# At the Intersection of HIV and COVID-19: Medicaid Data as a Complement to Cohort Studies

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $776,684

## Abstract

ABSTRACT
The Coronavirus Disease 2019 (COVID-19) pandemic has had an unprecedented impact on the lives of people
worldwide. Yet, the effect on persons living with HIV (PLWH) is not known. Emerging evidence suggests that
PLWH have a similar or modestly higher risk of COVID-19 acquisition, and higher risk for worse COVID-19
outcomes, including hospitalization and death. However, the data has been mixed as several studies have
suggested no difference in clinical outcomes. Several studies also found that outcomes are worse among
those without viral suppression and those with lower CD4 counts, highlighting the importance of continued HIV
care. Yet, early reports suggest that COVID-19 has disrupted services across the HIV care continuum. As the
pandemic continues to unfold, it is critical to better characterize the relationship between COVID and outcomes
among PLWH. In addition, we need to identify how the pandemic and the public health strategies to combat
the pandemic impacted the provision of care for PLWH, as well as whether any adverse effects are lasting.
Approximately 40% of PLWH are enrolled in Medicaid. The proposed project will include Medicaid beneficiaries
from 27 states and Washington, DC between 2018 and 2024 with a conservative estimate of 25 million
beneficiaries and 275,000 PLWH enrolled annually. Medicaid is an important complement to HIV cohort
studies as it affords us the breadth of data to evaluate differences by geographic location, social determinants
of health at the community level, as well as among important sub-populations. We will assess the relationship
between HIV and COVID-19 disease, including on hospitalization due to COVID-19 and adverse conditions
due to COVID like post-acute sequala of COVID-19 (PASC). We will also evaluate the impact of the COVID19
pandemic on the provision of care for prevention of HIV and HIV care. We will assess care across the HIV care
continuum including PrEP prescription, HIV testing, and annual HIV care visits, viral load tests, and ARV
medication possession ratio. We will also evaluate impacts on the provision of care for non-HIV conditions,
including annual wellness visits, preventive screenings and health condition management. We will compare
care rates during the pre-COVID period (2001-2019), acute COVID period (2020-2021), and post-acute COVID
period (2022-2024) overall and by geographic location (state, urban/rural, local government area [LGA],
smallest government region e.g. county, city, town, etc.) and regional severity of COVID-19 cases and COVID-
19 policies. Findings from the proposed study will help inform and target interventions to improve care for
PLWH in the future.

## Key facts

- **NIH application ID:** 10844497
- **Project number:** 5R01AI170240-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Corinne E. Joshu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $776,684
- **Award type:** 5
- **Project period:** 2022-06-10 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844497

## Citation

> US National Institutes of Health, RePORTER application 10844497, At the Intersection of HIV and COVID-19: Medicaid Data as a Complement to Cohort Studies (5R01AI170240-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10844497. Licensed CC0.

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