THE EPIDEMIOLOGY OF HIV AND HEALTH SERVICES AMONG IVDUS

IVDUS 中的艾滋病毒流行病学和卫生服务

• 批准号: 3210072
• 负责人: DALE D CHITWOOD
• 金额: $ 48.89万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-07-01 至 1995-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3210072
• 关键词: AIDS; AIDS /HIV test; HIV infections; behavior test; blood tests; communicable disease transmission; death certificates; disease /disorder proneness /risk; enzyme linked immunosorbent assay; health care cost /financing; health care service utilization; health insurance; human mortality; human subject; interview; intravenous drug abuse; longitudinal human study; medical records; prognosis; questionnaires; serology /serodiagnosis; western blottings

This proposal is a continuation of an epidemiologic study of HIV among intravenous drug users (IVDUs) . This study would extend to 8 years the follow-up of a cohort of 765 IVDUs to continue the investigation of 3 important epidemiologic questions (AIM 1) and to initiate the study of health services utilization and medical charges incurred by HIV negative & HIV positive IVDUs (AIMS 2-5): AIM 1a: Estimate the change in incidence of the presence of antibodies to HIV among IVDUs who initially screen negative; AIM 1b: Estimate mortality rates for seropositive and seronegative IVDUs and ascertain cause of death; AIM 1c: Conduct survival analyses to estimate relative survival and determine prognostic factors that relate to survival and death. AIM 2: Determine the use of all types of medical care services by seronegative and seropositive IVDUs. AIM 3: Determine the charges for all types of medical care services utilized by seronegative and seropositive IVDUs. AIM 4: Determine the status and type of insurance coverage of cohort members, the patterns of change in coverage over time, the predictors of these changes, and the association between insurance coverage and the receipt of care. AIM 5: Describe factors that affect patterns of health care utilization. To accomplish Aims 1a-c, the cohort will be followed 4 additional years at 6 month intervals. To accomplish Aims 2-5, a "nested" sample of the cohort will be supplemented with a sample of HIV positive IVDUs from an AIDS risk reduction program to create a pooled, stratified sample of 100 seronegative and 200 seropositive (100 asymptomatic, 100 symptomatic) IVDUs who will be followed at 6 month intervals for 4 years. To accomplish Aim 5, an ethnography of health services utilization will study 20 HIV-positive and 20 HIV negative IVDUs.

这项建议是对以下人群艾滋病毒流行病学研究的继续 静脉注射吸毒者(静脉吸毒者)。这项研究将持续8年 对765名静脉注射吸毒者进行跟踪调查，以继续调查3 重要的流行病学问题(目标1)，并启动对 HIV阴性患者的卫生服务利用和医疗费用 艾滋病毒阳性静脉注射吸毒者(AIMS 2-5)： 目标1a：估计抗体存在的发生率的变化 最初筛查阴性的静脉注射吸毒者中的艾滋病毒； 目标1b：估计血清阳性和血清阴性静脉注射吸毒者的死亡率 并查明死因； 目标1c：进行生存分析以估计相对存活率和 确定与生存和死亡相关的预后因素。 目标2：确定所有类型的医疗保健服务的使用情况 血清阴性和血清阳性静脉注射吸毒者。 目标3：确定所有类型医疗服务的收费 供血清阴性和血清阳性静脉注射吸毒者使用。 目标4：确定队列保险的状况和类型 成员，覆盖范围随时间的变化模式，预测 这些变化，以及保险覆盖范围和 接受照顾。 目的5：描述影响卫生保健利用模式的因素。 为了实现目标1a-c，该队列将再跟踪4年 间隔6个月。为了实现目标2-5，这是队列中的一个“嵌套”样本 将补充来自艾滋病风险人群的HIV阳性静脉注射吸毒者样本 减少计划，以创建100个血清阴性的混合分层样本 以及200名血清阳性(100名无症状，100名有症状)静脉注射吸毒者 每隔6个月随访4年。为了实现目标5，一个 卫生服务利用的民族志将研究20名艾滋病毒阳性和 20名HIV阴性静脉注射吸毒者。