PROVIDENCE – Amy Nunn, the director of the R.I. Public Health Institute, has been on the front lines of many public health issues.

Nunn, who holds masters and doctoral degrees from the Harvard School of Public Health, established a comprehensive, neighborhood-based HIV and HCV prevention and treatment program, called “Do One Thing,” in Philadelphia in 2012, serving a neighborhood with high rates of infection.

Nunn also helped to found Philly Faith in Action, a coalition of clergy in Philadelphia, to reduce racial disparities in HIV infection.

She expanded her work with clergy by establishing Mississippi Faith in Action in 2013.

Here in Rhode Island, Nunn has been involved with numerous public health efforts, including efforts to combat Hep C and food insecurity.

When Nunn spoke to ConvergenceRI about her work on a new study, just published in March-April 2016 edition of Public Health Reports, as being one of the most important studies she has been involved with, it was hard not to take notice.

The purpose of the study was to better understand the HIV epidemic in Rhode Island, looking at online hookup sites among newly diagnosed men having sex with men.

As the study detailed, from 2007 to 2011, the number of new annual HIV diagnoses declined, from 121 to 97. Yet, during that same time period, the percentage of newly diagnosed individuals who were men having sex with men increased from 47 of 121, or 39 percent, to 62 of 97, or 64 percent.

More recently, in 2014, the number of new HIV diagnoses increased 31 percent compared to 2013, jumping from 74 to 97 new HIV diagnoses, mostly among men have saving with men.

To better understand the HIV epidemic in Rhode Island, the authors characterized the role of hookup sites among newly diagnosed men having sex with men in Rhode Island and explored opportunities for delivering prevention messaging through these sites.

The five most popular sites and apps, some of which are also used by women, included: Grindr, Manhunt, Scruff, Adam4Adam and Craigslist, according to the study.

“We believe this is the first study to identify the websites and mobile apps where individuals newly diagnosed with HIV report meeting their sexual partners,” Nunn told ConvergenceRI. “This study included nearly everyone newly diagnosed with HIV across an entire state. We know, down to the app or website, exactly where men newly diagnosed with HIV are meeting the sexual partners.”

Nunn put the importance of the study in a nationwide context – as well as the opportunity to deliver public health HIV prevention and treatment messaging through these hookup sites to reach high-risk individuals.

“This is a nationwide phenomenon,” Nunn continued. “In Rhode Island, as elsewhere, we need to partner with these websites to reach men for HIV prevention services.”

In response, Nunn said that public health officials are issuing a call to action.

“We are issuing a formal call to action for apps and websites to do more to promote HIV prevention services that we know work,” she said, “like HIV screening, treatment, and pre-exposure prophylaxis, which is a pill that can dramatically reduce HIV transmission risks for HIV negative people.”

Slowing the spread of HIV
The lead author of the study was Dr. Philip Chan, assistant professor of medicine in the Alpert Medical School at Brown and director of the STD Clinic at The Miriam Hospital.

The other authors of the study included Nunn, Caitlin Towey, Joanna Poceta, Jennifer Rose, Dr. Rami Kantor, Julia Harvey, E. Karina Santamaria, and Dr. Nicole Alexander-Scott, and Nunn.

In the news release from Brown University, Chan reframed the research challenge: the widely used sites are part of the lifestyle and culture among many gay and bisexual men and can lead to lasting relationships, not just health risks. The goal of the research, Chan continued, was not to stigmatize sex or men who use the sites, but to instead inspire partnerships with the online companies to include more information that could slow the spread of HIV.

“Across the U.S., we are seeing MSM as the number-one risk group for HIV infection,” Chan said in the news release. “On these online hookup sites, many young MSM are meeting sex partners. It’s really an under-recognized and under-utilized approach we should be using to reach out to and engage this group.”

Alexander-Scott, a co-author of the study and currently the director of the R.I. Department of Health, said that prevention messaging is a vital tool in the work to prevent new HIV transmissions in Rhode Island. “A study like this is an urgent call to action for greater collaboration around education to address the health needs of men who have sex with men,” she said in the news release, adding that the rate of new HIV diagnoses among men who have sex with men represented an unacceptable health disparity.

That disparity was reinforced by a new study, released on Feb. 23 by the Centers for Disease Control and Prevention, which projected that half of gay and bisexual black men and a quarter of gay and bisexual Hispanic men will be diagnosed with HIV in their lifetimes.

The projections were based on data about HIV diagnoses and death rates collected from 2009 to 2013.

“These estimates are a sobering reminder that gay and bisexual men face an unacceptably high risk for HIV – and of the urgent need for action,” according to Dr. Eugene McCray, director of the CDC’s Division of HIV/AIDS Prevention, in a story in The Daily Beast. “If we work to ensure that every American has access to the prevention tools we know work, we can avoid the outcomes projected in this study.”

Panel to explore Zika strategies
Meanwhile, back at the ranch, the second in a series of panels hosted by the Watson Institute at Brown University on March 2 will explore strategies for tackling a world health emergency with the emerging epidemic of the Zika virus.

Panelists will include: Dr. Annie De Groot, founder and CEO of EpiVax; Dr. Alan Rothman, head of URI’s Laboratory of Viral Immunity and Pathogenesis; Andrew Mallon, Ph.D., CEO of Calista Therapeutics, and Jannelle Couret, Ph.D., Multicultural Post Doctoral Fellow in URI’s Department of Biological Sciences.