Document text
Principal Investigator: DAVID D. CELENTANO
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2020
Award: $159,411
Funding agency: National Institute on Drug Abuse
ABSTRACT
Current data suggest a disproportionate burden of COVID-19 illness and death among racial and ethnic minority
groups.1,2 In multiple urban cities across the United States (U.S.) Black and Latinx persons are disproportionately
impacted by COVID-19 illness and death.1,3-5 Disproportionate rates are likely the result of concomitant
comorbidities, and adverse social determinants of health, including high rates of substance use (SU), mental
health, structural racism, high population density, inadequate housing, and poor access to healthy foods.6,7 The
same social determinants of health that predispose communities to COVID-19 illness, contribute to high
rates of HIV in Black and Latinx sexual and gender minority youth (aged 15-24 ) (SGMY). COVID-19 will
likely worsen social and economic inequalities, which predispose Black and Latinx SGMY to SU and to HIV.
Exacerbated inequalities will also like result in further disruption of the HIV prevention and treatment cascades.8
The national strategy, Ending the HIV Epidemic (EHE), seeks to diagnose, treat and prevent onward infection in
communities hardest hit by HIV, particularly Black and Latinx SGMY. High rates of substance use12 in BLSGMY
has been identified as a key factor in treatment and prevention non-engagement, 13-15 and increased substance
use may occur during the COVID-19 pandemic as a coping mechanism. SARS-CoV-2, which causes COVID-19,
preferentially attacks the lungs, making YBLSGMY who smoke tobacco or marijuana, particularly at-risk.16-19 We
will use a sequential explanatory mixed methods design, inclusive of cross-sectional surveys among 200 PUSH
participants (both assigned male and female participants) (aim 1) and qualitative data of 48 participants and
their service providers (aims 2-3), to understand potential ways in which the COVID-19 epidemic has affected
personal life circumstances, risk behaviors, and health seeking behaviors; community barriers to COVID-19
prevention and treatment; and coping mechanisms to address psychosocial distressed experienced during this
time. Specific Aim 1: Using a cross-sectional survey among 200 Black and Latinx SGMY enrolled in PUSH to
characterize the psychosocial (including school closures, job loss, mental health and SU) disruptions and access
barriers to HIV prevention, treatment and substance treatment services due to COVID-19. Specific Aim 2:
Qualitatively describe how psychosocial disruptions due to COVID-19 alters BLSGMY’s access to HIV
prevention, treatment and substance treatment services and the coping mechanisms used to address disruptions.
Specific Aim 3: Identify potential community barriers to COVID-19 treatment and prevention among BLSGMY
and their service providers and how such experiences of medical mistrust and misinformation impact
experiences of social disruption in BLSGMY. Potential barriers will be explored using paired depth interviews
of BLSGMY and their providers. This supplement allows the team to better understand how the COVID-19
pandemic contributes to limited access for HIV prevention, treatment and substance treatment services, and
how potential community barriers and assigned sex at birth modifies this relationship.
Terms: <2019 novel coronavirus><2019-nCoV><AIDS Virus><AIDS prevention><AOD use><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adherence><Adolescent><Adolescent Youth><Affect><Alcohol or Other Drugs use><Baltimore><Birth><COVID-19><COVID-19 epidemic><COVID-19 pandemic><COVID19><COVID19 epidemic><COVID19 pandemic><Caring><Cessation of life><Cities><Communities><Cross Sectional Analysis><Cross-Sectional Analyses><Cross-Sectional Studies><Cross-Sectional Survey><Data><Data Collection><Death><Diagnosis><Differences between sexes><Differs between sexes><Disease Frequency Surveys><Distress><Economics><Enrollment><Epidemic><Face><Female><Funding><Gender and Sexual Minorities><Grant><HIV><HIV Infections><HIV Prevention><HIV/AIDS prevention><HTLV-III Infections><HTLV-III-LAV Infections><Health><Health Food><Housing><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Inequality><Infection><Interview><Jobs><LAV-HTLV-III><Life><Lung><Lung Respiratory System><Lymphadenopathy-Associated Virus><Marijuana><Medical><Mental Health><Mental Hygiene><Methods><Minority Groups><Misinformation><NIDA><National Institute of Drug Abuse><National Institute on Drug Abuse><Occupations><Parents><Participant><Parturition><Persons><Philadelphia><Population><Population Density><PrEP><Prevention><Professional Positions><Provider><Psychological Health><Reporting><Risk><Risk Behaviors><Risky Behavior><SARS-CoV-2><SARS-CoV2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related coronavirus 2><Sampling><Schools><Severe acute respiratory syndrome coronavirus 2><Sex Differences><Sexual and Gender Minorities><Sexual differences><Structure><THC co-use><THC use><Tetrahydrocannabinol co-use><Tetrahydrocannabinol use><Time><Tobacco smoke><United States><Viral><Virus-HIV><Washington><Wuhan coronavirus><Youth><Youth 10-21><aged><at risk behavior><cannabis use><co-morbid><co-morbidity><comorbidity><coping mechanism><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><coronavirus disease 2019><coronavirus disease 2019 epidemic><coronavirus disease 2019 pandemic><design><designing><enroll><ethnic minority><ethnic minority population><experience><faces><facial><health seeking behavior><healthy food><infection rate><infection risk><juvenile><juvenile human><male><marihuana><marijuana use><pandemic><pandemic disease><pre-exposure prophylaxis><prevent><preventing><psychosocial><pulmonary><racial minority><racism><rate of infection><service providers><sex><sex-dependent differences><sex-related differences><sex-specific differences><social><social health determinants><substance use><substance using><treatment services><uptake><using substances>