RESEARCH INTERESTS. In broad terms, my research interests are in behavioral medicine, infectious disease & psychiatric epidemiology, and global health. My program of research involves conducting longitudinal cohort studies, mixed methods (qualitative/quantitative) research, and developing and testing behavioral and psychosocial treatment interventions in the following areas:
1) HIV Primary & Secondary Biobehavioral Prevention: Developing and testing interventions to mitigate HIV risk with antiretrovirals. Current studies include interventions focused on: a) PrEP uptake, adherence, and retention in PrEP-related care (once-daily oral pill— emtricitabine/tenofovir—as pre-exposure prophylaxis for the prevention of HIV in uninfected individuals); b) nPEP phase 4 investigations to document tolerability, side effects, and completion rates (non-occupational post-exposure prophylaxis for prevention of HIV after sexual or injection drug use exposure); and c) antiretroviral therapy (ART for treatment of HIV) adherence.
2) Epidemiology of HIV & Other Sexually Transmitted Infections: Documenting prevalence, incidence, and determinants (psychosocial, behavioral, biological and structural) of HIV and STI emergence and transmission in various at-risk populations. This includes characterizing social, sexual and drug networks to better understand how connections (e.g., homophily, multiplexity), distributions (e.g., centrality, density), and segmentation (e.g., cohesion) potentiates HIV risk and infection.
3) Treatment Approaches for Drug Addiction & Concurrent HIV Risk: Developing and testing integrated psychosocial treatment [e.g., behavioral activation (BA)] and HIV risk reduction interventions. For example, problematic stimulant (i.e., crystal methamphetamine, cocaine, crack) use is a complex and treatment-resistant problem. One potential contributor to its intractability may be that existing treatments lack adequate attention to replacement activities or to the role of depressed mood/anhedonia relapse trigger, which is the cornerstone of a BA approach. BA is an evidence-based, cognitive behavior therapy approach for depression that involves re-learning how to engage in life by identifying and actively participating in pleasurable, goal-directed activities. The underlying hypothesis, for individuals abusing stimulants, is that re-learning how to engage in the non-drug using aspects of one’s life will facilitate their ability to benefit from concomitant HIV risk reduction counseling.
4) Behavioral Interventions for HIV Prevention: Development, evaluation, and implementation of interventions to modify behaviors that heighten an individual's vulnerability to becoming infected, or infecting others, with HIV. This includes interventions aimed to increase use of condoms and reduce numbers of sexual partners while taking individual characteristics into account, as well as their social, cultural, and economic context. Innovative approaches for delivering intervention content includes the use of technology (e.g., mobile phone counseling, text messaging, mobile apps, interactive video games using avatars, etc.). In addition, often times interventions will address the specific psychosocial problems that exacerbate HIV risks, such as empowerment, self-acceptance, and distress. Addressing these psychosocial problems as part of an HIV prevention intervention is a way to help individuals who suffer the damaging impact of adverse social conditions that they face--resulting in decreased distress and increased self-care--and therefore promoting their ability to benefit from HIV prevention efforts.
5) Global Health & HIV Prevention: Conducting HIV prevention research that advances health among myriad at-risk populations in resource-limited settings. Current studies are being conducted across 11 countries in Asia, Africa, North America, Latin America, and Eastern Europe. Prior population-based studies have surveyed at-risk groups via the internet--spanning all Latin American countries, North America, Spain, Portugal, and Vietnam--to better understand risk and protective factors for HIV infection.
6) Health & Human Rights Research: Documenting the epidemiology of violence, exploitation, abuse, neglect, and poor psychological well-being and access to medical, mental health and social services among adolescent refugees in Sub-Saharan Africa and Latin America, with the goal of developing and testing behavioral- and structural-level interventions to promote healthier conditions.
STUDY POPULATIONS. My federally funded studies involve a variety of populations, including sexual and gender minorities (LGBT individuals) and other key populations and marginalized groups, including: adolescents with HIV infection, men who have sex with men, and heterosexual men and women; injection drug users; individuals who engage in transactional sex; individuals with substance addiction; and marginalized groups in resource-limited settings globally, including adolescent refugees.
COUNTRIES ACROSS THE GLOBE. In addition to my domestic research program, countries where I have ongoing research studies include: South Africa (Durban/Umlazi), Zambia (Lusaka), Thailand (Chiang Mai and Bangkok), Vietnam (Ho Chi Minh City), India (Mumbai, Chennai and Pune), Brazil (Rio de Janeiro), Ecuador (Quito), and Peru (Lima). I also am collaborating on research projects with investigators at UPenn in Ukraine (Kiev) and Russia (St. Petersburg).
GRANT FUNDING AS PRINCIPAL INVESTIGATOR (PI). Currently I am / have been the PI of 15 federal research grants -- these include 13 NIH R-level grants (5 R01s, 4 R21s, 3 R34s, and 1 R03) and 2 CDC U01 grants, and greater than 15 additional research grants via private foundations, Harvard and Brown Centers For AIDS Research, Harvard Catalyst Grant Program, Brown Seed Award, Reagan Institute of MGH, MIT and Harvard, and other university-specific research grant opportunities. I have also been the PI of over 10 separate research grants / contracts funded by the MA State Department of Public Health, Office of HIV/AIDS. My extramural research funding as PI has totaled over 30 million dollars.
ACTIVE GRANTS FUNDED BY NIH AS PI. At the present time, I have 4 R01s, 2 R34s, and 1 R21 funded by NIH. These include the following studies:
R01DA042805-01A1 – Mimiaga/Safren (MPIs) 04/01/2017-03/31/2022 Integrated Behavioral Activation and HIV Risk Reduction Counseling for MSM with Stimulant Abuse. To test the efficacy of an integrated psychosocial treatment (behavioral activation) and HIV risk reduction for HIV uninfected men who have sex with men with stimulant use disorder.
R01NR017098-01 – Mimiaga/Garofalo (MPIs) 09/26/2016-06/30/2021 Adaptive intervention strategies trial for strengthening adherence to ARV HIV treatment among youth. The purpose of this study is to test the efficacy of an integrated technology- and counseling-based ART stepped care, adherence intervention (“Positive Steps”) for HIV infected adolescents, ages 16 to 24.
R34MH110369-01 – Mimiaga/Biello/Chan (MPIs) 09/23/2016-08/31/2019 Optimizing PrEP uptake & Adherence among MSWs using a 2-stage randomization design. This grant is to pilot test the “PrEPare for Work” package that includes two components: 1) peer-led strengths-based case management for PrEP initiation and 2) once PrEP is initiated, a counseling and problem-solving PrEP adherence intervention that addresses individualized barriers to optimal use.
R01MH100627-01A1 – Safren/Mimiaga (MPIs) 07/01/2014-06/30/2019 Fostering resilience to psychosocial and HIV risk in Indian MSM. This study is testing the efficacy of a self-acceptance-based intervention in comparison to HIV / VCT on co-primary outcomes: STI incidence and reduced episodes of unprotected anal sex among HIV-infected and uninfected MSM in India.
R34MH104072-01 - Mimiaga/Reisner/Clark (MPIs) 07/01/2014-06/30/2018 TransPrEP: Social Network-Based PrEP Adherence for Transgender Women in Peru. This research is to develop and pilot a social network-based intervention to promote PrEP adherence among PrEP naïve transgender women at risk for HIV infection in Lima, Peru.
R01HD075655-01A1 – Mimiaga/Garofalo/Stephenson (MPIs) 04/01/2013-03/31/2019 CVCTPlus: A Couples-Based Approach to Linkage to Care and ARV Adherence. This study is examining the efficacy of CVCT combined with dyadic adherence counseling (“CVTCPlus”) to improve linkage to care, retention in care, ART adherence and viral suppression among HIV- serodiscordant male-male couples in Atlanta, Boston, and Chicago.
R21DA039857-01- Grelotti/Mimiaga (MPIs) 09/30/2015-08/31/2018 Epidemiology of HIV antiretroviral exposure from whoonga use in South Africa. This is an epidemiological study to understand the use of whoonga, a drug cocktail in South Africa that may contain antiretroviral medication and illicit drugs. May inform future research to link recreational antiretroviral use to resistance among HIV-infected individuals who have yet to initiate HIV treatment.
ADDITIONAL RESEARCH CONTRIBUTIONS. At the present time, I am a co-investigator (Co-I) / primary mentor and key collaborator on several NIH R and K grants, as well as multi-site large-scale network (HPTN, HVTN, and CNICS) funded studies. For these, I contribute substantially as an expert in the areas of epidemiology, behavioral sciences, and clinical trial design/methods contributions, as well as research scholarship.
For example, I am a member of the protocol development team and Co-I for HPTN 063 (Chair: Dr. Steven Safren) – a proposal to develop international prevention trials for HIV-infected individuals (heterosexual women and men, and men who have sex with men) in care settings in Zambia, Thailand, and Brazil.
I am also a member of the protocol development team and co-I for three Adolescent Medicine Trials Network (ATN) for HIV/AIDS Interventions studies to: 1) develop and pilot test a smartphone, location-based app to facilitate routine HIV and STI testing, identify unknown HIV infections, and optimize adherence and retention in care for at risk youth (PIs: Drs. Biello and Mayer), 2) examine the efficacy--in a full scale RCT--of the app described above, and 3) determine the efficacy of "PrEP Steps," and nurse delivered intervention to promote uptake and adherence to PrEP for adolescent racial and ethnic minority MSM across three ATN sites.
To date, I have authored or co-authored over 240 peer-reviewed, original research publications, book chapters, and reviews/commentaries on these topics. See link below for (most of) my published scientific manuscripts.
Service on Scientific Grant Reviews
Standing Member; Behavioral and Social Science Consequences of HIV/AIDS Study Section [BSCH], National Institutes of Health, 2013-2019.
In addition, I have chaired and/or served as a reviewer on over 40 scientific grant review study sections for the National Institutes of Health and the Centers for Disease Control and Prevention, and over 20 additional grant review committees for other federal and non-federal agencies (e.g., amfAR Research Grant Program, the Harvard, Brown and University of Washington CFARs, the California HIV/AIDS Research Program, the Irish Research Council, and others).
Current Post-Doctoral Fellows & Ph.D. Advisees at Brown
•John Frank, Ph.D. (New York University); completed the Clinical Psychology Residency Program at Northwestern University; current Post-Doctoral Fellow in Public Health and Psychiatry & Human Behavior
•Adedotun Ogunbajo, MPH/MHS (Yale University / Johns Hopkins University); current Ph.D. student, Department of Behavioral & Social Health Sciences
•Arjee Restar, MPH (Columbia University); current Ph.D. student, Department of Behavioral & Social Health Sciences
•Harry Jin, MPH (Yale University); current Ph.D. student, Department of Epidemiology
Current Masters & Undergraduate (honors) Advisees at Brown
•Laura McPeake, MD (Assistant Professor of Emergency Medicine, Brown's Warren Alpert Medical School); current ScM student, Department of Behavioral & Social Health Sciences
•Peter Salhaney, BA (Providence College); current ScM student, Department of Behavioral & Social Health Sciences
•Ashley Truong; current undergraduate honors student
1) PH2090: Scientific Writing, Research Presentation, & Proposal Development (Summer)
This is an advanced graduate-level course designed to provide PhD and MD candidates (nearing degree completion), post-doctoral fellows and junior faculty with the skills to be more effective at scientific writing. Instruction focuses primarily on the process of writing scientific research manuscripts and federal research grants.
2) PH2360: Designing & Evaluating Public Health Interventions (Spring)
This is a graduate-level course designed to provide Masters and Doctoral students with the information and skills necessary to develop (or adapt) and ultimately test / implement a behavioral change intervention. This is achieved through course instruction, readings, and mastery of the material by initially drafting and subsequently revising (per instructor feedback) the key sections of an intervention protocol. The course starts with a discussion of the social determinants of health and the scientific basis for understanding individual health behavior. Drawing on theory and practice, students learn how program planners conduct needs assessments; set goals and objectives; develop intervention materials and messages; finalize intervention content, structure and format; and evaluate outcomes – all while taking into account factors such as gender, sexuality, race/ethnicity, socioeconomic position, culture, social support/social capital, etc.