Faculty

Lloyd A Goldsamt headshot

Lloyd A Goldsamt

Senior Research Scientist

1 212 998 5720

433 First Avenue
Room 739
New York, NY 10010
United States

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Professional overview

Lloyd A. Goldsamt, Ph.D. is a Senior Research Scientist at the New York University College of Nursing and an Adjunct Professor in NYU’s Steinhardt School of Culture, Education and Human Development. He has conducted NIH-funded research and community-based evaluations for the past 20 years. His primary research area is HIV and STI prevention among high-risk youth populations, including men who have sex with men, male sex workers and injection drug users. He is currently the Principal Investigator on a NIDA/PEPFAR-funded study developing and implementing a sexual health promotion intervention for young male sex workers in Hanoi and Ho Chi Minh City, Vietnam. Dr. Goldsamt has conducted training and program evaluations locally and nationally, focusing on drug courts and community-based organizations working to prevent HIV and drug abuse. He is currently the Evaluator for the Brooklyn Treatment Court and an evaluator on an Office of Juvenile Justice and Delinquency Prevention project developing nationwide Juvenile Drug Court Learning Collaboratives. Dr. Goldsamt is also on the faculty of the Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute and a licensed clinical psychologist in New York State.

Education

B.A., University of Massachusetts
M.A., State University of New York at Stony Brook
Ph.D. in Clinical Psychology, State University of New York at Stony Brook

Honors and awards

Phi Beta Kappa

Specialties

Global
LGBTQ
Substance use
HIV/AIDS

Publications

Publications

Heavy Alcohol Use Among Migrant and Non-Migrant Male Sex Workers in Thailand: A Neglected HIV/STI Vulnerability

Guadamuz, T. E., Clatts, M. C., & Goldsamt, L. A. (2018). Substance Use and Misuse, 1-8. 10.1080/10826084.2018.1436564
Abstract
Background: There is scarce research on male sex workers in the context of alcohol use. While heavy alcohol use has been established as a risk factor for HIV and STI infections among men who have sex with men (MSM), men who engage in sex work with other men, particularly from the Global South, have not been included in these studies. Moreover, studies among male sex workers in Asia often do not explore migration contexts of these men. Objectives: The objective of this exploratory study is to examine the prevalence and correlates of heavy alcohol use among migrant and non-migrant male sex workers in Bangkok and Pattaya, Central Thailand. Methods: Between August and October 2015, 18–24 year-old migrant and non-migrant male sex workers (n = 212) were recruited from various male sex work-identified venues (bars, clubs, massage parlors, and go-go bars) to take an interviewer-administered cross-sectional survey in Bangkok and Pattaya, Thailand. Measures were adapted from previous studies in similar populations and included structured questions across four domains, including demographic characteristics, alcohol use, stimulant use, and sexual behaviors. Multivariable logistic regression assessed the independent associations between heavy alcohol use (heavy versus not heavy) and demographic characteristics, stimulant use and sexual behavior. Results: Heavy alcohol use was prevalent among one-third of participants. Heavy alcohol use was positively associated with male sex workers who were non-migrant and Thai, currently using stimulants, having 15 or more male clients in the past month and having first consumed alcohol at age 15 years or younger. Conclusions: Current HIV prevention efforts should consider subpopulations of MSM, including male sex workers and migrants, as well as other risk behaviors like alcohol, as important contexts for HIV and STI risks.

HIV Testing and Associated Factors Among Men Who Have Sex with Men in Changsha, China

Zhou, J., Chen, J., Goldsamt, L., Wang, H., Zhang, C., & Li, X. (2018). Journal of the Association of Nurses in AIDS Care. 10.1016/j.jana.2018.05.003
Abstract
Promoting HIV testing is an important strategy to end the HIV epidemic. HIV incidence among men who have sex with men (MSM) has increased rapidly in China in recent years, but HIV testing rates are still low. Our cross-sectional study investigated HIV testing rates and analyzed associated factors in 565 MSM in Changsha between April and December 2014. In the previous year, 37.7% of participants had not been tested, 38.2% had had one test, and 24.1% had had two or more tests. Those who initiated sexual debut at an older age, had known someone infected with HIV, or had been diagnosed with a sexually transmitted illness (STI) were more likely to have had an HIV test. HIV intervention programs in China should focus on sexually active young MSM, integrate HIV testing and counseling services in STI clinics, and describe real experiences of living with HIV to improve HIV testing in MSM.

Implementation of Online Opioid Prevention, Recognition and Response Trainings for Laypeople: Year 1 Survey Results

Simmons, J., Rajan, S., Goldsamt, L. A., & Elliott, L. (2018). Substance Use and Misuse, 1-6. 10.1080/10826084.2018.1451891
Abstract
Background: This article reports on the first implementation of an online opioid-overdose prevention, recognition and response training for laypeople. The training was disseminated nationally in November 2014. Between 2000 and 2014, U.S. opioid deaths increased by 200%. The importance of complementary approaches to reduce opioid overdose deaths, such as online training, cannot be overstated. Objectives: A retrospective evaluation was conducted to assess perceived knowledge, skills to intervene in an overdose, confidence to intervene, and satisfaction with the training. Measurements: Descriptive statistics were used to report sample characteristics, compare experiences with overdose and/or naloxone between subgroups, and describe participants’ satisfaction with the trainings. Z-ratios were used to compare independent proportions, and paired t-tests were used to compare participant responses to items pre- and posttraining, including perceived confidence to intervene and perceived knowledge and skills to intervene successfully. Results: Between January and October 2015, 2,450 laypeople took the online training; 1,464 (59.8%) agreed to be contacted. Of these, 311 (21.2% of those contacted) completed the survey. Over 80% reported high satisfaction with content, format and mode of delivery and high satisfaction with items related to confidence and overdose reversal preparedness. Notably, 89.0% of participants felt they had the knowledge and skills to intervene successfully posttraining compared to 20.3% pretraining (z = −17.2, p <.001). Similarly, posttraining, 87.8% of participants felt confident they could successfully intervene compared to 24.4% pretraining (z = −15.9, p <.001). Conclusions: This study demonstrates the effectiveness of the GetNaloxoneNow.org online training for laypeople.

HIV and other STIs in male sex workers: Findings from a sexual health promotion intervention in Vietnam

Goldsamt, L. A., Clatts, M. C., Giang, L. M., Le, B. Q., Colby, D. J., & Yu, G. (2017). International Journal of STD and AIDS. 10.1177/0956462417740291
Abstract
Male sex workers (MSWs) in Vietnam are at high risk for acquisition and transmission of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), yet are extremely disengaged from the healthcare system. This contributes to large numbers of untreated or late-treated infections and increased secondary transmission. We enrolled 995 MSWs in Hanoi and Ho Chi Minh City (HCMC) in a Sexual Health Promotion intervention that included face-to-face delivery of seven content modules, a clinical examination and testing for HIV, syphilis, gonorrhea and Chlamydia. Onsite treatment was provided for STIs, and those who tested positive for HIV were referred to local treatment centers. While 64.6% of participants had never been to a health service and fewer than half (41.2%) had ever been tested for HIV, 67.1% returned for test results. This testing identified 109 (11.0%) participants who were HIV-positive and 312 (31.4%) who tested positive for at least one other STI. Substantive differences were seen in MSWs from different cities, with those from Hanoi more likely to have ever visited a health service (57.8% vs. 24.9%) and to have taken a prior HIV test (54.1% vs. 37.9%) than those in HCMC. Sexual health promotion is a promising approach to engaging MSWs in health services.

Implementation of online opioid overdose prevention, recognition and response trainings for professional first responders: Year 1 survey results

Simmons, J., Rajan, S., Goldsamt, L., & Elliott, L. (2016). Drug and Alcohol Dependence, 169, 1-4. 10.1016/j.drugalcdep.2016.10.003
Abstract
Background This article reports on the first web-based implementation of an opioid-overdose prevention, recognition and response training for professional first responders. The training was disseminated nationally over one listserv in November 2014. The same year, following Act 139, which mandated the provision of an online training for police officers in Pennsylvania, the Pennsylvania Department of Health approved the training. It was subsequently adopted as the primary training tool for police and other first responders in Pennsylvania and has been used as a training tool by first responders nationally. Methods Analyses employed descriptive statistics to report characteristics of a sample of 387 professional first responders who completed a survey about their experience with the online training. Z-ratios were used to compare independent proportions related to overdose, naloxone, and satisfaction with the training between key subgroups, and paired t-tests were used to compare participant responses to a range of items pre- and post-participation in the training. Results Between January–October 2015, 4804 first responders took the training; 1697 (35.3%) agreed to be contacted; of these, 387 (22.8%) completed a survey about the training and subsequent overdose response experiences. The majority (86.4%) were from Pennsylvania, with police representing over half of the sample. Analysis of the post-training survey indicates high satisfaction with content, format and mode of delivery, and high satisfaction with items related to confidence and overdose reversal preparedness. Conclusions This study demonstrates the feasibility and acceptability of implementing online training for first responders in overdose prevention, recognition and response.

Sexual Initiation and Complex Recent Polydrug Use Patterns Among Male Sex Workers in Vietnam: A Preliminary Epidemiological Trajectory

Yu, G., Goldsamt, L. A., Clatts, M. C., & Giang, L. M. (2016). Archives of Sexual Behavior, 45(4), 975-981. 10.1007/s10508-015-0667-1
Abstract
Little is known about the age of onset of sexual and drug risk and their association with complex patterns of recent drug use among male sex workers (MSW) in a developing country, such as Vietnam. The aim of this study was to determine whether latent class analysis (LCA) would aid in the detection of current individual and polydrug use combinations to predict how different trajectories of sexual and drug initiation contribute to different patterns of current illicit drug use. Data were collected from a cross-sectional survey administered to young MSWs between 2010 and 2011 in Vietnam (N = 710). LCA clustered participants into recent drug use groups, incorporating both the specific types and overall count of different drugs used. Men reported drug use within a 1 month period from an 11-item drug use list. LCA identified three distinct drug use classes: (1) alcohol use, (2) alcohol and tobacco use, and (3) high polydrug use. The current drug use classes are associated with sex worker status, housing stability, income level, educational attainment, marital status, sexual identity, and sexual preferences. High levels of drug use are strongly associated with being a recent sex worker, not having recent stable housing, higher than median income, more than a high school education, less likely to be currently in school and more likely to have non-homosexual preferences and heterosexual partners. An event history analysis approach (time-event displays) examined the timing of the age of onset of drug and sexual risks. Early ages of drug and sexual initiation are seen for all three classes. High current drug users show earlier onset of these risks, which are significantly delayed for moderate and low current drug users. LCA incorporating an overall count of different drugs detected three distinct current drug use classes. The data illustrates that the complexity of drug factors that must be accounted for, both in advancing our epidemiological understanding of the complexity of drug use and the use of drug and sexual risk initiation data to predict current drug use subtypes among high-risk populations.

Sexually transmissible infection and HIV prevention and treatment for young male sex workers in Vietnam: Findings from the SHEATH intervention

Clatts, M. C., Goldsamt, L. A., Giang, L. M., Quc Bo, L., Yu, G., & Colby, D. (2016). Sexual Health, 13(6), 575-581. 10.1071/SH16051
Abstract
Background Urban centres in Vietnam have high rates of HIV infection, especially among men who have sex with men (MSM). A subgroup of MSM, young male sex workers (YMSW), are at especially high risk due to concurrent sex with multiple male and female partners, low levels of knowledge regarding HIV and sexually transmissible infection (STI) transmission, and limited engagement with health services, including STI and HIV screening and treatment. Methods: A targeted intervention (SHEATH) derived from Harm Reduction and Sexual Health Promotion intervention technology was implemented in an out-of-treatment population of YMSW in Hanoi and Ho Chi Minh City (n≤919). Results: YMSW reported high levels of satisfaction with each of the seven core modules within the intervention and for the intervention as a whole. The intervention conferred significant benefit in relation to improved knowledge of STI and HIV transmission (P<0.001). Although only 36% of participants had seen a healthcare provider in the past year, following the intervention 81% intended to see one in the next 6 months. Similarly, although 71% of participants did not disclose that they were MSM the last time they visited a healthcare provider, following the intervention 71% intended to do so at their next visit. High rates of STIs (>10%) and HIV (9.5%) were also found. Conclusion: The data show that the SHEATH intervention can be implemented in this population and setting, is met with high rates of acceptability, and positively impacts STI and HIV knowledge and multiple health services outcomes (including knowledge of HIV status and disposition towards habituation of HIV screening).

Consent Challenges for Participation of Young Men Who Have Sex With Men in HIV Prevention Research in Thailand

Guadamuz, T. E., Goldsamt, L. A., & Boonmongkon, P. (2015). Ethics and Behavior, 25(2), 180-195. 10.1080/10508422.2014.949721
Abstract
Young men who have sex with men (YMSM) younger than 18 years are often excluded from HIV prevention research in Thailand due to cultural attitudes toward youth sexuality, social stigma, and difficulties obtaining guardian permission. Culturally sensitive focus group discussions conducted with parents and YMSM in Bangkok, Thailand, identified barriers and facilitators related to minors’ participation in HIV prevention research. Although gender and class differences emerged, mothers and fathers were generally accepting of research to reduce HIV risk but not in favor of waiver. Youth’s positive attitude toward parental permission was tempered by concerns about harms posed by disclosing same-sex attraction through permission forms.

Injection and sexual risk practices among young heroin users in Hanoi, Vietnam

Goldsamt, L. A., Clatts, M. C., Le, G., & Yu, G. (2015). Drugs: Education, Prevention and Policy, 22(2), 166-172. 10.3109/09687637.2014.979765
Abstract
Epidemiological data in Vietnam shows high HIV prevalence rates among injection drug users, especially in urban centres. However, there are limited data on specific practices used to prepare and inject drugs or on sexual practices among Vietnamese injectors. A street-based cross-sectional interview was conducted with 862 heroin injectors in Hanoi, Vietnam, to collect such data. Variability was seen in both injection and sexual risk, with 12.9% of current injectors reporting at least one unsafe method of drug sharing and 57.1% reporting unsafe sex in the past 30 days. These risks were strongly associated with those who engaged in unsafe injection significantly more likely to engage in unsafe sex (69.4% vs. 55.3%) and those engaging in unsafe sex significantly more likely to engage in unsafe injection (15.7% vs. 9.2%). These findings highlight the overlap of injection and sexual risk practices among Vietnamese heroin users and suggest the need for strong, broadly targeted HIV prevention activities among this population.

Prevalence and Behavioral Correlates of Depression and Anxiety Among Male Sex Workers in Vietnam

Goldsamt, L. A., Clatts, M. C., Giang, L. M., & Yu, G. (2015). International Journal of Sexual Health, 27(2), 145-155. 10.1080/19317611.2014.947055
Abstract
ABSTRACT. Objectives: This study assessed depression and anxiety symptoms and their association with high-risk sexual and drug behaviors among male sex workers in 3 Vietnamese cities. Methods: Male sex workers ages 16 to 35 years old completed an interview that included the Center for Epidemiological Studies Depression Scale to assess depressive symptoms and the Beck Anxiety Inventory to assess anxiety symptoms, as well as questions assessing drug and sexual risk practices. Results: A majority of participants reported depressive symptomatology, although fewer reported symptoms of anxiety. Risky sexual and drug use practices predicted both types of symptoms. Conclusions: Mental distress is associated with drug and sexual risk among male sex workers.