Alcohol Research Consortium in HIV: Ending the HIV Epidemic through interventions and Epidemiology at the intersection of the alcohol and HIV care Continua

艾滋病毒酒精研究联盟：通过酒精和艾滋病毒护理交叉点的干预措施和流行病学结束艾滋病毒流行 Continua

• 批准号: 10304371
• 负责人: GEETANJALI CHANDER
• 金额: $ 145.48万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10304371
• 关键词: Abstinence; Acquired Immunodeficiency Syndrome; Address; Age; Alcohol consumption; Alcohols; Attention; Biological Markers; Biostatistical Methods; Cardiovascular Diseases; Caring; Chronic Disease; Clinic; Clinical; Cognition; Collaborations; Communities; Computers; Continuity of Patient Care; Data; Database Management Systems; Development; Disease remission; Drug usage; Effectiveness; Electronic Health Record; Epidemic; Epidemiology; Evidence based intervention; Frequencies; Goals; HIV; Health; Hybrids; Individual; Infrastructure; Intervention; Intervention Studies; Intervention Trial; Knowledge; Liver diseases; Long-Term Effects; Longitudinal Studies; Malignant Neoplasms; Measures; Medical Records; Mental disorders; Methods; Neighborhoods; Outcome; Patient Outcomes Assessments; Patient Self-Report; Persons; Prevalence; Process; Quality of life; Recording of previous events; Relapse; Research; Research Infrastructure; Research Personnel; Research Priority; Research Project Grants; Resources; Risk; Severity of illness; Site; Social Environment; Source; Structure; System; Testing; United States Dept. of Health and Human Services; Universities; Viral hepatitis; Viremia; alcohol abstinence; alcohol abuse therapy; alcohol exposure; alcohol intervention; alcohol relapse; alcohol related problem; alcohol research; alcohol risk; alcohol screening; alcohol use disorder; analytical method; antiretroviral therapy; base; behavioral pharmacology; brief intervention; clinical care; clinical infrastructure; clinical research site; co-infection; cohort; comorbidity; computerized; contextual factors; design; disorder later incidence prevention; drinking; effectiveness implementation study; effectiveness implementation trial; epidemiology study; evidence base; frailty; high risk drinking; implementation research; implementation science; implementation strategy; novel; pilot trial; preventive intervention; programs; response; screening; social health determinants; success; synergism; treatment as prevention; treatment strategy; unsupervised learning; uptake

Established in 2011, the Alcohol Research Consortium in HIV (ARCH) conducts high impact epidemiological and intervention studies that address relationships between at-risk alcohol use and AUD, the HIV Care Continuum (HIV-CC) and health outcomes. ARCH is embedded in and has capitalized on the research and clinical infrastructure of the CFAR Network of Integrated Clinical Systems (CNICS), an eight site clinical cohort of university-based HIV clinics across the US, with many of these clinics located in high priority regions for Ending the HIV Epidemic (EHE). The overarching theme of the proposed P01 is to expand scientific knowledge and treatment interventions at the intersection of the Alcohol-Care Continuum (Alc-CC), HIV-CC and HIV related comorbidities across the full spectrum of alcohol use -- with particular attention to individual context and social determinants of health -- using implementation and epidemiological research. Our scientific goals are: 1) To implement evidence-based alcohol interventions (EBI) across the alcohol use spectrum among PWH using rigorous hybrid-implementation effectiveness designs; 2) To understand how multi-level contextual factors impact the alcohol use spectrum, the Alc-CC and HIV-CC, comorbidities, and intervention responses among PWH; 3) To determine optimal alcohol reduction targets (e.g. abstinence v low-risk drinking, reduction in WHO risk score) among PWH in the context of the Alc-CC, HIV-CC and HIV-related comorbidities. This ARCH P01 has three research projects. We are proposing a Hybrid Type III effectiveness-implementation trial integrating alcohol EBIs into HIV clinical care. This study is a direct extension of our earlier research findings demonstrating a robust effect of a computerized brief intervention embedded in a stepped care treatment approach for PWH with at-risk drinking. Our second project is a Hybrid Type1 effectiveness-implementation pilot trial developing and testing a novel relapse prevention intervention (RPI) for PWH. The importance of our focus on RPI is highlighted by our recent finding that any alcohol use among PWH with AUD is associated with increased viremia and the well-established high relapse prevalence of 50 – 75% of persons in remission. Our epidemiological project will provide outcomes data for the intervention trials as well as examine the full spectrum of alcohol use, the Alc-CC and their relationship to HIV-CC, comorbidities and co-infections in the context of social determinants of health. An administrative core provides the structure and processes to support collaboration and synergy across ARCH projects and investigators. A biostatistics and methods core supports analyses for the three projects and development of novel analytic methods. A transdisciplinary group of investigators brings depth and breadth of expertise to this program. Building on a decade of collaborative research progress and administrative structure in ARCH and capitalizing on the extensive resources of CNICS, this P01 proposal addresses issues of high relevance to the US goal of ending the HIV epidemic and the Office of AIDS Research priorities, including HIV Treatment as Prevention, HIV related comorbidities and disparities.

HIV（ARCH）的酒精研究联盟成立于2011年 以及解决高危酒精使用与AUD之间关系的干预研究，艾滋病毒护理 连续性（HIV-CC）和健康成果。拱门已嵌入其中，并已大写了研究， CFAR Integrated Clinical Systems（CNIC）的CFAR网络的临床基础设施，八个站点临床队列 在美国的大学艾滋病毒诊所中，许多此类诊所都位于高优先区域 结束HIV流行（EHE）。拟议的P01的总体主题是扩展科学知识 和酒精保健连续体（ALC-CC），HIV-CC和HIV的交点的治疗干预措施 遍布全部酒精饮酒的相关合并症 - 特别关注个人环境和 健康的社会决定者 - 使用实施和流行病学研究。我们的科学目标是：1） 使用PWH之间在PWH中实施基于证据的酒精干预措施（EBI） 严格的杂种实践有效性设计； 2）了解多层次上下文因素如何 影响酒精使用范围，ALC-CC和HIV-CC，合并症以及干预反应 PWH; 3）确定最佳的饮酒目标（例如禁欲v低风险饮酒，降低谁 在ALC-CC，HIV-CC和与HIV相关的合并症的背景下，PWH的风险评分）。这个拱形P01 有三个研究项目。我们提出了一项混合III型有效性实施试验 酒精EBIS进入HIV临床护理。这项研究是我们较早的研究结果的直接扩展 证明嵌入在阶梯护理治疗中的计算机化简短干预效果 PWH饮酒的方法。我们的第二个项目是Hybrid type1的有效性实现 PILOT试验为PWH开发和测试新型中继预防干预（RPI）。我们的重要性 我们最近的发现，PWH与AUD有关的任何酒精使用都与RPI有关 病毒血症的增加和公认的高浮雕患病率是50-75％的缓解率。我们的 流行病学项目将为干预试验提供结果数据，并检查完整 酒精使用范围，ALC-CC及其与HIV-CC的关系，合并症和共同感染 健康决定者的背景。管理核心为结构和过程提供 支持跨拱门项目和研究人员的协作和协同作用。生物统计学和方法核心 支持对这三个项目的分析以及新的分析方法的发展。一个跨学科小组 研究人员为该计划带来了深度和广度。建立十年的合作 研究进度和拱门的行政结构，并利用CNIC的广泛资源， 该P01提案涉及与美国结束艾滋病毒流行和办公室有关的高度相关性的问题 艾滋病研究的重点，包括艾滋病毒治疗作为预防，与艾滋病毒相关的合并症和差异。