With antiretroviral therapy, over 1 million HIV-infected Americans are living longer, healthier lives. Consequently there is increased need to develop high quality, cost-effective HIV clinical care standards. Dr. Berry is an infectious diseases fellow and PhD student in clinical investigation at Johns Hopkins. His long term career goal is to make important contributions to understanding effective and economically sound HIV and other infectious diseases care strategies. His plans for development into an independent investigator include gaining competency in longitudinal data analysis, prospective studies of the effectiveness of clinical interventions, economic evaluation methods, and sexually transmitted infections subject knowledge to complement his HIV knowledge base. He will benefit from an outstanding mentoring team led by Drs. Kelly Gebo and Jonathan Zenilman. His proposed research is nested within his mentors'ongoing projects, and he will take advantage of classes and conferences available within the rich research environment of the Johns Hopkins Schools of Medicine and Public Health. Tens of thousands of asymptomatic gonorrhea (GC) and chlamydia (CT) cases may go undetected each year among HIV-infected Americans engaged in medical care. Detecting these infections has the potential to decrease HIV transmission and reduce adverse outcomes of GC and CT such as pelvic inflammatory disease. Despite these potential benefits and screening guidelines issued by the Centers for Disease Control and Prevention in 2003, GC/CT screening remains poorly implemented in HIV clinics across the nation. This proposal's central hypothesis is that universal annual GC/CT screening programs can be effective in clinical HIV practice and cost-effective for HIV-infected women and men <40 years old. The proposed research aims to: 1) Compare annual GC/CT testing and case detection rates before and after the 2003 guidelines using existing data from the HIV Research Network, a multicenter clinical cohort. 2) Determine if computer facilitated universal screening increases GC/CT case detection compared to the current standard of care using a pre/post intervention study. 3) Determine the cost-effectiveness of computerized universal screening versus current practice and a program of no screening. Up to 10% of persons living with HIV may have asymptomatic gonorrhea (GC) or chlamydia (CT) at any given time. Detecting these GC and CT cases helps reduce HIV transmission and decreases the long-term consequences of GC and CT such as pelvic inflammatory disease. This research will examine if computer facilitated universal annual screening may be an optimal means of detection among HIV-infected persons.

Public Health Relevance

Up to 10% of persons living with HIV may have asymptomatic gonorrhea (GC) or chlamydia (CT) at any given time. Detecting these GC and CT cases helps reduce HIV transmission and decreases the long-term consequences of GC and CT such as pelvic inflammatory disease. This research will examine if computer facilitated universal annual screening may be an optimal means of detection among HIV-infected persons.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AI084854-05
Application #
8639447
Study Section
Acquired Immunodeficiency Syndrome Research Review Committee (AIDS)
Program Officer
Bacon, Melanie C
Project Start
2010-04-01
Project End
2015-03-31
Budget Start
2014-04-01
Budget End
2015-03-31
Support Year
5
Fiscal Year
2014
Total Cost
$134,165
Indirect Cost
$9,790
Name
Johns Hopkins University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Haines, Charles F; Fleishman, John A; Yehia, Baligh R et al. (2016) Closing the Gap in Antiretroviral Initiation and Viral Suppression: Time Trends and Racial Disparities. J Acquir Immune Defic Syndr 73:340-347
Shah, Maunank; Risher, Kathryn; Berry, Stephen A et al. (2016) The Epidemiologic and Economic Impact of Improving HIV Testing, Linkage, and Retention in Care in the United States. Clin Infect Dis 62:220-9
Berry, Stephen A; Fleishman, John A; Yehia, Baligh R et al. (2016) Healthcare Coverage for HIV Provider Visits Before and After Implementation of the Affordable Care Act. Clin Infect Dis 63:387-95
Crowell, Trevor A; Ganesan, Anuradha; Berry, Stephen A et al. (2016) Hospitalizations among HIV controllers and persons with medically controlled HIV in the U.S. Military HIV Natural History Study. J Int AIDS Soc 19:20524
Berry, S A; Fleishman, J A; Moore, R D et al. (2016) Thirty-day hospital readmissions for adults with and without HIV infection. HIV Med 17:167-77
Crowell, Trevor A; Gebo, Kelly A; Blankson, Joel N et al. (2015) Hospitalization Rates and Reasons Among HIV Elite Controllers and Persons With Medically Controlled HIV Infection. J Infect Dis 211:1692-702
Berry, Stephen A; Ghanem, Khalil G; Mathews, William Christopher et al. (2015) Brief Report: Gonorrhea and Chlamydia Testing Increasing but Still Lagging in HIV Clinics in the United States. J Acquir Immune Defic Syndr 70:275-9
Yehia, Baligh R; Stephens-Shields, Alisa J; Fleishman, John A et al. (2015) The HIV Care Continuum: Changes over Time in Retention in Care and Viral Suppression. PLoS One 10:e0129376
Crowell, Trevor A; Berry, Stephen A; Fleishman, John A et al. (2015) Impact of hepatitis coinfection on healthcare utilization among persons living with HIV. J Acquir Immune Defic Syndr 68:425-31
Crowell, Trevor A; Gebo, Kelly A; Balagopal, Ashwin et al. (2014) Impact of hepatitis coinfection on hospitalization rates and causes in a multicenter cohort of persons living with HIV. J Acquir Immune Defic Syndr 65:429-37

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