Document text
Principal Investigator: Shan Qiao
Organization: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
Fiscal Year: 2024
Award: $698,073
Funding agency: National Institute of Allergy and Infectious Diseases
Abstract
The global COVID-19 pandemic has imposed unprecedented pressure on health systems and has interrupted
public health efforts for other major health conditions, including HIV. HIV service interruptions in the forms
of redeployment of staff, reallocation of resources, lack of equipment and medicine (e.g., shortages of HIV/STI
testing kits, strained drug supply chain), and reduced access to care (e.g., travel restrictions, lock downs) may
have a profound and long-term impact on HIV treatment cascade outcomes, especially given the evolving
nature of the pandemic. There are several gaps in the existing literature in addressing HIV service
interruptions and their consequences. These gaps include a lack of using large-scale, real-world, multi-type
data with theoretical guidance; the focus on single or limited HIV treatment cascade outcomes; and limited
efforts to identify factors that can mitigate the negative impacts of such interruptions to inform potential
interventions and capacity building at state or local levels. In response to NOT-AI-21-057, we propose to
comprehensively investigate HIV service interruptions during the COVID-19 pandemic following a
socioecological model, assess their impacts on various outcomes of the HIV prevention and treatment cascade,
and identify resilience resources for buffering impacts of interruptions on HIV treatment cascade outcomes.
Specifically, we will assess HIV service interruptions in South Carolina (SC) since 2020 using operational
report data of Ryan White HIV clinics, in-depth interview data with clinic leaders and providers, and HIV
service utilization data based on both electronic health records (EHR) and publicly available cellphone-based
HIV clinics visitation data. We will further explore how HIV service interruptions affects HIV prevention and
treatment cascade outcomes at appropriate geospatial units based on the integration of multi-type datasets
(e.g., EHR, geospatial data) from multiple sources. Finally, we will identify institutional-, community-, and
structural-level factors (e.g., resilience resources) that may mitigate the adverse impacts of HIV service
interruptions based on the triangulation of quantitative (EHR data, online survey data) and qualitative (in-
depth interviews, focus group discussion) data regarding health infrastructure, social capital, and
organizational preparedness. Our proposed research can lead to a better understanding of complicated HIV
service interruptions in SC and resilience factors that can mitigate the negative effects of such interruptions on
various HIV treatment cascade outcomes. The multi-level resilience resources identified through data
triangulation will assist SC health departments and communities in developing strategic plans in response to
this evolving pandemic and other future public health emergencies (e.g., monkeypox, disasters caused by
climate change). The research findings can also inform public health policymaking and the practices of other
Deep South states with similar sociocultural contexts and experiences of HIV service interruptions during the
pandemic.
Terms: <AIDS><AIDS Virus><AIDS prevention><AIDS test><AIDS/HIV><AIDS/HIV test><Access to Care><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Address><Adherence><Affect><Buffers><CD4 Lymphocyte Count><CD4+ Cell Counts><CD4+ Counts><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 outbreak><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 period><COVID-19 public health crisis><COVID-19 years><COVID19 outbreak><CV-19><Caring><Cell Phone><Cellular Phone><Cellular Telephone><Censuses><Clinic><Clinical><Collaborations><Communities><Coronavirus Infectious Disease 2019><Data><Data Reporting><Data Science><Data Set><Deep South><Diagnostic Reagent Kits><Disasters><Disease Progression><Drugs><Electronic Health Record><Epidemic><Equipment><Focus Groups><Funding><Future><HIV><HIV Prevention><HIV diagnosis><HIV test><HIV-1 test><HIV-2 test><HIV/AIDS><HIV/AIDS prevention><HIV/STD><HIV/STI><Health><Health Care Providers><Health Facilities><Health Personnel><Health Policy><Health Services Accessibility><Health care facility><Health system><Healthcare Facility><Healthcare Providers><Healthcare worker><Hospitals><Human Immunodeficiency Viruses><Human immunodeficiency virus test><Infrastructure><Institution><Interruption><Intervention><Intervention Strategies><Interview><Investigation><Knowledge><LAV-HTLV-III><Literature><Lymphadenopathy-Associated Virus><Measures><Medical><Medication><Medicine><Mobile Phones><Modeling><Monitor><Monkey Pox><Monkeypox><NIH><National Institutes of Health><Nature><Outcome><Outcome Measure><Patients><Persons><Pharmaceutical Preparations><Policy Making><PrEP><Preparedness><Prevention><Provider><Provincial Government><Public Health><Readiness><Recommendation><Research><Research Resources><Resource Allocation><Resources><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 outbreak><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><STD/HIV><STI/HIV><Series><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 outbreak><Severe acute respiratory syndrome coronavirus 2 pandemic><Social Sciences><Solid><Source><South Carolina><State Government><Strategic Planning><Survey Instrument><Surveys><T4 Lymphocyte Count><Time><Transmission><Travel><United States National Institutes of Health><Viral><Viral Burden><Viral Load><Viral Load result><Virus-HIV><access to health care><access to health services><access to healthcare><access to services><access to treatment><accessibility of health care><accessibility to health care><accessibility to health services><accessibility to healthcare><antiretroviral therapy><antiretroviral treatment><availability of services><build resilience><build resiliency><care access><care facilities><care services><care systems><climate change><climatic changes><cohort><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 outbreak><coronavirus disease 2019 pandemic><coronavirus disease 2019 pandemic consequence><coronavirus disease 2019 pandemic impact><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 outbreak><coronavirus disease-19 pandemic><coronavirus infectious disease-19><data infrastructure><data representation><data representations><develop resilience><develop resiliency><diagnostic kit><drug/agent><effects following the COVID-19 pandemic><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><enhance resilience><enhance resiliency><experience><global climate change><health care access><health care availability><health care personnel><health care policy><health care service access><health care service availability><health care worker><health provider><health service access><health services availability><health workforce><healthcare access><healthcare accessibility><healthcare availability><healthcare personnel><healthcare policy><healthcare service access><healthcare service availability><iPhone><impact of the SARS-CoV-2 pandemic><improve resilience><improve resiliency><increase resilience><increase resiliency><interventional strategy><measurable outcome><medical personnel><mortality><mpox><multiple data types><outbreak of SARS-CoV-2><outcome measurement><pandemic><pandemic disease><pre-exposure prophylaxis><pressure><promote resilience><promote resiliency><public health emergency><resilience><resilience development><resilience factor><resiliency factor><resilient><response><service availability><service organization><service utilization><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><smart phone><smartphone><social capital><social culture><socio-cultural><sociocultural><stay-at-home mandate><stay-at-home order><stay-at-home ordinance><stay-at-home policy><supply chain><surveillance data><telehealth><test kit><transmission process><treatment access><treatment provider><uptake>