Don Operario, MD

Formative Research to Inform the Development of a Gender Affirmative and Anti-Transphobia Approach to Opioid Use Disorder Treatment for Transgender and Gender Diverse Adults

Professor of Behavioral and Social Sciences
Brown University School of Public Health

Biography

Don Operario is Professor of Public Health at Brown University. His research addresses two inter-related areas. The first general area concerns the social psychological determinants of HIV, mental health, and related health issues (substance use, structural violence, access to services) in historically marginalized communities, with an emphasis on developing and evaluating theory-based social and behavioral interventions that are relevant for delivery in complex communities. A second research area concerns the lived experiences associated with social inequality, with an emphasis on understanding the perspectives of intersectional identities and addressing health and psychosocial disparities. His NIH-funded projects examine these public health issues among racial and ethnic minority populations as well as sexual and gender minority populations in the United States, the Philippines, China, South Korea, Kenya, and South Africa.

Faculty Page

COBRE Abstract

Transgender and gender diverse (TGD) individuals are at elevated risk for substance use and substance use disorder (SUD). Effective, culturally relevant and gender-affirmative treatment interventions are necessary to reduce substance use-related morbidity and mortality in this population. However, research suggests that TGD people face numerous barriers accessing and engaging in SUD treatment. These barriers are theorized to be driven by multilevel sources of stigma that particularly impact those with intersecting marginalized identities, including TGD racial/ethnic minorities. Almost no research, however, has identified the specific manifestations of TGD stigma that operate synergistically at individual (e.g. personal beliefs and motivations), interpersonal (e.g., group norms and interpersonal interactions), and structural (e.g. clinic policies, practices, and environment) levels to impact access to and engagement in SUD treatment services for TGD populations. In order to develop effective interventions to improve uptake and engagement in SUD treatment for TGD people who use drugs, mixed-methods research is needed to identify the stigma-related facilitators and barriers to SUD treatment and supportive strategies that can be leveraged in future interventions. We propose a two-phase, mixed-methods pilot research study to identify and characterize stigma-related barriers and gender-affirming facilitators to treatment engagement for TGD people in Rhode Island. Phase 1 (i.e., Specific Aim 1) involves a quantitative web-based survey of n=100 SUD treatment providers to assess their understanding and capacity to provide gender-affirmative care to TGD people who use drugs. Phase 2 (i.e., Specific Aim 2) will draw on qualitative interviews conducted with n=20 TGD people who use drugs (approximately half the sample will report opioid use) and with n=20 SUD treatment administrators and clinicians to characterize multilevel experiences of stigma as well as identify opportunities for improving gender-affirmative treatment services. Upon completion of these aims, we will rapidly analyze the mixed-methods findings and identify strategies that can be leveraged in an NIH R34 intervention development grant to improve treatment outcomes for TGD people who use drugs.

Publications

Funded Research

5R01DA039971 (Nemoto) 09/15/16 – 06/30/21
NIDA
Substance and non-prescribed hormone use among transmen
The major goal of this project is to investigate the trajectories of substance use, prescribed hormone use, non-prescribed hormone use, and psychological well-being among transwomen (male-to-female transgender persons) and transmen (female-to-male transgender persons) who identify their gender other than that assigned at birth.
Role: MPI

D43TW01565 (Operario) 04/01/17 – 03/31/22
Fogarty International Center
Brown University and University of the Philippines Training Program for the prevention of HIV in vulnerable populations
This Fogarty International training grant will provide develop research capacity in HIV prevention with key populations for researchers and faculty at the University of the Philippines Manila.
Role: MPI

R34 MH119968 (Operario) 06/01/20 – 05/30/23
NIMH
HIV Risk Reduction Intervention for Transwomen with Intimate Partner Victimization
Development and pilot testing of a brief behavioral intervention to support HIV prevention and sexual safety for transwomen with history of intimate partner victimization.
Role: MPI

R01 MH115765 (Gamarel) 09/01/17 – 08/31/22
NIMH
A couples-based approach to HIV prevention for transgender women and their male partners
The major goal of this project is to test the efficacy of a couples-focused HIV prevention intervention for gender minority women and their primary male partners.
Role: MPI

R01 MH123352 06/01/20 – 05/30/25
NIMH
Mobile Health Intervention to Increase HIV Self Testing and Linkage to Services for High-Risk Men in China
Effectiveness-implementation hybrid type 1 research study to examine a mobile intervention to promote HIV self-testing and linkage to care in China.
Role: MPI

U01 PS005117 (van den Berg) 08/01/16 – 04/30/20
CDC
Reaching Black and Latino/Hispanic MSM through Social Media about Treatment as Prevention and
PreExposure Propohylaxis
This study will develop and pilot test an internet-based intervention to engage racial/ethnic minority MSM in
biomedical HIV prevention and treatment.
Role: Co-Investigator

P30 AI42853 (Cu-Uvin) 07/01/19 – 06/30/23
NIAID
Providence/Boston Center for AIDS Research
The mission of the Providence/Boston CFAR is to promote the NIH HIV priority research agenda of translational research to reduce the burden of HIV infection worldwide, with special focus on substance users, women, MSM, justice-involved persons, and at-risk youth.
Role: Co-Investigator

R21 DA045233 (Zaller/Yang) 08/01/19- 7/31/2
Preparing to Implement PrEP among High-Risk Men in China
Qualitative and social network analysis to examine community readiness, barriers, and facilitators related to future PrEP implementation policy and research in China.
Role: Consultant

Mentors

Formative Research to Inform the Development of a Gender Affirmative and Anti-Transphobia Approach to Opioid Use Disorder Treatment for Transgender and Gender Diverse Adults

Don Operario, MD

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