Lloyd A Goldsamt

Faculty

Lloyd A Goldsamt headshot

Lloyd A Goldsamt

PhD

Senior Research Scientist

1 212 998 5315

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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

Condom-Related Stigma Scale among Men Who Have Sex with Men in China: Development and Psychometric Tests

Shen, Y., Zhang, C., Goldsamt, L. A., Peng, W., Wang, R., & Li, X. (2023). International Journal of Environmental Research and Public Health, 20(6). 10.3390/ijerph20064779
Abstract
Abstract
Condom-related stigma is a frequently mentioned barrier to consistent condom use among men who have sex with men (MSM). Based on the concept and operational definition of condom-related stigma recently defined by our team, we developed the 20-item condom-related stigma scale (CRSS) and examined its psychometric properties among 433 MSM in China, following DeVellis’s scale development guidelines. The content validity, convergent validity, empirical validity, factorial validity, scale score reliability, split-half reliability, and test–retest reliability for the CRSS were all assessed. The scale consists of four domains: perceived distrust, perceived potential HIV/STI risk, perceived embarrassment, and perceived violation of the traditional understanding of sexual intercourse. The CRSS has good validity (the scale-level content validity index was 0.99; the empirical validity was greater than 0.70) and high reliability (the Cronbach’s alpha coefficient overall was 0.926; the split-half reliability overall was 0.795; the test–retest reliability overall was 0.950). This scale is recommended for assessing the level of condom-related stigma among Chinese MSM, which can serve as an evaluating indicator for safer-sex interventions to prevent HIV infection among the MSM population in a Chinese cultural context.

The development of social capital in a peer-led mHealth cognitive behavioral antiretroviral therapy adherence intervention for HIV + adolescents and young adults

Goldsamt, L. A., Liang, E., Handschuh, C., & Navarra, A. M. (2023). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV. 10.1080/09540121.2023.2262981
Abstract
Abstract
Adherence Connection for Counseling, Education, and Support (ACCESS)-I is a peer-led mHealth antiretroviral therapy adherence intervention for adolescents and young adults living with HIV who are in treatment but have detectable viral loads. Participants received five online sessions with peer health coaches who followed a structured intervention manual. Peers maintained intervention fidelity but also engaged in casual discussion that was not directly related to ART adherence or HIV. We conducted a qualitative analysis of the casual interactions that occurred during the ACCESS I intervention. Sessions were transcribed and coded, and these casual interactions were then coded into 10 subcodes to document their content, and also coded for three types of social capital–emotional, informational, and instrumental. Emotional and Informational social capital codes were the most common, while instrumental codes were rare. Activities was the most common topic overall, while encouragement was more common in emotional social capital narratives and personal experience was more common in informational social capital narratives. These casual interactions may strengthen peer-participant relationships, building social capital that could then be used to encourage positive behavior change. Although social capital was not directly measured, these analyses illustrate the value of attending to seemingly casual interactions in peer-led interventions.

HIV Syndemic Factor Associations Among Adolescent Gay and Bisexual Men in the Youth Risk Behavior Survey 2015-2019: A Secondary Data Analysis

Garcia, D. R., Fletcher, J., Goldsamt, L., Bell, D. L., Zheng, Y., & Dunn Navarra, A.-M. (2023). The Journal of the Association of Nurses in AIDS Care : JANAC, 34(5), 440-458. 10.1097/JNC.0000000000000423
Abstract
Abstract
This analysis of the Youth Risk Behavior Survey examined HIV syndemic factor associations (substance use, violence, mental health, and HIV risk behaviors) among adolescent gay, bisexual, and other men who have sex with men-a population with the highest prevalence of undiagnosed HIV infections. The representative sample ( n = 644) exhibited low condom use (52%) and HIV testing (21%). Adjusted multivariate logistic regression models showed that Blacks were less likely to report HIV testing (adjusted odds ratio [aOR] = 0.06, 95% confidence interval [CI] [0.01-0.44], p < .01), whereas Hispanics were more likely to report four or more lifetime sexual partners (aOR = 3.75, 95% CI [1.49-9.44], p < .01), compared with Whites. A syndemic of substance use and intimate partner violence (sexual, sexual dating, and/or physical dating violence) was associated with early intercourse, multiple sexual partners, and drugs/alcohol before intercourse. Multiple syndemic factor exposures were associated with additive risk, suggesting multilevel approaches for HIV prevention.

The Impact of Providing Free HIV Self-testing on Sexual Risk Behaviors Among Men who have Sex with Men in Hunan, China: A Randomized Controlled Trial

Zhang, C., Goldsamt, L. A., Zheng, S., Qian, H. Z., Wang, H., Li, Q., Li, X., & Koniak-Griffin, D. (2023). AIDS and Behavior, 27(2), 708-718. 10.1007/s10461-022-03804-4
Abstract
Abstract
HIV self-testing (HIVST) increases testing frequency among men who have sex with men (MSM). However, its impact on sexual risk behaviors is unclear. In a randomized controlled trial conducted in Hunan Province, China, HIV-negative MSM were randomized to receive one of two interventions for one year: (1) facility-based HIV testing, or (2) facility-based HIV testing augmented with free HIVST. From April to June 2018, 230 MSM were enrolled. They self-reported sexual behaviors every 3 months for 12 months. Among 216 MSM with follow-ups (intervention: 110; control: 106), adjusting for potential confounders in Generalized Estimating Equation models, there were no statistically significant differences in consistent condom use with male partners (regular/casual) or female partners, nor on number of male or female sexual partners. Provision of free HIVST kits does not increase risky sex and should be included in comprehensive HIV prevention packages, particularly for sexual minority men in China.

Integrative Review of Methods From Youth Risk Behavior Survey Secondary Data Analyses Examining HIV Syndemic Factors Among Adolescent Gay and Bisexual Men

Garcia, D. R., Fletcher, J., Goldsamt, L., & Dunn Navarra, A. M. (2023). Nursing Research, 72(2), 141-149. 10.1097/NNR.0000000000000632
Abstract
Abstract
Background Adolescent gay/bisexual men exhibit the highest prevalence of undiagnosed HIV infections. Ascertaining antecedents of behaviorally acquired HIV infections among adolescent gay/bisexual men can be challenging; however, these challenges can be overcome through the utilization of secondary data, such as the Youth Risk Behavior Survey. Objective Syndemics theory suggests that HIV infections are not a singular phenomenon; instead, many infections occur at the intersection of syndemic factors, such as substance use, violence, and mental health. Our objective is to describe and synthesize research methods of secondary data analyses that examine syndemic factors in relation to HIV risk behavior outcomes among subsamples of adolescent gay/bisexual men. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo were systematically searched. Inclusion criteria were (a) peer-reviewed Youth Risk Behavior Survey secondary data analyses conducted in the United States after 1991, (b) subsamples with adolescent gay/bisexual men, (c) one or more syndemic factor(s), and (d) one or more HIV risk behavior outcome(s). We used the National Institutes of Health Quality Assessment Tools for quality appraisal. Results Of 1,036 citations retrieved, nine studies met inclusion criteria. Results included using logistic regression analysis and data from 2015 to 2017 in six studies and underpinnings with minority stress theory in four studies. Eight studies omitted race/ethnicity in subsamples and six grouped lesbians with adolescent gay/bisexual men. Seven studies examined substance use, six examined violence, and five examined mental health. Condom use and number of partners were the most studied HIV risk behavior outcomes in four studies, whereas intercourse in the last 3 months was an outcome in only one study. Protective factors were not present. Conclusion Limitations found the need to highlight better inclusion of race/ethnicity and sexual orientation. Adding contemporary survey items is also necessary, such as nonbinary sex and gender identity, access to HIV prevention (condoms, HIV testing, and preexposure prophylaxis), and experiences with stigma, to elucidate risk behaviors among populations disproportionately affected by HIV infections, including Blacks/African Americans and Hispanics/Latinos.

Psychological pathways to HIV-related posttraumatic stress disorder symptoms among people living with HIV in China: the mediating role of rumination

Tang, C., Goldsamt, L. A., Yu, S., Zhao, T., & Wang, H. (2023). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 35(2), 165-169. 10.1080/09540121.2022.2092713
Abstract
Abstract
The occurrence of HIV-related posttraumatic stress disorder (PTSD) compromises the physical and mental health of people living with HIV (PLWH). This study examined the psychological pathways of HIV-related PTSD symptoms considering the influence of rumination in PLWH of China. A cross-sectional survey was conducted in Changsha, China. The data were collected using the PTSD Checklist−Civilian Version, the Ruminative Response Scale, the Multidimensional Scale of Perceived Social Support, and measures of sociodemographic and HIV-related clinic characteristics. A total of 602 PLWH were surveyed. The average score of HIV-related PTSD symptoms was (34.54 ± 13.58). The mediation model showed that perceived social stigma and physical health exhibited direct associations with PTSD symptoms (β = 0.093, −0.145, respectively), while the direct relations of family support, friend support and significant others support to PTSD symptoms were not significant. Rumination mediated the effect of perceived social stigma (β = 0.077), physical health (β = −0.150), family support (β = −0.144) and friend support (β = −0.105) on PTSD symptoms. The study findings underscore the importance of routinely assessing PTSD for PLWH, and developing trauma-focused interventions that alleviate HIV-related PTSD symptoms and reduce rumination while improving social support and physical health and reducing social stigma.

The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope

Wang, R., Zheng, F., Cao, G., Goldsamt, L. A., Shen, Y., Zhang, C., Yi, M., Peng, W., & Li, X. (2023). Frontiers in Public Health, 11. 10.3389/fpubh.2023.1271915
Abstract
Abstract
Introduction: HIV and mental health problems are a global syndemic. One key issue is that the significant mental health problems among people vulnerable to acquiring or living with HIV have not been fully addressed. Access to social support has been one of the biggest challenges for HIV-positive men who have sex with men (HIV+ MSM). Lower social support has been linked to more severe depression symptoms. However, the mechanisms underlying the association between social support and depression in HIV+ MSM are unclear. Two possible mediators include hope and psychological flexibility. This study aimed to examine the relationship between social support and depression in HIV+ MSM and to explore the single mediating effects of hope and psychological flexibility and the chain mediating effect of these two variables on this relationship. Methods: A convenience sample was used to recruit participants from the designated HIV/AIDS hospital in Changsha city, Hunan Province of China. A total of 290 HIV+ MSM completed questionnaires. Results: Our findings showed that hope mediated the relationship between social support and depression in HIV+ MSM. Furthermore, the chain mediation model confirmed a direct negative association between social support and depression, but this relationship was largely mediated by the chain effects of hope and psychological flexibility. Conclusions: Integrating hope and psychological flexibility into interventions may provide better mental health support for HIV+ MSM and improve their wellbeing and quality of life.

Self-efficacy mediates the effect of providing HIV self-testing kits on HIV testing frequency among Chinese men who have sex with men: results from a randomised controlled trial

Zhang, C., Huang, D., Goldsamt, L. A., Wang, H., Wiley, J., Shen, Y., Chi, Y., & Li, X. (2023). Sexual Health, 20(2), 118-125. 10.1071/SH22110
Abstract
Abstract
Background: HIV self-testing (HIVST) could promote HIV tests; however, knowledge about the mechanisms by which providing HIVST kits impacts the uptake of HIV testing is limited. This study aimed to examine how self-efficacy mediates the association between providing HIVST kits and HIV testing frequency. Methods: In this randomised controlled trial, HIV-negative men who have sex with men (MSM) were recruited in China and randomly assigned 1:1 into intervention and control groups. MSM in the control group could access site-based HIV testing services (SBHT). MSM in the intervention group could access SBHTs plus free HIVST kits. HIV testing self-efficacy, number of SBHTs, number of HIVSTs, and the total number of HIV tests were assessed every 3 months for 1 year. Results: Data from 216 MSM (intervention group: 110; control group: 106) were included in analysis. Results from Pearson's correlations and point-biserial correlations showed that participants with higher self-efficacy scores underwent a higher number of HIV tests (r = 0.241, P < 0.001), more HIVSTs (r = 0.162, P < 0.001), and more SBHTs (r = 0.138, P < 0.001). Bootstrap tests using PROCESS indicated self-efficacy partially mediated the effect of providing HIVST on the number of HIVSTs (indirect effect: 0.018, 95% bias-corrected confidence interval [BC CI]: 0.003-0.035; direct effect: 0.440, 95% BC CI: 0.366-0.513) and on total HIV tests (indirect effect 0.053 (0.030-0.787); direct effect 0.452 (0.365-0.539)), and completely mediated the effect of providing HIVST on the number of SBHTs (indirect effect 0.035 (0.019-0.056); direct effect 0.012 (-0.059 to 0.083)). Conclusions: Our findings indicated self-efficacy mediated the effect of HIVST provision on HIV testing frequency, suggesting improving self-efficacy might be an effective way to promote HIV testing among Chinese MSM.

Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study

Shelley, D., Alvarez, G. G., Nguyen, T., Nguyen, N., Goldsamt, L., Cleland, C., Tozan, Y., Shuter, J., & Armstrong-Hough, M. (2022). Implementation Science Communications, 3(1). 10.1186/s43058-022-00361-8
Abstract
Abstract
Background: Smoking rates remain high in Vietnam, particularly among people living with HIV/AIDS (PLWH), but tobacco cessation services are not available in outpatient HIV clinics (OPCs). The research team is conducting a type II hybrid randomized controlled trial (RCT) comparing the cost-effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV clinics in Vietnam. The study is simultaneously evaluating the implementation processes and outcomes of strategies aimed at increasing the implementation of tobacco dependence treatment (TDT) in the context of HIV care. This paper describes the systematic, theory-driven process of adapting intervention components and implementation strategies with demonstrated effectiveness in high-income countries, and more recently in Vietnam, to a new population (i.e., PLWH) and new clinical setting, prior to launching the trial. Methods: Data collection and analyses were guided by two implementation science frameworks and the socio-ecological model. Qualitative interviews were conducted with 13 health care providers and 24 patients in three OPCs. Workflow analyses were conducted in each OPC. Qualitative data were analyzed using rapid qualitative analysis procedures. Based on findings, components of the intervention and implementation strategies were adapted, followed by a 3-month pilot study in one OPC with 16 patients randomized to one of two intervention arms. Results: The primary adaptations included modifying the TDT intervention counseling content to address barriers to quitting among PLWH and Vietnamese sociocultural norms that support smoking cessation. Implementation strategies (i.e., training and system changes) were adapted to respond to provider- and clinic-level determinants of implementation effectiveness (e.g., knowledge gaps, OPC resource constraints, staffing structure, compatibility). Conclusions: Adaptations were facilitated through a mixed method, stakeholder (patient and health care provider, district health leader)-engaged evaluation of context-specific influences on intervention and implementation effectiveness. This data-driven approach to refining and adapting components aimed to optimize intervention effectiveness and implementation in the context of HIV care. Balancing pragmatism with rigor through the use of rapid analysis procedures and multiple methods increased the feasibility of the adaptation process. Trial registration: ClinicalTrials.gov NCT05162911 . Registered on December 16, 2021.

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, 34(1), 127-134. 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.