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Arnold School of Public Health

Li and Qiao receive $1 million grant from NIH to explore relationship between HIV-related stigma and clinical outcomes

March 7, 2017 | Erin Bluvas, 

Xiaoming Li, Professor of Health Promotion, Education, and Behavior (HPEB) and Director for the SmartState Center for Healthcare Quality (CHQ), and Shan Qiao, Assistant Professor of HPEB and CHQ, have received a $1 million grant (R01MH0112376-01) from the National Institutes of Health’s (NIH) U.S.-China Program for Biomedical Collaborative Research. They will use the grant to explore the linkages and mechanisms between HIV-related stigma (e.g., discrimination related to HIV/AIDS) and HIV clinical outcomes.

The Arnold School researchers will be working with their Chinese collaborators, who have been awarded an additional 2 million Chinese CNY from the National Natural Science Foundation of China to contribute to the study. The groups already have two ongoing NIH-funded research projects related to HIV disclosure.

“It is so encouraging to see USC researchers Xiaoming Li and Shan Qiao working across international lines with colleagues in China to investigate one of the biggest questions in HIV research," says USC Vice President for Research Prakash Nagarkatti. "This collaborative approach will help to ensure a deeper understanding of the HIV stigma that negatively impacts patients around the globe. I look forward to seeing how the new insights they gain through this project will improve outcomes for HIV patients.”

According to the researchers, there are substantial knowledge gaps in scientists and clinicians’ understanding of HIV-related stigma and the underlying mechanisms through which the stigma negatively affects clinical outcomes of people living with HIV. In this five-year project, Li and Qiao and their Chinese collaborators will conduct a longitudinal epidemiological assessment among 1,200 people living with HIV in Guangxi, China to fill these knowledge gaps.

“HIV-related stigma interferes with seeking and receiving appropriate treatment and care, contributes to depression, stress, and other psychiatric disorders, and produces lower quality of life and worsening clinical outcomes among people living with HIV/AIDS,” says Li. “Despite global efforts to tackle HIV-related stigma for decades, it remains a critical public health issue in U.S. and globally, particularly in low- and middle-income countries such as China.”

The research will test both the biological pathway (i.e., chronic stress) and behavioral pathway (i.e., medical adherence) of the effects of HIV-related stigma with behavioral data and biomarkers as well as intrapersonal, interpersonal, structural, and social factors that may moderate or mediate the effects of HIV-related stigma on intermediate outcomes (e.g., chronic stress and medical adherence) and endpoint clinical outcomes (e.g., CD4 count, viral load, disease progression). Li and Qiao expect that this U.S.-China collaborative research will yield valuable data regarding the causal relationships among HIV-related stigma, psychological/behavioral consequences, and clinical outcomes.

“We believe this study will broaden the research perspective through which we view the effects of HIV-related stigma among people living with HIV,” says Li. “The research will also contribute to our knowledge base by producing urgently needed data on both the public health relevance and underlying mechanisms of stigma that are relevant across health conditions or stigmatized statuses.”


Xiaoming Li will lead Analytic Core to support Scale it Up—a $15.7 million research program to enhance HIV-related self-management among youth

Qiao wins $362K from NIH to investigate the effects of HIV disclosure on clinical outcomes

Li awarded $400K from NIH to explore neurodevelopmental outcomes based on care settings of AIDS-orphaned children

Xiaoming Li and colleagues publish two special issues in leading international AIDS journals on findings and best practices related to HIV disclosure research


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