The purpose of this study is to characterize the nutritional status of a cohort of injecting drug users (IDU's) and to examine the relationships between nutritional status, dietary intake, and HIV-I infection. The proposed study will utilize an existing cohort of IDU's in the ALIVE study, an ongoing NIH/NIDA-sponsored cohort in Baltimore, Maryland. This cohort consists of 2,921 IDU's who were recruited in 1988 and have been followed semiannually for the natural history of HIV- 1 infection. Previous studies, mainly in gay/bisexual men, have suggested that nutritional status is important in HIV-1 infection and may influence disease progression. Little research has been published on the dietary habits and/or nutritional status of drug addicts. IDU's may represent a fairly heterogeneous group with regard to nutritional status and they are also at risk for HIV- 1 infection. Therefore, they form an ideal population in which to examine the relationships between these factors. Two hundred HIV-positive (125 male, 75 females) and 200 HIV-negative (125 male, 75 female) participants of the ALIVE study will be recruited into the proposed nutrition study. These subjects will be followed, semi-annually, for 18 months. At each of three visits, nutritional assessment will consist of anthropometric measurements (height, weight, four-site skinfold thickness measurements, and elbow breadth), bioelectrical impedance analysis, a 24-hour dietary recall questionnaire, a six-month food frequency questionnaire, and a few additional questions on dietary habits and physical activity. Blood will be drawn for estimation of serum/plasma nutrient levels at the first nutrition visit.
The specific aims of this study are: 1) to characterize the nutritional status and food intake patterns of a large cohort of community-based, male and female IDU's, with and without HIV-1 infection; 2) to validate nutrient intakes obtained from the six-month food frequency questionnaires with those obtained from the replicate 24-hour recalls; 3) to examine the association between nutritional status, immune function, and HIV- 1 disease status in IDU's; and 4) to examine the association between frequency, duration and type of drug use and nutritional status in current and former IDU's. The association between nutritional status and HIV disease progression will also be assessed during the 18-month follow-up period of this proposal. With these data, we will be able to assess the amount of heterogeneity that exists in this population and determine the feasibility of studying nutritional status and/or assessing dietary intake in IDU's. The information collected here could be used as baseline nutrition data for future epidemiologic and intervention studies on the relationships between nutritional status, HIV-1 infection, and AIDS progression in the ALIVE cohort.
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