Pilot Award Recipient: Adedotun Ogunbajo

Foreign-born Blacks (FBBs), defined as people born outside the United States to non-U.S. citizen parents who identify as Black or African American, make up 10% of the total Black population in the U.S. and are projected to account for one-third by 2060. Despite Black people representing only 12% of the U.S. population, they account for 37% of all new HIV infections, with African-born women experiencing HIV diagnosis rates 5.3 times higher than U.S.-born Black women. Previous research demonstrates that FBBs living with HIV face unique challenges across the HIV care continuum, including lower rates of HIV testing, higher likelihood of presenting with AIDS diagnoses, and reduced retention in care and viral suppression compared to U.S.-born Black individuals. However, there is a critical gap in understanding the specific predictors of HIV treatment adherence and care engagement among FBBs, and a lack of evidence-based interventions tailored to their unique needs. In Washington, D.C., where 16% of new HIV diagnoses in 2022 were among foreign-born individuals (with 33% diagnosed with AIDS within 3 months), addressing these disparities is urgent. This mixed-methods study will address these gaps through two specific aims. Aim #1 will investigate the predictors of antiretroviral therapy (ART) adherence, engagement in HIV services, and HIV viral load suppression among FBBs (N=359) and U.S.-born (N=6,564) Black individuals in the DC Cohort Longitudinal HIV Study, an ongoing longitudinal study of people engaged in HIV prevention and treatment services in the Washington DC metropolitan area utilizing path analysis through structural equation modeling. Aim #2 will use qualitative research methods to identify the content, format, & potential implementation challenges of a brief behavioral intervention to improve HIV outcomes among FBBs PLHIV enrolled in the DC Cohort who are currently virally unsuppressed and healthcare providers. This study is directly aligned with the NIH Strategic Plan for HIV and HIV-Related Research, addressing individual, interpersonal, community, and social-structural factors influencing health disparities, and utilizing innovative mixed methods approaches with a global implementation science focus. The findings will inform the development of an R34 grant application to test the preliminary efficacy of a culturally tailored brief intervention for FBBs living with HIV. By addressing both individual and structural determinants of care engagement, this research contributes to national goals of Ending the HIV Epidemic and improving health outcomes.

Project Summary provided by investigator.