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Principal Investigator: Keri Nicole Althoff
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2023
Award: $2,035,602
Funding agency: National Institute of Mental Health
PROJECT SUMMARY
Approximately half of all people with HIV (PWH) in the United States (US) have one or more mental health
disorder. Ending the HIV Epidemic in the US requires addressing the mental health needs of, and
improving HIV treatment outcomes for, PWH with mental health disorders. The goal of this project is to
advance our understanding of the impact of the COVID-19 pandemic – a disruption to HIV research and care –
on the mental health and HIV treatment outcomes of PWH in the US.
The COVID-19 pandemic is a significant risk to mental health. Mental health symptoms among PWH have
been exacerbated during the COVID-19 pandemic due to physical distancing restrictions, increased material
hardship, decreased social support, concerns about COVID-19 exposure, infection and long COVID, and
disruption to mental health services. Beyond symptoms, an important question remains unanswered: “Did
COVID-19 increase the burden of diagnosed mental health disorders and/or psychiatric-related
hospitalizations in PWH?” Mitigation policies to reduce the spread of SARS-CoV-2 led to restricted access to
routine non-emergent healthcare, interfering with routine HIV monitoring and perhaps increasing
hospitalizations particularly among PWH with mental health disorders, posing the question: “Was the
frequency of unsuppressed HIV viral load and hospitalization different in PWH with (vs. without)
diagnosed mental health disorders before and during the pandemic?”
Our team consists of clinicians and epidemiologists with expertise in mental health, HIV, and COVID-19. We
propose to leverage the research infrastructure of the North American AIDS Cohort Collaboration on Research
and Design (NA-ACCORD), the largest and most diverse collaboration of longitudinal HIV cohorts in the US, to
examine the COVID-19-related impact on mental health and HIV treatment outcomes. The specific aims for
this 3-year project are:
Aim 1: To examine trends and differences in the incidence rates of mental health diagnoses and
psychiatric-related hospitalizations among PWH in the US before and during the COVID-19 pandemic.
Aim 2. Aim 2. To evaluate the extent to which mental health- disparities in the rates of unsuppressed
HIV viral load and all-cause hospitalization widened during the COVID-19 pandemic among PWH.
This study directly addresses the priorities of the National Institute of Mental Health in the funding opportunity
Urgent Award: COVID-19 Mental Health Research (PAR-22-113). Our aims will rapidly generate critical
evidence of the impact of the COVID-19 pandemic on the mental health and HIV treatment outcomes among
PWH in the US (overall and within 9 key subgroups), inform strategies to mitigate such impacts on PWH during
and after the COVID-19 pandemic, and improve preparedness for future public health emergencies.
Terms: <2019 novel corona virus><2019 novel coronavirus><2019-nCoV><AIDS><AIDS Virus><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immuno-Deficiency Syndrome><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Acquired Immunologic Deficiency Syndrome><Address><American><Anxiety><Award><Binding><Bipolar Affective Psychosis><Bipolar Disorder><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 exposure><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><COVID-19 public health crisis><COVID-19 virus><COVID19><COVID19 crisis><COVID19 epidemic><COVID19 global health crisis><COVID19 global pandemic><COVID19 health crisis><COVID19 pandemic><COVID19 public health 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Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 exposure><Severe acute respiratory syndrome coronavirus 2 pandemic><Severe acute respiratory syndrome related corona virus 2><Social Distance><Social support><Subgroup><Symptoms><Time><Transmission><Treatment outcome><United States><Venous blood sampling><Viral><Viral Burden><Viral Load><Viral Load result><Virus-HIV><Visit><Vulnerable Populations><Wuhan coronavirus><access restrictions><bipolar affective disorder><bipolar disease><bipolar illness><care facilities><chronic COVID><chronic COVID-19><chronic novel coronavirus disease 2019><clinical care><cohort><corona 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SARS-CoV-2><exposure to SARS-CoV2><exposure to Severe acute respiratory syndrome coronavirus 2><exposure to coronavirus disease 2019><future pandemic><hCoV19><health care><health care policy><health disparity><healthcare policy><improved><long haul COVID><long haul COVID-19><long haul coronavirus disease><long haul coronavirus disease 2019><long-hauler COVID><long-hauler COVID-19><long-hauler coronavirus disease 2019><long-hauler syndrome><long-term COVID><long-term COVID-19><long-term coronavirus disease><long-term coronavirus disease 2019><longterm COVID><longterm COVID-19><longterm coronavirus disease><longterm coronavirus disease 2019><manic depressive disorder><manic depressive illness><medical appointment><mental health care><mental healthcare><mental illness><mortality><mpox><nCoV2><next pandemic><pandemic><pandemic disease><post COVID syndrome><post COVID-19 syndrome><post acute COVID syndrome><post acute COVID-19><post acute COVID-19 syndrome><post acute SARS-CoV-2><post acute 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