Boston Alcohol Research Collaboration on HIV/AIDS - Comorbidity Center (Boston ARCH CC)

项目总结/摘要 有效的抗逆转录病毒疗法延长了艾滋病毒感染者的寿命。酗酒， 在艾滋病毒相关疾病的风险和管理中发挥着越来越重要的作用。 合并症。不健康的饮酒会加剧两种高度流行的艾滋病毒相关合并症/并发症 条件，慢性疼痛和身体活动不足，这反过来又会加剧酒精的使用，影响身体和 PLWH的心理功能。我们提议成立波士顿酒精研究艾滋病合作组织- 作为我们波士顿酒精研究合作的延伸， 艾滋病毒/艾滋病（HIV/AIDS）队列于2011年启动，并在NIAAA的资助下于2016年更新。在波士顿， CC我们在随机试验中针对这两种可改变的条件，疼痛和身体活动不足， 对多种其他HIV相关合并症的关键影响。波士顿ECOCC包含4个集成的 为我们的跨学科方法做出独特贡献的组成部分：两项随机试验（研究 项目组成部分），协调P01的管理核心（AC），以及生物统计和数据 管理（BDM）核心，从方法上支持试验，并提供数据管理和 生物统计学专业知识，并继续使用现有的波士顿生物统计学数据进行二次分析。在 目标1我们将进行最先进的电子健康临床试验研究，研究可扩展的方法， 解决艾滋病毒相关的条件慢性疼痛和缺乏体力活动的艾滋病毒感染者与不健康 饮酒通过招募、评估和干预标准医疗访问之外的参与者， 通过完全在线的电子健康程序，我们的试验解决了复杂艾滋病毒护理中的不健康饮酒问题。 患者在目标2中，我们将支持对现有波士顿队列的二次分析， 为访问队列数据的学员和研究者提供支持和指导。近10- 一年前瞻性波士顿队列研究招募了目前或过去使用药物的PLWH，并提供了 为对相关科学问题感兴趣的早期酒精-艾滋病毒调查人员创建一个项目的基础 疼痛、身体活动不足以及身体和精神功能。为了实现解决这两个问题的目标， 同时发生的条件，我们汇集了多学科专家在各领域，包括酒精和艾滋病毒，公共 健康，成瘾医学，临床试验，心理学，疼痛，身体活动，生态瞬间 评估，功能状态测量，研究方法和服务（生物统计学和数据 管理）。跨这些领域的整合提供了一个有凝聚力的计划，整体大于 各部分的总和，支持调查人员的工作可以迅速转化为基于社区的 人口影响。

PROJECT SUMMARY/ABSTRACT Effective antiretroviral therapy has increased the lifespan of people living with HIV (PLWH). Alcohol use, common among PLWH, plays an increasingly important role in the risk for and management of HIV-associated comorbidities. Unhealthy drinking can exacerbate two highly prevalent HIV-related comorbidities/co-occurring conditions, chronic pain and physical inactivity, which in turn, can intensify alcohol use and affect physical and mental function in PLWH. We propose the Boston Alcohol Research Collaboration on HIV/AIDS – Comorbidity Center (Boston ARCH CC) as an extension of our Boston Alcohol Research Collaboration on HIV/AIDS (ARCH) cohort launched in 2011 and renewed in 2016 with funding from NIAAA. In Boston ARCH CC we target in randomized trials these two modifiable conditions, pain and physical inactivity, that have a critical impact on a variety of other HIV-related comorbidities. Boston ARCH CC contains 4 integrated components that make unique contributions to our interdisciplinary approach: two randomized trials (Research Project Components), an Administrative Core (AC) that coordinates the P01, and a Biostatistics and Data Management (BDM) Core that supports the trials methodologically and provides data management and biostatistical expertise to them, and continues secondary analyses using extant Boston ARCH data. In Objective 1 we will conduct state-of-the-art e-health clinical trials research on scalable approaches to address the HIV-associated conditions chronic pain and physical inactivity in PLWH with unhealthy alcohol use. By recruiting, assessing, and intervening with participants outside of standard medical visits, through entirely online e-health procedures, our trials address unhealthy drinking in the care of complex HIV patients. In Objective 2 we will support secondary analyses of the existing Boston ARCH cohort, and provide support and mentoring to trainees and investigators accessing the cohort data. The nearly ten- year prospective Boston ARCH cohort enrolled PLWH with current or past substance use, and provides the basis for creating a program for early stage alcohol-HIV investigators interested in scientific questions related to pain, physical inactivity, and physical and mental functioning. To achieve the goal of addressing these two co-occurring conditions, we bring together multidisciplinary experts in fields including alcohol and HIV, public health, addiction medicine, clinical trials, psychology, pain, physical activity, ecological momentary assessment, functional status measurement, and research methods and services (biostatistics and data management). The integration across these fields provides a cohesive program where the whole is bigger than the sum of the parts, supporting investigators whose work can be rapidly translated to community-based population impact.