To address both smoking and mental health challenges among Black adults living with HIV, Lorra Garey, research associate professor in the Department of Psychology and affiliate of the UH HEALTH Research Institute, has secured a $4.7 million grant from the National Institute on Minority Health and Health Disparities. The funding will support a randomized control trial of a mobile health app, which was developed to help users quit smoking, manage physiological stress, and improve chronic disease management.
"Our results will fuel the expansion of culturally tailored mobile health interventions, offering innovative, accessible support for those most in need," said Garey.
The struggle
Smoking plays a critical role in HIV disease management, as it can interfere with treatment effectiveness and worsen health outcomes. People living with HIV are not only more vulnerable to the negative effects of smoking, but they are twice as likely to smoke cigarettes compared to the general population and have greater difficulty quitting than smokers without HIV.
For Black smokers with HIV, the struggle to quit and manage their disease can be compounded because:
- Stressors related to racism
- HIV Stigma
- Discrimination
Garey says this group often experiences higher levels of general stressors and markedly higher levels of stress caused by discrimination related to their race or HIV status.
"The combination of smoking and HIV in the Black community amplifies health risks and makes it harder to manage both conditions, highlighting the urgent need for targeted interventions to address these overlapping health disparities," said Garey.
How Stress Feels
According to researchers, poor rates of smoking cessation and HIV disease management among Black people with HIV appear to be related to increased exposure to interoceptive stress symptoms, or physical sensations in the body linked to stress or emotional states like increased heart rate, shallow breathing, or feelings of discomfort that come from being anxious or stressed. These sensations are often heightened in people who face significant stress, like discrimination, making it harder for them to cope with challenges like quitting smoking or managing diseases like HIV.
"Consequently, smoking cessation interventions and HIV disease management directed toward Black people with HIV who smoke might benefit from a specific focus on decreasing emotional reactivity to interoceptive stress," said Garey.
The trial
More than 300 Black smokers with HIV will participate in the trial. All participants will have the option to receive nicotine replacement therapy.
"If the efficacy is established, it would serve as a low-burden and highly accessible treatment option for smoking cessation, improved mental health, and improved HIV care adherence/engagement, which all serve to support successful aging and improved well-being," said Garey.
Collaborators on the project from UH are Michael Zvolensky, Hugh Roy and Lillie Cranz Cullen Distinguished University Professor of Psychology and Professor of Psychology Matthew Gallagher. Those from other institutions are Michael Businelle, University of Oklahoma Health Sciences Center, Thomas Giordano, Baylor College of Medicine, Marshall Cheney, University of Oklahoma; Bettina Hoeppner, Harvard Medical School; Mary Jo Trepka, MD, Florida International University; Ank Nijhawan, UT Southwestern Medical Center.
