LSUHSC-NO Comprehensive Alcohol-HIV/AIDS Research Center

LSUHSC-NO 酒精-艾滋病毒/艾滋病综合研究中心

• 批准号: 10197507
• 负责人: PATRICIA E. MOLINA
• 金额: $ 10.25万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10197507
• 关键词: 2019-nCoV; AIDS/HIV problem; Adherence; Administrative Supplement; Aging; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Behavioral; Behavioral Mechanisms; Biological; CD8B1 gene; COVID-19; COVID-19 pandemic; Cessation of life; Chronic; Cities; Clinical; Cognitive; Communities; Country; Data; Data Collection; Depressive disorder; Disease; Disease Progression; Emotions; Enrollment; Exposure to; Fright; Government; HIV; HIV Seronegativity; HIV therapy; Health Sciences; Healthcare; Household; Immunologics; Individual; Infrastructure; Link; Louisiana; Measures; Mediating; Medical; Mental Depression; Mental Health; Morbidity - disease rate; Neighborhoods; Neurocognitive Deficit; Outcome; Participant; Pathway interactions; Patient Self-Report; Persons; Physiological; Play; Post-Traumatic Stress Disorders; Psyche structure; Psychosocial Stress; Quarantine; Request for Proposals; Research; Risk; Role; Serological; Shelter facility; Social Distance; Social Environment; Social Network; Stress; Testing; Time; Uncertainty; Unemployment; Universities; Viral; Viral Load result; Vulnerable Populations; alcohol research; alcohol use disorder; antiretroviral therapy; anxiety symptoms; base; behavioral adherence; cardiometabolism; community center; comorbid depression; comorbidity; coping mechanism; coronavirus disease; disorder risk; drinking behavior; experience; frailty; high risk drinking; immune activation; immunological status; mortality; pandemic disease; psychosocial; sample collection; social stressor; stress symptom; stressor; 2019-nCoV; AIDS/HIV problem; Adherence; Administrative Supplement; Aging; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Behavioral; Behavioral Mechanisms; Biological; CD8B1 gene; COVID-19; COVID-19 pandemic; Cessation of life; Chronic; Cities; Clinical; Cognitive; Communities; Country; Data; Data Collection; Depressive disorder; Disease; Disease Progression; Emotions; Enrollment; Exposure to; Fright; Government; HIV; HIV Seronegativity; HIV therapy; Health Sciences; Healthcare; Household; Immunologics; Individual; Infrastructure; Link; Louisiana; Measures; Mediating; Medical; Mental Depression; Mental Health; Morbidity - disease rate; Neighborhoods; Neurocognitive Deficit; Outcome; Participant; Pathway interactions; Patient Self-Report; Persons; Physiological; Play; Post-Traumatic Stress Disorders; Psyche structure; Psychosocial Stress; Quarantine; Request for Proposals; Research; Risk; Role; Serological; Shelter facility; Social Distance; Social Environment; Social Network; Stress; Testing; Time; Uncertainty; Unemployment; Universities; Viral; Viral Load result; Vulnerable Populations; alcohol research; alcohol use disorder; antiretroviral therapy; anxiety symptoms; base; behavioral adherence; cardiometabolism; community center; comorbid depression; comorbidity; coping mechanism; coronavirus disease; disorder risk; drinking behavior; experience; frailty; high risk drinking; immune activation; immunological status; mortality; pandemic disease; psychosocial; sample collection; social stressor; stress symptom; stressor

Abstract Administrative Supplement Research Component 1 (RC1) Comprehensive Alcohol Research Center. Community and Interpersonal Stress, Alcohol, and Chronic Comorbidities among PLWH. Louisiana had the third highest rates of SARS-CoV-2 cases and the second highest deaths per capita in the country during the peak of the COVID-19 pandemic. The alarming high rate of mortality in New Orleans led to strict government issued mandates for social distancing, self-quarantine, and shelter-in-place measures adding challenges like unemployment, loss of social networks, fear, and decreased access to personally delivered healthcare to the most vulnerable individuals. These stressful factors negatively impact pre-existing symptoms of stress, anxiety, and depression and may have unwanted consequences that contribute to morbidity and mortality of vulnerable populations. Persons living with HIV (PLWH) have an excessively high rate of exposure to chronic and lifetime social stressors, that are linked to elevated rates of poorer mental health including depressive disorders, alcohol use disorders (AUD), and post-traumatic stress disorder (PTSD). Alcohol consumption tends to increase during times of duress and uncertainty, and alcohol is often misused to cope with stress, anxiety, and other uncomfortable emotions. Psychiatric comorbidities decrease adherence to antiretroviral therapy and increase risk for substance use that together may increase risk for comorbidities or negatively impact disease progression particularly in aging PLWH. Heightened psychosocial and physiological stress among PLWH is associated with poorer immune status, increased viral load over time, faster disease progression, and higher rates of mortality. Our overarching hypothesis is that PLWH with AUD experience greater psychobehavioral and biological consequences of the COVID-19 pandemic. This administrative supplement proposes studies within the scope of those proposed in Specific Aim 1 of RC1: To examine the impact of neighborhood and interpersonal stress on alcohol use and its associated comorbidities in PLWH. This aim tests the hypotheses that a) Contextual stressors will be associated with alcohol use as well as clinical comorbidities (e.g., mental health, cardiometabolic conditions, neurocognitive impairment, and frailty) and b) Alcohol use mediates the relation between stress and clinical comorbidities. We propose to obtain self-reported measures of stress, anxiety, depression, and alcohol use of PLWH and HIV seronegative subjects enrolled in our longitudinal New Orleans Alcohol Use in HIV (NOAH) study during the pandemic. Quantitative and qualitative data collected during the government mandated shelter-in-place and within 2 months of reopening of the city will be integrated with individual level demographic, clinical (including serological immunological evidence of exposure), behavioral (alcohol use), and disease-specific (HIV viral loads and CD4/CD8 counts) data to determine the impact of COVID-19 related stress on drinking behavior, adherence to ART, and manifestation of anxiety symptoms. Moreover, we will elucidate the interaction of COVID-19 related stress and alcohol drinking during this stressful period with risk for comorbidities in PLWH and HIV seronegative individuals. These studies directly integrate in the overall framework of our center and leverage existing infrastructure to maximize data collection during this unique timeframe.

摘要行政补充研究组件1（RC1）综合酒精研究 中心。社区和人际压力，酒精和慢性合并症。 路易斯安那州的SARS-COV-2病例率是第三高，是人均死亡率第二高。 在COVID-19-19大流行高峰期间的国家。新奥尔良的高死亡率令人震惊地导致 严格的政府为社会疏远，自我汇率和现场措施颁布的授权增加了 诸如失业，社交网络丧失，恐惧以及对个人交付的访问权的挑战 医疗保健给最脆弱的人。这些压力因素对现有症状产生负面影响 压力，焦虑和抑郁症，可能带来不必要的后果，导致发病率和 脆弱人群的死亡率。患有艾滋病毒（PLWH）的人的暴露率过高 对于慢性和终身社会压力源，与较差的心理健康率有关，包括 抑郁症，酒精使用障碍（AUD）和创伤后应激障碍（PTSD）。酒精 在胁迫和不确定性时期，消费往往会增加，并且酒精通常被滥用以应对 带着压力，焦虑和其他不舒服的情绪。精神病合并症降低了依从性 抗逆转录病毒疗法并增加使用物质使用的风险可能会增加合并症的风险或 负面影响疾病进展，尤其是在老化的PLWH中。增强的社会心理和生理 PLWH中的压力与免疫状态较差，病毒负荷随着时间的流逝增加，疾病较快有关 进展和较高的死亡率。我们的总体假设是具有AUD经验的PLWH COVID-19大流行的更大心理和生物学后果。这个行政 补充提出了在RC1的特定目标1中提出的范围内的研究：检查 社区和人际压力对酒精使用及其相关合并症的影响 plwh。这个目的测试了a）上下文压力源也将与酒精使用相关的假设 作为临床合并症（例如，心理健康，心脏代谢状况，神经认知障碍和 脆弱）和b）饮酒介导了压力与临床合并症之间的关系。我们建议 获得自我报告的压力，焦虑，抑郁和饮酒的量度 在大流行期间，我们在艾滋病毒（Noah）研究中使用纵向新奥尔良饮酒的受试者。 在政府强制实地居住期间收集的定量和定性数据以及2 重新开放的几个月将与个人级别的人口统计，临床（包括 暴露的血清学免疫学证据），行为（饮酒）和特异性疾病（HIV病毒 负载和CD4/CD8计数）数据以确定相关压力对饮酒行为的影响， 遵守艺术和焦虑症状的表现。此外，我们将阐明 COVID-19在这个压力期间相关的压力和饮酒，与PLWH合并症的风险 和艾滋病毒血清神经个体。这些研究直接整合到我们中心的整体框架中 利用现有的基础架构在此独特的时间范围内最大化数据收集。