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)
Program Officer
Roach, Deidra
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Yale University
Internal Medicine/Medicine
Schools of Medicine
New Haven
United States
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Marshall, Brandon D L; Tate, Janet P; McGinnis, Kathleen A et al. (2017) Long-term alcohol use patterns and HIV disease severity. AIDS 31:1313-1321
Marshall, Brandon David Lewis; Tate, Janet P; Mcginnis, Kathleen A et al. (2017) Long-term alcohol use patterns and HIV disease severity: A joint trajectory analysis. AIDS :
Freiberg, Matthew S; Chang, Chung-Chou H; Skanderson, Melissa et al. (2017) Association Between HIV Infection and the Risk of Heart Failure With Reduced Ejection Fraction and Preserved Ejection Fraction in the Antiretroviral Therapy Era: Results From the Veterans Aging Cohort Study. JAMA Cardiol 2:536-546
Jackson, Sandra L; Safo, Sandra; Staimez, Lisa R et al. (2017) Reduced Cardiovascular Disease Incidence With a National Lifestyle Change Program. Am J Prev Med 52:459-468
Justice, Amy C; McGinnis, Kathleen A; Tate, Janet P et al. (2017) Validating Harmful Alcohol Use as a Phenotype for Genetic Discovery Using Phosphatidylethanol and a Polymorphism in ADH1B. Alcohol Clin Exp Res 41:998-1003
Gordon, Kirsha S; Edelman, E Jennifer; Justice, Amy C et al. (2017) Minority Men Who Have Sex with Men Demonstrate Increased Risk for HIV Transmission. AIDS Behav 21:1497-1510
So-Armah, Kaku A; Lim, Joseph K; Lo Re, Vincent et al. (2017) FIB-4 stage of liver fibrosis predicts incident heart failure among HIV-infected and uninfected patients. Hepatology 66:1286-1295
Muzaale, A D; Althoff, K N; Sperati, C J et al. (2017) Risk of End-Stage Renal Disease in HIV-Positive Potential Live Kidney Donors. Am J Transplant 17:1823-1832
Rajeevan, Nallakkandi; Niehoff, Kristina M; Charpentier, Peter et al. (2017) Utilizing patient data from the veterans administration electronic health record to support web-based clinical decision support: informatics challenges and issues from three clinical domains. BMC Med Inform Decis Mak 17:111
Dubrow, Robert; Qin, Li; Lin, Haiqun et al. (2017) Association of CD4+ T-cell Count, HIV-1 RNA Viral Load, and Antiretroviral Therapy With Kaposi Sarcoma Risk Among HIV-infected Persons in the United States and Canada. J Acquir Immune Defic Syndr 75:382-390

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