strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake. BackgroundAcross the United States (U.S.), the coronavirus disease 2019 (COVID-19) pandemic has amplified the social and health inequities with disproportionate burdens of prevalence, hospitalizations, and deaths among racial/ethnic minority populations (Gross et al., 2020;Ravi, 2020;Stokes et al., 2020;Webb et al., 2020). These disparities are due to social determinants of health such as having a lack of access to both medical care and to culturally appropriate health information (Kim et al., 2020;Millett et al., 2020;Thakur et al., 2020;Wadhera et al., 2020). To date, all Americans are encouraged to receive the COVID-19 vaccine and booster in order to prevent serious illness, hospitalizations, and death from the virus and its variants (CDC, 2021). However, general mistrust of vaccine benefits and related side effects can be barriers to achieving population immunity through vaccination, particularly among racial/ethnic minority groups (Paul et al., 2021). Vaccination hesitancy and refusal are often shaped by multi-level factors including religious and political beliefs at the individual level, a lack of effective communication and engagement strategies at the community level, and social inequities, including access, at the structural level (Dutta et al., 2021;Omer et al., 2021). Additionally, individuals who have experienced discrimination and racism Abstract The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/ Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants

the health, economic and social consequences of the COVID-19 pandemic were ubiquitous across the United States Hospitalisation and infections rates quadrupled between November and December, overwhelming healthcare systems (CDC, 2021).

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Objective Mental health recovery is possible for many individuals, but those with co-occurring disorders and homelessness face additional challenges. Though a non-linear course is assumed, few studies have analyzed recovery over time. This mixed methods study examined recovery trajectories of 38 participants with DSM Axis I diagnoses over 18 months after enrolling in supportive housing programs. Methods Qualitative interview data were quantified through consensual ratings to generate a recovery score for four waves of data collection based upon eight recovery domains culled from the literature. Case study analyses were conducted of participants whose scores varied by one standard deviation or more between baseline and 18 months to identify which domains were important. Results The majority (n=23) had no significant change in recovery, with eight having a positive and seven a negative trajectory. Case studies of these 15 participants showed domains that contributed to change (and numbers affected) were: significant other relationships (n=9), meaningful activities (n=9), mental health (n=7), family relationships (n=6), physical health (n=5), housing satisfaction (n=5), employment (n=2) and substance use (n=1). Except for mental health and substance use (only negative), domains were positive and negative in influence. Domains were intertwined in individuals' lives, e.g., variation in social relationships was linked to changes in meaningful activities. Conclusions This report showed little change in recovery over time for most and a decline in mental health for a small minority. Importantly, it underscores the importance of social relationships and meaningful activities among individuals with serious mental illness who experience complex challenges.

Increased access to antiretroviral treatment worldwide makes it more possible for children diagnosed with HIV before their 15th birthday to age into adolescence and beyond. Many HIV+ youth navigate stressors including poverty and resource scarcity, which may converge to produce emotional distress. For over a decade, CHAMP (Collaborative HIV Prevention and Adolescent Mental Health Project) investigators partnered with youth, caregivers, providers and community stakeholders to address the health, mental health and risk taking behaviors of perinatally HIV-infected youth. This paper explores the mental health needs of aging cohorts of HIV+ youth, across three global contexts, New York (U.S.), Buenos Aires (Argentina), and KwaZulu-Natal (South Africa), to inform the development and implementation of combination HIV care and prevention supports for HIV+ youth. Methods Analysis of data pooled across three countries involving HIV+ early adolescents and their caregivers over time (baseline and three month follow-up) was conducted. Univariate and multivariate analyses were applied to data from standardized measures used across sites to identify mental health needs of youth participants. The impact of the site specific versions of a family-strengthening intervention, CHAMP+U.S., CHAMP+Argentina, CHAMP+SA, was also examined relative to a randomized standard of care (SOC) comparison condition. Results Analyses revealed mental health resilience in a large proportion of HIV+ youth, particularly behavioral functioning and overall mental health. Yet, significant numbers of caregivers across country contexts reported impaired child emotional and prosocial wellbeing. Significant site differences emerged at baseline. Involvement in the CHAMP+ Family Program was related to significant improvement in emotional wellbeing and a trend towards enhanced prosocial behavior relative to SOC across global sites. Conclusions Ongoing partnerships with youth, family and provider stakeholders across global sites helped to tailor programs like CHAMP+ to specific contextual needs. This has global intervention research and care implications as cohorts of HIV+ children age into adolescence.