The goal of this project is to implement long-term clinical strategy trials in HIV/AIDS that will have the capacity to address questions for which much uncertainty remains among clinicians and patients. Philadelphia FIGHT proposes to utilize a decentralized network of primary care providers with a large, demographically representative patient base to maintain enrollments of at least 200 patients at all times in CPCRA protocols, while maintaining consistent data quality. FIGHT has assembled a local network of nine major AIDS clinics and private practices in Philadelphia, which see over 3,000 HIV infected individuals, including 72 percent African American or Latinos, 40 percent IV or injection drug users, and 11 percent women. FIGHT has been an active participant in CPCRA protocols since 1994 when it was selected as a site, contributing over 400 enrollments to 12 CPCRA protocols including two, Nutrition (CPCRA 038) and Acupuncture (CPCRA 022), to which they contributed the highest enrollments. The Principal Investigator (PI) and collaborating investigators at this CPCRA site have contributed their expertise to the development of the scientific agenda of the CPCRA and propose to support its implementation. Ellen Tedaldi, M.D., the PI, is Professor of Medicine at Temple University School of Medicine. She serves as the Chair of the Hepatitis Working Group of the CPCRA, has served as a member of the Science Planning Committee, is a member of the Performance Oversight Committee and has served on several protocol teams. Jay R. Kostman, M.D., is Chief of Infectious Diseases at Presbyterian Medical Center. He is a member of the Science Planning Committee, is Protocol Chair of the Protease Inhibitor Progression protocol (CPCRA 057) and Co-Chair of the Long-Term Monitoring protocol (CPCRA 060). He will begin serving as a member of the Publications and Presentations Committee in January 1999. Mary van den Berg-Wolf, M.D., serves as a member of the FIRST protocol team (CPCRA 058). The collaborating investigators, who practice at major hospitals and community-based clinics in Philadelphia, are 3 providers in the AIDS primary care system in this community. The sites now include the Jonathan Lax Immune Disorders Treatment Center initiated in 1997 by FIGHT that is one of the largest providers of HIV specialized primary care in this community. FIGHT is the region's largest provider of consumer education and treatment information. The applicants propose the investigators will contribute in significant ways to enrollment, data quality, and the scientific agenda of the CPCRA.
