Cathy Reback

Dr. Cathy Reback Receives Service Contract

FRI is pleased to announce that Dr. Cathy Reback has received a new contract entitled, “A Continuum of Behavioral Health Interventions from Low to High Intensity for 2S/LGBTQ+ Individuals Experiencing Multiple Syndemic Health Disparities.” The low-level intervention involves disseminating health education and harm reduction information to active users through street- and venue-based outreach (n=600). The medium-level intervention involves peer health navigation to address social determinants of health and individual-level health disparities that serve as contributing factors to substance use and HIV sexual risks (n=75). The high-level intervention involves trauma-informed skills-building groups designed for trans feminine individuals (n=45) and recovery groups for methamphetamine-using sexual minority men (n=60). The multi-tier program will use a range of behavioral health interventions and participant-centered care to address the social and structural determinants of health that contribute to substance use, HIV sexual risks, and impede advancement along the HIV prevention and care continua among 2S/LGBTQ+ individuals. The contract was funded by California Department of Health Care Services, Sierra Health Foundation, as part of the Health Equity in Access to Behavioral Health Recovery Services (HEAR US) program.

Cathy Reback

Dr. Cathy Reback Receives R01 Award

FRI is pleased to announce that Dr. Cathy Reback, along with Dr. Sean Murphy from Weill Cornell Medical College (MPIs), have received a five-year R01 grant from the National Institute on Drug Abuse entitled, “Comparative- and Cost-effectiveness Research Determining the Optimal Intervention for Advancing Transgender Women Living with HIV to Full Viral Suppression.” In addition to Drs. Reback and Murphy, the interdisciplinary investigative team of experts includes Drs. Tom Blue (FRI), Raphael J. Landovitz (UCLA), and Ali Jalali (Weill Cornell Medical College). This study builds on the promising findings from two HRSA-funded demonstration projects, The Alexis Project and Text Me, Girl!, which utilized Peer Health Navigation (PHN) and SMS (i.e., text messaging), respectively, for advancing trans women living with HIV to full viral suppression. Though the effectiveness of both interventions has been established, their comparative-effectiveness, required resources/costs, cost-effectiveness, and heterogeneous effects on subgroups, including those with a SUD, have not been evaluated. This Phase II comparative-effectiveness RCT will randomize participants (N=225) into: PHN alone (n=75), SMS alone (n=75), or PHN+SMS (n=75). Using the same time points as the HRSA projects, the repeated-measures design will assess participants at baseline, 3-, 6-, 12-, and 18-months post-randomization. The specific aims are to: 1) Conduct a comparative effectiveness research trial to determine the relative effectiveness of PHN vs. SMS vs. PHN+SMS in terms of: Primary (a) virologic suppression; and Secondary outcomes (b) HIV Treatment Adherence Self-Efficacy Scale scores; (c) the AIDS Health Belief Scale scores; (d) the Inventory of Socially Supportive Behaviors scores; and (e) urine drug screen results; 2) Identify the resources required to prepare for, implement, and sustain each intervention, and estimate the associated costs; 3) Conduct a comprehensive cost-effectiveness analysis to determine the relative value of each intervention from the healthcare-sector, state-policymaker, and societal perspectives; and, a Secondary Aim to determine heterogeneous intervention effects across interventions due to social and structural determinants of health and individual-level characteristics. Findings have the potential to improve individual and population health outcomes by generating significant improvements in viral suppression among trans women, and guiding service provision and public policy.

Friends Community Center Receives Grant

FRI’s community research site, Friends Community Center located in Hollywood, CA, was recently awarded the “Opioid Use and Stimulant Use Education and Outreach in 2S/LGBTQ+ Communities” grant funded by The Center at Sierra Health Foundation. Funding is awarded to organizations throughout California that are focused on expanding prevention and recovery services for people with substance use disorder.

In its second year of funding, The Spencer Project, will focus on implementing a holistic continuum of harm reduction and care services, specifically related to opioid and stimulant use, designed to benefit 2S/LGBTQ+ populations in the Hollywood/West Hollywood area of Los Angeles County. Using a two-pronged approach, The Spencer Project will combine harm reduction education through outreach to the community and a personalized treatment navigation plan for individuals identified as seeking treatment for opioid or stimulant use.

Friends Community Center Receives Grant

FRI’s community research site, Friends Community Center located in Hollywood, CA, was recently awarded the “Reducing Inequities in Priority Populations” grant funded through a partnership between Together Toward Health and Public Health Institute. Funding awarding aims to identify community-based organizations who provide services to populations disproportionately impacted by COVID-19 and Mpox. The project aims to serve hard-to-reach and historically underserved populations across Los Angeles County, specifically LGBTQ+ populations.

This project will focus on culturally appropriate outreach and engagement with LGBTQ+ individuals to increase good health outcomes surrounding COVID-19 and Mpox prevention and vaccination uptake. Direct service work with the communities will enable project staff to have two-way conversations to ensure personalized discussions, active listening, and wrap-around services to alleviate barriers to COVID-19 and Mpox vaccination.

Dr. Shannon Gwin Mitchell Receives R01 Award

FRI is pleased to announce that Dr. Shannon Gwin Mitchell (PI) was recently awarded a new R01 grant from the National Institute on Drug Abuse. The “Treating Polysubstance Use in Methadone Maintenance: Application of Novel Digital Technology” study will examine the use of a digital contingency management delivery tool for people with opioid and cocaine polysubstance use receiving methadone treatment. FRI Co-investigators include Drs. Maxine Stitzer, Jan Gryczynski, and Jesse Fletcher. Methadone is a highly effective treatment for opioid use disorder, but many patients leave treatment prematurely, placing them at high risk of relapse and overdose. Extensive research shows that comorbid cocaine use is associated with poor retention in methadone treatment. The newly-funded study will examine a novel intervention designed to improve methadone treatment retention and other outcomes among people with opioid and cocaine polysubstance use. The design is a 2-arm randomized controlled trial comparing participants receiving treatment as usual from the participating methadone treatment programs with those receiving the DynamiCare Health Contingency Management (DCM) app in addition to their methadone treatment. The primary behaviors relevant to retention that will be targeted with incentives using the DCM program include abstinence from opioids and cocaine, as verified via remote oral fluid testing, and medication pickup from the methadone program, as verified by clinic records. Findings from this project can improve the public health impact of methadone treatment by identifying an effective and scalable approach to address polysubstance use among patients at heightened risk of treatment dropout.