A mixed methods study of factors associated with HIV outcomes in people living with HIV

University Of Florida, Gainesville FL

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Abstract

Certain regions in the Southern United States continue to experience elevated rates of new HIV diagnoses and challenges in achieving consistent treatment outcomes. Multiple overlapping personal and environmental factors – such as substance use, emotional strain, and limited access to services – have been linked to these outcomes. These combined influences, referred to here as co-occurring conditions, may interact in ways that complicate care and long-term health management. At the same time, support from personal networks has emerged as a potential factor that may influence clinical outcomes. To date, no study has identified specific socioeconomic and sociodemographic individuals living with HIV who may benefit from a shared behavioral approach designed to enhance support and improve treatment outcomes. The goal of this K01 award is to provide me with the resources, training, mentoring and knowledge needed to investigate the intersection of behavioral factors and HIV outcomes using a mixed methods approach. This study will use an explanatory sequential mixed method design to accomplish the specific aims which include: 1a) apply latent class analyses (LCA) to identify individuals based on co-occurring conditions; 1b) examine associations between class membership and demographic characteristics; 2) assess the relationship between socioeconomic individual membership and perceived support; 3) evaluate individual differences in baseline one-year change in treatment outcomes; and 4) conduct semi-structured interviews to validate and contextualize quantitative findings. This project will leverage existing data from an ongoing NIAAA-funded longitudinal study (U24AA022002) and interviewing a purposive sample of 20 participants. This K01 application will build on my expertise in HIV outreach, public health, qualitative research, and behavioral research related to substance use and HIV with advanced training in: using LCA to model co-occurring conditions among individuals living with HIV, recruiting participants into behavioral research, identifying effective behavioral interventions and strategies to improve support and treatment outcomes among these individuals, and responsible conduct of research. Training will be guided by a multidisciplinary team of mentors: Drs. Robert Cook and Eric Schrimshaw (co-primary mentors) and Drs. Typhanye Dyer, Mattia Prosperi, Michael Marsiske, Sheldon Fields, and Nicole Ennis (co-mentors). This K01 award will allow me to establish myself as an independent investigator focused on improving HIV-related outcomes through tailored behavioral strategies.