Addressing Disaster Displacement for Recovery with Equitable and Sustainable Systems (ADDRESS) of HIV Care in Puerto Rico

PROJECT SUMMARY or ABSTRACT Project Abstract/Summary: Career Goal. My long-term career goals are: (1) to obtain and secure a full-time tenure track faculty appointment and (2) become an independently funded public health researcher who partners with public and private stakeholders to assess the health impact of natural events, and produce evidence-based, tailored interventions, and systems change to reduce the overall burden of HIV mortality and environmental determinants of HIV care, especially among African-Americans, Latino/a, highly mobile groups, and other groups facing healthcare barriers and poor health outcomes. Career Development. This K01 research and training plan will catalyze my efforts to acquire the advanced training necessary to develop and plan an intervention addressing the links between natural events and HIV treatment adherence and continuity. My training goals consist of (1) pursuing advanced training in longitudinal statistical quantitative methods necessary to examine the long-term impacts of natural events on the health of people with HIV (PWH); (2) acquiring expertise in the application of Social Network Analysis (SNA) methods to identify the networks that facilitate and limit HIV treatment continuity and ways to leverage networks to improve natural event related HIV care continuity; and (3) developing advanced competencies in implementation science to design an intervention prototype for an R01 network intervention. Research Project. This proposed five-year mixed-methods project explores the health implications of natural event-driven displacement for PWH in San Juan, PR. It aims to establish the link between natural event-related displacement and PWH's continuity of care and mental health. The study addresses how HIV providers, PWH, and organizations respond to natural events to bridge service gaps amid temporary or permanent displacement. Employing SNA and longitudinal analysis it investigates how strategies at individual, community, and government levels can be created with social network to improve HIV treatment continuity and mental health support during natural events. Specific Aims. Aim 1. Determine the displacement generated by natural events and the impact on HIV and mental health care in PR. Aim 2. Identify the role of social networks related to natural event response for HIV and mental health care continuity in PR. Aim 3. Systematically develop an intervention prototype, implementation, and dissemination plan for HIV care continuity around natural events using the 6 quality steps for intervention development (6SQuID) model in conjunction with the Health Promotion Research Center for (HPRC) Dissemination Framework. Mentorship Team: My efforts will be guided by an accomplished, interdisciplinary team of mentors committed to support my transition to an independent investigator.