The Veterans Aging Cohort Study (VACS) is the largest clinical cohort of HIV infected Individuals (HIV+) in North America and includes in depth, longitudinal data on alcohol, multisubstance use (MSU), and outcomes over 7 years on 7,312 HIV+/- veterans at 8 sites (VACS 8). We have observed that among HIV+ drinkers, MSU is the norm (64% also use tobacco, opioids, or cocaine), but we do not know its implications for alcohol treatment. As the naturalistic observation study in the Consortium to improve OutcoMes in hiv/Aids, Alcohol, Aging, and multi-Substance use (COMpAAAS), we propose to build on the prior work of VACS to contribute to our consortium mission, "to build and disseminate the evidence needed to optimize health care for HIV+ harmed by alcohol, MSU, HCV, and depression through coordinated, integrated, and externally validated observation, operations research (OR) modeling, and intervention studies." In this proposal we seek to characterize long-term (>10 year) longitudinal patterns and consequences of alcohol and MSU. This information that is essential to our mission and will inform all three U01 projects. We use this data to explore whether individually tailored health information on risks of alcohol and MSU increases motivation to change compared to generic advice to curtail alcohol use. To this end, we have developed and internationally validated the VACS Index (based on clinical biomarkers) and created a prototype VACS Index Calculator. While VACS analyses are essential to the COMpAAAS mission, our alcohol funding ends September 2011. Without additional follow up, our ability to characterize long-term longitudinal patterns and consequences of alcohol and MSU within important subgroups will be limited. Further, we hope to study contemporary patterns and consequences of alcohol and MSU among those initiating care since increased non medical use of prescription opioids (NMU) and changes in ART may be altering both patterns and consquences. Finally, Time Line Follow Back data (TLFB) are the gold standard for alcohol research but difficult to collect. By transitioning survey collection to a Web-Based format we will be able to collect TLFB data on alcohol and MSU and begin the transformation of VACS from a clinic cohort to an Interactive Web-Based Laboratory.
Among HIV infected individuals (HIV+) who drink, concurrent use of other substances (tobacco, opioids, or cocaine) is the norm. While we know that alcohol use can be harmful, we do not know the implications of this multisubstance use (MSU) for optimal alcohol treatment among HIV+. The first step in studying this problem will be to characterize patterns and consequences of alcohol and MSU in important subgroups.
|Kunisaki, K M; Akgün, K M; Fiellin, D A et al. (2015) Prevalence and correlates of obstructive sleep apnoea among patients with and without HIV infection. HIV Med 16:105-13|
|Petersen, Maya; Yiannoutsos, Constantin T; Justice, Amy et al. (2014) Observational research on NCDs in HIV-positive populations: conceptual and methodological considerations. J Acquir Immune Defic Syndr 67 Suppl 1:S8-16|
|Althoff, Keri N; Rebeiro, Peter; Brooks, John T et al. (2014) Disparities in the quality of HIV care when using US Department of Health and Human Services indicators. Clin Infect Dis 58:1185-9|
|Rebeiro, Peter F; Horberg, Michael A; Gange, Stephen J et al. (2014) Strong agreement of nationally recommended retention measures from the Institute of Medicine and Department of Health and Human Services. PLoS One 9:e111772|
|Akgün, Kathleen M; Tate, Janet P; Crothers, Kristina et al. (2014) An adapted frailty-related phenotype and the VACS index as predictors of hospitalization and mortality in HIV-infected and uninfected individuals. J Acquir Immune Defic Syndr 67:397-404|
|Armah, Kaku A; Chang, Chung-Chou H; Baker, Jason V et al. (2014) Prehypertension, hypertension, and the risk of acute myocardial infarction in HIV-infected and -uninfected veterans. Clin Infect Dis 58:121-9|
|So-Armah, Kaku A; Chang, Joyce; Alcorn, Charles et al. (2014) HIV infection, antiretroviral therapy initiation and longitudinal changes in biomarkers of organ function. Curr HIV Res 12:50-9|
|Womack, Julie A; Chang, Chung-Chou H; So-Armah, Kaku A et al. (2014) HIV infection and cardiovascular disease in women. J Am Heart Assoc 3:e001035|
|Anderson, Jeffrey P; Tchetgen Tchetgen, Eric J; Lo Re 3rd, Vincent et al. (2014) Antiretroviral therapy reduces the rate of hepatic decompensation among HIV- and hepatitis C virus-coinfected veterans. Clin Infect Dis 58:719-27|
|Freiberg, Matthew S; Chang, Chung-Chou H; Kuller, Lewis H et al. (2013) HIV infection and the risk of acute myocardial infarction. JAMA Intern Med 173:614-22|
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