Utilizing All of Us data to examine the impact of COVID-19 on mental health among people living with HIV

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Abstract In response to the NOSI (NOT-PM-22-002), we propose to expand the resilience conceptual framework in our parent grant (1R01MH127961-01A1, 12/2021-11/2026) to a different context (COVID-19) and a new population (people living with HIV [PLWH] in the United States). Further, we propose to explore if a resilience approach can be used to mitigate the negative impacts of COVID-19 on the mental health among PLWH. We will leverage multiple datasets from the All of Us program, including electronic health records (EHR), a series of COVID-19 Participant Experience (COPE) surveys, and other self-reported survey data. Integrating these data from about 12 thousand PLWH who participated in COPE, we will: 1) examine the trends and patterns of mental health outcomes (i.e., psychiatric disorder diagnoses via ICD-10 and mental health assessments via survey) among PLWH before and after the COVID-19 outbreak; and 2) identify protective factors at multiple socioecological levels including the individual level (e.g., resilience), interpersonal level (e.g., social support), and health institutional level (e.g., health service accessibility) that may mitigate the negative impacts of the COVID-19 pandemic on mental health outcomes among PLWH, especially the subgroups with socially disadvantaged status (low income and low education) and stigmatized identities (racial/ethnic minorities, sexual and gender minorities). Based on rich data from a large cohort of PLWH, the findings will advance our understanding of their mental health needs during the pandemic and mental health disparities of PLWH in the US and inform tailored health interventions to improve mental health outcomes among PLWH, especially those from disadvantaged subgroups. Our study goal is aligned with the Office of AIDS Research's and National Institute of Mental Health's research priorities in terms of social sciences studies and health disparities reduction. The proposed study will leverage existing NIH investment, capitalize on a rapid understanding of mental health needs among PLWH, stimulate additional collaborations with the All of Us program, and promote the translation of All of Us data to public health implications. The experience and preliminary data obtained from this supplement will position us for further efforts in utilizing All of Us data to improve mental and other health outcomes of PLWH in the US.