Southern HIV and Alcohol Research Consortium Administrative and Research Support Core

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 careand alcohol use could strengthen future HIV and alcohol care delivery to increase the resilience of theseprograms. Access to health research is also adversely affected by COVID-19. This shift to telehealth haspotential to help clinicians and researchers connect with hard-to-reach populations. However, we need tounderstand feasibility and acceptability of telehealth by persons living with HIV (PLWH) if we are to extendresearch and improve delivery of alcohol interventions and HIV care in the future. This request issupplementary to U24AA022002, providing supportive infrastructure to the Southern HIV Alcohol ResearchConsortium (SHARC), including the FL Cohort. The objective of the FL Cohort is to better understand barriersand facilitators to viral suppression, focusing on alcohol use. However, the planned FL Cohort will not be ableto distinguish if changes in alcohol use or HIV care are due to COVID-19, and will not have sufficient personsfrom rural or Haitian communities to assess differential effects in these underserved populations. Thissupplement will help determine how COVID-related social isolation and COVID disease have influenced theHIV 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 ofCOVID disease and related changes in psychosocial factors (e.g., loneliness, social support, economicinsecurity, domestic violence) on alcohol use and HIV-related care and health outcomes (ART adherence, careengagement, and viral suppression) as assessed before and during social distancing measures; 2) Extend FLCohort recruitment into rural areas and the Haitian community, and compare the psychosocial effects, changesin drinking, and HIV-related outcomes in rural vs. urban settings and within the Haitian community. 3) Assessthe feasibility, acceptability, and interest in remote enrollment and data collection for research, and delivery ofalcohol interventions and HIV clinical care among patients and providers, and compare optimal strategiesacross socio-demographic groups (e.g., age cohort, rural vs. urban, ethnic groups). We will accomplish theseaims by adding an additional COVID-related questionnaire to the existing measures in the parent FLCohort study, recruiting and additional 150 persons from rural areas and the Haitian community whowill complete a single, "light" version of the study, and conducting qualitative interviews from PLWHand healthcare personnel to better understand how we can learn from the crisis to adapt newinterventions. The study will have impact by directly informing strategies related to implementation of alcoholand HIV interventions, by expanding our knowledge related to the impact of a new infectious disease pandemicon drinking and HIV outcomes, and by enhancing the overall representativeness of our cohort sample.