Grant: RFA-AI-22-024 (PI: Dr. Gorbach)

Overview: Despite the widespread availability of effective antiretroviral therapy in the United States (US), there remains significant numbers of people living with HIV (PLWH) who fail to achieve and or maintain viral suppression (VS). Recent CDC data (2020) indicates persistent disparities with the lowest levels of VS among Blacks (60.4%), people who inject drugs (55.3%), youth ages 13-24 (63.5%) and people residing in rural areas (63.6%). 1 EPI-LOVE will enroll a large, digitally maintained cohort of PLWH in US who are not adequately virally suppressed (>200 copies/mL) and individuals who report prior gaps in HIV care engagement or lack of sustained VS. The research cohort will be followed over time to prospectively investigate trajectories of HIV care engagement and VS, as well as the temporal antecedents and multilevel factors that drive changes in care engagement, antiretroviral adherence, and VS. Key among these are substance use, mental health, and barriers to HIV care including stigma and physical distance from clinics/care.

Synopsis: 1 Recruit and retain a geographically and demographically diverse cohort of PLWH who are sub-optimally engaged in care and with a history of, at high risk for, or currently not virally suppressed. 2 Evaluate longitudinal patterns of care engagement and VS within the cohort by modeling and advanced epidemiologic methods utilizing a remote collection of biomarkers of HIV disease (e.g., viral load), online surveys, and brief, frequent app-based “check-ins”. 3 Develop and deploy a suite of just-in-time digital interventions targeting those in the cohort who are experiencing or at high risk for viral non-suppression (VNS).

Funder: National Institutes of Health

References 

  1. HIV Treatment as Prevention | HIV Risk and Prevention | HIV/AIDS at
    https://www.cdc.gov/hiv/risk/art/index.html.