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Larry Brown

Larry Brown

· Professor of Psychiatry and Human BehaviorVerified

Brown University · Microbiology and Immunology

Active 1979–2025

h-index62
Citations16.2k
Papers556119 last 5y
Funding$90.9M2 active
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About

Larry K. Brown is a Professor of Psychiatry and Human Behavior, serving as the Academic Director of the Division of Child and Adolescent Psychiatry and Vice Chair of the Department of Psychiatry and Human Behavior. His research primarily focuses on HIV and risk behaviors among adolescents and young adults, including conducting clinical treatment trials aimed at reducing substance use and depression in individuals with HIV. He is involved in developing innovative interventions such as an iPhone game to improve medical adherence for adolescents and young adults with HIV, and promotes engagement and adherence to pre-exposure prophylaxis among men who have sex with men in the Southern United States. Dr. Brown also holds leadership roles as co-Director of the Clinical and Behavioral Sciences Core of the Providence - Boston Center for AIDS Research, and as principal investigator of postdoctoral and psychiatry fellow training programs funded by the NIMH. His work emphasizes behavioral health, HIV prevention, and treatment strategies, with a focus on youth populations, and he has contributed extensively to the understanding and improvement of health outcomes related to HIV, mental health, and risk behaviors among adolescents.

Research topics

  • Psychology
  • Psychiatry
  • Medicine
  • Political Science
  • Environmental health
  • Clinical psychology
  • Family medicine
  • Sociology
  • Internal medicine
  • Nursing
  • Gender studies
  • Virology
  • Psychotherapist
  • Gerontology
  • Medical education
  • Social psychology
  • Developmental psychology

Selected publications

  • Use of a Medication Management Algorithm in Depressed Youth Living with HIV: Secondary Analysis of a Multisite Randomized Controlled Trial

    Journal of Child and Adolescent Psychopharmacology · 2025-11-03

    articleOpen accessSenior author

    Objectives: Depression is a prevalent co-occurring condition in youth living with HIV. This report is a secondary analysis of a multisite cluster randomized trial evaluating the efficacy of a health and wellness cognitive behavioral therapy (CBT) combined with a medication management algorithm utilizing measure-based care (COMB-R) compared with enhanced standard of care (ESC). We describe and compare antidepressant prescribing strategies (i.e., antidepressant treatment, type of antidepressant) for youth living with HIV at COMB-R sites to those at ESC sites over the 24-week intervention. We also describe self-reported adherence to antidepressants. Methods: Participants (12–24 years) were youth living with HIV diagnosed with moderate to severe depression (Quick Inventory of Depressive Symptomatology [QIDS], Clinician-Rated score ≥11). Thirteen sites were randomly assigned to either the COMB-R arm or the ESC arm. Site-level means were compared using t -tests. Results: While there was no difference at baseline in prescribing antidepressants, there was a significantly higher mean percentage of SSRI use at the COMB-R sites at week 24, compared with ESC sites (49.1% vs. 24.2%, p = 0.009). Although the COMB-R group had better outcomes on response and remission by week 24, there were no consistent within-group patterns in depression outcomes by group based on antidepressant treatment. The two groups differed in adherence in the last 30 days, with the COMB-R group reporting more missed medication. Conclusions: Our results support the use of the medication management algorithm and measure-based care for the treatment of depression in youth living with HIV. Although treating depression, particularly in youth living with HIV, remains very complex, these findings provide some potential factors to guide future research. Overall, this report supports the importance of medication management in the context of a collaborative treatment model with CBT in improving depression outcomes.

  • Acceptance-Based Pre-Exposure Prophylaxis Intervention (ACTPrEP) to Engage Young Black Men Who Have Sex With Men in the Southern United States: Protocol for a Pilot Randomized Controlled Trial

    JMIR Research Protocols · 2025-06-20

    articleOpen accessSenior author

    BACKGROUND: Given the high rates of HIV infection among young Black men who have sex with men in Jackson, Mississippi, and the underuse of pre-exposure prophylaxis (PrEP) in this population, there is a critical need for innovative interventions to promote PrEP use. Acceptance and commitment therapy (ACT) is a promising intervention for health behavior change. OBJECTIVE: This study aims to develop and test an intervention, ACTPrEP, to increase PrEP use among young Black men who have sex with men. METHODS: We conducted in-depth interviews with 20 young Black men who have sex with men and 10 PrEP staff to inform the development of ACTPrEP, an intervention that uses ACT to improve PrEP use. Specific ACTPrEP adaptations from the qualitative interviews included service settings (interventionists should be PrEP informed and well-integrated), target audiences (provide check-in calls, be caring, and authentically relate), modes of delivery (flexible delivery), and cultural adaptation (normalize PrEP use). A pilot randomized controlled trial will evaluate the feasibility and acceptability of ACTPrEP compared to that of Enhanced Standard of Care in promoting PrEP use among young Black men who have sex with men (N=66). We will specifically evaluate group differences in the proportion of participants who initiate PrEP, PrEP adherence, and PrEP persistence. Measures will be collected at baseline, 6 weeks, and 12 weeks. RESULTS: Research activities began in September 2023 and will be ongoing through June 2026. Preliminary findings are anticipated to be available in late 2026. CONCLUSIONS: This study will inform the development of a larger randomized controlled trial to evaluate the efficacy of ACTPrEP for increasing PrEP use among young Black men who have sex with men. TRIAL REGISTRATION: ClinicalTrials.gov NCT05087680; https://clinicaltrials.gov/study/NCT05087680. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/65921.

  • The behavioral health needs of legally involved sexual minority female adolescents

    Health & Justice · 2025-04-30

    articleOpen accessSenior author

    BACKGROUND: Sexual minority (SM) female adolescents involved in the legal system experience marginalization and health inequities. This study examined the differences in psychosocial functioning and risk behaviors among legally involved SM and heterosexual female adolescents to better understand their behavioral health needs. We hypothesized that SM females, as individuals at the intersection of two marginalized groups, would demonstrate greater psychiatric symptom severity and engagement in risk behaviors than their heterosexual counterparts. METHODS: Adolescents involved in the legal system (N = 423) enrolled in a prospective cohort study and completed baseline surveys assessing their demographics, SM status, psychiatric symptoms, substance use, and engagement in self-injurious, delinquent, and sexual risk behaviors. The responses of SM and heterosexual female adolescents (n = 193) were compared using bivariate and regression analyses. RESULTS: Participants were 12 to 18 years old (M = 14.49, SD = 1.55), ethnoracially diverse, and 38.3% identified as a SM. SM females, as compared to heterosexual females, reported more PTSD and emotional symptoms, difficulties with anger control and personal adjustment, and engagement in substance use, self-injurious, and sexual risk behaviors. CONCLUSION: Legally involved SM female adolescents in this study had greater psychiatric, substance use, and sexual health treatment needs compared to their heterosexual peers. These findings highlight the need for enhanced understanding of how to effectively support SM female adolescents, including utilization of culturally sensitive and clinically informative screening practices that do not contribute to further discrimination within the legal system. Future work should aim to develop identity-responsive interventions tailored to this population.

  • 54.1 Treatment of Depression for Youth With HIV

    Journal of the American Academy of Child & Adolescent Psychiatry · 2025-10-01

    article1st authorCorresponding
  • Storytelling in Health Behavior Research: An Adolescent Health Risk Data Collection Conundrum

    Health Behavior Research · 2025-03-10 · 1 citations

    articleOpen access

    Storytelling is as old as humankind predating any other form of oral history. Instructional methodologies used by teachers include fables, parables, legends, myths, and real-life stories conveying important instructional cognition and affect. This paper briefly discusses the scientific foundations and use of storytelling for, effective instruction and shares a real-world story of conflict involving adolescent psychosocial and biological data collection, a principal investigator and a church youth director. A review of literature synthesized storytelling from a variety of scientific perspectives. This health behavior research story is framed via the essential elements of a story and told via the perspective of the principal investigator. Storytelling is effective at the higher levels of the cognitive and affective domains of Bloom & Krathwohl’s Taxonomy of Educational Objectives and rooted in neuroscience, psychology and educational psychology. Personal stories are a relevant strategy connecting learning material with situations outside the classroom. The human brain responds to hearing, reading or viewing a story, similar to real life processing as a genuine life experience. This story is anchored to NIH study protocol, a data collection incident at an African American church and a perplexed PI and research team. The problem-solving process and resolution of the story conflict are described. Implications for instruction in health behavior research, community-based participatory research and program evaluation are discussed. Overall, storytelling increases learner interest, and interaction, making content personally relevant and easier to remember. Storytelling is the bedrock of the learning process and the foundation of the teaching process and profession.

  • Participant acceptability and clinician satisfaction of cognitive behavioural therapy and medication management algorithm compared with enhanced standard care for treatment of depression among youth with HIV

    Journal of Child and Adolescent Mental Health · 2024-11-17 · 2 citations

    articleOpen accessSenior author

    While these results support the use of CBT and MMA in treating depression among YWH, further research is required to determine generalisability.

  • A qualitative study identifying implementation strategies using the i-PARIHS framework to increase access to pre-exposure prophylaxis at federally qualified health centers in Mississippi

    Implementation Science Communications · 2024-08-28 · 5 citations

    articleOpen accessSenior author

    BACKGROUND: Mississippi (MS) experiences disproportionally high rates of new HIV infections and limited availability of pre-exposure prophylaxis (PrEP). Federally Qualified Health Centers (FQHCs) are poised to increase access to PrEP. However, little is known about the implementation strategies needed to successfully integrate PrEP services into FQHCs in MS. PURPOSE: The study had two objectives: identify barriers and facilitators to PrEP use and to develop tailored implementation strategies for FQHCs. METHODS: Semi-structured interviews were conducted with 19 staff and 17 PrEP-eligible patients in MS FQHCs between April 2021 and March 2022. The interview was guided by the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework which covered PrEP facilitators and barriers. Interviews were coded according to the i-PARIHS domains of context, innovation, and recipients, followed by thematic analysis of these codes. Identified implementation strategies were presented to 9 FQHC staff for feedback. RESULTS: Data suggested that PrEP use at FQHCs is influenced by patient and clinic staff knowledge with higher levels of knowledge reflecting more PrEP use. Perceived side effects are the most significant barrier to PrEP use for patients, but participants also identified several other barriers including low HIV risk perception and untrained providers. Despite these barriers, patients also expressed a strong motivation to protect themselves, their partners, and their communities from HIV. Implementation strategies included education and provider training which were perceived as acceptable and appropriate. CONCLUSIONS: Though patients are motivated to increase protection against HIV, multiple barriers threaten uptake of PrEP within FQHCs in MS. Educating patients and providers, as well as training providers, are promising implementation strategies to overcome these barriers.

  • Acceptance-Based Pre-Exposure Prophylaxis Intervention (ACTPrEP) to Engage Young Black Men Who Have Sex With Men in the Southern United States: Protocol for a Pilot Randomized Controlled Trial (Preprint)

    2024-08-29

    preprintSenior author

    <sec> <title>BACKGROUND</title> Given the high rates of HIV infection among young Black men who have sex with men in Jackson, Mississippi, and the underuse of pre-exposure prophylaxis (PrEP) in this population, there is a critical need for innovative interventions to promote PrEP use. Acceptance and commitment therapy (ACT) is a promising intervention for health behavior change. </sec> <sec> <title>OBJECTIVE</title> This study aims to develop and test an intervention, ACTPrEP, to increase PrEP use among young Black men who have sex with men. </sec> <sec> <title>METHODS</title> We conducted in-depth interviews with 20 young Black men who have sex with men and 10 PrEP staff to inform the development of ACTPrEP, an intervention that uses ACT to improve PrEP use. Specific ACTPrEP adaptations from the qualitative interviews included service settings (interventionists should be PrEP informed and well-integrated), target audiences (provide check-in calls, be caring, and authentically relate), modes of delivery (flexible delivery), and cultural adaptation (normalize PrEP use). A pilot randomized controlled trial will evaluate the feasibility and acceptability of ACTPrEP compared to that of Enhanced Standard of Care in promoting PrEP use among young Black men who have sex with men (N=66). We will specifically evaluate group differences in the proportion of participants who initiate PrEP, PrEP adherence, and PrEP persistence. Measures will be collected at baseline, 6 weeks, and 12 weeks. </sec> <sec> <title>RESULTS</title> Research activities began in September 2023 and will be ongoing through June 2026. Preliminary findings are anticipated to be available in late 2026. </sec> <sec> <title>CONCLUSIONS</title> This study will inform the development of a larger randomized controlled trial to evaluate the efficacy of ACTPrEP for increasing PrEP use among young Black men who have sex with men. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov NCT05087680; https://clinicaltrials.gov/study/NCT05087680 </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/65921 </sec>

  • 4.65 The Behavioral Health Needs of Legally Involved Sexual-Minority Female Adolescents

    Journal of the American Academy of Child & Adolescent Psychiatry · 2024-10-01

    articleOpen accessSenior author
  • Randomized Pilot Trial of the Text-Based Adherence Game for Ghanaian Youth with HIV

    AIDS and Behavior · 2024-12-24 · 2 citations

    articleSenior author

Recent grants

Frequent coauthors

  • Laura Whiteley

    244 shared
  • Christopher Houck

    235 shared
  • Ralph J. DiClemente

    New York University

    207 shared
  • David Barker

    Providence College

    198 shared
  • Wendy Hadley

    173 shared
  • Celia M. Lescano

    University of South Florida

    146 shared
  • Marina Tolou‐Shams

    142 shared
  • Geri R. Donenberg

    University of Illinois Chicago

    88 shared

Education

  • M.D., College of Physicians and Surgeons

    Columbia University

    1976
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