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An ecological momentary investigation of associations between PTSD, alcohol use, and medication adherence among young adults

Award Number: R01AA032464
ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/02/2026
PERIOD OF PERFORMANCE END DATE: 05/31/2031

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An ecological momentary investigation of associations between PTSD, alcohol use, and medication adherence among young adults - PROJECT SUMMARY People living with HIV (PWH) and those at risk of acquiring HIV, relative to the general population, have elevated rates of alcohol use and heavy episodic drinking (up to 41.1% compared to 11.2%) as well as post- traumatic stress disorder (PTSD; up to 74% compared to 8.3%). Post-traumatic stress disorder and alcohol use are highly interrelated with the former increasing risk of the latter and each of these serving as key proximal risk factors for medication non-adherence. For example, those with PTSD may have difficulty concentrating which can result in forgetting to take one’s medication. Meanwhile, alcohol use and heavy episodic drinking reduce adherence to antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) as prescribed by up to 55%. Taken together, both PTSD and alcohol use may be key risk factors for medication non-adherence among PWH and those at risk of acquiring HIV. People living in rural environments tend to engage in more heavy episodic drinking and have elevated rates of PTSD, potentially magnifying the risk for medication non-adherence, not to mention geospatial variation in ART success and HIV care in rural areas. Although individuals living in urban settings report higher levels of traumatic event exposure and subsequent PTSD symptomatology, those living in rural areas report higher rates of HIV-related psychological distress, itself associated with elevated rates of alcohol use and heavy episodic drinking. Further, rural inhabitants report lower access to HIV-related care, lower awareness of PrEP, and reduced access to primary care providers to initiate ART/PrEP prescriptions. This is alongside other barriers to rural healthcare such as a greater distances to services, higher cost of health care, and more limited access to services. Taken together, these differences suggest a need to focus on how the relationship between PTSD, alcohol use, and medication adherence differs based on urbanicity of residence. The goal of this R01 is to address two sides of the HIV prevention coin: sustained viral suppression among PWH and adherence to PrEP among HIV-negative individuals, focusing on the mechanistic pathway from PTSD through alcohol use as well as differences based on urbanicity. We will recruit a sample of 600 trauma-exposed young adults with probable PTSD and elevated heavy episodic drinking, aged 16-29, to accomplish the following aims: 1) Identify within-person associations between PTSD and medication adherence; 2) Examine alcohol use as a within-person mechanism of the association between PTSD and medication adherence; and 3) Test for moderation based on urbanicity of residence. The proposed study is in response to PAS-25-208 and NIAAA priorities to understand HIV Prevention and Alcohol. This R01 will inform the development of interventions to reduce heavy episodic drinking and PTSD and to increase medication adherence.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $713,536 )
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Alcohol Research Programs	000	1	9/4/2026	NEW	$713,536
														Subtotal = $713,536

Grand Total All Awards = $713,536

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An ecological momentary investigation of associations between PTSD, alcohol use, and medication adherence among young adults

Award Number: R01AA032464

ORGANIZATION: NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/02/2026

PERIOD OF PERFORMANCE END DATE: 05/31/2031

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