The goal of the HIV Registry Core is to provide support for studies that involve collecting and linking longitudinal databases concerning HIV/AIDS. These studies are designed to address questions concerning the clinical manifestation and progression of HIV infection, the provision of health care to persons with HIV/AIDS, and the validity of routinely collected state and national data on HIV/AIDS. Current clinical research includes studies of the 1) epidemiology of bacterial pneumonia, 2) spectrum of neuralgic and psychiatric abnormalities among HIV infected persons, 3) effect of preventative and prophylactic measures on development of opportunistic infections, 4) role of sexually transmitted and enteric infections on the development of Kaposi's sarcoma, and 5) relationship of gender, HIV exposure group, and ethnicity on illness and health care utilization patterns. Other health services-related issues which will be addressed include: 1) how health care setting including managed care settings vary in terms of patterns of utilization, and cost and quality care, 2) the frequency and determinants of patients transitions between provider types and 3) how to use of one type of service or facility such as in-patient, emergency room, ambulatory care, or intermediate care facilities influences the use of other types of services. The HIV/AIDS databases included detailed socio-demographic, clinical, laboratory, procedure, treatment, utilization, and cost of care information on a substantial proportion of individuals with HIV infection who seek care in Western Washington. The collection and maintenance of these datasets is funded by a variety of sources including the National Institute of Health, the Centers for Disease Control, and state and local health departments. An oversight committee entitled the Washington State HIV Database Research Committee (WSHDRC) has been established to review proposed projects for scientific merit and to ensure that linkages are performed with the necessary institutional approvals and that they adhere to established confidentiality guidelines. Key members of the WSHDRC are investigators on this core providing HIV/AIDS expertise in epidemiology, medicine, and health services. Within two years we anticipate that funding for key HIV/AIDS database linkages will come from sources outside of CFAR and thus, funding for this core is not requested beyond the third year. To date, investigators have been successful in obtaining funding from NCI for the link between the HIV/AIDS and cancer registries.
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