HIV CENTERS FOR UNDEREPRESENTED POPULATIONS IN RESEARCH CTU (HIV CURE CTU) Administrative Supplement

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Project Summary: COVID-19 is a disease caused by SARS CoV-2 virus, a novel coronavirus that has caused a pandemic due to lack of immunity to the virus in the general population and lack of effective therapy. Increased morbidity due to COVID-19 disease occurs in people age 65 years old and older, persons with hypertension, diabetes, chronic lung disease, and with immunodeficiency. COVID-19 disease has greatly impacted persons of color in the United States due to a high prevalence of comorbidities in persons of color and due to relative lack of access to medical care in persons of color, especially in areas of the country most impacted by poverty and lack of Medicaid expansion, such as some Southern states in the US, like Texas, which has the one of the highest rates of uninsured individuals in the country. Texas currently has had 45,198 cases of COVID-19 with 1,272 fatalities. Harris County/Houston has had 9,050 combined confirmed cases with 199 deaths. The COVID-19 pandemic coincides with the HIV pandemic currently impacting the US and both SARS CoV-2 and HIV cause high morbidity in Communities of Color. Aside from the impact of both viral infections, the socioeconomic and mental health impacts of the public health approach to controlling the spread of COVID-19 disease, social distancing, quarantine, and isolation, have detrimentally impacted persons with HIV over and above the effects on the general population. Mental health problems, poverty, food insecurity, economic vulnerability, work in service industry where jobs have been eliminated, and lack of safety net for children out of school, all disproportionately affect persons with HIV. The Texas Children's Hospital (TCH) proposal will address the impact of COVID-19 in children and youth living with HIV in the Houston area. TCH will evaluate for prevalent SARS CoV-2 infection by performing a PCR evaluation at baseline and in 6 months in 160 children and youth ages 2 to 24 years who receive care at TCH. Serology for SARS CoV-2 will also be evaluated at baseline and in 6 months to look for evolving immunity over time in this population. Surveys will be administered at baseline and 6 months to evaluate for the socioeconomic and mental health impact of social distancing on these families and youth. COVID-19 disease in persons with HIV infection will be described. Baseline and follow-up demographic, immunologic, socioeconomic, and mental health characteristics of the children and youth enrolled living with HIV will be described.