Stigma Mitigation & Health Equity Laboratory
About Our Program
The Stigma Mitigation and Health Equity Laboratory at the Psychiatry Research Institute at Montefiore Einstein (PRIME) studies strategies to mitigate human immunodeficiency virus (HIV)-related stigmas in healthcare settings that result in equitable improvements in the quality of care and health outcomes. We combine stigma science and implementation science, often using mixed methods to conduct studies that elucidate the functions, techniques and mechanisms of action responsible for changes in both health worker behavior and the health systems in which they operate. Our hope is that our work expedites the deployment of evidence-based strategies to mitigate HIV-related stigmas for those most affected by the HIV epidemic.
Areas of Concentration
We typically apply ontologies of human behavior based on the Human Behaviour Change Project to elucidate the theory-based components of these strategies. The lab is additionally involved in HIV treatment and pre-exposure prophylaxis, and the development of online training in motivational interviewing among health workers to improve the quality of care.
Current Projects & Collaborations
“Mitigating sexual stigma within healthcare interactions to improve engagement of MSM in HIV prevention” (K23 MH124569; PI: Kutner) aims to understand how to mitigate anal sex stigma through the development and evaluation of a bundle of implementation strategies provided to HIV services providers in Alabama, Mississippi and Tennessee. This project involves the development of clinician- and community-informed strategies, including a project website that provides informational support about anal pleasure and health in a credible, accurate and reliable manner.
Secondary projects include:
- “Interactive Internet-based Motivational Interviewing Training for HIV Counseling Support Staff to Improve Health Communication in HIV Care Interactions” (iMI4HIV) (R34 MH133468; PI: Balán, Co-I: Kutner) to develop and evaluate internet-based motivational interviewing training among lay HIV counselors in an effort to improve the quality of services
- “Accelerating Implementation of Multilevel-strategies to Advance Long Acting Injectables for Underserved Populations (ALAI UP)” (U1SHA46532; PI: Meyers, Co-I: Kutner) to promote the equitable delivery of long-acting injectable HIV therapy across eight HIV clinics throughout the United States
- “The TAIL-PrEP Study: Acceptability and Feasibility of a Tailored Adherence Intervention for safe discontinuation of Long-acting PrEP” (R21 MH133755; PI: Meyers; Co-I: Kutner) to assess the feasibility and acceptability of a theory-driven, dual-drug monitoring adherence intervention informed by behavioral economics to support patients to stay adherent to oral pre-exposure prophylaxis (PrEP) until long-acting PrEP has cleared their body, and reassure providers to increase their willingness to prescribe long-acting PrEP
About Bryan Kutner, MPH, PhD
Bryan Kutner, MPH, PhD
Assistant Professor, Montefiore Einstein Department of Psychiatry and Behavioral Sciences
Assistant Professor, Montefiore Einstein Department of Medicine
Dr. Bryan Kutner is a licensed clinical psychologist with training in epidemiology who has worked in the harm reduction movement since the late 1990s, primarily training HIV workers on best practices to serve marginalized clients. Dr. Kutner’s research aims to improve engagement in HIV services by understanding behavior change techniques and mechanisms of action responsible for mitigating HIV-related stigmas in healthcare settings.
He is currently conducting studies to understand how to mitigate anal sex stigma in HIV services and address loss to follow-up in high-resolution anoscopy among people with HIV. Dr. Kutner is also a co-investigator on several additional translational science studies, including understanding how to implement equitable access to long-acting injectable antiretroviral therapy and how to implement internet-based motivational interviewing training among HIV service workers.
Dr. Kutner received his MPH in epidemiology from Columbia University Mailman School of Public Health and his PhD in clinical psychology from the University of Washington. He completed his predoctoral clinical internship at Montefiore Einstein and a National Institute of Mental Health (NIMH)-funded postdoctoral fellowship in behavioral research at the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University.