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Geographic Variability in Time from HIV Diagnosis to Viral Suppression in the Deep South: A Roadmap to Accelerated Treatment Initiation

Award Number: R01AI142690
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 12/24/2018
PERIOD OF PERFORMANCE END DATE: 11/30/2024

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Geographic Variability in Time from HIV Diagnosis to Viral Suppression in the Deep South: A Roadmap to Accelerated Treatment Initiation - Project Abstract This proposal describes a 5-year research plan that seeks to address gaps in our understanding of the individual, geographic, and sociocontextual determinants of delays in achieving HIV viral suppression (VS) in the Deep South region of the United States (US), an area carrying a disproportionate burden of the country’s HIV epidemic. The proposal leverages a dynamic and innovative collaboration of experienced investigators from the University of Alabama at Birmingham (UAB) Center for AIDS Research (CFAR) and the HIV Divisions of the state health departments in Alabama (AL), Louisiana (LA), and Mississippi (MS). This novel research proposal utilizes a population-health approach to evaluate time to VS among newly diagnosed individuals and integrates a mixed-methods approach to examine the socioeconomic, demographic, and structural determinants of time to VS in this population in the development of an intervention to accelerate initiation of antiretroviral therapy (ART). The specific aims of this proposal are to: 1) Utilize HIV surveillance data collected by the states’ public health electronic HIV/AIDS Reporting System (eHARS) to characterize geographic variability in time from HIV diagnosis to VS (<200 c/mL) among newly reported HIV cases among those age ≥13 years at diagnosis between January 2014-December 2017 in AL, LA, and MS; 2) Identify individual and community-level determinants of time to VS, incorporating quantitative geospatial coding methods, in AL, LA, and MS among newly reported cases of HIV among those age ≥13 years at diagnosis from January 2014-December 2017 and contextualize these findings with qualitative key informant interviews among persons living with HIV (PLWH), HIV treatment and social services providers, and other community stakeholders in AL, LA, and MS; and 3) Engage stakeholders in developing a rapid ART initiation program focusing upon localities in the Deep South with disproportionately longer time from HIV diagnosis to VS. We will then incorporate these results in an R01 application testing the implementation of a community-level rapid ART initiation program in the Deep South, focusing on areas with longer time from HIV diagnosis to VS. Results of this research will lay the groundwork for a larger implementation trial that will include rigorous evaluation of interventions integrating clinical and public health systems aimed at improving time to VS in the US with consideration for cost-effectiveness.


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: 2025 ( Subtotal = -$123,486 )
2025	2023	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH STREET	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	5	4/15/2025	NON-COMPETING CONTINUATION	-$123,486
														Subtotal = -$123,486

Issue Date FY: 2023 ( Subtotal = $265,419 )
2023	2023	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	5	12/5/2022	NON-COMPETING CONTINUATION	$265,419
														Subtotal = $265,419

Issue Date FY: 2022 ( Subtotal = $427,546 )
2022	2022	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	4	11/9/2021	NON-COMPETING CONTINUATION	$427,546
														Subtotal = $427,546

Issue Date FY: 2021 ( Subtotal = $673,326 )
2021	2021	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	3	11/19/2020	NON-COMPETING CONTINUATION	$673,326
														Subtotal = $673,326

Issue Date FY: 2020 ( Subtotal = $512,866 )
2020	2020	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	2	11/26/2019	NON-COMPETING CONTINUATION	$512,866
														Subtotal = $512,866

Issue Date FY: 2019 ( Subtotal = $478,103 )
2019	2019	UNIVERSITY OF ALABAMA AT BIRMINGHAM	701 S 20TH ST	BIRMINGHAM	AL	35294	JEFFERSON	USA	Allergy and Infectious Diseases Research	000	1	12/24/2018	NEW	$478,103
														Subtotal = $478,103

Grand Total All Awards = $2,233,774

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Geographic Variability in Time from HIV Diagnosis to Viral Suppression in the Deep South: A Roadmap to Accelerated Treatment Initiation

Award Number: R01AI142690

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 12/24/2018

PERIOD OF PERFORMANCE END DATE: 11/30/2024

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