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NIH grant 1R01MH142154-01: Validating a Unified Model of Border Identity Stress, HIV Risk, and Mental Health Across Three U.S. Health Disparity Populations
Institute: {'code': 'MH', 'abbreviation': 'NIMH', 'name': 'National Institute of Mental Health', 'admin_org_id': '12500050', 'admin_funding_url': ''}. PI: Skyler Jackson. Award: $810629.
Start: 2026-07-23T00:00:00.
BACKGROUND. Border identity groups—such as those who are bisexual/pansexual (bi+), Biracial/Multiracial,
or gender nonbinary—challenge our nation's most basic group dichotomies (e.g., gay/straight, Black/White,
man/woman) and are rapidly growing segments of the U.S. population. As NIH health disparity populations, it
is unsurprising that border identity groups tend to demonstrate elevated HIV and mental health inequities as
compared with the general U.S. population. However, more vexing are studies showing that bi+, Multiracial,
and nonbinary people demonstrate greater sexual/mental health risk than their respective monosexual
minority, monoracial minority, and binary gender minority counterparts. The potential drivers of these co-occurring health inequities are insufficiently theorized, poorly measured, and unevenly studied across groups.
Yet, accumulating research supports an intriguing hypothesis—that bi+, Multiracial, and nonbinary populations
demonstrate similar health risk profiles because, beyond traditional minority stressors, they are vulnerable to a
distinct set of stigma-related stressors encountered by individuals holding identities that defy socially
sanctioned dichotomies (i.e., border identity stressors). OBJECTIVE. In response to NIMH PAR-23-062 and
NOT-MH-23-270, this R01 builds upon preliminary research to (a) develop a multigroup measure of border
identity stress, (b) test a unified model of border identity stress, HIV risk, and mental health problems among
bi+, Multiracial, and nonbinary adults, and (c) identify mutable mechanisms and protective factors concerning
relations between border identity stress and co-occurring sexual and mental health risks. SPECIFIC AIMS. PI
Jackson will work with Co-Is Bowleg, Esserman, Huynh, and Poteat to: develop a community-informed
multigroup border identity stress scale—optimized for cross-sectional, longitudinal, and EMA HIV research
(Aim 1); test longitudinally a conceptual model of border identity stress, HIV risk, and mental health—testing
theorized mediators and moderators across bi+, Multiracial, and nonbinary adults (Aim 2); and detect relations
between border identity stressors, daily HIV risk factors, and mental health symptoms among three higher-risk
border identity subgroups via a 14-day microlongitudinal study—isolating daily mechanisms for intervention
(Aim 3). SIGNIFICANCE. By highlighting how previously hidden forms of stigma drive health risk among bi+,
Multiracial, and nonbinary adults, this model is poised to facilitate the development of much-needed
interventions among three NIH health disparity groups disproportionately burdened by HIV—and is poised to
shift how the field conceptualizes stigma, measures stigma-related stress, and combines stigmatized groups
for study. DISSEMINATION. In addition to scholarly publications, we will produce and disseminate several
scientific products (e.g., infographic summaries) for community members and health professionals, including:
(1) bi+, Multiracial, and nonbinary research participants, (2) AIDS service organizations within Ending the HIV
Epidemic priority jurisdictions, and (3) a national network of mental health providers serving stigmatized clients.document fetched 2026-08-02 08:24