Effects of overlapping Pandemics on Coping and behavioral Health among young adults affected by HIV (EPOCH-HIV)

重叠流行病对受艾滋病毒影响的年轻人的应对和行为健康的影响（EPOCH-HIV）

• 批准号: 10484501
• 负责人: Philip Kreniske
• 金额: $ 23.99万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-18 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10484501
• 关键词: 12 year old; 2019-nCoV; AIDS education; AIDS prevention; AIDS/HIV problem; Address; Affect; Age; American; Area; Behavior Therapy; Behavioral; Black race; Blood Pressure; Body mass index; Budgets; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 vaccine; Caribbean region; Caring; Cessation of life; Characteristics; Chronic; Cohort Studies; Collaborations; Color; Communicable Diseases; Communities; Coupled; Data; Death Rate; Disease Outbreaks; Epidemic; Ethnic Origin; Ethnography; Evidence based intervention; Funding; Future; Gender; Grant; HIV; HIV Infections; Health; Health Care Visit; Health Services; Health Services Accessibility; Healthcare; Housing; Incidence; Individual; Institutional Racism; Intervention; Interview; Latinx; Lead; Life; Longitudinal cohort; Longitudinal cohort study; Mental Health; Mental disorders; Methods; Modification; New York City; Occupations; Outcome; Participant; Patient Recruitments; Perinatal; Persons; Plant Roots; Positioning Attribute; Poverty; Prevention; Provider; Psychosocial Factor; Public Health; Qualitative Methods; Race; Readiness; Reduce health disparities; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Sampling; Services; Social Impacts; Social support; Structural Racism; Training and Education; Trauma; Treatment outcome; Typology; United States; United States National Institutes of Health; Vaccination; Vaccines; Variant; Viral; Work; Youth; base; behavioral health; care systems; case control; clinical care; clinical practice; cohort; comorbidity; comparison group; coping; economic impact; experience; health care delivery; health disparity; implementation framework; improved; innovation; interest; mHealth; multidisciplinary; novel; pandemic disease; perinatal HIV; physical conditioning; physical health service; programs; protective factors; psychosocial; racial and ethnic disparities; racism; research to practice; response; secondary analysis; social health determinants; substance use; theories; therapy development; treatment adherence; unvaccinated; uptake; vaccine acceptance; vulnerable community; young adult

The COVID-19 pandemic has dramatically disrupted everyday life for many young people, including young adults who have grown up with perinatally-acquired HIV (YAPHIV). YAPHIV were vulnerable to poor health outcomes (mental illness, substance use, low rates of viral suppression) before the pandemic due to the multifaceted impact of HIV, racism, and poverty. YA who were perinatally HIV-exposed, but uninfected (YAPHEU) have grown up in similar vulnerable communities, but often without the same access to services as YAPHIV. In this R21, we will examine the Effects of the COVID-19 Pandemic On Coping and behavioral Health among young adults affected by HIV (EPOCH-HIV) in order to inform care and interventions that address behavioral health problems and HIV treatment and prevention for Black and Latinx YA affected by HIV. Leveraging resources from a longitudinal cohort of YAPHIV and YAPHEU (CASAH; R01-MH69133), and our collaboration with the Northeast/Caribbean AIDS Education and Training Center (NECA AETC), we will inform the tailoring of behavioral and physical health services to meet the needs of YA affected by HIV in an era of overlapping HIV and COVID-19 pandemics. CASAH has collected extensive psychosocial, psychiatric, and behavioral data on YAPHIV and YAPHEU, and health outcomes (including HIV outcomes) from 2003 (n=340; mean age 12 years) to the present (mean age 27 years). To achieve EPOCH-HIV’s aims, we will use latent class analysis (LCA) (Aim 1) to identify pandemic experience typologies (i.e., highly affected, moderately affected, minimally affected) based on pandemic-related changes to psychosocial factors (e.g., job/housing loss, trauma). We will then explore risk and protective factors for these typologies (e.g., race/ethnicity, gender, PHIV status, social support) as well as the relationship between pandemic experience typologies and the following outcomes: (a) behavioral health (i.e., mental health, substance use), (b) vaccine and booster uptake, c) physical health (e.g., body mass index, health care visits), and (d) YAPHIV viral suppression. Sampling from participants in each of these typologies, we will qualitatively examine lived experiences before and during the COVID-19 pandemic (Aim 2), to identify areas for modification in (a) behavioral health (b) vaccine and booster uptake, and (c) physical health, and (d) YAPHIV care. Our multidisciplinary team has expertise in infectious diseases, COVID-19, mental health, YA, perinatal HIV, qualitative methods, mHealth, structural racism, trauma, and psychosocial and behavioral intervention development, and together are uniquely positioned to conduct this work. Public Health Impact: EPOCH will use rigorous and innovative methods to identify and begin to address how the COVID-19 pandemic affected the behavioral and physical health and care for of YA affected by HIV. Our partnership with NECA AETC and leaders in health services will enable us to reach providers and rapidly disseminate findings and inform the tailoring of services to address the NIH OAR priorities of: 1) reducing health disparities in HIV incidence and treatment outcomes, 2) addressing HIV co-morbidities, 3) making a substantive research-to-practice clinical impact.

COVID-19大流行对包括年轻人在内的许多年轻人的日常生活急剧破坏 与围产期获得的艾滋病毒（yaphiv）一起长大的人。 Yaphiv容易受到健康状况不佳的影响 （精神疾病，药物使用，病毒抑制率低）在大流行之前，由于多方面的影响 艾滋病毒，种族主义和贫穷。 ya暴露于周围的艾滋病毒，但未感染（yapheu）已经长大了 类似的弱势社区，但通常没有与Yaphiv相同的服务访问。在此R21中，我们将 检查COVID-19大流行对受影响的年轻人的应对和行为健康的影响 艾滋病毒（Epoch-Hiv），以告知解决行为健康问题和艾滋病毒的护理和干预措施 黑人和拉丁裔YA受艾滋病毒影响的治疗和预防。利用纵向的资源 Yaphiv和Yapheu（Casah; R01-MH69133）的队列，以及我们与东北/加勒比海的合作 艾滋病教育和培训中心（NECA AETC），我们将告知行为和身体健康的裁缝 在重叠的艾滋病毒和199大流行病的时代，可以满足受艾滋病毒影响的YA需求。 卡萨（Casah 从2003年（n = 340;平均12岁）到现在的健康结果（包括艾滋病毒结局）（平均年龄27岁） 年）。为了实现Epoch-HIV的目标，我们将使用潜在类别分析（LCA）（目标1）来识别大流行 经验类型（即，基于大流行有关 改变社会心理因素（例如，工作/住房损失，创伤）。然后，我们将探索风险和保护因素 对于这些类型学（例如种族/种族，性别，phiv地位，社会支持）以及之间的关系 大流行经验类型和以下结果：（a）行为健康（即心理健康，基板 使用），（b）疫苗和助推器摄取，c）身体健康（例如体重指数，医疗访问）和（d） Yaphiv病毒抑制。来自每种类型的参与者的抽样，我们将定性检查 在Covid-19-19大流行之前和期间的生活经验（AIM 2），以确定（a）中修饰的区域 行为健康（B）疫苗和助推器摄取，以及（c）身体健康，以及（d）Yaphiv Care。我们的 多学科团队在传染病中拥有专业知识，Covid-19，心理健康，YA，围产期艾滋病毒， 定性方法，MHealth， 结构性种族主义，创伤以及社会心理和行为干预 开发和共同的独特位置来进行这项工作。公共卫生影响：时期将使用 严格而创新的方法，以识别并开始解决联想19的大流行如何影响 艾滋病毒影响的YA行为和身体健康和护理。我们与NECA AETC和领导者的合作关系 在卫生服务中将使我们能够与提供者联系并迅速传播发现并告知裁缝 解决：1）减少艾滋病毒事件和治疗中的健康差异的NIH OAR优先级的服务 结果，2）解决HIV合并症，3）对实践对实践的临床影响产生实质性的临床影响。