# Unhealthy alcohol use, other drug use, and mental health disorders: comorbidity burden in people with HIV, gaps in treatment, and impact on the HIV care continuum

> **NIH NIH K01** · JOHNS HOPKINS UNIVERSITY · 2022 · $179,088

## Abstract

PROJECT SUMMARY
The overall goal of this K01 application is to examine the impact of unhealthy alcohol use, cocaine use, non-
prescribed opioid use, depression, and anxiety on HIV care outcomes. Despite the durability of modern
antiretroviral therapy (ART) regimens, there is still a substantial minority of patients who have trouble
maintaining viral suppression. Unhealthy alcohol use, other drug use, and mental health disorders have all
been identified as drivers of viral non-suppression among people with HIV (PWH), yet these conditions have
typically been considered independently from one another. Furthermore, the impact of these conditions is
difficult to describe because symptoms are likely underreported and they are largely undertreated.
Pharmacologic treatments for alcohol use disorder (AUD), opioid use disorder, depression, and anxiety are
available but their long-term effects, particularly in people with comorbid substance use and mental health
disorders, and particularly on HIV care continuum outcomes has been insufficiently studied. The goal of this
K01 is to train the recipient to study the intersection of unhealthy alcohol use, other drug use, and mental
health disorders in people with HIV, accounting for challenges in identifying these conditions. Research aims of
this project are to: (1) describe the prevalence, co-occurrence, and durability of unhealthy alcohol use, cocaine
use, non-prescribed opioid use, depression, and anxiety among PWH in care, accounting for underreporting of
these conditions; (2) describe the care continua for AUD, opioid use disorder, cocaine use, depression, and
anxiety – that is, rates of clinical diagnoses, initiation on, and retention on pharmacologic treatment for these
disorders; and (3) estimate long-term effects of pharmacologic interventions on alcohol consumption, other
drug use, and mental health symptoms, and ultimately retention in HIV care and viral load. The training aims of
this project are to: (1) gain understanding of current and best practices for the prevention and clinical
management of unhealthy alcohol use, other drug use, and mental health disorders for PWH; (2) apply
innovative methods for handling measurement error in these conditions; (3) explore Bayesian methods for one
means of handling measurement error in the absence of validation data; and (4) obtain the research, writing,
and administrative expertise, and preliminary data, to submit a successful R01 grant in the penultimate year of
the K01 award period. Training aims will be accomplished through rigorous coursework, seminar participation,
mentored and collaborative research, and conference participation. Research aims will be conducted using
data from the Center for AIDS Research Network of Integrated Clinical Systems, which includes medical
record data and patient reported outcomes from over 34,000 PWH engaged in clinical care from 1995-present
at eight US HIV clinics. This project will address a critical gap in our understand...

## Key facts

- **NIH application ID:** 10475210
- **Project number:** 5K01AA028193-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Catherine Lesko
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $179,088
- **Award type:** 5
- **Project period:** 2019-09-25 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10475210

## Citation

> US National Institutes of Health, RePORTER application 10475210, Unhealthy alcohol use, other drug use, and mental health disorders: comorbidity burden in people with HIV, gaps in treatment, and impact on the HIV care continuum (5K01AA028193-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10475210. Licensed CC0.

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