Addressing community-level influences of HIV and COVID-19 disparities among people with HIV

解决艾滋病毒和 COVID-19 社区层面的影响以及艾滋病毒感染者之间的差异

• 批准号: 10556511
• 负责人: Diana Montserrat Sheehan
• 金额: $ 35.42万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10556511
• 关键词: 2019-nCoV; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Acute; Address; Area; Behavioral; Biological; Black Populations; COVID-19; COVID-19 diagnosis; COVID-19 disparity; COVID-19 mortality; COVID-19 pandemic; COVID-19 surveillance; California; Caring; Case Fatality Rates; Censuses; Chronic; Communities; Complex; County; Data; Data Science; Data Set; Environment; Epidemic; Ethnic Origin; Florida; Gender; Goals; HIV; HIV Infections; HIV diagnosis; Health Disparities Research; Health Services Accessibility; Healthcare Systems; Herd Immunity; Hispanic Populations; Hospital Mortality; Hospitalization; Hospitals; Human immunodeficiency virus test; Incidence; Individual; Intervention; Link; Minority-Serving Institution; National Institute on Minority Health and Health Disparities; New York; Not Hispanic or Latino; Outcome; Persons; Play; Policies; Population Study; Process; Race; Recommendation; Reporting; Reproducibility; Research; Research Priority; Research Project Grants; Resources; Risk Reduction; Role; Rural; SARS-CoV-2 infection; Source; Strategic Planning; Structure; System; Texas; Treatment outcome; Twin Multiple Birth; United States; United States National Institutes of Health; Viral; Virus; Vulnerable Populations; base; built environment; care outcomes; community engagement; community-level factor; comorbidity; experience; health care availability; health disparity; innovation; mortality; novel; pandemic disease; racial and ethnic; racial and ethnic disparities; severe COVID-19; social culture; social structure; socioeconomic disparity; socioeconomics; surveillance data; syndemic; theories; transmission process; urban disparity; urban residence

FIU-RCMI Research Project #3 Abstract The twin pandemics of human immunodeficiency virus (HIV) and COVID-19 share uncanny similarities with respect to racial/ethnic and socioeconomic disparities in both incidence and mortality. Structural strategies for HIV and COVID-19 outcomes could augment current agent-based (individual-level) interventions by addressing those factors that limit a person's ability to carry out risk reduction, as well as address transmission among people not easily reached by agent-based interventions. The primary objectives of this study are: (a) to identify modifiable community-level influences on gender, racial/ethnic, and rural/urban disparities in HIV and COVID-19 outcomes among people with HIV; and (b) to develop policy and programmatic recommendations to address these community-level influences. The proposed study will use individual-level 2017-2023 Florida HIV/AIDS surveillance data linked to individual-level 2020-2023 Florida COVID-19 surveillance data. Linked HIV and COVID-19 data will be merged with 10 additional census tract- and county- level community data for Florida. Using a mix of complex analytical approaches and guided by ecosocial theory and the National Institute on Minority Health and Health Disparities research framework, we propose to examine community factors that impact health disparities across 5 domains of influence: (1) biological, (2) behavioral, (3) physical/built environment, (4) sociocultural environment, and (5) health care system. Additionally, the proposed study will convene a strategic planning workgroup of HIV leaders across Florida to develop recommendations to address community influences of HIV and COVID-19 disparities among people with HIV. We propose three specific aims: Aim 1. Estimate the moderating effect of community factors on the association between gender, race/ethnicity, and rural/urban residence and both differences (from pre-COVID- 19 [2017-2019] to the acute period of the COVID-19 Pandemic [2020]) and trajectories (from pre-COVID-19 [2017-2019] through the evolving periods of the COVID-19 Pandemic [2020-2023]) in HIV outcomes among people with HIV. Aim 2. Estimate the moderating effect of community factors on the association between gender, race/ethnicity, and rural/urban residence and COVID-19 outcomes during the acute (2020) and evolving (2020-2023) periods of the COVID-19 Pandemic among people with HIV. Aim 3. Develop policy and programmatic recommendations to address community influences of gender, racial/ethnic, and rural/urban disparities in HIV and COVID-19 outcomes among people with HIV. Findings from this study will provide a novel understanding of the impact of community context on COVID-19 and HIV disparities among people with HIV, as well as develop an actionable plan to protect vulnerable populations of people with HIV and support the goals of Ending the HIV Epidemic in the COVID-19 era. This study further supports NIH's 2021-2025 research priority areas of studying HIV comorbidities and syndemics, and of focusing on community and social- structural factors influencing inequities in HIV outcomes.

FIU-RCMI 研究项目 #3 抽象的 人类免疫缺陷病毒 (HIV) 和 COVID-19 这两种流行病具有惊人的相似之处 尊重发病率和死亡率方面的种族/族裔和社会经济差异。结构性策略 HIV 和 COVID-19 的结果可以通过以下方式增强当前基于药物的（个人层面）干预措施： 解决限制个人降低风险能力的因素，并解决传播问题 难以通过基于代理的干预措施触及的人群。本研究的主要目标是：(a) 确定社区层面对艾滋病毒性别、种族/民族和城乡差异的可改变影响 HIV 感染者中的 COVID-19 结局； (b) 制定政策和方案 解决这些社区层面影响的建议。拟议的研究将使用个人水平 2017-2023 年佛罗里达州 HIV/艾滋病监测数据与个人层面 2020-2023 年佛罗里达州 COVID-19 相关 监测数据。关联的 HIV 和 COVID-19 数据将与另外 10 个人口普查区和县合并 佛罗里达州的一级社区数据。结合使用复杂的分析方法并以生态社会理论为指导 和国家少数民族健康和健康差异研究所的研究框架，我们建议 检查影响健康差异的 5 个影响领域的社区因素：(1) 生物学，(2) 行为，(3) 物理/建筑环境，(4) 社会文化环境，(5) 医疗保健系统。 此外，拟议的研究将召集佛罗里达州艾滋病毒领导者组成的战略规划工作组，以 制定建议以解决艾滋病毒和 COVID-19 人群差异对社区的影响 患有艾滋病毒。我们提出了三个具体目标： 目标 1. 估计社区因素对 性别、种族/民族和农村/城市居住地之间的关联以及两者之间的差异（从新冠疫情之前 19 [2017-2019] 到 COVID-19 大流行的急性期 [2020]）和轨迹（从 COVID-19 之前） [2017-2019] 到 COVID-19 大流行的演变时期 [2020-2023]） 艾滋病毒感染者。目标 2. 估计社区因素对之间关联的调节作用 急性期（2020 年）和 HIV 感染者中 COVID-19 大流行的演变时期（2020-2023 年）。目标 3. 制定政策和 解决性别、种族/民族和农村/城市的社区影响的方案建议 HIV 感染者之间 HIV 和 COVID-19 结果的差异。这项研究的结果将提供 对社区环境对 COVID-19 和 HIV 感染者差异影响的新认识 艾滋病毒，并制定一项可行的计划来保护艾滋病毒感染者和支持的弱势群体 在 COVID-19 时代结束艾滋病毒流行的目标。这项研究进一步支持 NIH 的 2021-2025 年计划 研究的优先领域是研究艾滋病毒合并症和流行病，以及关注社区和社会 影响艾滋病结果不平等的结构性因素。