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: 10707407
• 负责人: Diana Montserrat Sheehan
• 金额: $ 39.34万
• 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/10707407
• 关键词: 2019-nCoV; 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; Disparity; Environment; Epidemic; Ethnic Origin; Florida; Gender; Goals; HIV; HIV Infections; HIV diagnosis; HIV disparities; HIV/AIDS; Health Disparities Research; Health Services Accessibility; Healthcare Systems; Herd Immunity; Hispanic Populations; Hospital Mortality; Hospitalization; Hospitals; Human immunodeficiency virus test; Incidence; Individual; Inequity; 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; built environment; care outcomes; community engagement; community-level factor; comorbidity; ethnic disparity; experience; health care availability; health disparity; innovation; mortality; novel; pandemic disease; racial disparity; severe COVID-19; social culture; social structure; socioeconomic disparity; socioeconomics; structural determinants; 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 摘要 人类免疫缺陷病毒（HIV）和COVID-19的孪生流行病与 在发病率和死亡率方面的种族/族裔和社会经济差异。结构战略 艾滋病毒和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： 解决那些限制个人降低风险能力的因素，以及解决传播问题 在基于代理人的干预措施不易触及的人群中。本研究的主要目的是：（a） 确定社区一级对艾滋病毒感染的性别、种族/民族和城乡差异的可改变的影响 和COVID-19在艾滋病毒感染者中的结果;以及（B）制定政策和方案 建议解决这些社区一级的影响。本研究将使用个人水平 2017-2023年佛罗里达艾滋病毒/艾滋病监测数据与个人水平相关2020-2023年佛罗里达COVID-19 监视数据。相关的艾滋病毒和COVID-19数据将与10个额外的人口普查区和县合并， 佛罗里达的水平社区数据。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， 研究影响健康差异的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）社会文化环境和（5）医疗保健系统。 此外，拟议的研究将召集佛罗里达各地的艾滋病毒领导人的战略规划会议， 制定建议，以解决艾滋病毒和COVID-19在人群中的差异的社区影响 感染了艾滋病毒我们提出三个具体目标：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这两种差异（与COVID前相比， 19 [2017-2019]至COVID-19大流行急性期[2020]）和轨迹（自COVID-19前 [2017-2019]通过不断演变的COVID-19大流行时期[2020-2023]）， 艾滋病毒感染者。目标2.估计社区因素对 急性期（2020年）的性别、种族/民族、农村/城市居住地和COVID-19结局， 2020年至2023年，新冠肺炎疫情在艾滋病毒感染者中的流行期不断演变。目标3。制定政策和 解决性别、种族/族裔和城乡对社区影响的方案建议 艾滋病毒感染者之间艾滋病毒和COVID-19结果的差异。这项研究的结果将提供一个 对社区环境对COVID-19和艾滋病毒感染者之间差异的影响的新认识 艾滋病毒，以及制定一个可操作的计划，以保护艾滋病毒感染者和支持弱势群体 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了NIH的2021-2025年 研究艾滋病毒合并症和综合症的优先研究领域，并侧重于社区和社会- 影响艾滋病毒成果不平等的结构性因素。