help participants build skills to modify alcohol use and maximize medication adherence. PLUS will recruit 400 participants through referrals from health care facilities, especially HIV clinics.

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Exploring Issues in HIV Testing among Black Men Who Have Sex With Men
Funder: New York City Dept. of Health and Mental Hygiene (DOHMH) and theNYC HIV Prevention Planning Group (PPG)
Funding Period: 2006
Principal Investigator(s): Jose Nanin, Ed.D. (CHEST); Tokes Osubu, M.A. (GMAD)
Co-Investigators: Jeffrey Parsons, Ph.D.
Project Coordinator: Justin Brown, B.A.

Project Description:
This exploratory pilot study set out to investigate the various challenges and facilitators related to HIV testing among Black men who have sex with men in New York City, using a cross-sectional survey design enhanced by focus groups. Study results will inform HIV prevention efforts for Black MSM created by DOHMH with guidance from the NYC HIV PPG. Other agencies with programs focusing on the health needs of this population will also benefit from the results of this study.

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Project Description:
This one-year study examined sexual risk behaviors of an ethnically diverse sample of HIV-positive male and female injecting drug users in NYC.  Participants were recruited from street locations and referrals from other research studies.

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Project Description:
This one-year study explored the lives of gay-identified men advertising as "escorts" via magazine advertisements, Internet user profiles, and escort websites. Fifty men completed an anonymous face-to-face qualitative interview and survey. The interview explored the men’s motivations for entering sex work and the impact of sex work on their sex lives. The survey measured demographics and psychosocial variables related to sexual risk-taking, as well as sexual behaviors with clients and casual sex partners.   The Classified Project also asked study participants about the kinds of resources and services that would be helpful to sex workers.

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Project Description:
This two-year study explored the context and culture of methamphetamine use among HIV negative and positive gay and bisexual men in NYC.  TINA also examined the relationship between use of crystal methamphetamine and HIV risk behaviors.  While methamphetamine has been studied extensively among gay and bisexual men on the West Coast of the United States, the prevalence of its use has remained largely unexplored in the New York City metropolitan area.  In Project TINA, methamphetamine using gay/bisexual men completed in-depth qualitative interviews and quantitative surveys. Participants were recruited from gay venues, public sex environments, and community agencies.

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Project Description:
This three-year project tested the effects of an enhanced HIV prevention intervention for HIV positive men (n=500).  Investigators randomized participants into either a six-week group intervention or a one-time event.  The intervention was designed to promote safer sex behaviors and facilitate HIV serostatus disclosure among an ethnically diverse sample of HIV-positive men in New York City.  The intervention is based on formative research with HIV-positive MSM previously conducted by CHEST (see Project SUMS).  Participants were recruited from gay venues, public sex environments, and AIDS service organizations using active and passive recruitment strategies. This was a multi-site project and the same intervention was also evaluated in San Francisco by researchers at the Center for AIDS Prevention Studies (CAPS).

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Project Description:
Positive Choices involved the implementation and evaluation of a theory-based HIV and alcohol use reduction intervention.  Alcohol dependent or alcohol abusing HIV-positive MSM in NYC were randomized to an intervention or control condition. The intervention condition included 4 individual Motivational Enhancement Therapy (MET) sessions (focused on reducing alcohol use) and 4 peer-led group sessions (focused on promoting safer sex and peer support).  Positive Choices recruited participants from gay venues, alcohol treatment programs, and AIDS service organizations using active and passive recruitment strategies

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Project Description:
Informed Choices, in collaboration with Mount Sinai Medical Center, involved the implementation and  evaluation of a cognitive behavior therapy (CBT) intervention designed to reduce unsafe sex and alcohol  use among HIV-negative MSM in NYC.  Participants were randomized to the intervention condition (12  sessions of CBT) or control condition (4 sessions of MET).  Informed Choices recruited participants from  gay venues, alcohol treatment programs, and community organizations through both active and passive recruitment strategies.

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Project Description:
Project PILLS examined the effects of drug use/abuse, medication side effects, life events and  expectations on adherence to protease inhibitor (PI) regimens and on HIV transmission behaviors among  HIV+ gay and bisexual men in NYC. Project PILLS recruits participants from gay venues, drug treatment  programs, and AIDS service  organizations using active and passive recruitment strategies. Results from the study will help community agencies design and implement successful medication adherenc  interventions.

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Project Description:
Project BUMPS examines the use of five party drugs popular among many gay and bisexual men: ketamine, methylenedioxymethamphetamine (“Ecstasy”), crystal methamphetamine (“Tina”, “Crystal”, “Ice”) cocaine, and gamma-hydroxybutyrate (GHB).  Project BUMPS seeks to understand how the contexts of party drug use interacts with men’s psychological factors to influence sexual risk-taking.  Because drug use patterns can change over time, BUMPS has recruited 450 men and has followed them longitudinally for one-year to study how drug use evolves over time. Project BUMPS recruited participants from gay clubs, bars, public sex environments, community agencies and Internet chat rooms.

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Project Description:
Project SPIN assessed sexual compulsivity and underlying conditions such as depression, anxiety, and internalized homophobia. Specifically, we evaluated the impact of sexual compulsivity on the lives of MSM, their STD and HIV risk, and the co-existence of substance use. SPIN recruited over 200 participants through referrals from mental health professionals, sexual compulsivity support groups, gay cruising areas, Internet chat rooms, gay bars /clubs, and print advertising. Participants interested in medication for treatment of sexual compulsivity symptoms were offered enrollment in a double-blind placebo trial using Celexa being conducted at MSSM.

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