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Tyrel Starks

Ph.D., Southern Illinois University Carbondale


Department of Psychology
Hunter North, Room 941
695 Park Avenue
New York, NY 10065


Dr. Starks earned his undergraduate degree from the University of South Dakota (2003) and his doctoral degree in clinical psychology from Southern Illinois University Carbondale in 2009. He is a licensed psychologist in New York State and a member of the Motivational Interviewing Network of Trainers. He has taught undergraduate courses in Human Sexuality and Statistics as well as MA-level courses in Research Methods and Statistics at Hunter.



Current Areas of Research

My research focuses on substance use and sexual health in sexual minority populations, with a particular emphasis on relationship factors associated with sexual health in gay and bisexual men. After more than a decade, my team and I are responsible for the production of more than 50 publications on this topic. Noteworthy papers in this area include one of the most comprehensive assessments of whether associations between drug use and sexual behavior generalize from single to partnered sexual minority men (involving a sample of 65,000); the first paper testing indirect effects in the context of an Actor Partner Interdependence Model (APIM) with exchangeable dyads; and the first paper testing a 3-level APIM predicting day-level associations among partners' sexual behavior and drug use. Most recently, I introduced procedures for covariate hurdle modeling - an innovation that permits the incorporation of relationship covariates into analyses that pool single and partnered people - in a paper published by the Journal of Sex Research.


In 2009 when my research began, Motivational Interviewing (MI) was well-established; however, applications of MI with couples showed comparatively equivocal results. There was an absence of consensus about how to respond when relationship partners disagreed about change and some speculation that MI may not be amenable to wide application with couples. Funded by two intervention development grants (R34 DA043422 and R34 DA036419) and subsequently two R01 awards (DA045613 and DA050508) and protocol 156 in the Adolescent Trials Network, my research team and I have utilized qualitative research methods to analyze counseling session transcripts. The results have informed the development of multiple intervention protocols. Perhaps most important, findings informed the development of a novel framework for conducting MI with couples that has been articulated in a recent book.



Current grant-funded studies

Amy Conroy, PI; Tyrel Starks, Co-I: Couples-based Motivational Interviewing with technology to reduce alcohol consumption in HIV+ South African couples. Grant#: R34 DA029649. Total budget: $214,645 (year 1)

Tyrel J. Starks, PI: Expanding the potential of couples HIV testing: Adjunct modules to reduce drug use among vulnerable male couples. Grant # R01 DA050508. Funded by  National Institute of Drug Abuse. Project Period: 07/25/2020 - 05/30/2025. Total Budget: $3,912,425.

  • Tyrel J. Starks, PI. Evaluating the efficacy of annual CHTC retesting among male couples at high risk of HIV infection Grant #: R01 DA050508-S1. Project Period: 07/15/2020 - 5/31/2025. Funded by the National Institute on Drug Abuse. $1,286,386.

Tyrel J. Starks, PI: Intervention to reduce drug use and HIV incidence among high PrEP priority partnered YMSM. Grant # R01 DA045613. Funded by  National Institute of Drug Abuse. Project Period: 7/1/2017 - 5/31/2024. Total Budget: $4,701,017.  



Completed projects

Tyrel J. Starks & Sarah Feldstein Ewing, Project Co-Leads; Enhancing sexual safety: Couples communication and HIV testing among YMSM. ATN-156; Grant# U19 HD089875 (PI Naar) funded by the National Institute of Child and Human Development. Project Period: 9/1/2017 - 11/31/2022. Total Budget: $4,120,253.

Tyrel J. Starks, Project Lead. Effectiveness Implementation Research to Enhance HIV-Related Self-Management among Youth. ATN # 145; Grant #: U19 HD089875 (PI Naar). Project Period 10/01/2016 - 11/31/2022. Funded by the National Institute on Child and Human Development.

Tyrel J. Starks, PI. Examining community-based effectiveness of a substance use and HIV risk reduction intervention for young men of color Grant #: R01 DA041262. Project Period: 06/15/2016 - 04/30/2020. Funded by the National Institute on Drug Abuse. $1,197,529.

Tyrel J. Starks, PI: Couples-based intervention to reduce drug use and HIV transmission risk. Grant # R34 DA043422. Funded by the National Institute of Drug Abuse. Project Period 4/1/2017 - 2/29/2021. Total Budget: $666,900.

Tyrel J. Starks, PI. Improving HIV and Alcohol-Related Outcomes among HIV+ Persons in Community Settings. Grant #R01AA022302. Funded by the National Institute of Alcohol Abuse and Alcoholism. Project Period: 6/1/18 - 4/30/20. Total Budget: $3,206,624

Tyrel J. Starks, PI. Addressing substance use through CVCT. Grant # R34 DA036419.  Funded by the National Institute of Drug Abuse. Project Period 4/1/2014-3/30/2018.  Total Budget: $654,093



Recent Journal Publications

E-pubs ahead of print

Cain, D., Salsabilian, B., Jones, S.S. & Starks, T.J. (2023, July). Substance use, sexual agreements, and sexual risk behaviors among adolescent sexual minority males (aged 13-17) in the United States. Journal of Adolescent Health. DOI:

Cain, D. Sauermilch, D. & Starks, T.J. (2023, January). Client responses to video-based communication skills training involving PrEP for HIV: Tailoring an individual sexual health intervention for sexual minority men in relationships. AIDS and Behavior. DOI: 10.1007/s10461-023-03985-6.

Robles, G., Lee, J., Yu, M., Starks, T.J. (2023, May). Multilevel analysis of sociopolitical contexts, social support, mental health, and alcohol use among partnered sexual minority Latino men in the U.S. Journal of Racial and Ethnic Health Disparities. DOI:

Starks, T.J., Hillesheim, J., Stephenson, R. & Robles, G. (2023, June). Policy, relationships, and well-being: Associations between mental health and main partner relationships among cisgender sexual minority men in the context of US state-level policy. Psychology of Sexual Orientation and Gender Diversity. DOI:



Scales, D., Gorman, J.M., DiCaprio, P., Hurth, L., Radhnakrishnan, M., Windham, S., Akunne, A., Florman, J., Leininger, L. & Starks, T.J. (2022, December). Community-oriented Motivational Interviewing (MI): A novel framework extending MI to address COVID-19 vaccine misinformation in online social media platforms. Computers in Human Behavior, 141, 107609. 

Starks, T.J., Scales, D., Castiblanco, J., Gorman, J. & Cain, D. (2023, March). Correlates of mpox vaccination among sexual minority men in the United States: Sexual behavior, substance use, and main partner relationships. Journal of Sex Research, 60(5), 634-644.



Bosco, S.C., Robles, G., Stephenson, R., & Starks, T.J. (2022). Relationship power and intimate partner violence in sexual minority male couples. Journal of Interpersonal Violence, 37(1-2), NP671-NP695.

Bradford-Rogers, J. Lopez-Matos, J., Cain, D., Lopez, D. & Starks, T.J. (2022). Comparing the efficiency of online and field-based outreach for the recruitment of Black and Latino sexual minority men into an HIV prevention implementation trial. Prevention Science, 23(6), 900-906.

Dellucci, T.V., Jones, S.S., Adhemar, C., Feldstein Ewing, S.W., Lovejoy, T. & Starks, T.J. (2022). Correlates of HIV testing across the lifespan – adolescence through later adulthood – among sexual minority men in the US who are not on PrEP. Journal of Behavioral Medicine, 45(6), 975-982.

Randall, A.K., Totenhagen, C.J. & Starks, T.J. (2022). Underscoring risk and resilience factors in sexual and gender minority relationships from theory to practice. Couple and Family Psychology: Research and Practice, 11(2), 83-88.

Robles, G., Bosco, SC., Cardenas, I., Hostetter, J. & Starks, T.J. (2022). Psychosocial and culturally specific factors related to IPV victimization among a sample of Latino sexual minority men in the U.S. Journal of Interpersonal Violence, 37, 23-24:NP22501-NP22527.

Robles, G., Dellucci, T.V., Gupta, S.K., Rosenthal, L. & Starks, T.J. (2022). Identity and relationship based discrimination and mental health in a sample of sexual minority male couples. Gay and Lesbian Mental Health, 26(1), 76-97.

Robles, G., Dellucci, T. V., Del Rosario, B., Jimenez, R. H., Rodríguez-Díaz, C. E., & Starks, T. J. (2022). Factors associated with individual and couple participation in online sexual health research with Latinx sexual minority men. Journal of Latinx Psychology, 10(3), 241-252.

Robles, G., Hong, C., Yu, M. & Starks, T.J. (2021). Intersecting communities and PrEP uptake among US-based Latinx sexual minority men. Race and Ethnic Health Disparities, 9, 2157-2163.

Starks, T.J., Adebayo, T., Kyre, K.D., Millar, B.M., Stratton, M.J., Gandhi, M. & Ingersoll, K. (2022). Pilot randomized controlled trial of Motivational Interviewing with sexual minority male couples to reduce drug use and sexual risk: The Couples Health Project. AIDS and Behavior, 26(2), 310-327.

Starks, T.J., Doyle, K.M., Bosco, S.C., & Revenson, T.A. (2022). Partners’ consensus about joint effort predicts COVID-19 prevention among sexual minority men. Archives of Sexual Behavior, 51(1), 217-230.

Starks, T.J., Doyle, K.M., Stewart, J.L., Bosco, S.C., & Ingersoll, K. (2022). Development of Motivational Interviewing Treatment Integrity (MITI) fidelity codes assessing Motivational Interviewing with couples. AIDS and Behavior, 26(1), 13-20.

Starks, T.J., Skeen, S.J., Jones, S.S., Gurung, S., Millar, B.M., Ferraris, C., Ventuneac, A., Parsons, J.T. & Sparks, M.A. (2022). Effectiveness of a combined Motivational Interviewing and Cognitive Behavioral intervention to reduce substance use and improve HIV-related immune functioning. AIDS and Behavior, 26(4), 1138-1152.

Starks, T.J., Skeen, S.J., Jones, S., Millar, B.M., Gurung, S., Ferraris, C., Ventuneac, A., Parsons, J.T., & Sparks, M.A. (2022). The importance of domain-specific self-efficacy assessment for substance use and HIV care continuum outcomes among adults in an urban HIV clinic network. AIDS Care, 34(5), 670-678.

Trub, L. Doyle, K.M., Hubert, Z., Parker, V. & Starks, T.J. (2022) Sexting to Sex: Testing an attachment-based model of connections between texting behavior and sex among heterosexually active women. Computers in Human Behavior, 128, 107097.

Wells, B.E., Samrock, S., Pawson, M. & Starks, T.J. (2022). Pilot randomized trial of an expressive writing intervention to reduce HIV-transmission risk and substance use among emerging adult gay and bisexual men. AIDS and Behavior, 26(2), 584-595.



Bosco, S.C., Pawson, M., Parsons, J.T. & Starks, T.J. (2021). Biomedical HIV prevention among gay male couples: A qualitative study of motivations and concerns. Journal of Homosexuality, 68(8), 1353-1370.

Budhwani, H., Robles, G., Starks, T.J., MacDonell, K.K., Dinaj-Koci, V. & Naar, S. (2021). Healthy Choices intervention is associated with reductions in stigma among youth living with HIV in the United States (ATN 129). AIDS and Behavior, 25(4). 1094-1102.

Cain, D., Samrock, S., Jones, S.S., Jimenez, R.H., Dilones, R., Tanney, M., Outlaw, A., Friedman, L., Naar, S. & Starks, T.J. (2021). Marijuana and illicit drugs: Correlates of condomless anal sex among adolescent and emerging adult sexual minority men. Addictive Behavior, 122, 107018.

Dellucci, T.V., Carmichael, C, & Starks, T.J., (2021). Arrangements versus agreements: evaluating two approaches to measuring male couples’ rules and understandings around sex with outside sex partners. Archives of Sexual Behavior, 50, 1689-1700.

Gupta, S.K., Dellucci, T.V., Stewart, J.L. & Starks, T.J. (2021). Perceived risk, optimistic bias, and united action: A socio-ecological examination of COVID-19 prevention behaviors among sexual minority men. Psychology of Sexual Orientation and Gender Diversity, 8(2), 201-212.

Millar, B.M., Adebayo, T., Dellucci, T.V., Behar, E. & Starks, T.J. (2021). Keeps me awake at night: The potential of the COVID-19 pandemic to affect sleep quality among sexual minority men in the U.S.A. Psychology of Sexual Orientation and Gender Diversity. 8(2), 213-219.

Robles, G., Bosco, S.C., Sauermilch, D., Starks, T.J. (2021). Population-specific correlates of sexual arrangements and communication in a national sample of partnered Latinx sexual minority men. Archives of Sexual Behavior, 50(4), 1449-1460.

Robles, G., Sauermilch, D., Gandhi, M. & Starks, T.J. (2021). PrEP demonstration project showed superior adherence with tenofovir alafenamide/emtricitabine compared to tenofovir disoproxil fumarate/emtricitabine in a sample of partnered sexual minority men. AIDS and Behavior, 25(4), 1299-1305.

Skeen, S.J., Starks, T.J., Jimenez, R.H., Rendina, H.J. & Cain, D. (2021). Heterosexual cisgender men partnered with transgender women exhibit higher HIV/STI sexual risk than their gay, bisexual and queer counterparts: Findings from a U.S.-based convenience sample recruited online. AIDS and Behavior, 25(10), 3279-3291.

Starks, T.J., Dellucci, T.V., Lovejoy, T., Robles, G., Jimenez, R., Cain, D. Naar, S. & Feldstein Ewing, S. (2021). Adolescent sexual minority males, relationship functioning, and condomless sex. Journal of Adolescent Health, 68, 419-421.

Starks, T.J., Kyre, K., Cowles, C., Castiblanco, J, Washington, C., Parker, J., Kahle, E. & Stephenson, R. (2021). A full-factorial randomized controlled trial of adjunct Couples HIV Testing and Counseling components addressing drug use and communication skills among sexual minority male couples. BMC Public Health, 21(1), 2158.

Starks, T.J., Lovejoy, T., Sauermilch, D., Robles, G., Stratton Jr, M., Cain, D., Naar, S. & Feldstein Ewing, S. (2021). Developmental barriers to couples’ HIV testing and counseling among adolescent sexual minority males: A dyadic socio-ecological perspective. AIDS and Behavior, 25, 787-797.

Starks, T.S., Sauermilch, D., Adebayo, T., Kyre, K.D., Stratton, M. & Darbes, L.A. (2021). Day-level associations between drug use and sexual behavior in male couples: Actor Partner Interdependence Modeling of timeline follow-back data. Drug and Alcohol Dependence, 225(1), 108758.

Trub, L. Doyle, K.M., Parker, V. & Starks, T.J. (2021). Drunk Texting: When the phone becomes a vehicle for emotional dysregulation and problematic alcohol use. Substance Use and Misuse, 56(12), 1815-1824.



Starks, T.J. (2022). Motivational Interviewing with Couples: A Framework for Behavior Change Developed with Sexual Minority Men, Oxford University Press.


Book Chapters

Cain, D., Starks, T.J. (in press). Sexual Agreements and Arrangements. In Goldberg, A. E. (Ed.). The SAGE Encyclopedia of LGBTQ+ Studies (2nd Edition). SAGE publications.

Starks, T.J., Cabral, C. & Talan, A. (2020). Drug use among sexual and gender minority populations. In Rothblum, E. (Ed). Oxford Handbook of Sexual and Gender Minority Mental Health, Oxford University Press.

Starks, T.J., & Millar, B.M. (2017). Special issues in psychotherapy with sexual minority and TGNC adolescents. In K. DeBord, T. Perez, A.R. Fischer, & Bieschke, K. (Eds). Handbook of Sexual Orientation and Gender Diversity in Counseling and Psychotherapy, APA Books: Washington, DC.