This application proposes a training program to develop P. Todd Korthuis, MD, MPH into an independent clinician-scientist in investigations of drug abuse and HIV. Dr. Korthuis is a General Internist who specializes in caring for HIV-infected patients. The mentored career development plan consists of a three-tiered approach: formal coursework to augment his previously acquired skills, a broad-based experiential learning program, and a mentored clinical research experience. The primary goal of this program will be for Dr. Korthuis to achieve independence as a clinical investigator in all respects. His educational goals for this award are to advance his understanding of drug abuse theory and treatment and obtain advanced expertise in qualitative and quantitative research design and analysis methods while maintaining his expertise in HIV treatment and prevention issues pertinent to patients with drug abuse. He will conduct mentored clinical research under the direction of his primary mentor, Dr. Dennis McCarty, Director of the Center for Substance Abuse Research and Policy, and co-mentors Dr. David Hickam, Professor of Medicine and health services researcher at OHSU, Dr. Carla Green, an experienced qualitative methods researcher, and Dr. Steven Asch, Associate Professor of Medicine at UCLA and director of the Veteran's Administration HIV Quality Enhancement Research Initiative. Dr. Richard Moore, principal investigator of the national HIV Research Network, and Dr. Ruth Finkelstein, principal investigator of the HRSA Special Projects of National Significance Integrated Buprenorphine and HIV Care Evaluation and Support Center will assure data access and continued support for the proposed aims. The proposed research focuses on identifying quality outcomes for patients with co-occurring drug abuse and HIV infection. Though effective treatments exist for both drug abuse and HIV infection, their impact on improving quality of care outcomes like HIV viral suppression remains unclear. I theorize that patients with co-occurring drug abuse and HIV infection achieve quality outcomes through a combination of healthcare structural and patient characteristics. My central hypothesis is that among persons with a history of drug abuse, better HIV quality of care summary scores are associated with access to drug abuse treatment, high levels of indicated care, and centrally integrated drug abuse treatment care. To test this hypothesis, I aim to conduct three studies to (1) determine the effect of access to drug abuse treatment on HIV quality of care, (2) determine the effect of indicated care on HIV outcomes, and (3) determine the effect of integrated drug abuse and HIV care on HIV quality of care among persons with varying degrees of drug use over time.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA019809-03
Application #
7641061
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Jones, Dionne
Project Start
2007-07-20
Project End
2012-06-30
Budget Start
2009-07-01
Budget End
2010-06-30
Support Year
3
Fiscal Year
2009
Total Cost
$178,416
Indirect Cost
Name
Oregon Health and Science University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
096997515
City
Portland
State
OR
Country
United States
Zip Code
97239
Callon, Wynne; Saha, Somnath; Wilson, Ira B et al. (2017) How does decision complexity affect shared decision making? An analysis of patient-provider antiretroviral initiation dialogue. Patient Educ Couns 100:919-926
Callon, Wynne; Beach, Mary Catherine; Saha, Somnath et al. (2016) Assessing Problematic Substance Use in HIV Care: Which Questions Elicit Accurate Patient Disclosures? J Gen Intern Med 31:1141-7
Flickinger, Tabor E; Saha, Somnath; Roter, Debra et al. (2016) Respecting patients is associated with more patient-centered communication behaviors in clinical encounters. Patient Educ Couns 99:250-5
Korthuis, Philip Todd; McGinnis, Kathleen A; Kraemer, Kevin L et al. (2016) Quality of HIV Care and Mortality Rates in HIV-Infected Patients. Clin Infect Dis 62:233-239
Callon, Wynne; Saha, Somnath; Korthuis, P Todd et al. (2016) Which Clinician Questions Elicit Accurate Disclosure of Antiretroviral Non-adherence When Talking to Patients? AIDS Behav 20:1108-15
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
Beach, Mary Catherine; Roter, Debra L; Saha, Somnath et al. (2015) Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients. Patient Educ Couns 98:1078-83
Berry, Stephen A; Gebo, Kelly A; Rutstein, Richard M et al. (2014) Trends in hospitalizations among children and young adults with perinatally acquired HIV. Pediatr Infect Dis J 33:488-94
Laws, M Barton; Lee, Yoojin; Rogers, William H et al. (2014) Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity. AIDS Behav 18:1279-87
Flickinger, Tabor E; Berry, Stephen; Korthuis, P Todd et al. (2013) Counseling to reduce high-risk sexual behavior in HIV care: a multi-center, direct observation study. AIDS Patient Care STDS 27:416-24

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