About
Dr. Amy Nunn is an Adjunct Professor of Behavioral and Social Sciences at the Brown University School of Public Health, with a secondary appointment in the Division of Infectious Diseases at Brown University Medical School. She is also the Executive Director of the Rhode Island Public Health Institute (RIPHI). Her work focuses on applied research and public health programs aimed at promoting healthy living, with significant contributions to HIV prevention, LGBTQ health, and food security initiatives. Dr. Nunn has led efforts to improve access to HIV prevention medications through legislation and advocacy, resulting in Rhode Island establishing one of the most progressive PrEP laws in the country. She has been instrumental in launching innovative community partnerships, including faith-based programs to promote HIV and COVID testing in the Deep South, and statewide campaigns like NOURISH RI to enhance food security through SNAP incentives. Her research and advocacy have led to substantial policy changes and public health improvements, including the launch of Rhode Island's first LGBTQ clinic, Open Door Health, which provides comprehensive primary and sexual health care. With a background in social science, Dr. Nunn has conducted international and domestic research on HIV/AIDS, reproductive health, and health policy, authoring a book on the politics of AIDS treatment in Brazil. She holds advanced degrees from Harvard School of Public Health, is a former Fulbright Scholar, and speaks fluent Spanish and Portuguese. Her work has been recognized with numerous awards, including the NIH Career Development Award and community service honors, reflecting her dedication to advancing health equity and community health.
Research topics
- Political Science
- Medicine
- Family medicine
- Nursing
- Virology
- Internal medicine
- Psychology
Selected publications
AIDS Patient Care and STDs · 2026-02-17
articleSenior authorAIDS and Behavior · 2025-10-28
articleOpen accessSenior authorIn the United States (U.S.), the highest burden of new HIV diagnosis continues to occur in Southern states. Healthcare access among at-risk populations is crucial to mitigate HIV transmission, yet data on the association between HIV risk and healthcare access is limited. This study examined the association between HIV risk, (i.e., injecting any drug other than those prescribed, engaging in transactional sex, receiving treatment for a sexually transmitted infection, having condomless anal sex, or having four or more lifetime sexual partners-all within the past year) and healthcare access among adults in the South, adjusting for covariates. The 2022 Behavioral Risk Factor Surveillance System for Southern states was analyzed, and 191,266 respondents participated. Rao-Scott Chi-square tests and weighted logistic regression analyses using complex sampling design were performed in SAS v. 9.4. Findings suggest that U.S. adults in the South at risk for HIV had higher odds of not having health insurance coverage (OR=1.55; 95% CI: 1.34-1.79), not having a personal doctor (OR=2.00; 95% CI: 1.78-2.25), delaying routine check-ups for a year or more (OR=1.75; 95% CI: 1.57-1.96), and being unable to afford medical care in the past year (OR=2.26; 95% CI: 2.00-2.56), compared to those not at risk, for unadjusted analyses. After adjusting for covariates, findings suggest that adults in the South at risk for HIV had 1.69 higher odds of being unable to afford medical care in the past year due to financial constraints (95% CI: 1.45-1.97) compared to those not at risk. Among adults at risk for HIV in the South, enhancing access to HIV preventive services, particularly during public health emergencies, has the potential to mitigate HIV transmission risks and reduce the associated financial burden. This association warrants reevaluation in the post-pandemic era to guide future prevention efforts effectively.
AIDS Care · 2025-10-13
articleDaily oral pre-exposure prophylaxis (PrEP) effectively reduces HIV infection risks. However, adherence has been suboptimal across the United States (US), particularly among African Americans and Hispanic populations. We assessed racial and ethnic differences in PrEP primary non-adherence using two pharmacy-based measures: PrEP reversal (failure to pick up the first insurance-approved prescription) and PrEP abandonment (a reversed prescription not picked up within 365 days). Data from 2015 to 2019 were obtained from Symphony HealthCare Analytics, which covers approximately 75% of US PrEP claims. We analyzed PrEP reversal and abandonment rates among newly prescribed Black (non-Hispanic), White (non-Hispanic), and Hispanic adults using logistic regression with predicted margins to estimate unadjusted and adjusted rates. Among N = 21,653 adults, reversal rates were 23% for Black, and 19% for White and Hispanic, while abandonment rates were 17% for Black, 13% for White, and 12% for Hispanics. Across several sociodemographic characteristics, Black adults had higher unadjusted reversal and abandonment rates than White adults. Conversely, abandonment rates were lower in Hispanic compared to White adults. Lastly, after controlling for sociodemographic characteristics, no significant assoications were found. The study suggests that factors other than race, including socioeconomic and structural determinants, may drive disparities in PrEP primary non-adherence.
UNC Libraries · 2025-03-20
articleOpen accessGrant Terminations in the US Threaten HIV Research and Future Progress
JAMA · 2025-08-21 · 5 citations
articleSenior authorThis Viewpoint discusses how recent terminations of grants focused on LGBTQ+ and racial and ethnic minority groups have posed significant challenges for the health of those groups and for the Ending the HIV Epidemic initiative, and it calls for the strengthening and expansion of that initiative and the preservation of federal investments in HIV prevention.
Journal of Racial and Ethnic Health Disparities · 2025-03-18
reviewOpen accessAIDS and Behavior · 2025-06-16 · 2 citations
articleOpen accessHIV testing is an entry point for both HIV prevention and treatment, and the CDC recommends that all adults of reproductive age undergo HIV testing at least once in their lifetime. However, HIV testing rates remain suboptimal. This study analyzed trends in HIV testing using Behavioral Risk Factor Surveillance System data from 2017 to 2023 across nine Deep South states-Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Descriptive statistics and Joinpoint linear regression were employed to assess lifetime HIV testing and testing within the past 12 months. Findings showed that the overall trend in having ever tested for HIV rose from 43% in 2017 to 47% in 2019 but declined to 40% in 2022, with a slight increase to 41% in 2023. Significant declines in ever testing were observed in North Carolina and among adults aged 25-44, non-Hispanic Black, non-Hispanic multiracial, and those identifying as lesbian or gay. Furthermore, the overall trend in HIV testing in the past 12 months declined significantly from 48% in 2017 to 42% in 2022, with a slight increase to 43% in 2023. Significant declines were found in Florida, Georgia, Louisiana, North Carolina, and South Carolina, and among adults aged 18-34, non-Hispanic White, non-Hispanic Black, male, female, and heterosexual individuals. These trends, observed largely during the COVID-19 pandemic, underscore the need to scale up HIV prevention and care initiatives, particularly in populations and regions experiencing significant declines. Trends should continue to be monitored and examined post-COVID pandemic.
Impact of Social Determinants of Health on Pre-Exposure Prophylaxis Care for HIV Prevention
JAIDS Journal of Acquired Immune Deficiency Syndromes · 2025-01-09 · 3 citations
articleSenior authorBACKGROUND: HIV continues to disproportionately affect men who have sex with men (MSM) in the United States. Pre-exposure prophylaxis (PrEP) is effective, but disparities persist. Limited studies have conducted systematic evaluations of social determinants of health (SDOH) and their effects on PrEP persistence among MSM. SETTING: We enrolled MSM into a prospective observational cohort to assess progression through the PrEP care continuum. We enrolled patients from 3 diverse settings in the United States from 2018 to 2022. METHODS: We explored the impact of SDOH on PrEP persistence (defined as successfully obtaining PrEP prescriptions and/or clinical documentation of retention in PrEP care) at 6 and 12 months using multilevel, mixed-effects logistic models. RESULTS: A total of N = 300 MSM were enrolled. Median age was 28 years; 40% were Black/African American, and 11% were Hispanic/Latino (H/L). PrEP persistence was 84.7% and 49.3% at 6- and 12-months, respectively. In the unadjusted analysis, Black/African American and H/L individuals were 56% and 54%, respectively, less likely to demonstrate PrEP persistence at 6-and 12-months compared with White/non-H/L individuals. Findings were no longer significant after adjusting for economic stability and educational attainment. Individuals with higher levels of internalized homophobia were less likely to persist on PrEP. Every 1-unit increase on a validated measure of internalized homophobia was independently and negatively associated with PrEP persistence (adjusted odds ratio = 0.95, 95% confidence interval: 0.93 to 0.98). CONCLUSIONS: SDOH are important predictors of racial and ethnic disparities in PrEP persistence among MSM. Addressing these factors could help mitigate racial disparities in PrEP persistence in the United States.
2025-06-25
preprint<sec> <title>BACKGROUND</title> The HIV epidemic in the United States disproportionately impacts gay, bisexual, and other men who have sex with men (MSM). Despite the effectiveness of HIV pre-exposure prophylaxis (PrEP) in preventing HIV acquisition, uptake among MSM remains suboptimal. Motivational interviewing (MI) has demonstrated efficacy at increasing PrEP uptake among MSM but is resource-intensive, limiting scalability. The use of artificial intelligence (AI), particularly large language models with conversational agents (i.e., “chatbots”) such as ChatGPT, may offer a scalable approach to delivering MI-based counseling for PrEP and HIV prevention. </sec> <sec> <title>OBJECTIVE</title> This study aimed to describe the development of an AI-based chatbot and evaluate its ability to provide MI-aligned education about PrEP and HIV prevention. </sec> <sec> <title>METHODS</title> The Chatbot for HIV Prevention and Action (CHIA) was built on a GPT-4o base model embedded with a validated knowledge database on HIV and PrEP in English and Spanish. CHIA was fine-tuned through training on a large MI dataset and prompt engineering. Use of the AutoGen multi-agent framework enabled CHIA to integrate two agents, the PrEP Counselor Agent and the Assistant Agent, which specialized in providing MI-based counseling and handling function calls (e.g., assessment of HIV risk), respectively. During internal testing from March 10-April 28, 2025, we systematically evaluated CHIA’s performance in English and Spanish using a set of five-point Likert scales to measure accuracy, conciseness, up-to-dateness, trustworthiness, and alignment with aspects of the MI spirit (e.g., collaboration, autonomy support) and MI-consistent behaviors (e.g., affirmation, open-ended questions). Descriptive statistics and independent samples t tests were used to analyze the data. </sec> <sec> <title>RESULTS</title> A total of 305 responses, including 140 English responses and 165 Spanish responses, were collected during the internal testing period. Overall, CHIA demonstrated strong performance across both languages, receiving the highest combined scores in the general response quality metrics including up-to-dateness (mean 4.6, SD 0.8), trustworthiness (mean 4.5, SD 0.9), accuracy (mean 4.4, SD 0.9), and conciseness (mean 4.2, SD 1.1). CHIA generally received higher combined scores for metrics that assessed alignment with the MI spirit (i.e. empathy, evocation, autonomy support, and collaboration) and lower combined scores for MI-consistent behaviors (i.e. affirmation, open-ended questions, and reflections). Spanish responses had significantly lower mean scores than English responses across nearly all MI-based metrics. </sec> <sec> <title>CONCLUSIONS</title> These findings highlight the potential of AI-based chatbots including CHIA as a scalable tool for delivering MI-aligned counseling in English and Spanish to promote HIV prevention and PrEP uptake. </sec>
The benefits and limits of rapid start antiretroviral therapy in 2024
AIDS · 2025-01-29
article1st author
Recent grants
Frequent coauthors
- 573 shared
Philip A. Chan
Brown University
- 161 shared
Rupa Patel
The Centers
- 158 shared
Catherine E. Oldenburg
University of California, San Francisco
- 147 shared
Lauren Brinkley‐Rubinstein
Duke University
- 146 shared
Matthew J. Mimiaga
Los Angeles LGBT Center
- 141 shared
Leandro Mena
- 130 shared
Kenneth H. Mayer
Fenway Health
- 108 shared
Kenneth H. Mayer
Fenway Health
Education
Ph.D.
Harvard School of Public Health
M.S.
Harvard School of Public Health
Awards & honors
- Outstanding New Researcher Award (2009) from CDC HIV Prevent…
- NIH Career Development Award (2010)
- Program Innovation Award (2021) from RI Public Health Associ…
- Cheryl Snead Servant Leader Award (2022) from American Heart…
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