# URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study)

> **NIH NIH U01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2020 · $163,640

## Abstract

This proposal is an urgent competitive revision designed to supplement an existing NIH-funded study to assess
the impact of the COVID-19 pandemic on alcohol and other drug use, and medication adherence that is critical
for preventing HIV disease progression, among people living with HIV (PLWH). The COVID-19 pandemic has
profoundly affected lives around the world. In addition to the effects of infection itself, to which PLWH may be
more susceptible, COVID-19 has affected employment, access to healthcare, and very likely, the incidence
and consequences of other health conditions, by limiting access to healthcare, and through the implementation
of physical (social) distancing. PLWH may be at higher risk of consequences of social isolation, and those with
addiction, unemployment and homelessness are at an even higher risk with restrictions that affect food
availability, hygiene (e.g. handwashing), shelter, and other traditional supports now absent from the already
fragile societal safety net.
 The over-arching goal of this proposal is to assess the impact of the COVID-19 pandemic and the effects of
physical (social) distancing and other mitigation strategies (collectively termed “pandemic exposure”) on
substance use (heavy alcohol use and/or other drug use including nonmedical prescription medication use)
and HIV medication adherence among PLWH.
 Among an ongoing, well-characterized cohort of people living with HIV/AIDS (the existing Boston ARCH
Cohort parent study), this project will:
Aim 1: Determine prospective associations between pandemic exposure and changes in alcohol (and other
drug) use (primarily) and HIV antiretroviral (ARV) medication nonadherence (secondarily).
Aim 2: Identify associations between pandemic exposure and secondary stressors, specifically, food
insecurity, loneliness, and pain interference (with activities); and associations between those stressors and
changes in alcohol (and other drug) use and HIV ARV medication nonadherence.
Aim 3: Determine who is most affected by the pandemic by examining moderators of the associations between
pandemic exposure and changes in substance use and HIV ARV nonadherence.
 To achieve these aims, a supplemental COVID-19 specific assessment will be administered to participants
at two time points (6 months apart). Baseline data on substance use, depression, and frailty, collected during
pre-pandemic assessments as part of the parent study will be compared against data collected via
supplemental COVID-specific assessments. Achieving this proposal’s aims is an important step to identifying
modifiable targets for interventions to prevent increased substance use and HIV disease progression after an
extreme event such as COVID-19.

## Key facts

- **NIH application ID:** 10165944
- **Project number:** 3U01AA020784-10S1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Timothy C. Heeren
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $163,640
- **Award type:** 3
- **Project period:** 2011-09-20 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10165944

## Citation

> US National Institutes of Health, RePORTER application 10165944, URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study) (3U01AA020784-10S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10165944. Licensed CC0.

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