Effects of overlapping Pandemics on Coping and behavioral Health among young adults affected by HIV (EPOCH-HIV)

新冠肺炎疫情极大地扰乱了许多年轻人的日常生活，包括年轻人 他们在成长过程中感染了围产期获得性艾滋病毒(YAPHIV)。YAPHIV很容易受到不良健康结果的影响 (精神疾病、药物使用、病毒抑制率低)大流行之前，由于多方面的影响 艾滋病毒、种族主义和贫困。围产期感染艾滋病毒但未感染的YA(YAPHEU)在 类似的弱势社区，但往往没有像YAPHIV一样获得服务的机会。在这款R21中，我们将 检查新冠肺炎大流行对受影响的年轻人的应对和行为健康的影响 通过艾滋病毒(新纪元-艾滋病毒)，以便为解决行为健康问题和艾滋病毒的护理和干预提供信息 感染艾滋病毒的黑人和拉丁裔YA患者的治疗和预防。从纵向角度利用资源 YAPHIV和YAPHEU的队列(CASAH；R01-MH69133)，以及我们与东北/加勒比地区的合作 艾滋病教育和培训中心(NECA AETC)，我们将通知裁剪行为和身体健康 在艾滋病毒和新冠肺炎疫情重叠的时代，满足受艾滋病毒影响的雅加达人的需求的服务。 CASAH收集了大量关于YAPHIV和YAPHEU的心理、精神和行为数据，以及 从2003年(n=340；平均年龄12岁)到现在(平均年龄27岁)的健康结果(包括艾滋病毒结果) 年)。为了实现划时代艾滋病毒的目标，我们将使用潜在类别分析(LCA)(目标1)来识别大流行 基于与大流行相关的经验类型(即，高度影响、中度影响、最小影响) 心理社会因素的变化(例如，失业/住房损失、创伤)。然后，我们将探讨风险和保护因素 对于这些类型(例如，种族/族裔、性别、艾滋病毒感染状况、社会支持)以及 大流行经历的类型学和下列结果：(A)行为健康(即精神健康、物质 使用)、(B)疫苗和促进剂摄取、c)身体健康(例如，体重指数、保健就诊)和(D) YAPHIV病毒抑制。从这些类型的参与者中抽取样本，我们将定性地检查 新冠肺炎大流行之前和期间的生活经历(目标2)，以确定(A)中需要修改的领域 行为健康：(B)疫苗和增强剂的摄取；(C)身体健康；(D)预防艾滋病的护理。我们的 多学科团队在传染病、新冠肺炎、精神卫生、青年会、围产期艾滋病毒、 定性方法，移动健康， 结构性种族主义、创伤、心理社会和行为干预 发展，并共同处于开展这项工作的独特地位。公共健康影响：纪元将使用 严谨和创新的方法，以确定和开始处理新冠肺炎大流行如何影响 艾滋病患者的行为和身体健康及护理。我们与NECA AETC和Leaders的伙伴关系 将使我们能够接触到医疗服务提供者，并迅速传播调查结果，并为定制 为解决美国国立卫生研究院OAR优先事项提供的服务：1)减少艾滋病毒发病率和治疗方面的健康差距 结果，2)解决艾滋病毒并存问题，3)从研究到实践的实质性临床影响。

The COVID-19 pandemic has dramatically disrupted everyday life for many young people, including young adults who have grown up with perinatally-acquired HIV (YAPHIV). YAPHIV were vulnerable to poor health outcomes (mental illness, substance use, low rates of viral suppression) before the pandemic due to the multifaceted impact of HIV, racism, and poverty. YA who were perinatally HIV-exposed, but uninfected (YAPHEU) have grown up in similar vulnerable communities, but often without the same access to services as YAPHIV. In this R21, we will examine the Effects of the COVID-19 Pandemic On Coping and behavioral Health among young adults affected by HIV (EPOCH-HIV) in order to inform care and interventions that address behavioral health problems and HIV treatment and prevention for Black and Latinx YA affected by HIV. Leveraging resources from a longitudinal cohort of YAPHIV and YAPHEU (CASAH; R01-MH69133), and our collaboration with the Northeast/Caribbean AIDS Education and Training Center (NECA AETC), we will inform the tailoring of behavioral and physical health services to meet the needs of YA affected by HIV in an era of overlapping HIV and COVID-19 pandemics. CASAH has collected extensive psychosocial, psychiatric, and behavioral data on YAPHIV and YAPHEU, and health outcomes (including HIV outcomes) from 2003 (n=340; mean age 12 years) to the present (mean age 27 years). To achieve EPOCH-HIV’s aims, we will use latent class analysis (LCA) (Aim 1) to identify pandemic experience typologies (i.e., highly affected, moderately affected, minimally affected) based on pandemic-related changes to psychosocial factors (e.g., job/housing loss, trauma). We will then explore risk and protective factors for these typologies (e.g., race/ethnicity, gender, PHIV status, social support) as well as the relationship between pandemic experience typologies and the following outcomes: (a) behavioral health (i.e., mental health, substance use), (b) vaccine and booster uptake, c) physical health (e.g., body mass index, health care visits), and (d) YAPHIV viral suppression. Sampling from participants in each of these typologies, we will qualitatively examine lived experiences before and during the COVID-19 pandemic (Aim 2), to identify areas for modification in (a) behavioral health (b) vaccine and booster uptake, and (c) physical health, and (d) YAPHIV care. Our multidisciplinary team has expertise in infectious diseases, COVID-19, mental health, YA, perinatal HIV, qualitative methods, mHealth, structural racism, trauma, and psychosocial and behavioral intervention development, and together are uniquely positioned to conduct this work. Public Health Impact: EPOCH will use rigorous and innovative methods to identify and begin to address how the COVID-19 pandemic affected the behavioral and physical health and care for of YA affected by HIV. Our partnership with NECA AETC and leaders in health services will enable us to reach providers and rapidly disseminate findings and inform the tailoring of services to address the NIH OAR priorities of: 1) reducing health disparities in HIV incidence and treatment outcomes, 2) addressing HIV co-morbidities, 3) making a substantive research-to-practice clinical impact.