Research
Program Mission
The Sexual, Reproductive, and Mental (SRM) Health Disparities Program in the Department of Psychological and Brain Sciences at Boston University focuses on the intersection of sexual, reproductive, and mental health in minoritized and marginalized populations, both domestically and internationally. We aim to (1) identify psychosocial barriers to optimal sexual and reproductive health, (2) develop and/or adapt interventions that mitigate the influence of these barriers among populations at risk for poor sexual and reproductive health, and (3) implement and sustain these interventions. We seek to continue and grow our collaborations with international and local research teams to maintain these interventions across health systems.
Ongoing & Upcoming Projects
Our current projects span sexual, reproductive, and mental health research in the United States and internationally.
Domestic Projects
eSense TRANScend
Adapting and testing a sexual function intervention for trans women
Kenneth H. Mayer Fellowship, funded by The Fenway Institute
PI: Dr. Amelia Stanton
eSense TRANScend is an online sexual wellbeing intervention based in cognitive behavioral therapy and mindfulness-based therapy, adapted to meet the unique sexual health needs of trans women. eSense TRANScend was adapted from eSense, guided by feedback from trans women in our community. The project is currently recruiting trans women to test whether eSense TRANScend is feasible and acceptable in improving sexual wellbeing. Participants will be compensated for their time.
View study aims
- Adapt the eSense intervention to improve sexual function and genital self-image among transgender women.
- The intervention consists of an online interactive program, with participants receiving either the cognitive-behavioral therapy (CBT) or mindfulness-based therapy (MBT) arm.
PRIDE QUIT
Promoting Recovery in Diverse Experiences – Quitting Tobacco
MPIs: Dr. Conall O’Cleirigh and Dr. Amelia Stanton
Promoting Recovery in Diverse Experiences – Quitting Tobacco (PRIDE QUIT) is adapting an existing smoking cessation intervention, known as QUIT, to better meet the needs and experiences of transgender and gender expansive (TGE) individuals. TGE individuals provided feedback on QUIT to help us understand how the intervention can be tailored for TGE communities. The study is currently recruiting participants to test whether the adapted intervention is feasible and acceptable. Participants will be compensated for their time.
We are recruiting adults who identify as transgender or gender expansive and currently smoke cigarettes.
Email pridequit@fenwayhealth.org or learn more here.
View study aims
- Conduct qualitative interviews with key informants to identify ways to adapt an existing smoking cessation intervention, known as QUIT, for transgender and gender expansive populations.
- Analyze interviews and develop the PRIDE QUIT intervention.
- Adapt the existing QUIT smoking cessation intervention for transgender and gender expansive populations.
- Test the feasibility and acceptability of the adapted intervention.
Project ECHO
Identifying Sexual and Gender Minority Youth at Increased Risk for Suicidality to Inform a Systems-Level Intervention: A Data Mining Approach
PI: Dr. Amelia Stanton
Co-I: Dr. Qimin Liu
Project ECHO aims to improve suicide prevention for sexual and gender minority youth and young adults. We are exploring factors that may contribute to suicide risk and barriers that can prevent young people from receiving support. The study will help inform ways healthcare systems can use electronic health records to identify youth who may be at increased risk and connect them with mental health resources.
View study aims
- Explore factors that are perceived to increase the risk of suicidal ideation in subgroups of sexual and gender minority youth.
- Understand perceived barriers to assessment and access to care, as well as preferences and implementation challenges for electronic health record-based suicide screening and resource provision interventions.
Addressing Trauma Through Sleep
PI: Dr. Amelia Stanton
Co-I: Dr. Martin Seehus
Addressing Trauma Through Sleep trains providers to use cognitive behavioral therapy for insomnia (CBTi) to improve sleep and reduce posttraumatic stress disorder (PTSD) symptoms among patients who have experienced trauma. By making effective sleep care available in settings where people already receive healthcare, we hope to expand access to care for people who have difficulty receiving specialty mental health services.
View study aims
- Improve sleep and PTSD symptoms for patients who have experienced trauma.
- Train primary care and specialty clinic clinicians to apply Cognitive Behavioral Therapy for Insomnia (CBTi) and its brief version (bCBTi).
- Increase access to effective, low-cost insomnia treatment in community clinics that serve populations who often face barriers to receiving specialty mental health care.
International Projects
PrEP Zingisa
Reducing psychological barriers to PrEP persistence among pregnant women in Cape Town, South Africa
NIMH K23MH131438
PI: Dr. Amelia Stanton
PrEP Zingisa, which means “persist” in isiXhosa, is a brief intervention designed to support PrEP adherence and persistence among pregnant and postpartum persons in Cape Town, South Africa. The study explores how depression and posttraumatic stress disorder (PTSD) may affect PrEP use and how a brief intervention can be integrated into routine antenatal care. In a randomized controlled trial, we are evaluating whether PrEP Zingisa is feasible, acceptable, and helpful for supporting continued PrEP use during pregnancy and postpartum.
View study aims
- Explore the ways in which posttraumatic stress and depression impact PrEP use during pregnancy and the postpartum transition.
- Develop a brief PrEP adherence and persistence intervention and assess barriers and facilitators to implementation in antenatal care.
- Evaluate the feasibility and acceptability of the intervention in a pilot randomized controlled trial.
Nakekela
Identifying and addressing barriers to retention in the cervical cancer cascade among women with HIV in South Africa: Part 2
NCI R21CA279942
MPIs: Dr. Amelia Stanton and Dr. Christina Psaros
Nakekela (“take care” in isiZulu) aims to improve cervical cancer prevention and engagement in care for women living with HIV who are at increased risk for cervical cancer in Durban, South Africa. We are exploring barriers that can make it difficult to attend follow-up appointments after an abnormal Pap test, including challenges faced by both patients and healthcare providers. Based on what we learn, we will develop a brief intervention for patients, as well as brief training and handout materials for healthcare providers. We will then test whether the intervention is feasible, acceptable, and helps women stay engaged in follow-up care.
View study aims
- Examine barriers and facilitators to engagement in care after receiving an abnormal Pap smear result among women with HIV.
- Use mixed-methods data to inform the development of a brief intervention that addresses challenges to attending follow-up visits.
- Test the acceptability and feasibility of the intervention in a pilot randomized controlled trial with women with HIV who recently received an abnormal Pap smear result.
TENDAI4PrEP
Adaptation of a problem-solving intervention to address individual- and provider-level barriers to PrEP uptake and adherence among pregnant persons in Zimbabwe
NIMH R34MH134698
MPIs: Dr. Amelia Stanton, Dr. Conall O’Cleirigh, and Dr. Walter Mangezi
TENDAI4PrEP is a project developing and testing a brief problem-solving intervention to help pregnant persons in Harare, Zimbabwe overcome barriers to starting and continuing PrEP. The intervention focuses on challenges such as mental health, stigma, limited support, and difficulties accessing PrEP care. Participants complete individual treatment sessions, including one session with their partner. The study also includes training for healthcare providers to increase their knowledge of PrEP and strengthen support for PrEP use during pregnancy and beyond.
View study aims
- Explore barriers to PrEP uptake, adherence, and persistence during pregnancy, as well as barriers to providing PrEP among antenatal care providers.
- Use formative data to design a PrEP uptake, adherence, and persistence intervention based on the TENDAI program with input from patients, their partners, and providers.
- Evaluate the feasibility and acceptability of the intervention in a pilot randomized controlled trial.
Kuyeka!
Treatment development for smoking cessation, depression, and engagement in HIV/TB care
PI: Dr. Conall O’Cleirigh
Co-I: Dr. Amelia Stanton
This study is adapting a smoking cessation program developed in the United States for use among people living with HIV and tuberculosis (TB) in South Africa. We are working to understand how the program can be tailored to the local culture, healthcare system, and experiences of people in South Africa, including challenges related to depression. The adapted program will then be tested to see whether it is feasible and acceptable.
View study aims
- Collect qualitative data to inform the adaptation of an existing smoking cessation intervention for people with HIV and TB in South Africa.
- Specify the intervention manual and conduct a small open trial of the intervention.
- Assess the feasibility and acceptability of the intervention in a pilot randomized controlled trial.
Completed Projects
Mental Health and PrEP
Mental health barriers to PrEP uptake among pregnant women in South Africa
Funded by the Harvard Center for AIDS Research, NIH/NIAID 5P30AI060354-17
PI: Dr. Amelia Stanton
This study explored how depression and posttraumatic stress may affect PrEP use among pregnant and postpartum persons in South Africa. Through qualitative interviews, the team examined barriers and facilitators related to starting and continuing PrEP during pregnancy and after childbirth. Participants described ways that negative emotions, low energy, fear, worry, and forgetfulness could contribute to skipped doses or delayed PrEP pickup. The findings helped inform the development of the PrEP Zingisa intervention.
Cervical Cancer Care Follow-Up
Identifying and addressing barriers to retention in the cervical cancer treatment cascade among women with HIV in South Africa
Funded by the Providence/Boston Center for AIDS Research
PI: Dr. Amelia Stanton
This study explored barriers and facilitators to attending follow-up appointments among women with HIV in Durban, South Africa after receiving a high-risk abnormal Pap smear result. The project also focused on developing a brief intervention for patients and a toolkit for healthcare providers to support follow-up care and retention in cervical cancer treatment. The team then examined whether this approach was feasible and acceptable in a small open pilot.
View study aims
- Explore barriers and facilitators to follow-up appointment attendance and subsequent treatment among women with HIV who received a recent high-risk abnormal Pap smear in Durban, South Africa.
- Develop a brief patient-level intervention and provider toolkit to increase retention in care among women with HIV.
- Test the feasibility and acceptability of the intervention in an open pilot.
