The PI?s long-term goal is to develop trauma-focused interventions that will improve mental health, HIV care outcomes along the treatment cascade, and overall health-related quality of life (HRQoL) for older populations living with HIV. Her short-term career goals are to: 1) Acquire knowledge about the main facets of trauma- focused intervention development addressing childhood sexual abuse (CSA) among older adults living with HIV; 2) Attain additional training in mixed-methods research and apply to formative work for intervention development; 3) Learn more about HIV and aging, and application of gerontological theories to research; 4) Learn more about the syndemic of CSA and HIV; and 5) Obtain additional training in longitudinal data analysis for clinical trials such as mixed-effect modeling and longitudinal mediational analysis. As an epidemiologist, the PI has a strong background in advanced epidemiologic research methods, and has experience in doing research among populations living with HIV. Nevertheless, to become an independent researcher in interventions for older people living with HIV, she requires additional training, which can be obtained through the K01 award. As a result, the PI proposes to receive training from Dr. Julianne Serovich, her primary mentor, in intervention development, specifically for populations living with HIV. Dr. Timothy Heckman will provide training in interventions, specifically for older adults living with HIV. Dr. Nathan Hansen will provide training in the syndemic of HIV and CSA, and trauma-focused interventions. Dr. William Haley will provide training in application of gerontological theories to research and Dr. Brent Small will provide training in longitudinal data analysis techniques for clinical trials. Each mentor brings a specific area of expertise to her mentorship team and will help her to accomplish the goals outlined. The PI will receive training at the University of South Florida (USF), which is a high-impact, global research university with numerous research and health care partnerships with hospitals and not-for-profit organizations in the Tampa metropolitan statistical area (MSA). The proposed project will take place in the College of Behavioral and Community Sciences at USF, which houses relevant mental health disciplines housed in the Departments of Aging Studies, Child and Family Studies, Mental Health Law & Policy and Social Work. Study participants will be recruited from the Florida Department of Health, AIDS service organizations, and the Tampa MSA. The PI also plans to conduct a qualitative study to explore the perceptions of aging with HIV and its impact on HRQoL within the context of a history of CSA; and a quantitative study to assess the relationship between CSA, mediators such as adaptive coping, substance use, depressive symptoms, and outcomes: ART adherence, viral suppression and HRQoL. These studies will help to inform the development of The Coping with Childhood Sexual abuse, HIV and Aging (CoSHA) one-on-one intervention, which will also be pilot-tested. The proposed project aligns well with the NIMH HIV/AIDS priorities (NOT-OD-15-137), by meaningfully including HIV outcomes/endpoints and examining health and social issues within the context of living with HIV.
HIV/AIDS continues to be a major public health issue for older adults, and it is estimated that by 2020, 50 to 70% of people living with HIV in the US will be 50 and older. Research has shown that childhood sexual abuse, depressive symptoms, and substance use are common among older people living with HIV, however, intervention research, especially those that are trauma-focused, are truly limited among older people living with HIV. The proposed K01 award will provide training and research opportunities to the PI in the areas of developing trauma-focused interventions, mixed-methods approaches, the intersection of HIV and aging, the syndemic of HIV and CSA, and specific longitudinal data analytic techniques for clinical trials.
