Multilevel Influences on HIV and Substance Use in a YMSM Cohort

摘要 关键和紧迫的新冠肺炎研究问题将通过描述SARS-CoV-2的特征来解决 在不同种族的物质队列中，在基线和 6个月后，再次使用家庭收集的定量检测抗体，预计将中和SARS- 冠状病毒2型的体外感染性。具体目标如下： (1)通过检验以下假设来表征新冠肺炎的社会行为风险： A.在2020年夏季进行第一波检测时，SARS-CoV-2血清阳性率和症状率将更高 在黑人和拉丁裔参与者中的比例高于白人。随后的血清转换率也会更高 黑人和拉丁克斯物质-使用YMSM雷达参与者。 B.药物使用将与血清阳性率和症状的增加相关。具体而言，利用 可燃或蒸发的尼古丁或大麻产品以及甲基苯丙胺将增加 SARS-CoV-2感染的流行情况。使用这些物质也可以预测血清转换。 随后的随访。 C.报告自2020年3月以来共用吸食毒品/蒸发用具的参与者将获得 由于额外的传播风险，血清阳性率增加，超过单独使用的影响 联系。共用第1波的用具也可以预测后续的血清转换。 (2)了解与系统性炎症、艾滋病毒相关因素有关的新冠肺炎风险，以及 通过测试以下假设来降低抗SARS-CoV-2抗体： A.全身性炎症与血清流行率/阴转率增加和症状有关。 B.SARS-CoV-2血清阳性率在感染艾滋病毒和未感染艾滋病毒的参与者之间可能不同，或者与 在控制全身炎症后，用作PrEP或治疗(ART)的抗逆转录病毒药物。 C.(艾滋病毒携带者)较低的CD4细胞计数与抗SARS-CoV-2抗体的下降有关 受体结合域(RBD)、免疫球蛋白G数量和/或持续时间。 D.较低的可检测到的抗SARS-CoV-2抗体的数量和/或丢失与较高的风险相关 SARS-CoV-2再感染(在随后的病例高峰中出现第二个单独的PCR阳性病例)。

ABSTRACT Critical and urgent COVID-19 research questions will be addressed by characterizing SARS-CoV-2 seroprevalence and symptom profile in a racially diverse cohort of substance-using YMSM at baseline and again 6 months later using a home-collected, quantitative assay for antibodies expected to neutralize SARS- CoV-2 infectivity in vitro. The following are the specific aims: (1) Characterize socio-behavioral risks of COVID-19 by testing hypotheses that: a. At time of wave 1 testing in summer 2020, SARS-CoV-2 seroprevalence and symptom rates will be higher among Black and Latinx than White participants. Subsequent seroconversion will also be greater among Black and Latinx substance-using YMSM RADAR participants. b. Substance use will be associated with increased seroprevalence and symptoms. Specifically, utilization of combustible or vaporized nicotine or cannabis products, as well as methamphetamine, will increase prevalence of SARS-CoV-2 infection. Use of these substances will also predict seroconversion over subsequent follow-up. c. Participants who report sharing of drug smoking/vaporizing paraphernalia since March 2020 will have an increased seroprevalence, over-and-above the effect of use alone, due to additional transmission risk from contact. Sharing paraphernalia at wave 1 will also predict seroconversion over subsequent follow-up. (2) Understand COVID-19 risks associated with systemic inflammation, HIV-associated factors, and declining anti-SARS-CoV-2 antibodies by testing hypotheses that: a. Systemic inflammation is associated with increased sero-prevalence/-conversion and symptoms. b. SARS-CoV-2 seroprevalence may differ between HIV-infected and HIV-uninfected participants, or with antiretroviral use as PrEP or treatment (ART), after controlling for systemic inflammation. c. Lower CD4 cell count (in people living with HIV) is associated with decreased anti-SARS-CoV-2 spike receptor binding domain (RBD) IgG quantity and/or duration. d. Lower quantity and/or loss of detectable anti-SARS-CoV-2 spike RBD IgG is associated with higher risk of SARS-CoV-2 reinfection (a second, separate episode of PCR positivity in a subsequent peak of cases).