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.
|Rebeiro, Peter F; Gange, Stephen J; Horberg, Michael A et al. (2016) Geographic Variations in Retention in Care among HIV-Infected Adults in the United States. PLoS One 11:e0146119|
|Cesar, Carina; Koethe, John R; Giganti, Mark J et al. (2016) Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America. J Int AIDS Soc 19:20684|
|Rachlis, Beth; Karwa, Rakhi; Chema, Celia et al. (2016) Targeted Spontaneous Reporting: Assessing Opportunities to Conduct Routine Pharmacovigilance for Antiretroviral Treatment on an International Scale. Drug Saf 39:959-76|
|McGinnis, Kathleen A; Tate, Janet P; Williams, Emily C et al. (2016) Comparison of AUDIT-C collected via electronic medical record and self-administered research survey in HIV infected and uninfected patients. Drug Alcohol Depend 168:196-202|
|Buchacz, Kate; Lau, Bryan; Jing, Yuezhou et al. (2016) Incidence of AIDS-Defining Opportunistic Infections in a Multicohort Analysis of HIV-infected Persons in the United States and Canada, 2000-2010. J Infect Dis 214:862-72|
|McGinnis, Kathleen A; Fiellin, David A; Tate, Janet P et al. (2016) Number of Drinks to "Feel a Buzz" by HIV Status and Viral Load in Men. AIDS Behav 20:504-11|
|Althoff, Keri N; Rebeiro, Peter F; Hanna, David B et al. (2016) A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts. J Int AIDS Soc 19:20707|
|Klein, Marina B; Althoff, Keri N; Jing, Yuezhou et al. (2016) Risk of End-Stage Liver Disease in HIV-Viral Hepatitis Coinfected Persons in North America From the Early to Modern Antiretroviral Therapy Eras. Clin Infect Dis 63:1160-1167|
|Koethe, John R; Jenkins, Cathy A; Lau, Bryan et al. (2016) Higher Time-Updated Body Mass Index: Association With Improved CD4+ Cell Recovery on HIV Treatment. J Acquir Immune Defic Syndr 73:197-204|
|Rentsch, Christopher; Tate, Janet P; AkgÃ¼n, Kathleen M et al. (2016) Erratum to: Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011. AIDS Behav 20:565|
Showing the most recent 10 out of 62 publications