Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV

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Project Summary/Abstract In response to NOT-OD-21-020, Notice of Special Interest: Administrative Supplement for Research and Capacity Building Efforts Related to Bioethical Issues, this innovative proposal aims to conduct bioethical research to promote equitable COVID-19 vaccine decision-making among Black and Latinx people living with HIV (PLWHIV) and cardiovascular (CVD) risk. To mitigate the disproportionate impact of COVIID-19 on communities of color, COVID-19 vaccines must quickly reach those in greatest need. However, vaccine hesitancy and lack of access to reliable COVID-19 information compromise informed decision-making, reducing equitable and fair access to COVID-19 vaccines and inhibiting vaccine uptake in vulnerable subpopulations. This proposal seeks to expand the reach of public health messages (e.g., The COVID-19 Vaccine Education Initiative Public Health Toolkit and The Community Engagement Alliance (CEAL) against COVID-19),with an interactive session that acknowledges COVID-19 vaccine concerns, supports discussion of sources of hesitancy, and facilitates equitable access to reliable information within the context of multiple values (e.g., personal, bodily, communal) that impact COVID-19 vaccine decision-making. The Specific Aims are to: 1) evaluate the effect of a virtual session on knowledge of, access to, and trust in reliable COVID-19 public health messages among 60 HHMB participants (20 Spanish) living with HIV and at risk for CVD, 2) identify COVID-19 vaccine concerns specifically related to HIV and CVD risks, 3) determine the impact of the virtual session on HHMB participants’ perception that they have adequate information to make a COVID-19 vaccine decision, making a COVID-19 decision, and whether or not the decision is to receive a COVID- 19 vaccine, and 4) evaluate the relationship between use of personal, bodily, and communal values taught in the virtual session, making a COVID-19 decision, and deciding whether or not to receive a COVID-19 vaccine. These aims will be addressed through a novel, culturally consistent session, “Promoting COVID-19 Vaccine Decision-Making (HHMB-PVDM) for enrolled virtual HHMB participants. Without the opportunity to engage in dialogue about personal and historical experiences that impact hesitancy and provide support for increasing knowledge of and access to accurate, clear, and understandable COVID-19 public health and vaccine information, Black and Latinx PLWHIV and CVD risks will continue to lack equity in making COVID-19 vaccine decisions. Supporting COVID-19 vaccine decision-making approaches will facilitate population-level vaccine uptake, contributing to the mitigation of disparities in COVID-19 morbidity and mortality in communities of color. Findings will be refined to inform vaccine decision-making approaches to reach other vulnerable subpopulations.