# Deconstructing HIV Disparities: Multistate Study of Data, Outcomes and Mediators

> **NIH NIH K08** · UNIVERSITY OF VIRGINIA · 2022 · $192,456

## Abstract

PROJECT SUMMARY/ABSTRACT
This K08 Mentored Career Development Award's overall objective is to support Dr. Kathleen A. McManus at the
outset of her career, providing sufficient time to focus her research on critical issues in the intersection of
epidemiology, HIV health outcomes, and health policy. Her Career Development Plan will use the context of her
research for three goals: 1) master skills (design, analysis, and interpretation) of quantitative epidemiologic
research; 2) gain expertise in the application of these analyses to state and federal health policy; and 3)
independence. Her overarching K08 research goal is to deconstruct HIV viral suppression disparities.
Specifically, she will perform secondary analyses of multistate (Virginia and South Carolina) data to 1) identify
demographic and healthcare system-level factors associated with loss to follow-up of AIDS Drug Assistance
Program (ADAP) clients; 2) estimate the effect of Affordable Care Act (ACA) Qualified Health Plan status on
sustained individual HIV viral suppression and assess disparities in outcomes among ADAP clients; and 3)
quantify the state/population level effect of modifiable healthcare delivery factors as mediators that impact
disparities in viral suppression by race/ethnicity among ADAP clients. HIV viral suppression is a key outcome. It
benefits individuals' longevity as well as the community since it is associated with decreases in new cases of
HIV infection. This research will inform policies to reduce disparities for low-income PLWH served by ADAP. In
order to monitor progress toward achieving HIV goals, states need accurate, timely data. If loss to follow-up
results in data that is not missing completely at random, this could result in biased data and suboptimal policies.
Understanding factors affecting loss to follow-up will help ADAPs to identify priority groups for interventions and
will allow for adjustment of future analyses for selection bias. Studying this multistate ADAP cohort's ACA
experience is applicable to ~225,000 ADAP clients across the nation. If the ACA is changed or repealed, or if
Virginia or South Carolina expand Medicaid, the project will be adjusted to study the impact of those changes.
This proposal will provide important information for state and federal policy and could become a model for HIV
analyses in other states and at the federal level. It fulfills main components of the United States' National
HIV/AIDS Strategy by identifying strategies to strengthen the timely availability and use of high quality data and
by characterizing modifiable factors' effects on disparities that can be targeted for interventions. This proposal
benefits from a strong advisory team of leading researchers with expertise in epidemiology, casual inference,
econometrics, health outcomes, health policy, and HIV outcomes. Drawing from the mentorship, collaboration,
and support of the Divisions of Infectious Diseases and Public Health Sciences, and state partners in Vir...

## Key facts

- **NIH application ID:** 10455464
- **Project number:** 5K08AI136644-05
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Kathleen Ann McManus
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $192,456
- **Award type:** 5
- **Project period:** 2018-08-14 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10455464

## Citation

> US National Institutes of Health, RePORTER application 10455464, Deconstructing HIV Disparities: Multistate Study of Data, Outcomes and Mediators (5K08AI136644-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10455464. Licensed CC0.

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