Consortium to improve OutcoMes in HIV/Aids, Alcohol, Aging & multi-Substance use

描述（由申请人提供）：退伍军人老龄化队列研究（VACS）是北美最大的HIV队列研究（40,594）。它包括一个嵌套的、同意的地点样本（VACS 8），其中3660名感染艾滋病毒（HIV+）的退伍军人与3652名未感染艾滋病毒（HIV-）的退伍军人在人口统计学上相匹配，该样本有近10年的纵向深度数据，涉及酒精、药物使用、健康和行为结果。VACS 8的艾滋病毒阳性受试者中，63%饮酒，32%不健康饮酒。由于VACS包括未感染的比较者，我们能够描述艾滋病毒感染在酒精相关结果中的作用。VACS包括大量未充分研究但重要的亚组：中年人和老年人、有色人种、与男性发生性关系的黑人男性、丙型肝炎病毒感染者（HCV+）。我们建议招收更多的妇女和新患者。我们进行了观察性研究，并在VACS中进行了有限的操作建模和干预研究，重点关注酒精在确定HIV+/-可改变结局中的作用。我们有一个全国性的调查网络在西黑文退伍军人医疗中心有一个高效的协调中心。我们的团队已经发表了100多篇被广泛引用的出版物。我们为我们提供的教育和职业发展支持感到自豪，但VACS对酒精研究的资助将于2011年9月结束。我们建议将VACS转变为改善艾滋病毒/艾滋病、酒精、衰老和多种物质使用结果的联盟（COMpAAAS）： 1)扩大我们在干预和操作建模方面的工作，同时保持观察数据分析的卓越性；2)将我们基于临床的观察性研究转变为基于交互式网络的实验室，并为我们的研究人员网络提供管理和方法支持。3)利用我们在北美和欧洲的合作者网络来验证和扩展我们的发现。我们联盟的使命是通过战略协调、整合和外部验证的观察、操作建模和干预研究，逐步建立和传播所需的证据，以优化由酒精、多种物质使用、HCV和抑郁症损害的HIV+的卫生保健。

DESCRIPTION (provided by applicant): The Veterans Aging Cohort Study (VACS) is the largest HIV cohort in the North America (40,594). It includes a nested, consented 8 site sample (VACS 8) of 3,660 HIV infected (HIV+) veterans demographically matched to 3652 uninfected veterans (HIV-) which has longitudinal in-depth data spanning nearly 10 years on alcohol, substance use, and health and behavioral outcomes. Of the HIV+ subjects in VACS 8, 63% drink alcohol and 32% have unhealthy alcohol use. Because VACS includes uninfected comparators, we are able to characterize the role of HIV infection in alcohol associated outcomes. VACS include large well characterized samples of understudied, but important subgroups: middle aged and older individuals, people of color, Black men who have sex with men, those with HCV infection (HCV+). We propose to enroll more women and those new to care. We have conducted observational research, and limited operations modeling and intervention studies within VACS focused on the role of alcohol in determining modifiable outcomes among HIV+/-. We have a national network of investigators and a highly effective Coordinating Center at the West Haven VA Medical Center. Our group has produced >100 widely cited, publications. We are proud of the education and career development support we have offered, but VACS funding for alcohol research ends September 2011. We propose to transform VACS into the Consortium to improve OutcoMes in HIV/Aids, Alcohol, Aging, and multi-Substance use (COMpAAAS) by 1) expanding our work in intervention and operations modeling while maintaining excellence in observational data analyses, 2) Converting our clinic based observational study into an Interactive Web Based Laboratory and providing administrative and methodological support to our network of investigators, and 3) Tapping our network of collaborators in North America and Europe to validate and extend our findings. Our consortium mission is to incrementally build and disseminate the evidence needed to optimize health care for HIV+ harmed by alcohol, multisubstance use, HCV, and depression through strategically coordinated, integrated, and externally validated observation, operations modeling, and intervention studies.