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 酒精研究联盟 (ARCH) 成立于 2011 年，开展了高影响力的流行病学研究 以及解决高危饮酒与 AUD（艾滋病毒护理）之间关系的干预研究 连续体（HIV-CC）和健康结果。 ARCH 融入并利用了研究和 CFAR 综合临床系统网络 (CNICS) 的临床基础设施，一个八站点临床队列 美国各地有许多以大学为基础的艾滋病毒诊所，其中许多诊所位于艾滋病病毒感染的高度优先地区 结束艾滋病毒流行（EHE）。拟议 P01 的首要主题是扩展科学知识 酒精护理连续体 (Alc-CC)、HIV-CC 和 HIV 交叉点的治疗干预措施 整个饮酒过程中的相关合并症——特别注意个人情况和 健康的社会决定因素——利用实施和流行病学研究。我们的科学目标是：1) 在使用酒精的 PWH 中实施基于证据的酒精干预措施 (EBI) 严格的混合实施有效性设计； 2）了解多层次情境因素如何 影响酒精使用谱、Alc-CC 和 HIV-CC、合并症和干预反应 焊后卫生保健； 3) 确定最佳戒酒目标（例如戒酒与低风险饮酒、减少世界卫生组织 在 Alc-CC、HIV-CC 和 HIV 相关合并症的背景下，PWH 中的风险评分）。这个拱门 P01 拥有三个研究项目。我们正在提议一项混合 III 型有效性实施试验，将 酒精 EBI 纳入 HIV 临床护理。这项研究是我们早期研究结果的直接延伸 展示嵌入阶梯式护理治疗中的计算机化简短干预的强大效果 针对有饮酒风险的感染者的方法。我们的第二个项目是混合型 1 型有效性实施 试点试验开发和测试一种新型的感染者复发预防干预措施（RPI）。我们的重要性 我们最近的发现强调了对 RPI 的关注，即患有 AUD 的感染者中任何饮酒都与 病毒血症增加，并且在缓解期患者中有 50-75% 的人有明显的高复发率。我们的 流行病学项目将为干预试验提供结果数据，并检查全面的 酒精使用谱、Alc-CC 及其与 HIV-CC 的关系、合并症和合并感染 健康问题社会决定因素的背景。管理核心提供结构和流程 支持 ARCH 项目和研究人员之间的协作和协同。生物统计学和方法核心 支持对三个项目的分析和新颖分析方法的开发。跨学科小组 的研究人员为该计划带来了深度和广度的专业知识。以十年合作为基础 ARCH的研究进展和管理架构，并利用CNICS的广泛资源， 这项 P01 提案解决了与美国结束艾滋病毒流行的目标以及办公室高度相关的问题 艾滋病研究重点，包括艾滋病毒治疗作为预防、艾滋病毒相关合并症和差异。