The Veterans Aging Cohort Study (VACS) is the largest HIV cohort in the North America (40,594). It includes a nested, consented 8 site sample (VACS 8) of 3,660 HIV infected (HIV+) veterans demographically matched to 3652 uninfected veterans (HIV-) which has longitudinal in-depth data spanning nearly 10 years on alcohol, substance use, and health and behavioral outcomes. Of the HIV+ subjects in VACS 8, 63% drink alcohol and 32% have unhealthy alcohol use. Because VACS includes uninfected comparators, we are able to characterize the role of HIV infection in alcohol associated outcomes. VACS include large well characterized samples of understudied, but important subgroups: middle aged and older individuals, people of color, Black men who have sex with men, those with HCV infection (HCV+). We propose to enroll more women and those new to care. We have conducted observational research, and limited operations modeling and intervention studies within VACS focused on the role of alcohol in determining modifiable outcomes among HIV+/-. We have a national network of investigators and a highly effective Coordinating Center at the West Haven VA Medical Center. Our group has produced >100 widely cited, publications. We are proud of the education and career development support we have offered, but VACS funding for alcohol research ends September 2011. We propose to transform VACS into the Consortium to improve OutcoMes in HIV/Aids, Alcohol, Aging, and multi-Substance use (COMpAAAS) by 1) expanding our work in intervention and operations modeling while maintaining excellence in observational data analyses, 2) Converting our clinic based observational study into an Interactive Web Based Laboratory and providing administrative and methodological support to our network of investigators, and 3) Tapping our network of collaborators in North America and Europe to validate and extend our findings. Our consortium mission is to incrementally build and disseminate the evidence needed to optimize health care for HIV+ harmed by alcohol, multisubstance use, HCV, and depression through strategically coordinated, integrated, and externally validated observation, operations modeling, and intervention studies.

Public Health Relevance

We propose to organize a collaboration of research experts, clinicians, patients, and policy makers into the Consortium to improve OutcoMes in HIV/AIDS (COMpAAAS). Our mission is to provide new knowledge to improve the health care of HIV infected persons harmed by alcohol and related conditions (multisubstance use, HCV, and depression) through insights from observation, intervention, and simulation modeling.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Resource-Related Research Projects--Cooperative Agreements (U24)
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Special Emphasis Panel (ZAA1-DD (04))
Program Officer
Roach, Deidra
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Yale University
Internal Medicine/Medicine
Schools of Medicine
New Haven
United States
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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
Ingle, Suzanne M; May, Margaret T; Gill, M John et al. (2014) Impact of risk factors for specific causes of death in the first and subsequent years of antiretroviral therapy among HIV-infected patients. Clin Infect Dis 59:287-97
Boulle, Andrew; Schomaker, Michael; May, Margaret T et al. (2014) Mortality in patients with HIV-1 infection starting antiretroviral therapy in South Africa, Europe, or North America: a collaborative analysis of prospective studies. PLoS Med 11:e1001718
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

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