SHARE Program: Innovations in Translational Behavioral Science to Improve Self-management of HIV and Alcohol Reaching Emerging adults

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SHARE P01 ABSTRACT The purpose of the SHARE P01 research program project is to address HIV and alcohol use around three themes; 1) Emerging adulthood (ages 18 -29); 2) Self-management of HIV and alcohol; and 3) Translational behavioral science. Emerging adulthood is a developmental stage marked by significant change in social roles, expectations as a new adult, and increased responsibilities. It is also marked by poor HIV self- management and increased alcohol use. Emerging adults with HIV (hereafter called young people living with HIV; YPLWH) may face even more challenges given intersectional stigma. This age group continues to have very high rates of new HIV infections. Interventions designed specifically for the unique developmental challenges of emerging adults are needed, yet emerging adults are often included with older adults in intervention programs. The concept of self-management emerged concurrently within both the substance abuse and chronic illness literatures, and fits well with the developmental challenges of emerging adulthood. Self-management, a framework we have utilized in our work with YPLWH, refers to the ability to manage symptoms, treatments, lifestyle changes, and consequences of health conditions. Current research now identifies individual-level self-management skills such as self-control, decision-making, self-reinforcement, and problem solving as that protect against substance use and improve other health outcomes and can be embedded in the Information-Motivation-Behavioral Skills model. Although we have conducted multiple studies with YPLWH, only one intervention to date (Healthy Choices conducted by our team) improved both alcohol use and viral suppression in YPLWH in large trials. The goal of the SHARE P01 is to utilize advances in translational behavioral science to optimize behavioral interventions and define new developmentally- and culturally-appropriate intervention targets to improve self-management of alcohol and HIV in YPLWH. We will focus our efforts in Florida, a state hardest hit by the HIV epidemic but with a particularly strong academic- community partnership to support translation. We have assembled research teams to conduct self- management studies across the translational spectrum to address self-management and improve alcohol use and viral suppression (and thereby reduce transmission) in diverse YPLWH in Florida. The P01 will consist of three research projects (DEFINE, ENGAGE, and SUSTAIN), representing different stages on the translational spectrum and targeting different core competencies, supported by two cores (Community Engagement Core and Data Science Core). If successful, the SHARE P01 has the potential to greatly advance programs promoting self-management of HIV and alcohol use among a particularly vulnerable, but under-researched group, emerging adults living with HIV. SHARE also has a high potential for scale-up and implementation beyond Florida and across the United States.