Southern HIV and Alcohol Research Consortium Administrative and Research Support Core

摘要 目前尚不清楚冠状病毒（COVID-19）大流行是否对艾滋病毒结果产生了不同的影响， 农村或少数民族人口的饮酒行为。了解COVID-19如何改变艾滋病毒护理 和酒精使用可以加强未来的艾滋病毒和酒精护理提供，以提高这些人的复原力， 程序. 2019冠状病毒病也对健康研究产生了不利影响。这种向远程医疗的转变 帮助临床医生和研究人员与难以接触的人群建立联系的潜力。但我们需要 了解艾滋病毒感染者（PLWH）远程保健的可行性和可接受性，如果我们要扩大 研究和改善未来的酒精干预措施和艾滋病毒护理的提供。该请求 U24 AA 022002的补充，为南部艾滋病毒酒精研究提供支持性基础设施 联盟（SHARC），包括FL队列。FL队列的目标是更好地了解障碍 和抑制病毒的促进者，重点是酒精的使用。然而，计划的FL队列将无法 以区分酒精使用或艾滋病毒护理的变化是否是由于COVID-19， 从农村或海地社区，以评估这些服务不足的人口的差异影响。这 补充将有助于确定与COVID相关的社会隔离和COVID疾病如何影响 艾滋病毒护理连续性，酒精使用和治疗，以及接受远程保健，在NOT-AA-20中表示的兴趣- 011和高度优先的艾滋病毒研究领域。本附录的目的是：1）确定 COVID疾病和心理社会因素的相关变化（例如，孤独，社会支持，经济 不安全、家庭暴力）对酒精使用和艾滋病毒相关护理和健康结果（抗逆转录病毒治疗依从性、护理 参与度和病毒抑制）; 2）延长FL 将农村地区和海地社区的招募进行分组，并比较心理社会影响， 在农村与城市环境中以及在海地社区内，3)评估 可行性，可接受性，以及对远程注册和数据收集的兴趣，以供研究和交付 酒精干预和艾滋病毒临床护理的患者和提供者，并比较最佳策略 跨社会人口统计群体（例如，年龄组、农村与城市、族裔群体）。我们将实现这些目标 目的是在母FL的现有措施中增加额外的COVID相关问卷 队列研究，从农村地区和海地社区招募150人， 将完成一个单一的，“轻”的研究版本，并进行定性访谈，从PLWH 和医疗保健人员，以更好地了解我们如何从危机中学习，以适应新的 干预措施。这项研究将通过直接告知与实施酒精相关的战略产生影响。 和艾滋病毒干预措施，扩大我们对新的传染病大流行的影响的了解 饮酒和艾滋病毒的结果，并通过提高我们的队列样本的整体代表性。

Abstract It is not clear whether the coronavirus (COVID-19) pandemic has differentially affected HIV outcomes or drinking behavior among rural or ethnic minority populations. Understanding how COVID-19 changes HIV care and alcohol use could strengthen future HIV and alcohol care delivery to increase the resilience of these programs. Access to health research is also adversely affected by COVID-19. This shift to telehealth has potential to help clinicians and researchers connect with hard-to-reach populations. However, we need to understand feasibility and acceptability of telehealth by persons living with HIV (PLWH) if we are to extend research and improve delivery of alcohol interventions and HIV care in the future. This request is supplementary to U24AA022002, providing supportive infrastructure to the Southern HIV Alcohol Research Consortium (SHARC), including the FL Cohort. The objective of the FL Cohort is to better understand barriers and facilitators to viral suppression, focusing on alcohol use. However, the planned FL Cohort will not be able to distinguish if changes in alcohol use or HIV care are due to COVID-19, and will not have sufficient persons from rural or Haitian communities to assess differential effects in these underserved populations. This supplement will help determine how COVID-related social isolation and COVID disease have influenced the HIV care continuum, alcohol use and treatment, and acceptance of telehealth, stated interests in NOT-AA-20- 011 and high priority HIV research areas. The aims of this supplement are to: 1) Determine the impacts of COVID disease and related changes in psychosocial factors (e.g., loneliness, social support, economic insecurity, domestic violence) on alcohol use and HIV-related care and health outcomes (ART adherence, care engagement, and viral suppression) as assessed before and during social distancing measures; 2) Extend FL Cohort recruitment into rural areas and the Haitian community, and compare the psychosocial effects, changes in drinking, and HIV-related outcomes in rural vs. urban settings and within the Haitian community. 3) Assess the feasibility, acceptability, and interest in remote enrollment and data collection for research, and delivery of alcohol interventions and HIV clinical care among patients and providers, and compare optimal strategies across socio-demographic groups (e.g., age cohort, rural vs. urban, ethnic groups). We will accomplish these aims by adding an additional COVID-related questionnaire to the existing measures in the parent FL Cohort study, recruiting and additional 150 persons from rural areas and the Haitian community who will complete a single, “light” version of the study, and conducting qualitative interviews from PLWH and healthcare personnel to better understand how we can learn from the crisis to adapt new interventions. The study will have impact by directly informing strategies related to implementation of alcohol and HIV interventions, by expanding our knowledge related to the impact of a new infectious disease pandemic on drinking and HIV outcomes, and by enhancing the overall representativeness of our cohort sample.