Secondary Analysis of Existing Alcohol & HIV/AIDS Data

对现有酒精的二次分析

• 批准号: 6892414
• 负责人: KATHRYN WHETTEN
• 金额: $ 18.12万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6892414
• 关键词: AIDS; AIDS therapy; HIV infections; alcoholism /alcohol abuse; behavioral /social science research tag; disease /disorder proneness /risk; geographic difference; health care cost /financing; health care service availability; health care service utilization; health disparity; health insurance; health services research tag; health surveys; helper T lymphocyte; high risk behavior /lifestyle; human data; human immunodeficiency virus; intravenous drug abuse; longitudinal human study; meta analysis; patient /disease registry; substance abuse related behavior; therapy compliance; virus load; zidovudine

DESCRIPTION (provided by applicant): The purpose of the proposed study is to examine the effects of alcohol consumption on (1) individuals' preventive and risk behaviors associated with contracting HIV, (2) the probability of HIV positive individuals being prescribed HIV medications and adherence to such medication, (3) health status, and (4) health care utilization and costs, including barriers to accessing health care and insurance coverage. These relationships will be analyzed using four databases: the HIV Cost and Services Utilization Study (HCSUS), Coping with HIV/AIDS in the Southeast (CHASE), the National Health Interview Surveys (NHIS) with linked mortality data, and the Medical Expenditure Panel Survey (MEPS). Alcohol impairs individuals' ability to think rationally, may increase risk behaviors such as unprotected sex or IV drug use, and may decrease prevention efforts such as testing for HIV. These relationships will be analyzed using NHIS, HCSUS, and CHASE. Alcohol alters the effectiveness of HIV medications in reducing the viral load. Physicians may avoid prescribing HIV medications to alcoholics for fear of the HIV virus developing drug resistance due to inadequate adherence to prescribed drug regimens. These relationships will be analyzed using HCSUS and CHASE. Alcohol weakens an individual's immune system and coping abilities, especially in HIV infected persons. The effect of alcohol on self-reported health and functioning, co-infections, and clinical markers such as CD4 count and viral load will be studied using HCSUS and CHASE. Heavy alcohol consumption reduces an individual's likelihood of being employed and having private insurance, and increases the likelihood of being on Medicaid or uninsured. Thus, alcoholic HIV infected persons are more likely to face problems in accessing adequate medical care. The relationship between alcohol, insurance coverage, health care utilization and costs will be studied using HCSUS, CHASE, MEPS and NHIS. The proposed analyses will greatly improve our knowledge of causal pathways due to the use of longitudinal data from multiple sources; provide estimates of cost associated with heavy alcohol consumption in HIV positive individuals; allow for national estimates for the U.S. population and for HIV positive adults; provide current estimates of the associations for the Deep South; and allow for an evaluation of changes in the relationships over time as our data span much of the time period since the beginning of the HIV epidemic.

描述（申请人提供）：这项拟议研究的目的是检查饮酒对以下方面的影响：（1）个人与感染艾滋病毒相关的预防和风险行为，（2）艾滋病毒阳性个体被处方艾滋病毒药物的概率和对此类药物的依从性，（3）健康状况，以及（4）医疗保健利用和成本，包括获得医疗保健和保险的障碍。这些关系将使用四个数据库进行分析：艾滋病毒成本和服务利用研究（HCSUS），应对艾滋病毒/艾滋病在东南部（CHASE），全国健康访谈调查（NHIS）与相关死亡率数据，以及医疗支出小组调查（MEPS）。酒精会损害个人理性思考的能力，可能会增加无保护性行为或静脉注射毒品等风险行为，并可能减少艾滋病毒检测等预防工作。将使用NHIS、HCSUS和CHASE分析这些关系。酒精会改变HIV药物在降低病毒载量方面的有效性。医生可能会避免给酗酒者开艾滋病毒药物，因为他们担心艾滋病毒会因不充分遵守规定的药物治疗方案而产生耐药性。将使用HCSUS和CHASE分析这些关系。酒精会削弱个人的免疫系统和应对能力，特别是对艾滋病毒感染者。将使用HCSUS和CHASE研究酒精对自我报告的健康和功能、合并感染和临床标志物（如CD 4计数和病毒载量）的影响。大量饮酒降低了个人就业和拥有私人保险的可能性，并增加了医疗补助或无保险的可能性。因此，酗酒的艾滋病毒感染者更有可能在获得适当医疗服务方面面临问题。将使用HCSUS、CHASE、MEPS和NHIS研究酒精、保险范围、医疗保健利用和费用之间的关系。由于使用了来自多个来源的纵向数据，拟议的分析将大大提高我们对因果途径的了解;提供与HIV阳性个体重度饮酒相关的成本估计;允许对美国人口和HIV阳性成年人进行国家估计;提供目前对南方腹地相关性的估计;并允许对关系随时间的变化进行评估，因为我们的数据跨越了自艾滋病毒流行开始以来的大部分时间段。