1/3 Alcohol Research Consortium in HIV - Administrative Core (ARCH-AC)

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This supplemental funding application for the Alcohol Research Consortium on HIV (ARCH) seeks to add COVID-19 related aims to our existing alcohol and HIV epidemiologic and intervention research. This proposal capitalizes on the strengths of the CFAR Network of Integrated Clinical Systems (CNICS), which include systematic, on-going collection of patient reported outcomes (PROs) at regular intervals as well as inpatient and outpatient electronic medical record (EMR) abstraction. First, using data from all active CNICS patients (N > 13,000), we will examine associations between alcohol use prior to and during the SARS-CoV-2 pandemic with rates of SARS-CoV-2 infection, and COVID-19-related hospitalizations, hospitalization duration, ICU admissions, and mortality. Second, in a subset of hazardous drinkers (N=100/site across 6 sites), we will implement a COVID-19 alcohol survey to capture longitudinal data (4 surveys over 12 – 18 months) on quantity/frequency of alcohol consumption, drinking locations and partners, as well as motivations for drinking. The survey also will assess perceived personal and family threat from SARS-CoV-2, compliance with social distancing and stay-at-home orders, COVID-19 specific stressors (e.g., reduced wages, reduced/no childcare, food shortage, transportation, access to health care for ongoing health problems), and levels of perceived stress. We will examine changes in alcohol use characteristics during and after the SARS-CoV-2 pandemic as a function of pre-pandemic alcohol use patterns, depressive and anxiety symptom severity, perceived stress and compliance with social distancing and stay-at- home orders. Third, we will study the impact of changes in alcohol use patterns on HIV treatment outcomes. We will validate drinking self-report using the alcohol biomarker PEth in a subsample of survey participants (N=40/site across 6 sites). Finally, survey participants will rate their interest in telehealth alcohol counseling and provide information on availability of equipment and internet access for implementation. Findings on COVID-19 related changes in drinking characteristics and patient interest in telehealth care models will position us to effectively implement remote counseling models for alcohol interventions in the future.