# Advancing knowledge on factors that promote or impede engagement along the HIV care continuum over time: A longitudinal mixed methods study of Black and Latinx youth/emerging adults living with HIV

> **NIH NIH R01** · NEW YORK UNIVERSITY · 2021 · $761,164

## Abstract

PROJECT SUMMARY: Young people living with HIV (LWH) in the developmental periods from adolescence to
emerging adulthood (ages 16-28 years), which we refer to as “youth and emerging adults” (YEA), have the
lowest rates of engagement along the HIV care continuum (HCC) of any age group. This poor engagement is
most pronounced for African American/Black and Latinx YEA-LWH, including sexual/gender minorities, those
who use alcohol/drugs, and individuals from low socioeconomic status backgrounds. Yet, our knowledge of
factors that promote or impede engagement along the HCC, and how they operate and interplay over time, is
insufficient, for both limited occurrence behaviors (e.g., HIV care appointments) and repeated occurrence
behaviors (e.g., ART adherence). These gaps limit innovations to policy and health services. The proposed
prospective longitudinal study uses mixed methods and focuses on African American/Black and Latinx YEA-
LWH both with and without viral suppression. The study uses quantitative, qualitative, biomarker (HIV viral
load, drug use), and ecological momentary assessment approaches to uncover, describe, and better
understand factors contributing to trajectories of engagement along the HCC over time, with precision,
including from YEA-LWH’s perspectives. The study is grounded in Social Action Theory, a comprehensive
social-cognitive/ecological model that allows for examination of changes in contextual influences (e.g., action
contexts such as racism and homophobia; self-regulatory resources such as substance use), self-change
processes (e.g., social interaction processes including social networks; motivational appraisals), and action
states (e.g., attendance at HIV care appointments, substance use treatment [as needed], ART re-initiation).
The study’s primary outcome is HIV viral suppression (VS). Two interconnected aims are proposed: to
describe trajectories of engagement along the HCC (Aim 1), and guided by Social Action Theory, to identify,
describe, and understand the contextual influences, self-change processes, and action states that impede or
support the behaviors that comprise engagement along the HCC over time, including YEA-LWH’s
perspectives on these factors (Aim 2). A Youth Advisory Board will be joined by scientific advisors to develop
actionable recommendations based on study findings, which will be disseminated. Participants (N=270, half
with HIV VS and half non-suppressed at enrollment) will be diverse African American/Black or Latinx
behaviorally infected YEA-LWH recruited in New York City and Newark, NJ using a proven hybrid strategy. We
will follow participants prospectively for 18 months using mixed methods, combining baseline and follow-up
data (N ≈ 810 viral load observations), to assess the multifaceted domains expected to facilitate or impede
engagement along the HCC, and YEA-LWH’s perspectives on their causes and meanings. The research team
is expert in longitudinal mixed methods studies, HCC research, and AAB...

## Key facts

- **NIH application ID:** 10273344
- **Project number:** 1R01DA054081-01
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Marya Gwadz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $761,164
- **Award type:** 1
- **Project period:** 2021-07-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10273344

## Citation

> US National Institutes of Health, RePORTER application 10273344, Advancing knowledge on factors that promote or impede engagement along the HIV care continuum over time: A longitudinal mixed methods study of Black and Latinx youth/emerging adults living with HIV (1R01DA054081-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10273344. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*