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: 3210067
• 负责人: DALE D CHITWOOD
• 金额: $ 47.51万
• 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/3210067
• 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; 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.

这项建议是一项艾滋病毒流行病学研究的继续， 静脉吸毒者（IVDU）。这项研究将延长到8年， 随访765例静脉吸毒者，继续研究3例 重要的流行病学问题（AIM 1），并开始研究 艾滋病毒阴性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）： 目的1a：估计存在抗 最初筛查结果为阴性的静脉注射吸毒者中的艾滋病毒感染者; 目的1b：估计血清阳性和血清阴性静脉吸毒者的死亡率 并确定死因; 目的1c：进行生存分析以估计相对生存率， 确定与生存和死亡相关的预后因素。 目标2：通过以下方式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的静脉内用药者。 目标3：确定各类医疗服务的收费 由血清阴性和血清阳性的静脉内用药者使用。 目的4：确定队列的保险覆盖状况和类型 成员，覆盖率随时间变化的模式， 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，将对队列再随访4年， 6个月间隔。 为了实现目标2-5，队列的“嵌套”样本 将补充一份来自艾滋病风险人群的艾滋病毒阳性静脉吸毒者样本， 减少程序，以创建100例血清阴性的合并分层样本 和200名血清反应阳性（100名无症状，100名有症状）的静脉吸毒者，他们将被 每隔6个月随访4年。 为实现目标5， 卫生服务利用的民族志将研究20个艾滋病毒阳性和 20例艾滋病毒阴性静脉注射吸毒者。