Adjunct Professor of Epidemiology
- Post-Doctoral Fellowship, Harvard Medical School, 2008
- ScD, Harvard School of Public Health, 2007
- MPH, Boston University School of Public Health, 2003
- Associate Professor of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA
- Director of Epidemiology & Global Health Research, The Fenway Institute, Fenway Health, Boston, MA
- Senior Consultant, John Snow Research & Training Institute, Inc., Boston, MA
My Research Program Currently Includes: 3 Post-Doctoral Fellows [Dr. Katie Biello–PhD from Yale; Dr. David Grelotti–MD from Hopkins; Dr. Sari Reisner–ScD from Harvard], 6 Graduate Students (I am the academic advisor for students in the ID Epi and Psych Epi Concentrations), 3 Epidemiology Project Managers, 1 Data Analyst, 1 Study Therapist, and 12 Research Assistants/Project Coordinators.
In broad terms my research interests are in behavioral medicine, infectious disease and psychiatric epidemiology, and global health. My program of research involves conducting longitudinal epidemiological investigations, mixed-methods (qualitative/quantitative) research, and developing and testing both behavioral and biomedical intervention trials in three primary areas: 1) HIV primary and secondary prevention (both epidemiology of, and developing and testing behavioral interventions), including PrEP [once-daily oral pill (emtricitabine/tenofovir) as pre-exposure prophylaxis for the prevention of HIV in uninfected individuals], nPEP (non-occupational post-exposure prophylaxis for sexual or injection drug exposure), ART (antiretroviral therapy for HIV treatment) demonstration and medication adherence intervention trials, as well as HIV prevention in the context of co-morbid mental health conditions; 2) Substance abuse prevention and treatment development studies for crystal methamphetamine and other stimulant (cocaine, crack) dependence in the context of concurrent HIV sexual risk behavior and/or suboptimal HIV related primary care; and 3) Global public health research that universally takes place in settings for which very little, if any, work has been done with respect to HIV prevention, treatment for substance dependence, and addressing intertwined psychosocial syndemic conditions (e.g., depression, victimization, etc.) that potentiates HIV risk behaviors and infection.
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, injection drug users, MSM, heterosexual men and women, individuals who engage in transactional sex, transgender women, substance users, and individuals in resource limited settings globally.
In addition to my domestic research program, I have ongoing global public health research studies across multiple continents focused on HIV primary and secondary prevention. Current 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), Peru (Lima), and collaborating on research projects with investigators at U Penn in Ukraine (Kiev) and Russia (St. Petersburg).
I am currently the Principal Investigator (PI) of six active NIH funded R grants (three R01s, two R21s, one R34s), an NIH competitive supplement, a CDC research grant, and a grant funded by the Ragon Institute of MGH, MIT & Harvard working in these areas of research. Over the past few years, I have successfully completed several research grants as PI, including an R34, R03, and R21 (NIH), two Harvard Center for AIDS Research grants, a Harvard Catalyst grant, a CDC research grant, and a grant funded by the Lenovo Hope Fund. My extramural research funding as PI has totaled nearly 17 million dollars.
At the present time, I am also a co-investigator and key collaborator on several NIH R grants and multi-site large-scale network (HPTN, HVTN, and CNICS) funded studies where I contribute substantially as an expert in the areas of epidemiology, behavioral science, substance abuse treatment, HIV prevention, and 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 (PI: Dr. Steven Safren) – a proposal to develop international prevention trials for HIV infected individuals in care settings in Zambia, Thailand, and Brazil. Finally, I am the PI of an online study surveying all MSM members of one of the largest social/sexual networking Internet sites in all Latin American countries, Spain, and Portugal.
Research scholarship. To date, I have authored or co-authored over 180 peer-reviewed, original research publications, book chapters, and published reviews/commentaries on these topics.
NIH grant review membership. I am a standing member of the NIH Behavioral and Social Consequences of HIV/AIDS Study Section [BSCH], 2013-2019.
Current Extramural Funded Research Studies For Which I Am PI:
R01MH100627-01A1 – Mimiaga/Safren (MPI) ** 07/01/2014-06/30/2019 ** NIMH – Fostering Resilience to Psychosocial and HIV Risk in Indian MSM. This study is testing the efficacy of the self-acceptance-based intervention in comparison to HIV / VCT on co-primary outcomes: STI incidence and reduced episodes of unprotected anal sexamong HIV-infected and uninfected MSM in Chennai and Mumbai India. The incremental cost-effectiveness of the intervention and HIV/STI VCT relative to HIV/STI VCT alone is being assessed, considering individual and public health benefits as well as downstream cost-savings due to HIV infections averted.
R34MH104072-01 – Mimiaga/Reisner/Clark (MPI) ** 07/01/2014-06/30/2017 ** NIMH – TransPrEP: Social Network-Based PrEP Adherence for Transgender Women in Peru. This research is to develop a social network-based intervention to promote PrEP adherence among PrEP naïve transgender women at risk for HIV infection in Lima, Peru. Once the intervention is developed through multiple forms of qualitative methods, an RCT pilot will be conducted randomizing by social network-based clusters of transgender women. All participants will be provided with daily Truvada for the study period. The intervention includes a mix of individual counseling, group (peer) based workshops, and social network interactions.
R01MH094323-01A1 – Garofalo/Mimiaga (MPI) ** 07/01/2011-06/30/2017 ** NIMH – HIV Prevention Intervention for Young Transgender Women. This study is testing the efficacy of a uniquely targeted HIV risk reduction intervention (“Life Skills”) for sexually experienced young transgender women, ages 16 to 24, in a three-arm randomized controlled trial in two major U.S. cities: Boston and Chicago. Competitive Supplement: We were awarded an NIH competitive supplement to adapt the existing intervention for young transgender men. Note: Dr. Sari Reisner (Post-Doctoral Fellow in ID Epi at HSPH) is a Co-I on this grant.
R21DA033720-01 – Mimiaga (PI) ** 09/30/2011-08/31/2015 ** NIDA – Information Technology for HIV Prevention Among Vulnerable Men in India. This study is to develop and pilot test an intervention that will use mobile phone technologies to deliver HIV prevention counseling to reduce sexual risk among male sex workers in Chennai and Mumbai, India. Note: Dr. Beena Thomas is the India/ICMR PI on this grant.
R01HD075655-01A1 – Stephenson/Mimiaga/Garofalo (MPI) ** 04/10/2013-03/31/2018 ** NICHD – CVCTPlus: A Couples-Based Approach to Linkage to Care and ARV Adherence. This study proposes to use CVCT combined with dyadic adherence counseling (“CVTCPlus”) to improve linkage to care, retention in care, ARV adherence and viral suppression among HIV-serodiscordant male-male couples in Atlanta, Boston, and Chicago.
R21DA035113-01A1 – Mimiaga/Biello (MPI) ** 05/10/2013-04/30/2016 ** NIDA – HIV Risk for MSM Sex Workers: A Social, Sexual and Drug Network Simulation Study. This is a longitudinal epidemiological study of MSM sex worker networks in Massachusetts to identify protective and risk factors that affect HIV transmission dynamics. Longitudinal data will enhance our understanding of how contemporary social, sexual, and drug abuse network characteristics contribute to increased HIV and STI spread among MSM sex workers. The information gained will be used to develop a simulation model to examine which prevention modality (e.g., network-based, conditional cash transfer, PrEP, etc) would impact decreased HIV incidence most successfully.
U01PS0053307-01 – Mimiaga (PI) ** 10/01/2012-12/31/2014 ** CDC – Testing Brief Messages for Black and Latino MSM: Emerging HIV Prevention Information. The aims of this study are to understand the differing effects of biomedical and behavioral prevention messaging among Black and Latino MSM who are at risk for HIV infection. This project will help advance CDC’s high impact prevention efforts to achieve the goals of the National HIV/AIDS Strategy.
Completed Extramural Funded Research Studies For Which I Was PI:
R34DA031028-01 – Mimiaga (PI) ** 09/01/2010-02/28/2015 ** NIDA – Behavioral Activation and HIV Risk Reduction for MSM with Crystal Meth Abuse. This study (“Project IMPACT”) was to test a novel treatment for crystal methamphetamine dependence and sexual risk behavior in HIV uninfected MSM, incorporating behavioral activation training therapy with integrated HIV risk reduction counseling.
R21MH095535-01 – Mimiaga/Mitty (MPI) ** 08/09/2011-01/31/2015 ** NIMH – Understanding PrEP Implementation among Club Drug Using MSM. This study had two phases: qualitative interviews (phase 1) and a larger epidemiological assessment (phase 2) among HIV uninfected MSM who report recent heavy substance use and concurrent potential exposure to HIV via condomless sex (in the last 3 months) to gain a better understanding of the facilitators and barriers to PrEP implementation among this group.
2P30AI060354-06 – Mimiaga (PI) ** 06/01/2010-12/31/2012 ** NIAID (Harvard CFAR) – Improving Antiretroviral Medication Adherence Among HIV Infected Youth. This study was to develop (through extensive qualitative methods) and pilot test in an RCT design a theoretically-driven intervention curriculum (“Positive STEPS”) grounded in the social-cognitive and contextual realities of HIV infected adolescents (aged 13-24) to improve medication adherence.
2P30AI060354-06 – Mimiaga/Mitty (MPI) ** 06/01/2010-12/31/2012 ** NIAID (Harvard CFAR) – Sustaining Effects of CM on Stimulant Use in HIV Infected Persons. The aims of this study were to develop and implement through an open phase pilot a combined contingency management (CM) and behavioral activation training therapy intervention (“Project REWARD”) aimed at HIV infected individuals who were engaged in HIV care and dependent on stimulants (cocaine, crack or crystal methamphetamine).
UL1RR025758-02 – Colby/Mimiaga (MPI) ** 02/01/2010-10/31/2011 ** NIH (Harvard Catalyst) – Sexual Health Needs of Male Sex Workers in Ho Chi Minh City, Vietnam. The aim was to conduct formative research to better understand risk and protective factors for HIV/STI transmission among MSW in Ho Chi Minh City. These findings were used to develop a specific intervention designed to decrease HIV/STI risk behavior among MSW in Vietnam, which we are currently pilot testing among a sample of 100 MSW.
U01PSHCMC-01 – Colby/Mimiaga (MPI) ** 11/01/2012-12/31/2014 ** CDC – Group Based HIV prevention Intervention for Male Sex Workers in Vietnam. This study enrolled 100 MSW from Ho Chi Minh City in a pilot trial of a group-based theory-driven, HIV prevention intervention focused on barriers to HIV risk reduction and problem solving/skills building. The intervention consisted of 4 group sessions facilitated by trained MSW peer health educators. The study assessed feasibility, acceptability, and reductions in sexual risk behavior.
R03DA023393-01 – Mimiaga (PI) ** 02/01/2008-01/31/2011 ** NIDA – Behavioral Activation and HIV Risk Reduction for MSM with Crystal Meth Abuse. The aim of this project was to develop and openly pilot test a behavioral intervention that integrates behavioral activation and HIV risk reduction counseling for MSM with crystal meth abuse. This study serves as the major preliminary data supporting my recently completed NIDA funded R34.
MDPH06-10ID – Mimiaga (PI) ** 01/01/2006-12/31/2010 ** MDPH, Division of Infectious Diseases – HIV Prevention among Sexual and Gender Minorities at Risk for HIV Infection in MA. These projects changed yearly and were reviewed competitively through a proposal process with MDPH. Prior studies include: 1) Monitoring state-wide trends in HIV and STD prevalence and incidence though the development of an enhanced surveillance system among MA MSM; 2) Social and sexual networks, knowledge of STIs and HIV, perceptions of risk for disease, and barriers and motivators to accessing care from the perspective of Black MSM in MA; and 3) Assessing how specific environmental contexts potentiate sexual risk (or facilitate safer sexual behaviors) and HIV infection among MSM in MA.
Lenovo2008-10 –Mimiaga (PI) ** 01/01/2008-12/31/2010 ** Lenovo Hope Fund of Triangle Community Foundation – Reach 50 through Hope Web Design. This study was funded via a competitive RFP through the Lenovo Hope Fund. “Reach 50″ assessed if providing free, personalized websites enhanced personal communication and quality of life among 50 adolescents (18 years and younger) who were diagnosed with cancer (malignant tumor or malignant neoplasm, no specific etiology/diagnosis).
Teaching / Courses Taught
My teaching interests are consistent with my research interests described above. I am actively involved with teaching ongoing seminars to Clinical Interns and Fellows in the Behavioral Medicine and Adult Cognitive Behavioral Therapy (CBT) tracks in the Department of Psychiatry at HMS/MGH. I am also actively involved with teaching at HSPH in the Department of Epidemiology since 2007 (and currently); course described below.
EPI 220 – Psych Diagnosis; Clinic and Community Populations (Spring). My primary course, EPI 220, is an applied, mid-level course in the psychiatric epidemiology track that focuses on interview schedules designed to diagnose psychiatric disorders in clinical settings, household surveys, and behavioral research. The course provides practical experience in differential diagnosis, in the administration of different kinds of interview schedules, and in analysis of responses. Through my appointment in Psychiatry at HMS, students in my course conduct psychiatric assessments on patients at the MGH acute psychiatric service (APS) and with members of their communities as part of an IRB approved classroom protocol. The course is designed primarily for students wanting specific training in psychiatric assessment for their future work in mental health research and epidemiology.
As part of the Harvard CFAR Social and Behavioral Sciences Leadership Core, my role is to provide consultation and mentorship on behavioral and social science projects related to HIV across the Harvard University community.