AMETHST Year 2 Update

The American Transformative HIV Study (AMETHST) cohort— co-led by ISPH Investigator Dr. Christian Grov and Dr. Adam Carrico of Florida International University—is wrapping up Year 2!

In 2022-2023, Dr. Grov and team enrolled 5,404 sexual and gender minority (SGM) individuals who are vulnerable to HIV from all 50 US states and Puerto Rico. The primary aim of the cohort is to identify multi-level (i.e., structural, psychological, and social) and bio-behavioral (i.e., rectal cytokines/chemokines) determinants of amplified HIV seroconversion risk for SGM, including methamphetamine use. Findings from the cohort will serve to guide targeted, combination interventions to reduce HIV incidence. Thus, the cohort overenrolled individuals experiencing heightened vulnerability to HIV, including Black and Latinx/o SGM who represent over half of the cohort, as well as those who use methamphetamine (52% of the cohort).

In Year 2, the AMETHST team followed up with the primary cohort for their annual assessment, which was completed by 4,050 participants by early May. The study team has also sent participants HIV test and rectal test kits; the latter will be used to assess the relationship between inflammation in the gut and HIV vulnerability. Thus far, the study has observed 199 incident seroconversions, inclusive only of those who reported a negative test result within the past year at baseline or who tested negative through the study during Year 1.

The team is revving up dissemination of baseline findings including a protocol paper presently under review as well as a paper looking at injection methamphetamine use observed during screening for the cohort. In our protocol paper, we report an HIV incidence rate that’s nearly eight-fold amongst participants who use methamphetamine, when compared with those who did not report methamphetamine use.

Under the next phase of funding (UH3), the AMETHST cohort continues through Years 3 through 5 (2024 – 2027), with the addition of a randomized-control trial, led by Dr. Carrico at Florida International University in collaboration with the AMETHST CUNY team. The trial will test the effect of motivational interviewing and contingency management on PrEP uptake among participants in the cohort.