About

Gary Harper, PhD, MPH, is a Professor in the Department of Health Behavior and Health Equity and also serves as a Professor of Global Public Health at the University of Michigan School of Public Health. His research and community work focus on the mental health and sexual health needs of adolescents and young adults who experience oppression and marginalization, with particular attention to Black gay/bisexual young men, transgender and non-binary youth, and youth living with HIV. Dr. Harper's efforts aim to increase access to mental health services for LGBTQ+ youth and to work with policymakers to ban the use of conversion therapy with LGBTQ+ minors. With over 25 years of experience, he has collaborated with community agencies and members to develop and evaluate culturally and developmentally appropriate mental health, sexual health, and HIV prevention programs both domestically and internationally, including in Botswana, Haiti, Kenya, Mozambique, and Zambia. His research employs mixed-methods and qualitative approaches to better understand the lived experiences and social justice needs of diverse groups of adolescents and young adults, emphasizing social justice and health equity in his work.

Research topics

• Political Science
• Sociology
• Medicine
• Psychology
• Psychotherapist
• Gender studies
• Medical education
• Law
• Clinical psychology

Selected publications

• Acceptability, Feasibility, and Safety of the Shauriana Intervention for Young Kenyan Gay, Bisexual, and Other Men who Have Sex with Men, and Exploration of Potential Impact on Sexual Health Outcomes

  AIDS and Behavior · 2025-11-25

  articleOpen accessSenior author

  In rights-constrained settings with pervasive stigma, a holistic approach to HIV prevention is needed to ensure knowledge and use of different HIV prevention tools and promote both sexual and mental health. In close collaboration with GBMSM community leaders in Kisumu, we developed a theory-based, culturally-tailored HIV prevention intervention that integrates sexual health and mental health support for young Kenyan GBMSM. We conducted a randomized trial with 6 months of follow-up to assess acceptability, feasibility, and safety of the intervention and explore its potential impact on secondary outcomes, compared to standard care. Among 60 participants, median age was 25 years (inter-quartile range 22-28). Retention at month 6 was 93.1% (27 of 29) in the intervention arm and 87.1% (27 of 31) in standard care. Acceptability was high, with most participants rating each session's value and relevance at 1 ("strongly agree"). Intervention delivery was feasible and attendance was excellent, with 29 (100%) intervention participants completing all five sessions and 18 (62.1%) attending an optional session to consolidate learning. No social harms occurred. Exploratory analyses suggest improved PrEP knowledge and improved knowledge about healthy relationships and communication, as well as higher condom use at last sex. The intervention was found to be acceptable, feasible and safe in this small study. Future work is warranted to evaluate this intervention in a larger trial, given the need for person-centered, holistic interventions supporting sexual health, mental well-being, and the full range of HIV prevention tools available.Clinical trial registration: NCT04550221, registered on 9/8/2020.

  PublisherOA PDFDOI

• Brothers Building Brothers by Breaking Barriers: Protocol for a Pilot Trial of a Telehealth Social Capital Intervention for Young Black Sexual Minority Men Living With HIV

  JMIR Research Protocols · 2025-12-01 · 1 citations

  articleOpen access

  BACKGROUND: Young Black sexual minority men are disproportionately affected by HIV, especially in the Southern United States. To address this, we developed Brothers Building Brothers by Breaking Barriers (B6) intervention with a goal of enhancing social capital and engagement in care among young Black sexual minority men living with HIV. However, we encountered challenges to feasibility in recruiting and engaging for an in-person intervention. OBJECTIVE: The objectives of this study are to iteratively adapt the original B6 intervention for telehealth delivery (Phase 1), and pilot test the intervention through a waitlist-control trial to evaluate its feasibility, acceptability, and safety (Phase 2). METHODS: In Phase 1, we used the assessment, decision, adaptation, production, topical experts, integration, training, and testing (ADAPT-ITT) framework to structure the iterative adaptation process of B6, working with a diverse study team and a Youth Advisory Board (YAB). After completing the preliminary adaptation process, we conducted initial Telehealth Brothers Building Brothers by Breaking Barriers (Tele-B6) pilot testing with a community partner organization. The result was a 5-week group-level intervention, delivered entirely remotely, consisting of a series of adapted activities to address bonding and bridging social capital, affirm intersectional identities, and engage in resilience-building processes. Following feedback integration from pilot-testing, we conducted Phase 2 with 60 young Black sexual minority men living with HIV recruited over the course of one year and who were randomized at the group level to either the immediate intervention or delayed (waitlist control) intervention group. Various data sources will be used to measure feasibility, acceptability, and safety, including surveys, postsession evaluation data, in-depth qualitative interviews, and review of medical records for HIV clinical outcomes. RESULTS: Phase 1, the adaptation process of B6, began in fall 2022 and was completed in spring 2023. Phase 2, the implementation of the waitlist control trial, began in spring 2023 and concluded in summer 2024. Final follow-up assessments were completed in fall 2024 and the results of the mixed methods evaluation are expected in winter 2025. CONCLUSIONS: The adaptation process and telehealth delivery of B6 will add to the knowledge of strengths-based interventions designed to improve care engagement among young Black sexual minority men living with HIV. TRIAL REGISTRATION: ClinicalTrials.gov NCT05829759,https://clinicaltrials.gov/study/NCT05829759. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69961.

  PublisherDOI

• “Stay strong! keep ya head up! move on! it gets better!!!!”: resilience processes in the healthMpowerment online intervention of young black gay, bisexual and other men who have sex with men

  UNC Libraries · 2025-08-29

  articleOpen access1st authorCorresponding

  Overlapping stigmas related to sexual minority-, race/ethnicity-, and HIV-status pose barriers to HIV prevention and care and the creation of supportive social networks for young, Black, gay, bisexual, and other men who have sex with men (GBMSM). A risk-based approach to addressing the HIV epidemic focuses on what is lacking and reinforces negative stereotypes about already-marginalized populations. In contrast, a strengths-based approach builds on Black GBMSM's existing strengths, recognizing the remarkable ways in which they are overcoming barriers to HIV prevention and care. HealthMpowerment (HMP) is an online, mobile phone optimized intervention that aimed to reduce condomless anal intercourse and foster community among young Black GBMSM (age 18-30). Applying a resilience framework, we analyzed 322 conversations contributed by 48 HMP participants (22/48 living with HIV) on the intervention website. These conversations provided a unique opportunity to observe and analyze dynamic, interpersonal resilience processes shared in response to stigma, discrimination, and life challenges experienced by young Black GBMSM. We utilized an existing framework with four resilience processes and identified new subthemes that were displayed in these online interactions: (1) Exchanging social support occurred through sharing emotional and informational support. (2) Engaging in health-promoting cognitive processes appeared as reframing, self-acceptance, endorsing a positive outlook, and agency and taking responsibility for outcomes. (3) Enacting healthy behavioral practices clustered into modeling sex-positive norms, reducing the risk of acquiring or transmitting HIV, and living well with HIV. (4) Finally, empowering other gay and bisexual youth occurred through role modeling, promoting self-advocacy, and providing encouragement. Future online interventions could advance strengths-based approaches within HIV prevention and care by intentionally building on Black GBMSM's existing resilience processes. The accessibility and anonymity of online spaces may provide a particularly powerful intervention modality for amplifying resilience among young Black GBMSM.

  PublisherDOI

• LGBTQ+ Cultural Sensitivity Training for Mental Health Professionals in the USA

  Archives of Sexual Behavior · 2025-03-25 · 2 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

• Factors that influence communication between healthcare providers and sexual minority men in HIV service delivery in Zambia

  AIDS Care · 2025-04-15

  articleOpen accessSenior author

  Studies that have investigated client-provider interactions in HIV service delivery have focused mainly on the views of sexual and gender minorities. This study explored the views of both Healthcare Providers (HCPs) and Sexual Minority Men (SMM) in Zambia about factors that influence client-provider interactions and how this could affect HIV service delivery. We conducted in-depth interviews with 20 HCPs (>25 years old) and 20 SMM (20-34 years old) purposively recruited from Lusaka with help from local partners in 2021. Interviews lasted 30-80 min, were conducted in English, and were audio-recorded. Verbatim transcripts of audio files were iteratively coded using Nvivo. Thematic analysis was performed using the inductive approach. Study findings suggest that a lack of trust in HCPs among SMM and the religious and cultural persuasions of some HCPs negatively impact communication between SMM and HCPs. The above factors will likely make establishing a good working relationship between HCPs and SMM difficult and could negatively influence HIV service delivery. Therefore, promoting an SMM-friendly environment at health facilities and promoting HCPs' understanding of the health needs of SMM are critical to ensure the delivery of quality HIV services to SMM in Zambia.

  PublisherOA PDFDOI

• Closing the Gap: The Need to Eliminate Loopholes in Legislation at the Intersection of Gun Violence and Intimate Partner Violence

  Undergraduate Journal of Public Health · 2025-06-24

  articleOpen accessSenior author

  Gun violence and intimate partner violence (IPV) are two public health issues that intersect significantly in the United States, contributing to the urgent need for legislative changes. There is federal legislation that aims to address the rising firearm-related deaths that result from IPV by prohibiting persons convicted of misdemeanor domestic violence offenses from possessing firearms. Yet, this legislation leaves loopholes in interpretation by each state, whereby some have chosen to strengthen and others to weaken regulations. Gaps persist in legal definitions of "domestic violence" as well as how the removal of firearms is enforced. To address the intersection of these two life-threatening public health issues, federal legislation must be amended to increase clarity and standardize processes of enforcement. Thus, the purpose of this paper is to highlight the shortcomings among current IPV-related firearm legislation while recommending that further action be taken to amend these considerations. Specifically, the Strengthening Protections for Domestic Violence and Stalking Survivors Act of 2023 could account for the omitted considerations among current legislation. In turn, this will extend protections to more individuals and may prevent cases of firearm-related intimate partner violence.

  PublisherOA PDFDOI

• Mental Health, Substance Use, and HIV Prevention Among Gay and Bisexual Men Among Kenya

  Undergraduate Journal of Public Health · 2025-06-24

  articleOpen access

  Gay and bisexual men and other men who have sex with men (GBMSM) are disproportionately impacted by human immunodeficiency virus (HIV) in Kenya, and elsewhere in Sub-Saharan Africa. GBMSM face unique mental health (MH) and substance use barriers that negatively influence their ability to protect themselves from HIV. To examine the relationship between mental health/substance use and their potential influence on HIV prevention among GBMSM we conducted a secondary data analysis of qualitative data from the Uzima Bora research study. This study focused on the integration of mental health/substance use and HIV-related services for GBMSM living in Kisumu Kenya. Respondents shared that mental health and substance use challenges were associated with deprioritizing HIV prevention among GBMSM through four main thematic areas; (a) depression and loneliness, (b) substance use, (c) discriminatory stress, and (d) internalized homonegativity. These themes were identified after a thorough analysis of participants' responses from community charrettes. The findings from this analysis highlight the importance of addressing mental health and substance use challenges when conducting HIV prevention activities. The co-occurrence of mental health and substance use behaviors must be addressed together to improve HIV prevention strategies for GBMSM in Kenya.

  PublisherOA PDFDOI

• Stigma Diminishes the Protective Effect of Social Support on Psychological Distress Among Young Black Men Who Have Sex With Men.

  UNC Libraries · 2025-09-09

  articleOpen accessSenior author

  Addressing stigma remains a pressing HIV priority globally. Young Black men who have sex with men (YBMSM, ages 18-30; N = 474) completed an in-person baseline survey and reported their experiences of externalized stigma (i.e., racial and sexuality discrimination), internalized stigma (i.e., homonegativity), social support, and psychological distress (i.e., anxiety and depression symptoms). We used structural equation modeling to test the association between stigma and psychological distress, and examined whether social support mediated the relationship between stigma and psychological distress. Recognizing that these associations may differ by HIV status, we compared our models by self-reported HIV status (n = 275 HIV negative/unknown; n = 199 living with HIV). Our findings suggest that YBMSM who experience stigma are more vulnerable to psychological distress and may have diminished buffering through social support. These effects are accentuated among YBMSM living with HIV, highlighting the need for additional research focused on the development of tailored stigma reduction interventions for YBMSM.

  PublisherDOI

• Recommendations from transgender youth for health care providers: “Treat Us With Dignity, Be Person-Centered, and Be Compassionate”

  Nursing Outlook · 2025-12-19

  articleOpen accessSenior author
  PublisherOA PDFDOI

• ‘It kills the freedom or the spirit of people being who they are’: impact of sexuality-based stigma and discrimination on the lives of gay and bisexual men in Kenya

  Global Public Health · 2025-04-14

  articleOpen accessSenior author

  Gay and bisexual men (GBM) in Kenya are subjected to frequent experiences of sexuality-based stigma and discrimination, yet how GBM navigate these experiences and their impact on mental health has remained understudied. The aim of this study was to understand how GBM in Kenya respond to everyday experiences of sexuality-based stressors. We conducted 60 individual in-depth interviews with GBM between the ages of 20-46 residing in Kisumu and Nairobi. The following four key themes regarding how GBM in Kenya respond to sexuality-based stressors emerged: enacting identity protection strategies, using alcohol and other substances, avoiding healthcare providers and services, and being hypervigilant to avoid violence. These findings highlight the urgent need for interventions that reduce sexuality-based stigma and improve access to safer social and healthcare spaces for GBM in Kisumu and Nairobi.

  PublisherDOI

Recent grants

• NIH Grant R34MH095571

  NIH · $700k · 2015

• Supporting Graduate Education and Careers in Behavioral and Social Science Research on Mental Health and HIV for Undergraduates: The Student Opportunities for AIDS/HIV Research Program

  NIH · $1.4M · 2021–2027

• NIH Grant R03DA011125

  NIH · $141k · 2001

• Intersecting stigma against MSM in clinical settings in Zambia

  NIH · $361k · 2019–2022

Frequent coauthors

• Laura Jadwin‐Cakmak

  University of Michigan–Ann Arbor

  76 shared

• José A. Bauermeister

  University of Pennsylvania

  40 shared

• Sari L. Reisner

  University of Michigan–Ann Arbor

  34 shared

• Sybil Hosek

  University of Illinois Chicago

  27 shared

• M. Margaret Dolcini

  Oregon State University

  27 shared

• Douglas Bruce

  DePaul University

  25 shared

• Sarah A. Gutin

  Unity Health System

  24 shared

• Elliot Popoff

  24 shared

Labs

• Health Behavior and Health EquityPI