An emerging body of work shows that unhealthy alcohol use substance use, smoking, and depression often co-occur in HIV-infected patients. In a large multisite observational study of aging and HIV, unhealthy alcohol use, substance use smoking, and depression were common among those with HIV and exhibited striking temporal concordance, often remitting and recurring together. For example, greater alcohol use decreases the odds of smoking cessation. While unhealthy alcohol use, substance use, smoking, and depression often co-occur, their screening and treatment does not. Screening and treatment strategies for these conditions are typically specified separately and enacted separately because of a multitude of factors, including distinct clinical guidelines, varying strength of evidence underlying those guidelines and distinct providers and programs for the treatment of each condition. As a result, patients who are screened for one may not be screened for another, and patients who are treated for one may not be treated for another. We propose developing a decision-analytic model to evaluate beneficial effects as well as potentially harmful effects and resource implications of integrated screening and treatment.

Public Health Relevance

This proposal aims to inform guideline development for screening and treatment of unhealthy alcohol use, substance use, smoking and depression in HIV-infected persons. The target population is HIV-infected individuals in care at integrated health systems in regions with high HIV incidence.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA024706-02
Application #
9353264
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Roach, Deidra
Project Start
2016-09-15
Project End
2021-06-30
Budget Start
2017-07-01
Budget End
2018-06-30
Support Year
2
Fiscal Year
2017
Total Cost
Indirect Cost
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10010