Over the past decade, we have established the Florida Cohort to support research and training with a mission to maximize HIV viral suppression and improve health outcomes in PWH. Key features of the Florida Cohort include a focus on alcohol-related issues, academic and community-based partnerships across the state, targeted enrollment of diverse populations, and linkage to statewide HIV surveillance data. The overarching goals of the current grant proposal are to advance understanding of the mechanisms influencing adherence to contemporary HIV therapeutic regimens and to incorporate alcohol-related interventions into emerging clinic- and community-based strategies to achieve and maintain HIV viral suppression across diverse populations.

We propose to enroll and survey 1200 new Florida Cohort participants, with targeted enrollment for heavy drinkers and sexual/ethnic minorities. The survey data, with linkage to statewide HIV surveillance data, will allow us to identify multilevel factors contributing to ART adherence and viral suppression among alcohol using PWH. From the overall cohort, 80 alcohol using PWH will complete “enhanced monitoring (EM)” for one month. The EM group will wear a wrist alcohol biosensor, report alcohol and other risk factors (e.g., real-time anxiety, depression) and ART adherence through an ecological momentary assessment (EMA) app and provide two dried blood spots (DBS) viral load tests.

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