Lloyd A Goldsamt

Faculty

Lloyd A Goldsamt headshot

Lloyd A Goldsamt

Senior Research Scientist

1 212 998 5315

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

Lloyd A Goldsamt's additional information

Lloyd A. Goldsamt, PhD, is a senior research scientist at NYU Rory Meyers College of Nursing and a licensed clinical psychologist in New York State. He has conducted NIH-funded research and community-based evaluations for more than 25 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. Dr. Goldsamt is also on the faculty of the Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute and the Associate Director of the Dissemination Core at the Center for Drug Use and HIV/HCV Research in the NYU School of Global Public Health.

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, an Evaluator on an Office of Juvenile Justice and Delinquency Prevention (OJJDP) project developing nationwide Juvenile Drug Court Learning Collaboratives, and an Evaluation Consultant for the OJJDP Opioid Affected Youth Initiative.

Dr. Goldsamt holds a PhD and MA in clinical psychology from the State University of New York at Stony Brook and a BA from the University of Massachusetts at Amherst.

PhD, Clinical Psychology - State University of New York at Stony Brook
MA - State University of New York at Stony Brook
BA - University of Massachusetts at Amherst

Global
LGBTQ
Substance use
HIV/AIDS

Faculty Honors Awards

Phi Beta Kappa

Publications

The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China

Chi, Y., Huang, D., Lindgren, T., Goldsamt, L., Zhou, J., Ren, Y., Zhang, L., & Li, X. (2022). AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 10.1080/09540121.2021.2008859
Abstract
Abstract
Disclosure of HIV status can encourage spouses of people diagnosed with HIV to prioritize HIV prevention. However, few studies have reported the HIV disclosure status of married men who have sex with men (MSM) and their female spouses. The purpose of this study was to describe the prevalence of HIV disclosure, and whether it was associated with spouses’ HIV testing uptake and unprotected vaginal intercourse within marriage for MSM living with HIV (HIV + MSM) in China. A cross-sectional study was conducted in three Chinese cities. Of 309 participants, only 31.1% of men had disclosed their HIV status to spouses. About 80% of participants reported that their spouses had been tested for HIV. A small proportion of men (9.1%) had unprotected sex with their spouse after HIV diagnosis. Multivariate analyses indicated HIV disclosure was positively associated with HIV testing uptake of spouses, but there was no significant association between HIV disclosure and unprotected marital sexual behaviors for HIV + MSM. The findings indicated that HIV disclosure to spouses is uncommon among married HIV + MSM in China, and HIV disclosure is associated with increased uptake of HIV testing among spouses of MSM, but it does not decrease the unprotected sexual behaviors in marriage.

Interrelationships Between Intimate Partner Violence, Coping Style, Depression, and Quality of Life Among the Regular Female Sexual Partners of Men Who Have Sex With Men

Yan, F., Tang, S., Goldsamt, L., Wang, H., Chen, J., & Li, X. (2022). Journal of Interpersonal Violence, 37(1), NP651-NP670. 10.1177/0886260520917519
Abstract
Abstract
The regular female sexual partners of men who have sex with men (MSM), namely, “Tongqi” in China, increasingly attract attention in the field of public health due to their high levels of depression and intimate partner violence (IPV), and their potential risk of HIV infection. Few studies have explored the relationships among IPV, coping style, depression, and quality of life (QOL) in this population. To examine these relationships, a cross-sectional online survey was conducted in China from February 2016 to March 2017. A questionnaire, including the Revised Conflict Tactics Scales, the Simplified Coping Style Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the World Health Organization Quality of Life Scale, was completed by a total of 194 Chinese Tongqi. Structural equation modeling (SEM) was used to test the relationships among IPV, coping style, depression, and QOL. IPV (β = −0.12, p =.002), depression (β = −0.79, p <.001), and active coping style directly (β = 0.17, p <.001) affected the QOL of this group of women; IPV also indirectly affected QOL through the mediating effect of passive coping style and depression, and the positive coping style indirectly affected QOL through the mediating effect of depression. The proposed model showed good fit of indices, χ2/d = 43.72/34 = 1.286 < 3, p =.123, root mean square error of approximation (RMSEA) = 0.038. Chinese Tongqi experienced high levels of IPV, which led to a poor QOL, partially through the mediating role of passive coping strategy and depression. Future studies or interventions should emphasize the IPV experienced by Chinese Tongqi and provide psychological support so as to improve the overall well-being of this vulnerable female population.

Emotional distress among frontline research staff

Nguyen, M., Goldsamt, L., Mazibuko, N., Zondo, S., & Fielding-Miller, R. (2021). Social Science and Medicine, 281. 10.1016/j.socscimed.2021.114101
Abstract
Abstract
Public health research frequently deals with sensitive topics. A growing body of evidence suggests that frontline researchers who elicit or process participant's traumatic experiences are themselves at risk of developing emotional distress or secondary trauma from daily immersion in these data. This both threatens a study's data quality and calls into question how the harms and benefits of conducting research are distributed across a study team. The objective of this study was to explore how frontline research staff in Eswatini experience and process emotional distress as part of their daily work and to describe potential strategies for resilience and coping using qualitative research methods. We conducted 21 in-depth interviews with informants who had worked in data collection, data entry, and transcription on a number of sensitive topics, including HIV, sex work, and LGBT health. We found that emotional distress is a salient experience among frontline research staff working in Eswatini. This distress stems from conducting research against a generalized backdrop of high rates of HIV, violence, and poverty, particularly since research staff are drawn from affected communities and have their own firsthand knowledge of the phenomena they are studying. Moreover, the qualities study staff are often hired for – empathy, compassion, and emotional intelligence – are also traits that may increase their likelihood of feeling distressed by the narratives they encounter in their work. The workplace can serve as a prism, exacerbating or potentially mitigating these risks into harm at the individual, interpersonal, and community level. While not all study teams may have access to formal mental health services, several informants recommended incorporating regular meetings with a trained counselor as part of the overall project. Others recommended building time for team-building or debriefing conversations into the normal workweek, a strategy that would address both the issue of workload and could bolster the already existent strategy of relying on team members for mental health support.

Hospital ethical climate associated with the professional quality of life among nurses during the early stage of COVID-19 pandemic in Wuhan, China: A cross-sectional study

Jiang, W., Zhao, X., Jiang, J., Zhou, Q., Yang, J., Chen, Y., Goldsamt, L., Williams, A. B., & Li, X. (2021). International Journal of Nursing Sciences, 8(3), 310-317. 10.1016/j.ijnss.2021.05.002
Abstract
Abstract
Objectives: To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight in Wuhan and especially examine whether the hospital ethical climate was independently associated with nurses’ professional quality of life. Methods: A cross-sectional online survey was conducted from March 2020 to April 2020. The nurses working in Wuhan from the other parts of China were the target population. The Professional Quality of Life Scale version 5, the Hospital Ethical Climate Survey, and a basic information sheet were used to collect data. Descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression analysis were used to analyze the data. Results: In total, 236 nurses participated in this study, and 219 valid questionnaires were analyzed. The average age of the participants was 31.2 ± 5.0 years. Most nurses were female (176/219; 80.4%) and married (145/219; 66.2%). In term of professional quality of life, nurses reported moderate (129/219; 58.9%) to high (90/219; 41.1%) levels of compassion satisfaction, low (119/219; 54.3%) to moderate (100/219; 45.7%) levels of burnout, and low (67/219; 36.0%) to high (10/219; 4.6%) levels of secondary traumatic stress. Regarding hospital ethical climate, nurses reported moderately high hospital ethical climates with an average score of 4.46. After controlling for socio-demographic characteristics, the multiple linear regression models showed that the hospital ethical climate subscale of “relationship with physicians” was independently associated with the compassion satisfaction (β = 0.533, P < 0.01) and burnout (β = −0.237, P < 0.05); the hospital ethical climate subscale of “relationship with peers” (β = −0.191, P < 0.01) was independently associated with the secondary traumatic stress. Conclusions: During the early stage of the pandemic, nurses demonstrated moderate to high level of compassion satisfaction, low to moderate level of burnout, and all nurses experienced secondary traumatic stress. Nurses perceived a high level of hospital ethical climate, and the perceived hospital ethical climate played an important role in promoting nurses’ professional quality of life during a life-threatening infectious disease pandemic.

How Black and Latino young men who have sex with men in the United States experience and engage with eligibility criteria and recruitment practices: implications for the sustainability of community-based research

Philbin, M. M., Guta, A., Wurtz, H., Kinnard, E. N., Bradley-Perrin, I., & Goldsamt, L. (2021). Critical Public Health. 10.1080/09581596.2021.1918329
Abstract
Abstract
Research recruitment, eligibility, and who chooses to participate shape the resulting data and knowledge, which together inform interventions, treatment, and programming. Patterns of research participation are particularly salient at this moment given emerging biomedical prevention paradigms. This paper explores the perspectives of Black and Latino young men who have sex with men (BL-YMSM) regarding research recruitment and eligibility criteria, how their experiences influence willingness to enroll in a given study, and implications for the veracity and representativeness of resulting data. We examine inclusion and recruitment as a complex assemblage, which should not be reduced to its parts. From April to July 2018, we conducted in-depth interviews with 30 BL-YMSM, ages 18–29, in New York City. Interviews were recorded, transcribed, and analyzed using the constant comparative method. Black and Latino YMSM’s responses unveiled tensions between researchers’, recruiters’, and participants’ expectations, particularly regarding eligibility criteria (e.g. age, sex frequency), assumptions about ‘risky behaviors,’ and the ‘target’ community. Men preferred peer-to-peer recruitment, noting that most approaches miss key population segments. Findings highlight the need to critically examine the selected ‘target’ community, who sees themselves as participants, and implications for data comprehensiveness and veracity. Study eligibility criteria and recruitment approaches are methodological issues that shape knowledge production and the policies and programs deployed into communities. These findings can inform how future research studies frame recruitment and eligibility in order to better meet the needs of participants and ensure future research engagement.

The impact of COVID-19 on opioid treatment programs in the United States

Goldsamt, L. A., Rosenblum, A., Appel, P., Paris, P., & Nazia, N. (2021). Drug and Alcohol Dependence, 228. 10.1016/j.drugalcdep.2021.109049
Abstract
Abstract
Background: The COVID-19 pandemic had the potential to severely disrupt the delivery of methadone and buprenorphine, as social distancing and other public health regulations made in-person services difficult to maintain. Federal and state regulators changed requirements regarding the dispensing of medication and in-person counseling at opioid treatment programs. Understanding staff and patient reactions to these changes can help determine whether they should be maintained. Methods: We interviewed 25 directors of OTP programs located throughout the United States. Note takers wrote summaries of each interview which were coded for topics and themes covered in the interview guide, including changes to clinic practices, take-home medications, telehealth, patient and staff reactions to new COVID-related protocols, and financial concerns for programs. Results: Most programs rapidly incorporated new regulatory requirements, and directors were generally positive about the impact of increased take-home doses of medication and increased reliance on telehealth. Some directors voiced concerns about these changes, and some reported that patients missed the daily clinical contact with staff. Directors also suggested that more time was needed to assess the full impact of these changes. Financial impacts varied, although many directors were quick to point out that the ongoing opioid epidemic has delivered a steady stream of new patients, thus offsetting potential financial losses. Conclusions: Overall, this study demonstrated the generally positive view of OTP directors to the regulatory changes necessitated by the COVID-19 pandemic. More time is needed to fully evaluate the impact of these changes on clinical outcomes.

The Mediating Role of Coping Style: Associations Between Intimate Partner Violence and Suicide Risks Among Chinese Wives of Men Who Have Sex With Men

Wu, W., Zhang, Y., Goldsamt, L., Yan, F., Wang, H., & Li, X. (2021). Journal of Interpersonal Violence, 36(11), NP6304-NP6322. 10.1177/0886260518814264
Abstract
Abstract
The wives of men who have sex with men, known as “Tongqi” in China, have increasingly attracted public attention due to their potential risks of suicide and sexually transmitted infections and HIV. However, few studies have explored the association between intimate partner violence (IPV) and suicide risk or the mediating effect of coping style on these associations among Tongqi in China. To describe these relationships, a cross-sectional online survey was conducted in China from February 2016 to February 2017. A questionnaire, which consisted of the Revised Conflict Tactics Scales, the Simplified Coping Style Questionnaire, the Beck Scale for Suicidal Ideation, and reports of suicide attempts, was completed by 178 Chinese Tongqi. Bootstrap tests were performed to determine the mediating role of coping styles on the association between IPV and suicide risks. The median IPV score was 14 (range: 0-50), with the domain of negotiation ranking highest. The average coping style score was.37±.73; 61.2% of Tongqi have had suicidal ideation, and 11.8% had attempted suicide. IPV was significantly correlated with suicidal ideation (rs =.19, p <.01) and suicide attempts (rs =.29, p <.001). Participants with a negative coping style had higher suicidal ideation (rs = –.39, p <.01) and suicide attempts (rs = –.22, p <.01). Coping style had a full mediating effect on the association between IPV and suicidal ideation and a partial mediating effect on suicide attempts. Chinese Tongqi experienced high level of IPV and suicide risks. IPV contributed to the suicide risks of Chinese Tongqi, but these associations were mediated by coping style. Therefore, interventions to improve mental health and prevent suicide risks of Chinese Tongqi should focus on helping them develop a positive coping style to achieve the goal of Healthy China in 2030.

Normal physiologic birth continuing professional development: From a national health priority to expanded capacity

Shakpeh, J. K., Tiah, M. W., Kpangbala-Flomo, C. C., Matte, R. F., Lake, S. C., Altman, S. D., Tringali, T., Stalonas, K., Goldsamt, L., Zogbaum, L., & Klar, R. T. (2021). Annals of Global Health, 87(1). 10.5334/aogh.3247
Abstract
Abstract
Background: The Republic of Liberia has experienced many barriers to maintaining the quality of its healthcare workforce. The Resilient and Responsive Health Systems (RRHS) Initiative supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has responded to Liberian identified health priorities. Liberia’s maternal morbidity and mortality rates continue to rank among the highest in the world. Recent country regulations have put forth required continuing professional development (CPD) for all licensed healthcare workers for re-licensure. Methods: The Model for Improvement was the guiding framework for this CPD to improve midwifery and nursing competencies in assisting birthing women. Two novel activities were used in the CPD. We tested the formal CPD application and approval process as this is a recent regulatory body policy. We also included the use of simulation and its processes as a pedagogical method. Over a two-year period, we developed a two-day CPD module, using didactic training and clinical simulation, for Liberian midwives. We then piloted the module in Liberia, training a group of 21 participants, including midwives and nurses, including pre-and post-test surveys as well as observational evaluation of participant skills. Findings: There were no significant changes in knowledge acquisition noted in the post-test. Small tests of change were implemented during the program, supporting the stages of the Model of Improvement. Observation of skill acquisition was done; however, using a formal observation checklist, such as an Observed Structured Clinical Evaluation (OSCE), would add more robust findings. The CPD and follow-up activity highlighted the need for human and financial support to maintain the simulation kits and to create sustainability for future trainings. Videotaping the didactic and simulation two-day continuing professional development train-the-trainer workshop expands the sustainability beyond newly prepared trainers. Simultaneous with this CPD, the Liberian Board for Nursing and Midwifery (LBNM) worked with a partner to create a CPD portal. The CPD partners created modules from the videos and have uploaded these modules to the LBNM’s new CPD portal. Conclusions: Using a quality improvement model as a framework for developing and implementing CPDs provides a clear structure and supports the dynamic interactions in learning and clinical care. It is too soon to determine measurable health outcomes resulting from this project. Anecdotal feedback from clinicians and leaders was not directly related to the content of the CPD; however, it does demonstrate an increased awareness of examining changes in practice to support expanded health outcomes. Further research to examine methods and processes to determine the quality and safety outcomes of CPD trainings is necessary.

Privacy and Confidentiality Concerns Related to the Use of mHealth Apps for HIV Prevention Efforts among Malaysian Men Who Have Sex with Men: Cross-sectional Survey Study

Shrestha, R., Fisher, C., Wickersham, J. A., Khati, A., Kim, R., Azwa, I., Mistler, C., & Goldsamt, L. (2021). JMIR Formative Research, 5(12). 10.2196/28311
Abstract
Abstract
Background: The use of mobile health (mHealth), including smartphone apps, can improve the HIV prevention cascade for key populations such as men who have sex with men (MSM). In Malaysia, where stigma and discrimination toward MSM are high, the mHealth platform has the potential to open new frontiers for HIV prevention efforts. However, little guidance is available to inform researchers about privacy and confidentiality concerns unique to the development and implementation of app-based HIV prevention programs. Objective: Given the lack of empirical data in this area, we aim to understand the privacy and confidentiality concerns associated with participation in a hypothetical app-based research study for HIV prevention efforts. Methods: A cross-sectional, web-based survey was conducted between June and July 2020 among 355 Malaysian MSM. The survey included demographic and sexual health questions and a series of short videos describing a hypothetical app-based HIV prevention program, followed by questions related to privacy and confidentiality concerns in each step of the app-based program (ie, recruitment, clinical interaction, risk assessment, and weekly reminder). Multivariable logistic regression models were used to identify the correlates of willingness to use such an app-based program. Results: Most of the participants (266/355, 74.9%) indicated their willingness to participate in a hypothetical mHealth app–based HIV prevention program. Participants expressed concerns about privacy, confidentiality, data security, and risks and benefits of participating in all stages of the app-based HIV research process. Multivariate analyses indicated that participants who had a higher degree of perceived participation benefits (adjusted odds ratio [aOR] 1.873; 95% CI 1.274-2.755; P=.001) were more willing to participate. In contrast, participants who had increased concerns about app-based clinical interaction and e-prescription (aOR 0.610; 95% CI 0.445-0.838; P=.002) and those who had a higher degree of perceived risks of participating (aOR 0.731; 95% CI 0.594-0.899; P=.003) were less willing to participate. Conclusions: Overall, our results indicate that mHealth app–based HIV prevention programs are acceptable for future research on Malaysian MSM. The findings further highlighted the role of privacy and confidentiality, as well as the associated risks and benefits associated with participation in such a program. Given the ever-evolving nature of such technological platforms and the complex ethical–legal landscape, such platforms must be safe and secure to ensure widespread public trust and uptake.

Structure, process, and outcomes of liberian national nursing and midwifery curricular revisions

Kpangaala-Flomo, C. C., Tiah, M. W., Clinton Zeantoe, G., Loweal, H. G., Matte, R. F., Lake, S. C., Altman, S. D., Mendoza, M., Tringali, T., Stalonas, K., Goldsamt, L., Kurz, R., Zogbaum, L., & Toft Klar, R. (2021). Annals of Global Health, 87(1). 10.5334/aogh.3248
Abstract
Abstract
Background: The Republic of Liberia has had major disruptions to the education of its health care cadres. Post Ebola, the Resilient and Responsive Health Systems (RRHS) initiative began a new era of capacity building with the support of PEPFAR and HRSA. Nursing and Midwifery serve as the largest healthcare cadres in Liberia. The national nursing and midwifery curricula were overdue for the regulated review and revisions. Methods: The Science of Improvement was used as the framework to accomplish this multilateral activity. The Institute for Healthcare Improvement’s (IHI) stages of improvement included: 1) Forming the team, 2) Setting the aims, 3) Establishing measures, 4) Selecting measures, 5) Testing changes, 6) Implementing changes, and 7) Spreading changes. These stages served as the blueprint for the structures and processes put into place to accomplish this national activity. Findings: The RN, Bridging, and BScM curricula all had redundant content that did not reflect teaching pedagogy and health priorities in Liberia. Courses were eliminated or reconfigured and new courses were created. Development of Nursing and Midwifery Curricular Taskforces were not as successful as was hoped. Two large stakeholder meetings ensured that this was the curricula of the Liberian faculty, deans and directors, and clinical partners. Monitoring and evaluation tools have been adopted by the Liberian Board for Nursing and Midwifery to serve as another improvement to check that the new curricula are being implemented and to identify gaps that may require future cycles of change for continued quality and improvement.