Alcohol use, abuse, and dependence are prevalent among HIV-infected individuals, and are associated with delayed initiation of and adherence to antiretroviral therapy (ART), and with HIV disease transmission and progression. Prior research on the intersection of alcohol and HIV has been conducted in relatively small samples or in select groups whose results may not be generalizable to the overall population of HIV-infected individuals. The Alcohol Research Consortium in HIV - Epidemiology Research Arm (ARCH-ERA), will address this deficit in our knowledge by studying the short and long-term effects of alcohol on clinical outcomes among persons with HIV. We will accomplish this by elucidating the burden of alcohol use, its effect on HIV disease progression, and its impact on engagement in clinical care, health care utilization and costs. ARCH-ERA will be based in the CFAR Network of Integrated Clinical Systems (CNICS), a national network of 8 HIV clinical care sites and over 20,000 HIV-infected men and women receiving HIV care. CNICS is the ideal setting for ARCH-ERA because of its collection of comprehensive patient care and clinical outcomes data that is linked to patient-provided information on alcohol use, substance use, medical and psychiatric morbidities, adherence, HIV transmission risk behaviors, and quality of life (QOL). Capitalizing on the resources and infrastructure of CNICS, we propose the following aims: To determine the burden of hazardous alcohol consumption to HIV infected individuals;to determine the impact of different levels and pattern of alcohol use on HIV disease progression over time, and to evaluate the impact of alcohol use on HIV health care utilization and costs of care. Particular attention will be paid to the roles of sex/gender, illicit drug use, and mental health symptoms in the relationship between alcohol and HIV.

Public Health Relevance

Alcohol use, abuse and dependence are prevalent among HlV-infected individuals and are associated with poor outcomes, more severe psychiatric and medical comorbidities, and high individual and social costs. Elucidating how alcohol affects HIV in the short- and long-term, and the associated economic costs, will inform interventions to improve HIV care, reduce alcohol use, and improve quality of life and survival among persons with HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AA020793-03
Application #
8527634
Study Section
Special Emphasis Panel (ZAA1-DD (04))
Program Officer
Roach, Deidra
Project Start
2011-09-20
Project End
2016-08-31
Budget Start
2013-09-01
Budget End
2014-08-31
Support Year
3
Fiscal Year
2013
Total Cost
$424,774
Indirect Cost
$93,870
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Crane, Heidi M; Fredericksen, Rob J; Church, Anna et al. (2016) A Randomized Controlled Trial Protocol to Evaluate the Effectiveness of an Integrated Care Management Approach to Improve Adherence Among HIV-Infected Patients in Routine Clinical Care: Rationale and Design. JMIR Res Protoc 5:e156
Yang, Cui; Crane, Heidi M; Cropsey, Karen et al. (2016) Implementation of Computer-delivered Brief Alcohol Intervention in HIV Clinical Settings: Who Agrees to Participate? J Addict Res Ther 7:
Solorio, R; Ayala, N C; Paez, E et al. (2016) Use of Cognitive Interviews to Adapt PROMIS Measurement Items for Spanish Speakers Living with HIV. AIDS Res Treat 2016:8340863
Edwards, Todd C; Fredericksen, Rob J; Crane, Heidi M et al. (2016) Content validity of Patient-Reported Outcomes Measurement Information System (PROMIS) items in the context of HIV clinical care. Qual Life Res 25:293-302
Chander, Geetanjali; Monroe, Anne K; Crane, Heidi M et al. (2016) HIV primary care providers--Screening, knowledge, attitudes and behaviors related to alcohol interventions. Drug Alcohol Depend 161:59-66
Gibbons, Laura E; Fredericksen, Rob; Merrill, Joseph O et al. (2016) Suitability of the PROMIS alcohol use short form for screening in a HIV clinical care setting. Drug Alcohol Depend 164:113-9
Monroe, Anne K; Lau, Bryan; Mugavero, Michael J et al. (2016) Heavy Alcohol Use Is Associated With Worse Retention in HIV Care. J Acquir Immune Defic Syndr 73:419-425
Crane, H M; Nance, R M; Delaney, J A C et al. (2016) A Comparison of Adherence Timeframes Using Missed Dose Items and Their Associations with Viral Load in Routine Clinical Care: Is Longer Better? AIDS Behav :
Mimiaga, Matthew J; Biello, Katie; Reisner, Sari L et al. (2015) Latent class profiles of internalizing and externalizing psychosocial health indicators are differentially associated with sexual transmission risk: Findings from the CFAR network of integrated clinical systems (CNICS) cohort study of HIV-infected men eng Health Psychol 34:951-9
Fredericksen, Rob J; Edwards, Todd C; Merlin, Jessica S et al. (2015) Patient and provider priorities for self-reported domains of HIV clinical care. AIDS Care 27:1255-64

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