Michele D. Kipke

BACKGROUND Public support for biomedical sciences, including participation in clinical trials for new drugs, diagnostics or procedures, is crucial for the development and adoption of medical advances. In an effort to explore the role of popular media in influencing public perceptions of biomedical sciences, two centers at the University of Southern California are investigating the intersection of scripted entertainment (including television and film) and medical advances (e.g., clinical trials, precision medicine, AI, biotechnology). Questions of interest are: How are these topics portrayed in scripted entertainment, how do audiences respond, and what opportunities exist to increase participation in research by leveraging this medium? In this paper, we describe our approaches to engaging key partners, gathering data, and assessing outcomes through a series of research projects that will examine the current landscape and identify opportunities for future investigation in this emerging field. OBJECTIVE In separate but complementary studies, we aim to understand the perspectives of entertainment industry leaders and medical experts on incorporating medical advances in film and television storylines; investigate how frequently the topic is portrayed and in what types of shows; assess the attributes of the characters involved in clinical trial storylines and of the trials themselves; and evaluate the impact of targeted entertainment storylines on viewers' knowledge, attitudes, and behavior, specifically concerning clinical trial participation. METHODS We will implement a series of mixed-methods studies. We will conduct hour-long semi-structured interviews with key opinion leaders and analyze transcripts using the constant comparative method to identify themes. We will search recent English-language television and film scripts for terms related to the future of medicine. Counts will be analyzed by genre, viewership, and other variables. We will perform a similar analysis on transcripts and subtitles of Spanish-language content. Using a sample of episodes and films that frequently mention clinical trials, we will conduct a systematic analysis of storylines to understand how trials are portrayed, then repeat the analysis on a subset of highly popular shows, according to Nielsen ratings. Finally, we will conduct a large, survey-based study on select clinical trial storylines to gauge viewers’ knowledge, attitudes, and behavior using standard and novel instruments. RESULTS Results are forthcoming. CONCLUSIONS Together, these studies will provide a robust set of analytical methods for exploring scripted television content, quantitative and qualitative descriptions of how medical advances have appeared in that content, and possible uses of popular media to garner public support for biomedical sciences. These studies will also provide a framework for other researchers seeking to examine specific themes in scripted entertainment. Finally, our findings will highlight challenges and opportunities of using entertainment media to inform audiences about medical advancement and the importance of public participation in science.

To identify contextual factors that harm and protect the mental health of Black and Latinx gay and bisexual men, this study examined (a) associations between dating app use and psychological distress over time mediated by sexual racism, with (b) moderation by different sources of supportive social connections (i.e., general social support, gay community connection, and racial/ethnic community connection). Using three waves of the Healthy Young Men's Cohort Study with Black and Latinx gay and bisexual men (N = 412), multiple moderated mediation path analyses were tested. Dating app use was associated with more sexual racism, and sexual racism was positively associated with psychological distress. High, but not low, racial/ethnic community connection diminished the effects of sexual racism on psychological distress, and social support from family and friends and gay community connection did not. Furthermore, the indirect effect of dating app use on psychological symptoms through sexual racism was significant. All social support indicators modified this indirect effect, such that the indirect effects were significant only at low values of general social support and at low racial/ethnic and gay community connection. For Black and Latinx gay and bisexual men, the impact of dating app use on psychological distress may occur through elevated experiences of sexual racism. These associations may be diminished with greater access to general social support and community connection. Findings highlight the dual need for reducing racism on dating apps and for increasing access to general and community-specific forms of social connection and support. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The present study investigated whether the patterns of intersectional stigma experiences were associated with differences in the developmental, parallel trajectories of anxious and depressive symptoms across the transition to adulthood among Black, Latinx, and Afro-Latinx cisgender sexual minority young men. Data were from the Healthy Young Men's Cohort Study collected semiannually from 2016 to 2020 in Los Angeles and included 426 cisgender Black, Latinx, and Afro-Latinx sexual minority young men between the ages of 18 and 25 at baseline. Multidomain latent growth modeling with a complex grouping variable was used to estimate the parallel trajectories of anxious and depressive symptoms and whether these trajectories varied based on the patterns of intersectional stigma at baseline. Models were adjusted for individually varying age of observations to approximate the growth processes from ages 18 to 29. Results demonstrated a general decline in anxious symptoms and depressive symptoms over time. Relative to all other patterns of stigma experiences, the subgroup characterized by a pattern of compounding racism and heterosexism exhibited the highest levels of anxious and depressive symptoms and an earlier peak in anxious symptoms. This compound stigma group also exhibited an earlier and the highest peak in anxious symptoms compared to all other groups. Results highlight the impact of intersecting stigma on mental health across early adult development, the need for mental health intervention early or before the transition to adulthood, and continued effort to challenge and combat racist and heterosexist biases. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Pre-exposure prophylaxis (PrEP) is a powerful tool to prevent the transmission of HIV. Interventions promoting PrEP must focus on populations most impacted by systemic barriers to uptake. Historically, young sexual minority men and transgender women have the highest demonstrated rates of new HIV diagnoses, but prevalence within other gender minority populations is now being studied. Few interventions have focused on addressing PrEP uptake with sexual and gender minority (SGM) youth, particularly through mobile health (mHealth) technologies. Built on the successful foundation of the HealthMpowerment Platform, PrEPresent aimed to engage SGM youth across diverse gender, racial, and ethnic identities in the Greater Los Angeles area. Objective: The aim of this study was to evaluate the feasibility and acceptability of a digital peer patient-navigation PrEP uptake app. Methods: PrEPresent incorporated patient activation theory into an mHealth intervention. The study took place over a 6-month period with visits at baseline, 3 months, and 6 months. The intervention period lasted from baseline to 3 months. Control participants received an information-only app. Intervention participants received an enhanced app and access to an interventionist, the PrEPresentative. Intervention participants could meet with the PrEPresentative four times over the 3-month period via phone, Health Insurance Portability and Accountability Act–compliant videoconferencing, or an in-app text messaging. PrEP uptake was measured through survey responses and the UrSure rapid urine test of tenofovir. Results: PrEPresent comprised of 147 sexual and gender-diverse participants—75 participants were randomized into the control arm and 72 into the intervention arm. A total of 48% (71/147) were Latinx and 18% (27/147) were Black or African American. Most (98/147, 67%) were transgender or gender diverse, and the remaining (49/147, 33%) were cisgender men. PrEP was initiated by 25% (14/56) of intervention participants and 19% (11/58) of control participants. In total, 50% (36/72) of intervention participants completed two or more sessions with the interventionist. Intervention participants had an average of 15.93 (SD 15.85) logins compared to 6.31 (SD 9.27) logins for control participants. Average use of the mHealth platform was 9.51 (SD 11.47) minutes for intervention participants and 3.03 (SD 5.70) minutes for control participants. Conclusions: PrEPresent met primary outcome measures of feasibility and acceptability. Despite this, PrEP uptake was low, and use of the platform was low compared to other HealthMpowerment projects. While mHealth offers promising HIV prevention outcomes, fostering active app engagement is crucial in promoting behavior change. Mixed success in initiating PrEP uptake across mHealth interventions involving SGM youth warrants further inquiry into how these platforms can address prevention barriers with this population. Interventions targeting uptake and adherence will need to adapt as the landscape of PrEP delivery evolves with the adoption of on-demand and long-acting injectable modalities.

Background Although racially, sexually, and gender minoritized (RSGM) persons experience chronic and sometimes severe financial life stressors that increase their risk of mental health problems across the life course, no studies in this population have examined psychological resilience factors, such as optimism, that may mitigate these negative effects. Purpose To investigate how exposure to financial stressors is associated with symptoms of anxiety, depression, and somatization, and whether optimism moderates these associations. Method Two hundred and eighty-five RSGM emerging adults (M_age = 25.18, SD = 1.94) completed the Stress and Adversity Inventory and Brief Symptom Inventory online. Participants were Black (22.1%), Latinx (57.9%), and biracial Black–Latinx (20%), and they primarily identified as male (94.7%) and gay (74.2%). Results As hypothesized, multiple regression analyses with interaction terms indicated that more frequent and severe acute and chronic lifetime financial stressors were related to greater anxious, depressive, and somatic symptoms. Moreover, greater optimism was associated with fewer mental health symptoms. Additionally, greater optimism was associated with fewer somatic symptoms than lower optimism when exposed to more financial stressors. Similarly, greater optimism attenuated the negative effects of greater financial stressors’ severity on depressive symptoms. Conclusions Financial stressors are related to worse mental health among RSGM emerging adults, and optimism may mitigate these effects. Screening for lifetime financial stressors and bolstering optimism may help reduce mental health disparities related to financial stressors in this population.

Although sexual minority men experience substantial discrimination, in addition to increased risk for several serious mental and somatic health problems, the biological mechanisms underlying these effects are unclear. To address this issue, we examined how experiences of social safety (i.e., community connection) and social threat (i.e., discrimination, in the forms of homophobia and racism) were related to conserved transcriptional response to adversity (CTRA) gene expression profiles across time, and whether these associations differed across HIV status, in a well-characterized, racially diverse sample of sexual minority men (M_age = 22.61, SD = 1.90). Experiences of community connection, homophobia, and racism were assessed via self-report, and blood samples were obtained at three timepoints over approximately 2 years. We then used these blood samples to characterize participants' CTRA gene expression, which we quantified using an a priori 53-transcript composite score derived from RNA sequencing data from peripheral blood leukocytes. As hypothesized, greater community connection was significantly related to decreased CTRA gene expression across time. These effects were similar regardless of HIV status and were robust to statistical adjustment for several potential confounding factors. In contrast, neither homophobia nor racism were related to CTRA gene expression. These results suggest that community connection may be a protective factor that reduces biological processes known to negatively impact health. Consequently, interventions and policies aimed at reducing health disparities in marginalized populations may benefit from increasing community connection and inclusion. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

BACKGROUND Pre-exposure prophylaxis (PrEP) is a powerful tool to prevent the transmission of HIV. Interventions promoting this medication must focus on populations most impacted by systemic barriers to uptake. Historically, young sexual minority men (YSMM) and transgender women have the highest demonstrated rates of new HIV diagnoses, but prevalence within other gender minority populations is now being studied. To date, few interventions have focused exclusively on addressing PrEP uptake with sexual and gender minority (SGM) youth, particularly through mobile health (mHealth) technologies. Built on the successful foundation of the HealthMpowerment (HMP) Platform, PrEPresent aimed to engage with SGM youth across diverse gender and racial and ethnic identities in the Greater Los Angeles area. OBJECTIVE The aim of this study was to evaluate the feasibility and acceptability of a digital peer patient-navigation PrEP uptake application. METHODS The PrEPresent intervention took place over a 6-month timepoint with visits at baseline, 3 months, and 6 months. The active intervention period lasted from baseline to 3 months. Control participants received an information only version of the app. Intervention participants received an enhanced app with additional features and access to an interventionalist, the PrEPresentative. Intervention participants could meet with the PrEPresentative 4 times over the 3-month period via phone, HIPPA-compliant video conferencing, or in-app text messaging system. PrEP uptake was measured through survey response and UrSure rapid urine test of tenofovir. RESULTS PrEPresent comprised of 147 sexual and gender diverse participants – 48.3% (71/147) were Latinx and 18.4% (27/147) were Black/African American. Most (66.6%, 98/147) were transgender or gender diverse and the remainder (33.3%, 49/147) were cisgender men. PrEP was initiated by 14/56 (25.0%) of intervention participants and 11/58 (19.0%) of control participants. 50% (36/72) of intervention participants completed two or more sessions with the interventionalist. Intervention participants had an average of 15.93 logins compared to 6.31 logins for control participants. Average usage of the mHealth platform was 9.51 minutes for intervention participants and 3.03 minutes for control participants. CONCLUSIONS PrEPresent met primary outcome measure metrics of feasibility and acceptability, demonstrating that mHealth-based peer-navigator support has potential to increase PrEP uptake in racially and ethnically diverse SGM. Despite this, PrEP uptake was low across both arms and usage of the platform was low compared to other iterations of HMP projects. While mHealth offers promising HIV prevention outcomes, fostering active participant app engagement will continue to be crucial in promoting behavior change. With the widescale adoption of on-demand and long-acting injectable PrEP, interventions targeting uptake and adherence will need to adapt as the landscape of PrEP delivery evolves. Larger trials powered for efficacy are warranted to understand how mHealth platforms and peer-navigation systems can address barriers related to PrEP uptake. CLINICALTRIAL ClinicalTrials.gov NCT05281393; https://clinicaltrials.gov/ct2/show/NCT05281393 INTERNATIONAL REGISTERED REPORT RR2-10.2196/50866