URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study)

URBAN ARCH (5/5) 波士顿队列 - 酒精和 HIV 相关合并症和并发症：虚弱、功能障碍、跌倒和骨折（4F 研究）

• 批准号: 10165944
• 负责人: Timothy C. Heeren
• 金额: $ 16.36万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-20 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10165944
• 关键词: 2019-nCoV; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Acute; Address; Affect; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anti-Retroviral Agents; Area; Award; Boston; COVID-19; COVID-19 pandemic; Cessation of life; Collaborations; Coronavirus; County; Data; Data Analyses; Disease; Disease Progression; Drug Use Disorder; Drug usage; Emergency Situation; Employment; Epidemic; Event; Exposure to; Fire - disasters; Food; Fracture; Funding; Goals; HIV; HIV Infections; HIV Seropositivity; HIV antiretroviral; Handwashing; Health; Health Services Accessibility; Health system; Healthcare Systems; Heavy Drinking; Homelessness; Hygiene; Illicit Drugs; Incidence; Infection; Infrastructure; Intervention; Interview; Lead; Loneliness; Massachusetts; Mental Depression; Mental Health; Mission; National Institute on Alcohol Abuse and Alcoholism; Natural Disasters; Outcome; Pain interference; Parents; Participant; Pharmaceutical Preparations; Population; Prevalence; Preventive care; Prospective Studies; Prospective cohort; Public Health; Research; Research Priority; Risk; Russia; Severities; Shelter facility; Social Distance; Social isolation; Social support; Stress; Substance Use Disorder; Surveys; Symptoms; Time; Translational Research; Uganda; Uncertainty; Unemployment; United States National Institutes of Health; addiction; alcohol and other drug; alcohol research; alcohol use disorder; co-infection; cohort; comorbidity; coronavirus disease; depressive symptoms; design; falls; food insecurity; frailty; functional disability; health care availability; high risk; infection rate; medication compliance; medication nonadherence; member; novel; novel coronavirus; opioid mortality; pandemic disease; parent grant; prevent; prospective; safety net; stressor

This proposal is an urgent competitive revision designed to supplement an existing NIH-funded study to assess the impact of the COVID-19 pandemic on alcohol and other drug use, and medication adherence that is critical for preventing HIV disease progression, among people living with HIV (PLWH). The COVID-19 pandemic has profoundly affected lives around the world. In addition to the effects of infection itself, to which PLWH may be more susceptible, COVID-19 has affected employment, access to healthcare, and very likely, the incidence and consequences of other health conditions, by limiting access to healthcare, and through the implementation of physical (social) distancing. PLWH may be at higher risk of consequences of social isolation, and those with addiction, unemployment and homelessness are at an even higher risk with restrictions that affect food availability, hygiene (e.g. handwashing), shelter, and other traditional supports now absent from the already fragile societal safety net. The over-arching goal of this proposal is to assess the impact of the COVID-19 pandemic and the effects of physical (social) distancing and other mitigation strategies (collectively termed “pandemic exposure”) on substance use (heavy alcohol use and/or other drug use including nonmedical prescription medication use) and HIV medication adherence among PLWH. Among an ongoing, well-characterized cohort of people living with HIV/AIDS (the existing Boston ARCH Cohort parent study), this project will: Aim 1: Determine prospective associations between pandemic exposure and changes in alcohol (and other drug) use (primarily) and HIV antiretroviral (ARV) medication nonadherence (secondarily). Aim 2: Identify associations between pandemic exposure and secondary stressors, specifically, food insecurity, loneliness, and pain interference (with activities); and associations between those stressors and changes in alcohol (and other drug) use and HIV ARV medication nonadherence. Aim 3: Determine who is most affected by the pandemic by examining moderators of the associations between pandemic exposure and changes in substance use and HIV ARV nonadherence. To achieve these aims, a supplemental COVID-19 specific assessment will be administered to participants at two time points (6 months apart). Baseline data on substance use, depression, and frailty, collected during pre-pandemic assessments as part of the parent study will be compared against data collected via supplemental COVID-specific assessments. Achieving this proposal’s aims is an important step to identifying modifiable targets for interventions to prevent increased substance use and HIV disease progression after an extreme event such as COVID-19.

该建议是一项紧急竞争性修订，旨在补充现有的NIH资助研究以评估 COVID-19大流行对酒精和其他药物使用的影响以及至关重要的药物依从性 在艾滋病毒（PLWH）中预防艾滋病毒疾病进展。 COVID-19大流行有 深远影响了世界各地的生活。除了感染本身的影响外，PLWH可能是 Covid-19更容易受到影响，影响了就业，获得医疗保健，并且很可能是事件 以及其他健康状况的后果，通过限制获得医疗保健和实施 物理（社会）距离。 PLWH可能面临社会隔离后果的风险更高，与 成瘾，失业和无家可归的风险更高，受到影响食物的限制 可用性，卫生（例如洗手），庇护所和其他传统支持现在已经存在 脆弱的社会安全网。 该提案的整理目标是评估19009年大流行的影响以及 物理（社交）距离和其他缓解策略（统称为“大流行暴露”） 药物使用（大量饮酒和/或其他药物使用，包括非医学处方药） PLWH中的HIV药物依从性。 在持续的，充分表现的艾滋病毒/艾滋病的人群中（现有的波士顿拱门 同类父母研究），该项目将： 目标1：确定大流行暴露与酒精变化之间的前瞻性关联（以及其他 药物使用（主要是）和HIV抗逆转录病毒（ARV）药物不遵守（次要）。 目标2：确定大流行暴露与次应力源之间的关联，特别是食物 不安全感，孤独和疼痛干扰（活动）；以及这些压力源与 酒精（和其他药物）使用和HIV ARV药物不遵守的变化。 目标3：通过检查主持人的关联之间的主持人，确定谁受到大流行的影响 大流行的暴露以及药物使用和HIV ARV不遵守的变化。 为了实现这些目标，将对参与者进行补充COVID-19的特定评估 在两个时间点（相距6个月）。有关物质使用，抑郁和脆弱的基线数据，在 作为父母研究的一部分，大流行评估将与通过 补充共价特异性评估。实现这一建议的目标是确定的重要步骤 可修改的靶标，以防止在 极端事件，例如Covid-19。