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.

这项提案是一项紧急的竞争性修订，旨在补充现有的NIH资助的研究，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 预防艾滋病毒疾病进展，在艾滋病毒感染者（PLWH）。COVID-19疫情 深刻地影响了世界各地的生活。除了感染本身的影响，PLWH可能是 更容易受到影响，COVID-19已经影响了就业，获得医疗保健，很可能，发病率 和其他健康状况的后果，通过限制获得医疗保健，并通过实施 物理（社会）距离。PLWH可能面临更高的社会隔离风险， 成瘾、失业和无家可归的风险甚至更高， 可用性，卫生（例如洗手），住所和其他传统支持现在已经缺席 脆弱的社会安全网。 该提案的总体目标是评估COVID-19大流行的影响以及 物理（社会）距离和其他缓解策略（统称为“大流行暴露”）， 物质使用（重度酒精使用和/或其他药物使用，包括非医疗处方药使用） 艾滋病毒感染者的药物依从性。 在一个正在进行的、特征明确的艾滋病毒/艾滋病感染者队列（现有的波士顿艾滋病研究中心）中， 队列母研究），本项目将： 目标1：确定大流行暴露与酒精（和其他）变化之间的前瞻性关联 药物）使用（主要）和艾滋病毒抗逆转录病毒（ARV）药物不依从性（其次）。 目标2：确定大流行暴露与次级压力源（特别是食物）之间的关联 不安全感、孤独感和疼痛干扰（与活动）;以及这些压力源与 酒精（和其他药物）使用的变化和艾滋病毒抗逆转录病毒药物治疗的不依从性。 目标3：通过审查艾滋病毒/艾滋病与艾滋病之间的关联的调节因素，确定谁受这一流行病的影响最大。 大流行暴露和物质使用的变化以及艾滋病毒抗逆转录病毒治疗的不依从性。 为了实现这些目标，将对参与者进行补充COVID-19特定评估 在两个时间点（相隔6个月）。药物使用、抑郁和虚弱的基线数据， 作为母研究的一部分，大流行前评估将与通过以下方式收集的数据进行比较 补充COVID特定评估。实现这一建议的目标是确定 预防药物使用增加和艾滋病毒疾病进展的干预措施的可修改目标， 比如COVID-19。