LSUHSC-NO Comprehensive Alcohol-HIV/AIDS Research Center

Abstract Administrative Supplement Research Component 1 (RC1) Comprehensive Alcohol ResearchCenter. Community and Interpersonal Stress, Alcohol, and Chronic Comorbidities among PLWH.Louisiana had the third highest rates of SARS-CoV-2 cases and the second highest deaths per capita in thecountry during the peak of the COVID-19 pandemic. The alarming high rate of mortality in New Orleans led tostrict government issued mandates for social distancing, self-quarantine, and shelter-in-place measures addingchallenges like unemployment, loss of social networks, fear, and decreased access to personally deliveredhealthcare to the most vulnerable individuals. These stressful factors negatively impact pre-existing symptomsof stress, anxiety, and depression and may have unwanted consequences that contribute to morbidity andmortality of vulnerable populations. Persons living with HIV (PLWH) have an excessively high rate of exposureto chronic and lifetime social stressors, that are linked to elevated rates of poorer mental health includingdepressive disorders, alcohol use disorders (AUD), and post-traumatic stress disorder (PTSD). Alcoholconsumption tends to increase during times of duress and uncertainty, and alcohol is often misused to copewith stress, anxiety, and other uncomfortable emotions. Psychiatric comorbidities decrease adherence toantiretroviral therapy and increase risk for substance use that together may increase risk for comorbidities ornegatively impact disease progression particularly in aging PLWH. Heightened psychosocial and physiologicalstress among PLWH is associated with poorer immune status, increased viral load over time, faster diseaseprogression, and higher rates of mortality. Our overarching hypothesis is that PLWH with AUD experiencegreater psychobehavioral and biological consequences of the COVID-19 pandemic. This administrativesupplement proposes studies within the scope of those proposed in Specific Aim 1 of RC1: To examine theimpact of neighborhood and interpersonal stress on alcohol use and its associated comorbidities inPLWH. This aim tests the hypotheses that a) Contextual stressors will be associated with alcohol use as wellas clinical comorbidities (e.g., mental health, cardiometabolic conditions, neurocognitive impairment, andfrailty) and b) Alcohol use mediates the relation between stress and clinical comorbidities. We propose toobtain self-reported measures of stress, anxiety, depression, and alcohol use of PLWH and HIV seronegativesubjects enrolled in our longitudinal New Orleans Alcohol Use in HIV (NOAH) study during the pandemic.Quantitative and qualitative data collected during the government mandated shelter-in-place and within 2months of reopening of the city will be integrated with individual level demographic, clinical (includingserological immunological evidence of exposure), behavioral (alcohol use), and disease-specific (HIV viralloads and CD4/CD8 counts) data to determine the impact of COVID-19 related stress on drinking behavior,adherence to ART, and manifestation of anxiety symptoms. Moreover, we will elucidate the interaction ofCOVID-19 related stress and alcohol drinking during this stressful period with risk for comorbidities in PLWHand HIV seronegative individuals. These studies directly integrate in the overall framework of our center andleverage existing infrastructure to maximize data collection during this unique timeframe.