Posts classified under: Risk

Battling Stigma for Service Engagement among Women with HIV in Vietnam

Abstract:Women living with HIV/AIDS (WLHA) bear a higher level of stigma because of their socio-cultural vulnerabilities. Women are more likely to internalize social stigma and produce a sense of shame and loss of self-worth, which results in a delay in health service seeking and compromised health outcomes. In Vietnam, stigma towards WLHA is exacerbated by the deeply rooted female inferiority culture. However, research targeting WLHA is generally lacking. We propose this study to address stigma among WLHA and explore the use of virtual support system in WLHA’s service engagement in Vietnam. The 2-year study will proceed in two phases in Hanoi, Vietnam. Phase 1 will be formative studies, including in-depth interviews with 30 WLHA and focus groups with 20 service providers and community stakeholders. This phase aims to investigate the cultural and contextual background of HIV and gender roles in Vietnam and to identify effective strategies to support and engage WLHA in healthcare. These formative findings will inform the development of an intervention to be pilot tested in the next phase. Phase 2 will be a 6-month intervention pilot with 90 WLHA using an online/offline hybrid approach. During Month 1 of the pilot, WLHA will participate in an in-person section to form mutual support groups and prepare for the following online components. During Month 2-4 of the pilot, study investigators will teach WLHA a series of empowerment strategies to cope with stigma and utilize social support to seek healthcare services. These skills will be taught via interactive online group activities. During Month 4-6, WLHA will self-administer the online groups without the intervention of study investigators. WLHA’s multidimensional stigma measures, mental health burdens, and service use self- efficacy will be assessed at baseline, month 4, and month 6. Progress data of the intervention will be documented to inform the feasibility and sustainability of the online support approach. Acceptability data and feedback will be collected from the WLHA participants upon completion of the 6-month pilot period.

Project Number: 1R21TW012018-01

https://reporter.nih.gov/search/9c5dRBJyvkGOpSB3l9HRSw/project-details/10302007

 

Contact PI/ Project Leader

LIN, CHUNQING,  (lincq@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV stigma and discrimination have enormous negative impacts on women, and reducing internalized stigma has significant implications for the effort to engage women in HIV prevention and care. This proposed study will devise strategies to empower women living with HIV in Vietnam to combat HIV and gender intersectional stigma. This study will lead to implementable and scalable approaches to promote women living with HIV’s mental health and service seeking not only in Vietnam but also globally.

 

 

Project Start Date: 17-September-2021

Project End Date: 31-May-2023

Budget Start Date: 17-September-2021

Budget End Date: 31-May-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF DRUG ABUSE + FOGARTY INTERNATIONAL CENTER / FY Total Cost by IC: $219,421

Engaging Seronegative Youth to Optimize HIV Prevention Continuum

Abstract:Young people at highest risk for HIV in the U.S. will be gay, bisexual transgender youth (GBTY) and homeless youth (HY) in communities with high HIV incidence and overwhelmingly Black and Latino. Focusing on Los Angeles and New Orleans, seronegative youth at highest risk for HIV will be screened in homeless shelters and gay-identified community-based organizations (CBO). A cohort of 1500 seronegative youth will be recruited that is 82% male (79% GBTY), 66% Black, 16% Latino, and 18% white, non-Hispanic. About 27% will be 12-17 and 73% between 18-24 years old. All youth will be followed longitudinally over 24 months at four month intervals and tested for HIV, STI, serious substance abuse, health care utilization, and comorbid conditions – a Prototypical Retention/Prevention (R/P) Strategy. Over 24 months, acutely HIV infected youth will be triaged to Study 1. This Prototypical R/P Strategy operationalizes the CDC’s recommendations for the engagement of GBTY in repeat HIV testing, linkage to care, and options for combination prevention (PrEP, PEP – with behavioral interventions). Building on this team’s extensive experience with behavioral and mobile/social media interventions, a randomized controlled trial (RCT) will be conducted with four intervention conditions: 1) an Automated Messaging and Monitoring Intervention (AMMI), which will use texts to diffuse prevention messages daily and to monitor risk behaviors weekly (n=900); 2) a Peer Support intervention on a social media platform (i.e., Facebook) in which young people will post messages and stories about their experiences preventing HIV, plus the AMMI (n=200); 3) an eNavigator intervention in which a B.A.-level staff supports youth, primarily through texting and social media, but also in-person meetings, to provide support in crisis situations, refer to treatment, and assist in gaining access to health care and other services, plus Peer Support and AMMI (n=200); and, 4) a combined intervention of eNavigator, Peer Support, and AMMI (n=200). A single outcome will be composed of six key behaviors (access to medical care, accessing and adherence to PrEP or PEP, treatment of all STI, and 100% condom use). In addition to evaluating the added benefit of increasing levels of intervention, the brief 7- item weekly text-messaging monitoring surveys will provide approximately 100,000 weekly reports of indicators of primary and secondary outcomes that can inform our understandings about the relationships between risk and comorbid states. This study will have policy implications for the allocation of resources to HIV testing resources in local communities, the uptake and scalability of text and social media interventions, and the models for diffusing evidence-based interventions (EBI) globally (without requiring replication with fidelity to a manual).

Project Number: 5U19HD089886-05

https://reporter.nih.gov/search/4vgAl9SY20-gSBejiQexgQ/project-details/10161248

 

Contact PI/ Project Leader

SWENDEMAN, DALLAS TRAVIS, ASSOCIATE PROFESSOR, CENTER CO-DIRECTOR (dswendeman@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:  Unavailable

 

FOA: RFA-HD-16-035/ Study Section: ZHD1-DSR-N

 

Project Start Date: Unavailable

Project End Date: 31-May-2022

Budget Start Date: 01-June-2020

Budget End Date: 31-May-2021

 

NIH Categorical Spending

Funding IC:  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT / FY Total Cost by IC: $200,503

Getting Off: A Theory-based mHealth Intervention for Methamphetamine-using MSM

Abstract: Methamphetamine (MA) use among men who have sex with men (MSM) is associated with increased rates of HIV prevalence and transmission, as well as substandard advancement along the HIV Prevention and Care Continua. MA use among MSM is deeply integrated into socio-sexual networks including the use of smartphone applications (“app”) and websites to find sexual partners. Given the growth of mobile health technology, it is no longer necessary or reasonable to limit MA treatment options to physical sites, clustered in urban areas, and administered using generic, non-tailored content. The project builds upon the established efficacy of our manualized MA-abuse treatment intervention, “Getting Off: A Behavioral Treatment Intervention for Gay and Bisexual Male Methamphetamine Users,” and the highly promising findings from our successful Stage I proof-of-concept study, to complete translation of Getting Off into a cross-platform (iOS and Android) app and assess the app’s efficacy and non-inferiority in a scientifically rigorous randomized trial. The Getting Off app, like the group-based intervention before it, will use the principles of Cognitive Behavioral Theory and Stages of Change to help MSM reduce or eliminate MA use and HIV sexual risk behaviors, and increase advancement along the HIV Prevention or Care Continuum (including uptake of HIV testing, pre-, and post- exposure prophylaxis [PEP/PrEP] and PrEP adherence and persistence for those who are HIV negative; ART uptake and adherence for those who are HIV positive). This project will 1) refine and enhance the first 8 sessions of the Getting Off MA-abuse treatment intervention developed in Stage I based on feasibility pilot test user feedback, 2) conduct formative research to develop the remaining 16 sessions of the Getting Off MA- abuse treatment intervention into a cross-platform computerized mobile app targeted to reduce MA use and HIV sexual risk behaviors, and increase advancement along the HIV Prevention or Care Continuum, and 3) conduct a RCT to evaluate reductions of MA use and HIV sexual risk behaviors, and increased advancement along the HIV Prevention or Care Continuum, using three approaches: a) Efficacy Trial – a two-arm RCT to determine intervention effects through comparison of the Immediate Delivery (ID; n=150) and Delayed Delivery (DD; n=150) arms; b) Efficacy Trial – an observed treatment effects analysis to compare pre/post data from the pooled ID and DD conditions (N=300); and, c) Non-inferiority Trial – a two-arm historical matched comparison design to evaluate the outcomes of the Getting Off app (ID + DD; N=300) relative to a matched sample of participants having previously attended the brick-and-mortar group-based Getting Off intervention (N~600; total N=900). The RCT uses repeated measures to assess participants at baseline, 1-, 2- (DD condition only), 3-, 6-, and 9-month follow-up. This study could have significant public health impact by greatly expanding access to effective, affordable, private, culturally competent and highly scalable MA treatment to this very high-risk population.

Project Number: 1R01DA045562-01A1

https://reporter.nih.gov/search/wXqheaHzyUy0u0LsyaI8ew/project-details/9628755

 

Contact PI/ Project Leader

REBACK, CATHY J, PROFESSOR (reback@friendsresearch.org)

 

Organization

FRIENDS RESEARCH INSTITUTE, INC.

 

PUBLIC HEALTH RELEVANCE: Methamphetamine (MA) use among MSM is strongly associated with HIV infection and interrupted progression along the HIV Prevention and Care Continua. This study will complete the development and evaluation of an evidence-based, theory-driven, and culturally competent treatment app for MA-using MSM, designed to reduce or eliminate MA use and HIV sexual risks, increase uptake of HIV testing and pre- and post-exposure prophylaxis (PrEP/PEP), including PrEP adherence and persistence for those who are HIV negative, and increase retention in HIV care and adherence to ART for those who are HIV positive. Given the severe personal and public health consequences of MA use, the public health significance of this app is very high as it will provide this population with a tailored treatment opportunity that is easily accessible, affordable, private, and highly scalable.

 

Project Start Date: 15-July-2018

Project End Date:30-April-2023

Emerging Issues in Minority Aging Research

Abstract: Emerging Issues in Minority Aging Research will create five different one-day conferences on current NIA priority areas relevant to minority aging research. The conference series goal is to increase the quality, quantity, and relevance to communities of color of NIA-fundable research by providing both junior and senior researchers with new knowledge and greater interest in these emerging issues as applied to minority elderly. This is significant because the U.S. racial and ethnic minority older population is growing rapidly: minorities will increase from 25% to over 40% of the older population between 2020 and 2050. Protecting and improving the health of these elderly requires a highly skilled research workforce with interests and capabilities to produce new and useful knowledge. Yet the number and success of minority researchers funded by NIH is insufficient. The NIA’s Resource Centers for Minority Aging Research (RCMAR) program works to mentor and train junior faculty who conduct research on minority aging to strengthen the next generation of NIA-funded ethnic and racial minority research and researchers. Conferences topics are: Recruitment and retention of elders of color; Access to care & improved outcomes for cognitively impaired minority elderly; Applying the science of behavior change to intervention development for elders of color; Pragmatic intervention trials with minority elders; and Using biological measures of risk in health disparities research with older adults. Each will feature leading scholars on the topic, top scholars on minority aging, and representatives from multiple NIA-funded centers and networks. The programs will disseminate the state of the art on the topic, inform researchers on how existing research can be modified or expanded to be more valid and relevant for minority elders, and provide resources that can be used by researchers to further develop the fields in research with minority elders. They will be held as preconferences to the Gerontological Society of America (GSA) annual scientific meetings with an average of 50 participants each; the majority will be minorities and/or women. The planning committee will be compromised of the confirmed keynote speakers who are leaders in the field and researchers from RCMAR sites with expertise in the topic. The executive committee will be the RCMAR directors group. The project is innovative in the topics covered, the research networks involved, and the synergy with GSA. Program evaluation includes a process evaluation, a retrospective pre/post knowledge and confidence survey, and four-month follow-up survey on conference impacts. The lead investigators are national leaders in minority and aging research who have successfully led previous GSA preconferences. This proposal is a renewal of the previous successful series with new topics but similar objectives of improving the knowledge and interest in emerging issues supported by NIA among those with research agendas in minority aging and raising awareness of minority aging among leading researchers in each topic.

Project Number: 2R13AG023033-16

https://reporter.nih.gov/search/YfhOgZ8LmEm_RStNdvCEhA/project-details/9913950

 

Contact PI/ Project Leader

WALLACE, STEVEN PAUL,PROFESSOR OF COMM.HEALTH SCI. (SWALLACE@UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:Emerging Issues in Minority Aging Research: This project will create five different one-day conferences on current NIA initiatives that are relevant to minority aging research. The goal of the proposed conference series is to increase the quality, quantity, and relevance to communities of color of NIA-fundable research by providing both junior and senior researchers with new knowledge and greater interest in these emerging issues as they apply to minority elderly.

 

 

Project Start Date: 15-September-2019

Project End Date: 31-May-2024

Budget Start Date: 15-September-2019

Budget End Date:31-May-2020

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON AGING/ FY Total Cost by IC: $50,000

Biobehavioral Research Approaches to reduce Effects of Trauma on Mental and Physical Health and Cognitive Outcomes in South Africa

Abstract: The UCLA/South African Trauma Training Research (Phodiso) Program seeks five additional years of funding to prepare future investigators to conduct research on trauma exposure and injury prevention in the context of South Africa’s high levels of interpersonal and community violence and intentional injuries. The Phodiso Program is an international collaboration between UCLA and the South African Research Consortium (SARC), which includes the Human Sciences Research Council (HSRC), North-West University (NWU), and University of Cape Town (UCT) and is based on a number of NIH-funded projects: 1) The Eban Project, a randomized clinical trial testing a culturally congruent intervention for HIV serodiscordant African American couples (R01; 2001-2009; El Bassel, et al., 2010); 2) The Implementation of the Eban Project, (NIH RO1; 2012-2017) 3) The Aftermath of Rape among South African Women (The Fulufhelo Project), a study examining the short- and long-term psychosocial sequelae of rape among South African women (R03; 2009-2013); and 4) The HIV/AIDS Substance use and Trauma Training Program for racial and ethnic minority postdoctoral scholars and early career investigators (R25; 2013-2018) (Wyatt and Milburn, co-PIs). Guided by ecological theory, social learning theory, and the Sexual Health Model, the focus of the Phodiso Scholar’s research will be to minimize the negative health and mental health effects of trauma exposure, specifically depression and post-traumatic stress disorder (PTSD), in South Africa. An additional emphasis of the training will focus on the neurobiological and neurobehavioral manifestations of trauma, disease, substance use and intentional injury. In the past 10 years of funding, a total of eleven scholars have graduated from the Phodiso program and will join the core SARC and the TAMT, to assist with mentoring new Scholars. For this renewal, the UCLA and SARC core faculty and TAMT will conduct a countrywide application process to select one early career research candidate per year for a two-year postdoctoral fellowship. Scholars will receive research mentorship including a quarter of study (i.e., a 3-month period) at UCLA, one selection and planning meeting and one short-term trauma workshop each year in South Africa. Scholars will conduct their own research projects in South Africa as a basis for future studies in this field, and work closely with their SARC host university and TAMT mentors. The Phodiso Trauma Training program and the research careers of the scholars will be tracked over time. Specifically, the sustainability of the training program and integration into academic, private, and government-supported agencies and the Scholar’s ability to establish and sustain independent research careers will be evaluated and documented. Future goals will include encouraging the South African government to adopt the Phodiso program as a successful and replicable model of cross-cultural trauma research training.

Project Number: 2D43TW007278-11

https://reporter.nih.gov/search/3mBMfcaKOkGk9o8D_fB3Zw/project-details/9232020

 

Contact PI/ Project Leader

WYATT, GAIL E, PROFESSOR (GWYATT@MEDNET.UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Myanmar has experienced one of the most serious HIV/AIDS epidemics in Southeast Asia. Because the country has been isolated from the rest of the world for 50+ years, there are very few researchers and public health specialists trained in advanced research methodologies who can do research to guide HIV/AIDS policy and staff the Myanmar University of Public Health. This program will address that need by providing degree and postdoctoral training in advanced research methodology.

 

 

Project Start Date: 25-May-2005

Project End Date: 31-August-2021

Budget Start Date: 15-September-2016

Budget End Date: 31-August-2017

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER + OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH/ FY Total Cost by IC: $269,997

Evaluation of pre-exposure prophylaxis cascade in pregnant and breastfeeding women in Cape Town, South Africa

Abstract: HIV-uninfected pregnant and breastfeeding women in South Africa are at high risk of HIV acquisition despite increased uptake of antiretroviral therapy (ART) and maternal seroconversion during pregnancy and breastfeeding contributes significantly toward pediatric HIV infections. Comprehensive HIV prevention programs that include biomedical interventions, such as pre-exposure prophylaxis (PrEP), could dramatically reduce HIV incidence in pregnant and breastfeeding women in high HIV incidence areas and reduce vertical HIV transmission. The overarching goal of this proposal is to evaluate the feasibility and acceptability of integrating PrEP into antenatal and postnatal care, to describe the cascade in women initiating PrEP in this setting, and to evaluate the reasons for attrition along the PrEP cascade in a cohort of pregnant and breastfeeding women Candidate: I am an HIV epidemiologist with a background in HIV research and program development, implementation in Africa. I am applying for a five-year Fogarty IRSDA K01 award to obtain training, mentorship, and research experience to become an independent investigator capable of obtaining R01 funding. Mentoring: I have put together an exceptional multi-disciplinary mentoring team with extensive experience in HIV prevention research in South Africa that integrates clinical research, epidemiology, PrEP and qualitative methods. Drs. Thomas Coates (UCLA) and Landon Myer (University of Cape Town, South Africa) will serve as co-Primary mentors and bring complementary expertise in behavioral science and clinical trials. In addition to my two Primary mentors, my co-mentors provide expertise in specific content areas and methodologies and are based in both the U.S. and South Africa. My co-mentorship team includes: Dr. Pamina Gorbach (U.S.-based, behavioural epidemiologist with significant experience in mixed methods research, Dr. Linda-Gail Bekker (SA-based, clinical trials, PrEP and research in young women). Training: Specific training in clinical trials, advanced biostatistics, behavioural science and mixed methods analysis, will be achieved through intensive mentored training, coursework, workshops and and primary research in South Africa. Guided by my mentorship team, these training and research experiences will establish my independent investigator career as an expert in research in pregnant and breastfeeding women in low resource settings. Research: The specific aims are to: (1) Evaluate the feasibility and acceptability of integrating PrEP into antenatal and postnatal/well-baby services; (2) Describe the PrEP cascade of initiation, retention, and adherence in a cohort of HIV-uninfected pregnant and breastfeeding women, (3) Evaluate attrition and associated factors across the PrEP cascade. The results from our study will provide a model to implement WHO guidance and scale-up PrEP delivery in pregnant and breastfeeding women at risk of HIV and contribute to the elimination of vertical HIV transmission. We will use the formative research to apply for a R01 grant to evaluate interventions to improve retention in the PrEP cascade in a larger cohort of pregnant and breastfeeding women.

Project Number: 5K01TW011187-02

https://reporter.nih.gov/search/07mRB8oPokuMg0OWfAXBVA/project-details/9789716

 

Contact PI/ Project Leader

JOSEPH DAVEY, DVORA POSTDOCTORAL FELLOW (dvoradavey@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV-negative pregnant and breastfeeding women in South Africa are at high-risk of HIV. Pre-exposure prophylaxis (PrEP) is safe and effective at preventing HIV. Our study will evaluate: (1) Acceptability & feasibility of integrating PrEP into ante and postnatal care, (2) the PrEP cascade (initiation, retention, adherence) and (3) Loss to follow up and factors associated with loss in a cascade in 200 pregnant/breastfeeding women.

 

 

Project Start Date: 21-September-2018

Project End Date: 31-January-2023

Budget Start Date: 01-April-2019

Budget End Date: 31-January-2020

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER/ FY Total Cost by IC: $139,018

Innovative strategies to increase ART Initiation and viral suppression among HIV+ men in Malawi

Abstract: Men continue to be missed by HIV testing and treatment services. Index partner testing is a critical strategy for reaching men. Index HIV self-testing (HIVST), whereby ART clients take HIVST kits home to their sexual partners for testing, is a new strategy that dramatically increases index testing among men, and is being taken to scale across Malawi. However, only 25% of men identified as HIV-positive through Index HIVST initiate ART after 6- months. Innovative strategies to increase ART initiation and retention among men are urgently needed. The overarching goal of the proposed K01 is to develop and pilot a home-based ART intervention (ART initiation + 3-months ART care) to increase ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among men who test HIV-positive through Index HIVST in Malawi. Candidate: I am a social scientist with a background in HIV research in sub-Saharan Africa. My long-term goal is to transition from observational social science to clinical trials research in innovative HIV service delivery models among hard-to-reach populations, such as men. I am applying for a five-year K01 award to obtain training, mentorship, and research experience. Mentoring: I have an exceptional multi-disciplinary mentoring team with extensive experience in HIV care and management and clinical trials in the region. The team has complementary expertise in social science and clinical trials in HIV service delivery models (Dr. Thomas Coates – Primary Mentor), best practices in HIV care and management and differentiated models of care in Malawi (Drs. Judith Currier and Risa Hoffman), scalability and sustainability of interventions (Dr. Sundeep Gupta – Malawi-based), and advanced biostatistics (Dr. Ron Brookmyer). Career Development: To achieve my long-term goals, we have developed a detail plan to build skills in four additional areas: (1) best clinical practices for ART care and maintenance; (2) clinical trials in novel approaches to HIV service delivery; (3) advanced statistical methods; and (4) ethics in clinical trials research in low-resource settings. Research Activities: The specific aims accompanying the career development plan are to: (1) Develop a home-based ART intervention for male partners tested through Index HIVST, using in-depth interviews with male Index HIVST users (n=15-20) and their partners (n=15-20), and focus group discussions with key informants (n=18-30). (2) Determine the potential effectiveness of home-based ART versus standard facility-based ART (on ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among male Index HIVST users in a pilot trial with 200 HIV-positive men. Expected Outcomes: Results from this study will inform definitive trial to test home-based ART services for men identified as HIV-positive through index HIVST strategies. The project will also give me the additional skillsets needed to become an independent investigator in clinical trials.

Project Number: 1K01TW011484-01

https://reporter.nih.gov/search/lzNvPVXZdEyO9lcrU7nKLQ/project-details/9889473

 

Contact PI/ Project Leader

DOVEL, KATHRYN L, POSTDOCTORAL FELLOW (KDovel@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Men in sub-Saharan Africa who test HIV-positive continue to have poor ART initiation and retention outcomes. By developing and piloting a home-based ART intervention for men who use index HIV self-testing (HIVST) strategies, the proposed project will provide additional knowledge on how to best reach men with HIV services across the testing and treatment continuum. The project has the potential to improve public health by engaging HIV-positive men across the cascade, a critical population to curbing the HIV epidemic.

 

 

Project Start Date: 16-September-2019

Project End Date: 30-June-2024

Budget Start Date: 16-September-2019

Budget End Date:30-June-2020

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER/ FY Total Cost by IC: $145,233

MWCCS Covid-19 Supplement Activities

Abstract: COVID-19 cases continue to rise, with over 3,000,000 cases and 130,000 deaths in the US and almost 12 million cases worldwide to date. Manifestations of SARS CoV-2 infection range from asymptomatic to mild, moderate, or severe disease, and primarily affects the lung, but increasing data suggests involvement of other organ and blood systems. Studies document more severe disease and higher mortality among people who are older and/or have co-morbidities, such as hypertension, diabetes, obesity, and chronic lung disease. However, there is a paucity of data regarding the acquisition, occurrence and severity of infection among people with HIV (PWH). There is also little data to guide prevention and treatment recommendations for this population, many of whom are older and have comorbidities that may increase not only their risk for acquiring infection, but also the morbidity and mortality among those who acquire infection. Moreover, early reports suggest substantial racial disparities in US COVID-19 rates, with increases in mortality among African Americans. The MACS- WIHS Combined Cohort Study (MWCCS), the largest and longest-running observational cohort of men and women living with or at risk for HIV in the US provides a unique opportunity to address important knowledge gaps in the acquisition, occurrence, severity and outcomes of COVID-19. The MWCCS is a geographically and racially/ethnically diverse cohort of aging men and women with a high prevalence of risk factors for progression to severe COVID-19 disease including hypertension, diabetes, obesity, and smoking. The MWCCS has a rich biorepository of specimens, collects rigorous clinical measures including pulmonary, cardiac, kidney, neurocognitive, and physical function, body composition and has performed cohort-wide genome association studies. The overarching goal of this application is to understand the impact of the COVID-19 epidemic among US men and women with or at risk for HIV infection and to evaluate host factors that contribute to disease acquisition, expression, severity and recovery. The proposed studies will determine COVID incidence, short- term and long-term clinical outcomes, including thrombotic and pulmonary sequelae, and how racial and geographic disparities; immune and genetic risk factors impact these outcomes in the MWCCS.

Project Number: 3U01HL146333-02S3

https://reporter.nih.gov/search/dDP79kXfKka7LIMBd16rtA/project-details/10226756

 

Contact PI/ Project Leader

DETELS, ROGER, PROFESSOR (DETELS@UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: This research would contribute to improved understanding of COVID-19 manifestations, the social factors that drive distribution and outcomes of disease in vulnerable populations, pathophysiologic and genetic factors, as well as the interactions between comorbid conditions, such as HIV. Improved understanding of these factors could improve care and aid development of therapies, and inform efforts to control future outbreaks.

 

FOA: PA-18-591/ Study Section: Unavailable

 

Project Start Date: 01-April-2019

Project End Date: 31-March-2026

Budget Start Date: 11-September-2020

Budget End Date: 31-March-2021

 

NIH Categorical Spending

Funding IC:  NATIONAL HEART, LUNG, AND BLOOD INSTITUTE/ FY Total Cost by IC:$110,256

Behavioral Economics to improve Antihypertensive Therapy Adherence (BETA)

Abstract: Hypertension is one of the most prevalent cardiovascular disease risk factors, with over 45% of the United States population having elevated blood pressure. Decades of research have demonstrated that controlling blood pressure can reduce the risk of serious adverse cardiovascular events including stroke, myocardial infarction, and heart failure. A key component of successfully obtaining control of hypertension is the use of medications to lower blood pressure. Unfortunately, more than 50% of Americans demonstrate medication non-adherence, a statistic that directly contributes to suboptimal blood pressure control and, therefore, excess preventable cardiovascular events. Strong data indicates that linking the taking of medications to daily routines (‘anchoring’) increases adherence, however, existing interventions built on this information have failed to create successful, long term improvements in medication adherence. This study aims to leverage behavioral economic insights to improve medication adherence to antihypertensive medications. Specifically, we propose to complement linking medication taking to a daily routine with two added components to make it easier for participants to stick to their anchoring plan: increasing information salience through frequent text messages and providing intermittent rewards for pill-taking according to the anchoring plan. This study will be implemented in a pilot randomized controlled trial (RCT) in a high-volume clinical practice to establish feasibility, acceptability, and preliminary efficacy. The specific aims include 1) a formative phase to develop the intervention and evaluate its feasibility and acceptability via focus groups with key stakeholders; 2) a RCT of 60 hypertensive patients in which a control group (n=20) is provided education on anchoring medication taking to a daily routine, and two intervention groups, one (n=20) who receives anchoring education and daily text message reminders and another (n=20) which receives anchoring education, text messages, and financial incentives for adherence in accordance with their anchoring plan; and 3) data collection in preparation for a future R01 application, including focus group discussions with key stakeholders (patients, providers [Physicians, Nurses, Advanced Care Practitioners, Pharmacists] and clinic staff) and exit focus groups with study participants regarding ways to improve the intervention. The main hypothesis is: the intervention is effective by anchoring pill-taking to an existing routine, tested by comparing the pooled (Message group + Incentive group) vs. the Control group. The secondary hypothesis is: adding incentives to the text messages is more effective for routinizing pill-taking (testing outcomes in the Incentive group vs. Message group). Outcomes from this study have the potential to greatly enhance our understanding of the barriers and facilitators of medication adherence among hypertensive patients and potentially provide evidence for a low-cost and scalable intervention to improve medication adherence in clinical practice.

Project Number: 1R21HL156132-01

https://reporter.nih.gov/search/dL93-SB4GEav4RQXqIh6Sw/project-details/10108865

 

Contact PI/ Project Leader

EBINGER, JOSEPH, FELLOW (Joseph.Ebinger@cshs.org)

 

Organization

CEDARS-SINAI MEDICAL CENTER

 

PUBLIC HEALTH RELEVANCE: Hypertension represents a major cardiovascular risk factor that can be controlled through the use of medications, yet medication non-adherence represents a common problem that leaves patients at elevated risk for adverse cardiovascular outcomes. Interventions to improve medication adherence have thus far been either unsuccessful or unsustainable. We propose an intervention that leverages insights from behavioral economics to improve medication adherence among hypertensive patients.

 

 

Project Start Date: 01-May-2021

Project End Date: 30-April-2023

Budget Start Date: 01-May-2021

Budget End Date:30-April-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL HEART, LUNG, AND BLOOD INSTITUTE/ FY Total Cost by IC: $282,197

Los Angeles CRS for the MACS/WIHS Combined Cohort Study

Abstract: The UCLA Clinical Research Site (CRS) of the Multicenter AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WIHS) Combined Cohort Study (CCS) proposes to continue to document clinical, immunologic, physiologic, behavioral, virologic, genetic and psychosocial changes in HIV‐infected and ‐uninfected men‐who‐ have‐sex‐with‐men (MSM). This includes proposed studies to document these changes in MSM recruited previously, as well as plans to recruit new untreated and recently treated HIV‐infected MSM (primarily African‐ and Hispanic‐ Americans), to maintain the cohort. The UCLA CRS will provide leadership and participation in the working groups, CCS‐wide and local studies and research publications, as well as collaborative multi‐ cohort studies, as it has since the inception of the MACS 35 years ago. The UCLA CRS has recruited a large team of early career and established co‐investigators from a wide range of disciplines. These investigators have developed, and are continuing to develop, innovative proposals to advance our understanding of co- morbid conditions that arise in people living with treated HIV infection, as well as the pathophysiology, immunology, genetics and bio-behavioral characteristics of treated and untreated HIV infection. The breadth, enthusiasm, experience and innovation of the UCLA CRS investigators, combined with the experience and commitment of the long‐term staff, and our leadership of several areas of HIV/AIDs research, will continue to play an invaluable role in the success of the CCS over the next seven years.

Project Number: 3U01HL146333-02S1

https://reporter.nih.gov/search/2GhA0lGvQUa0Ika5JZbzxA/project-details/10125498

 

Contact PI/ Project Leader

DETELS, ROGER, PROFESSOR (DETELS@UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: This is a proposal to continue the UCLA Clinical Research Site (CRS) of the Multicenter AIDS Cohort Study (MACS) / Women’s Interagency HIV Study (WHIS) Combined Cohort Study (CCS), which studies clinical, immunologic, physiologic, behavioral, virologic, genetic and psychosocial changes in HIV‐infected and HIV‐ uninfected men‐who‐have‐sex‐with‐men (MSM). The ongoing studies of the CCS will provide key information to advance our understanding of co-morbid and iatrogenic conditions occurring in people living with HIV infection (PLWH) receiving anti-retroviral therapy (ART), as well as inform the natural history of HIV at the molecular level, psychosocial determinants of disease and treatment compliance, and factors affecting optimal treatment of PLWH.

 

FOA: PA-18-591/ Study Section: ZHL1(O2)

 

Project Start Date: 15-April-2019

Project End Date: 31-March-2026

Budget Start Date: 01-July-2020

Budget End Date: 31-March-2021

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM/ FY Total Cost by IC:$46,610

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