Prevalence of DSM-IV Disorders in an Multi-Center HIV+ Women's Cohort

多中心 HIV 女性队列中 DSM-IV 疾病的患病率

• 批准号: 8435480
• 负责人: JUDITH A COOK
• 金额: $ 26.51万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-19 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8435480
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adherence; Adult; African American; Age-Years; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Area; Caring; Chicago; Cocaine Abuse; Cocaine Dependence; Cohort Studies; Comorbidity; Consent; Crack Cocaine; DSM-IV; Data; Dependence; Development; Diagnosis; Diagnostic; Disease; Disease Progression; District of Columbia; Drug usage; Epidemiology; Evaluation Studies; Frequencies; Funding Applicant; Genomics; Gold; HIV; HIV Seropositivity; HIV-1; Half-Life; Health; Highly Active Antiretroviral Therapy; Immune; Immunologics; Individual; International; Interview; Interviewer; Knowledge; Latina; Link; Los Angeles; Measures; Medical; Mental Depression; Mental Health; Mental disorders; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; National Institute of Child Health and Human Development; National Institute of Drug Abuse; Nature; Neurocognitive; Outcome; Outcome Study; Patient Self-Report; Pelvic Examination; Pharmaceutical Preparations; Population; Poverty; Prevalence; Process; Public Health; RNA; Recovery; Regimen; Research; Research Personnel; Salivary; Sampling; San Francisco; Serological; Severities; Site; Street Drugs; Structure; Study Subject; Substance Use Disorder; Substance abuse problem; Training; Travel; Visit; Woman; World Health Organization; addiction; alcohol abuse therapy; antiretroviral therapy; behavioral health; cohort; depressive symptoms; high school; laptop; member; men; mortality; prospective; psychosocial; public health relevance; reconstitution; service utilization; therapy adherence

DESCRIPTION (provided by applicant): Funded by NIAID, NIDA, NCI, and NICHD, the Women's Interagency HIV Study (WIHS) is a multi-site cohort study of HIV disease progression in 1,508 HIV-positive women at 6 sites in the U.S. including Brooklyn, Bronx, Chicago, Los Angeles, San Francisco/Bay Area, and Washington, DC. Since 1994, women have participated in bi-annual study visits that include physical and gynecological exams, serologic and salivary samples, and administration of an extensive battery of measures regarding health, psychosocial status, service utilization, and demographic features. The cohort is primarily African American (72%) and Latina (27%); half live in poverty (52%); two-thirds are not employed (66%); a substantial proportion did not complete high school (40%); and women average 45 years of age. To date, assessment of mental health and substance use in the WIHS has been limited to self- reported symptoms of depression and anxiety, and self-reported use of alcohol and street drugs. The purpose of this study is to administer to the WIHS cohort the gold standard in structured diagnostic interviews for behavioral health epidemiology, the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI). The first study aim is to determine the prevalence, type, and severity of mental health and substance use disorders (MH/SUD) in the cohort. The second aim is to conduct analyses addressing associations between 2 specific MH/SUDs -- depression and crack cocaine abuse/dependence - and immunological and virological components of disease progression and immune reconstitution, AIDS-defining illnesses, mortality, and HAART use and adherence. This will involve administering the WMH-CIDI to members of the WIHS cohort at each of its 6 sites in 2010 and 2011, and linking their diagnostic data to WIHS core data. These core data will provide 6-month and 12-month outcomes assessing disease progression (e.g., HIV1-RNA, CD4, AIDS-defining illnesses) and AIDS-related mortality. The WMH-CIDI will be administered at a separate study visit by WIHS interviewers who have been trained and certified in laptop CIDI administration by World Health Organization-sponsored trainers. Study subjects will undergo a separate consent process, and will receive a research honorarium along with travel stipends. Given the paucity of our knowledge about co-morbidity of HIV and MH/SU disorders in large cohorts of HIV+ individuals, this study has the potential to enhance our knowledge about how behavioral health factors impact recovery and long- term survival. WMH-CIDI data will also be made available to investigators in the larger WIHS, enabling them to examine the impact of MH/SUD in their ongoing neurocognitive, genomic, virologic, and immunologic studies.

描述（由申请人提供）：由 NIAID、NIDA、NCI 和 NICHD 资助，妇女机构间 HIV 研究 (WIHS) 是一项针对美国 6 个地点（包括布鲁克林、布朗克斯、芝加哥、洛杉矶、旧金山/湾区和华盛顿特区）的 1,508 名 HIV 阳性女性的 HIV 疾病进展的多地点队列研究。自 1994 年以来，女性每年参加两次研究访问，包括体检和妇科检查、血清学和唾液样本，以及针对健康、心理社会状态、服务利用和人口特征的一系列广泛措施的管理。该群体主要是非裔美国人 (72%) 和拉丁裔美国人 (27%)；一半生活贫困（52%）；三分之二没有工作（66%）；很大一部分人没有完成高中学业（40%）；女性平均年龄45岁。迄今为止，WIHS 对心理健康和物质使用的评估仅限于自我报告的抑郁和焦虑症状，以及自我报告的酒精和街头毒品使用情况。本研究的目的是向 WIHS 队列实施行为健康流行病学结构化诊断访谈的黄金标准，即世界心理健康综合国际诊断访谈 (WMH-CIDI)。第一个研究目的是确定队列中心理健康和药物滥用障碍 (MH/SUD) 的患病率、类型和严重程度。第二个目标是针对两种特定 MH/SUD（抑郁症和强效可卡因滥用/依赖）与疾病进展和免疫重建、艾滋病定义疾病、死亡率以及 HAART 使用和依从性的免疫学和病毒学成分之间的关​​联进行分析。这将涉及在 2010 年和 2011 年对 6 个地点的 WIHS 队列成员进行 WMH-CIDI 管理，并将他们的诊断数据与 WIHS 核心数据联系起来。这些核心数据将提供 6 个月和 12 个月的结果，评估疾病进展（例如 HIV1-RNA、CD4、艾滋病定义疾病）和艾滋病相关死亡率。 WMH-CIDI 将由 WIHS 访谈员在单独的研究访问中进行管理，这些访谈员接受过世界卫生组织资助的培训师在笔记本电脑 CIDI 管理方面的培训和认证。研究对象将接受单独的同意程序，并将获得研究酬金和旅行津贴。鉴于我们对大量 HIV+ 个体中 HIV 和 MH/SU 疾病的共病知之甚少，这项研究有可能增强我们对行为健康因素如何影响康复和长期生存的了解。 WMH-CIDI 数据也将提供给更大的 WIHS 的研究人员，使他们能够检查 MH/SUD 在正在进行的神经认知、基因组、病毒学和免疫学研究中的影响。