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

重叠流行病对受艾滋病毒影响的年轻人的应对和行为健康的影响（EPOCH-HIV）

• 批准号: 10622621
• 负责人: Philip Kreniske
• 金额: $ 19.99万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-18 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10622621
• 关键词: 12 year old; AIDS education; AIDS prevention; Address; Affect; Age; American; Area; Behavior Therapy; Behavioral; Black race; Blood Pressure; Body mass index; Budgets; COVID-19; COVID-19 disparity; COVID-19 mortality; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 vaccine; Caribbean region; Caring; Cessation of life; Characteristics; Chronic; Classification; Cohort Analysis; Cohort Studies; Collaborations; Color; Communicable Diseases; Communities; Consolidated Framework for Implementation Research; Coupled; Critical Race Theory; Data; Death Rate; Disease Outbreaks; Disparity; Epidemic; Ethnic Origin; Ethnography; Evidence based intervention; Funding; Future; Gender; Grant; HIV; HIV Infections; HIV/AIDS; Health; Health Care Visit; Health Services; Health Services Accessibility; Healthcare; Housing; Incidence; Individual; Institutional Racism; Intervention; Interview; Latinx; Lead; Life; Longitudinal cohort; Longitudinal cohort study; Mental Health; Mental disorders; Methods; Modification; New York City; Occupations; Outcome; Participant; Patient Recruitments; Perinatal; Persons; Positioning Attribute; Poverty; Prevention; Provider; Psychosocial Factor; Public Health; Qualitative Methods; Race; Readiness; Reduce health disparities; Research Infrastructure; Research Personnel; Resources; Risk; Risk Factors; Sampling; Services; Social Impacts; Social support; Structural Racism; Training and Education; Trauma; Treatment outcome; Typology; United States; United States National Institutes of Health; Vaccination; Vaccines; Variant; Viral; Virus Diseases; Work; Youth; behavioral health; care systems; case control; clinical care; clinical practice; cohort; comorbidity; comparison group; coping; economic impact; ethnic disparity; experience; future pandemic; health care delivery; health disparity; improved; innovation; interest; mHealth; multidisciplinary; novel; pandemic disease; perinatal HIV; physical conditioning; physical health service; poor health outcome; pre-pandemic; programs; protective factors; psychosocial; racial disparity; racism; research to practice; response; secondary analysis; social health determinants; substance use; therapy development; treatment adherence; unvaccinated; uptake; vaccine acceptance; vulnerable community; young adult

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.

COVID-19 大流行极大地扰乱了许多年轻人（包括年轻人）的日常生活 成长过程中感染围产期艾滋病毒 (YAPHIV) 的人。 YAPHIV 很容易受到不良健康结果的影响 （精神疾病、药物滥用、病毒抑制率低）在大流行之前由于多方面的影响 艾滋病毒、种族主义和贫困。围产期暴露于艾滋病毒但未感染的 YA (YAPHEU) 已在 类似的弱势群体，但往往无法获得与 YAPHIV 相同的服务。在这个R21中，我们将 检查 COVID-19 大流行对受影响年轻人的应对和行为健康的影响 艾滋病毒 (EPOCH-HIV) 旨在为解决行为健康问题和艾滋病毒的护理和干预措施提供信息 受艾滋病毒影响的黑人和拉丁裔青少年的治疗和预防。纵向利用资源 YAPHIV 和 YAPHEU 队列（CASAH；R01-MH69133），以及我们与东北/加勒比地区的合作 艾滋病教育培训中心（NECA AETC），我们将告知量身定制行为和身体健康 在 HIV 和 COVID-19 大流行重叠的时代，满足受 HIV 影响的青少年的需求。 CASAH 收集了有关 YAPHIV 和 YAPHEU 的大量社会心理、精神病学和行为数据，并且 2003 年（n=340；平均年龄 12 岁）至今（平均年龄 27 岁）的健康结果（包括艾滋病毒结果） 年）。为了实现 EPOCH-HIV 的目标，我们将使用潜在类别分析 (LCA)（目标 1）来识别大流行 基于流行病相关的经历类型（即严重影响、中度影响、轻微影响） 心理社会因素的变化（例如，失去工作/住房、创伤）。然后我们将探讨风险和保护因素 这些类型（例如，种族/民族、性别、PHIV 状况、社会支持）以及之间的关系 大流行经历类型和以下结果： (a) 行为健康（即心理健康、物质健康 使用），(b) 疫苗和加强接种，c) 身体健康（例如体重指数、医疗保健就诊），以及 (d) YAPHIV 病毒抑制。我们将从每种类型的参与者中进行抽样，定性地检查 COVID-19 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) 疫苗和加强接种，以及 (c) 身体健康，以及 (d) YAPHIV 护理。我们的 多学科团队拥有传染病、COVID-19、心理健康、YA、围产期艾滋病毒、 定性方法、移动医疗、 结构性种族主义、创伤以及心理和行为干预 发展，并共同处于开展这项工作的独特地位。公共健康影响：EPOCH 将使用 采取严格和创新的方法来确定并开始解决 COVID-19 大流行如何影响 受艾滋病毒影响的青少年的行为和身体健康及护理。我们与 NECA AETC 和领导者的合作伙伴关系 卫生服务方面的工作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调整医疗服务提供信息 解决 NIH OAR 优先事项的服务：1) 减少艾滋病毒发病率和治疗方面的健康差距 结果，2) 解决艾滋病毒合并症，3) 产生实质性的研究到实践的临床影响。