The DC Cohort: A Longitudinal Population-Based Cohort Study of People Living with HIV in Washington, DC

华盛顿特区队列：对华盛顿特区艾滋病毒感染者进行的一项基于人群的纵向队列研究

• 批准号: 10880859
• 负责人: Amanda Derryck Castel
• 金额: $ 36.31万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10880859
• 关键词: Achievement; Acquired Immunodeficiency Syndrome; Address; Area; Basic Science; Capital; Caring; Cessation of life; Cities; Clinic; Clinical; Cohort Studies; Collection; Communities; Computerized Medical Record; Continuity of Patient Care; Data; Data Collection; Data Linkages; Data Sources; Databases; Effectiveness; Electronic Health Record; Enrollment; Epidemic; Epidemiology; Feedback; Framingham Heart Study; Funding; Future; Geography; Goals; HIV; HIV diagnosis; Health; Health Resources; High Prevalence; Infrastructure; Intervention; Intervention Studies; Knowledge; Laboratories; Learning; Link; Longitudinal cohort; Longitudinal cohort study; Medical; Molecular Epidemiology; Monitor; National Institute of Allergy and Infectious Disease; Newly Diagnosed; Outcome; Participant; Patient Outcomes Assessments; Performance; Persons; Pharmacy facility; Population; Positioning Attribute; Prevalence; Prevention; Productivity; Provider; Public Health; Quality of Care; Reduce health disparities; Research; Research Personnel; Research Proposals; Resources; Risk; Services; Social Behavior; Testing; Therapeutic; Thinking; Time; United States National Institutes of Health; Viral; Washington; Work; age group; care outcomes; clinical research site; cohort; community engagement; comorbidity; dashboard; data repository; data visualization; efficacy evaluation; epidemiology study; health disparity; implementation science; improved; novel; novel therapeutics; population based; response; tool; transmission process; urban area

Project Abstract Washington, DC has approximately 13,000 people living with HIV (PLWH) and is one of the HIV “hotspots” in the US that collectively contribute to 50% of new HIV diagnoses. As we strive to end the HIV epidemic, the ability to characterize persons who are newly diagnosed with HIV, effectively direct treatment efforts for HIV and its co-occurring conditions, and use novel prevention tools to avert further transmissions, are of critical importance. The DC Cohort, a longitudinal cohort study of over 10,000 PLWH receiving care at 15 clinical sites in DC, is uniquely positioned to help end the HIV epidemic. The Cohort was launched in 2011 with the goal of bending the trajectory of the HIV epidemic in DC by improving the quality of care. The Cohort engages academic and community-based clinics, links to DC Health Department (DOH) databases, and provides near real-time performance feedback to clinics on HIV outcomes using a data visualization Clinical Dashboard. All of this is achieved through automated data extraction and harmonization of electronic medical records data from varied clinical settings and all age groups. The Cohort provides a representative, population-level and scientifically productive research resource that does not exist in most urban high prevalence cities. Building off the Cohort’s infrastructure and achievements, we will expand this robust population-level data repository to comprehensively and longitudinally track outcomes among PLWH in a high prevalence city. We will incorporate new data sources into the Cohort including administrative, service, pharmacy, additional co-morbidity and patient-reported outcomes data. Access to multi-level data will enhance the monitoring of HIV and co- morbidities outcomes. Next, we propose to use the Cohort to monitor the impact and effectiveness of Ending the HIV Epidemic (EHE) initiatives in DC and contribute lessons learned to national EHE efforts. The Dashboard will monitor key EHE indicators: retention in care; viral suppression (VS); availability, initiation and efficacy of new ARV therapeutics; and reductions in health disparities. With this tool, local HIV providers and the DC DOH can support those at greatest risk for suboptimal outcomes. Finally, we will use the Cohort to develop pioneering interventions to improve the quality of care among PLWH. We will partner with the DC Center for AIDS Research, local and national HIV investigators, and community stakeholders to identify and develop clinical, epidemiologic, socio-behavioral, basic science, and implementation science interventions to improve care. We will use the Cohort infrastructure to identify potential participants and clinical sites for these studies in support of NIH-funded and other research proposals. The goals of the Cohort align with OAR, NIAID, and EHE priorities which focus on reducing health disparities, achieving VS, monitoring quality of care, and improving the management of HIV-related clinical outcomes. The DC Cohort is an unparalleled clinical, research, and public health resource which enables us to monitor care in a high prevalence city. Lessons learned will produce generalizable knowledge that can be applied in other urban hotspots across the US.

项目摘要 华盛顿特区约有13，000名艾滋病毒感染者（PLWH），是美国艾滋病毒“热点”之一。 美国占艾滋病新诊断病例的50%。在我们努力结束艾滋病毒流行的同时， 能够确定新诊断感染艾滋病毒者的特征，有效指导艾滋病毒治疗工作 及其共同发生的条件，并使用新的预防工具，以避免进一步的传播，是至关重要的 重要性DC队列，一项在15个临床研究中心接受治疗的10，000多名PLWH的纵向队列研究 在华盛顿特区，它在帮助结束艾滋病流行方面具有独特的地位。该队列于2011年启动，目标是 通过提高护理质量来扭转华盛顿特区艾滋病流行的轨迹。The Cohort参与 学术和社区诊所，链接到DC卫生部（DOH）数据库，并提供近 使用数据可视化临床仪表板向诊所提供有关艾滋病毒结果的实时性能反馈。所有 这是通过自动数据提取和协调电子病历数据来实现的， 不同的临床环境和所有年龄组。该队列提供了一个具有代表性的，人口水平和 科学生产研究资源，不存在于大多数城市高流行率的城市。建立在 我们将扩大这一强大的人口层面数据库， 在一个高患病率城市中，全面和纵向跟踪PLWH的结局。我们将合并 队列的新数据来源，包括行政、服务、药房、其他合并症和 患者报告的结局数据。获得多层次数据将加强对艾滋病毒的监测， 发病率结果。接下来，我们建议使用队列来监测结束的影响和有效性 艾滋病毒流行病（EHE）在华盛顿特区的倡议，并提供经验教训，国家EHE的努力。的 仪表板将监测关键EHE指标：保持护理;病毒抑制（VS）;可用性、启动和 新的抗逆转录病毒疗法的疗效;以及减少健康差距。有了这个工具，当地的艾滋病毒提供者和 DC DOH可以支持那些处于最大风险的次优结果。最后，我们将使用队列来 制定开创性的干预措施，以提高艾滋病毒携带者的护理质量。我们将与DC合作 艾滋病研究中心、地方和国家艾滋病毒调查人员以及社区利益相关者， 制定临床、流行病学、社会行为、基础科学和实施科学干预措施， 改善护理。我们将使用队列基础设施来确定潜在的参与者和临床研究中心， 支持NIH资助的研究和其他研究提案。队列的目标与OAR、NIAID、 和EHE优先事项，重点是减少健康差距，实现VS，监测护理质量， 改善艾滋病毒相关临床结果的管理。DC队列是一个无与伦比的临床， 研究和公共卫生资源，使我们能够在一个高流行率的城市监测护理。教训 所学到的知识将产生可推广的知识，可应用于美国其他城市热点地区。

项目成果

Integrase Inhibitor Prescribing Disparities in the DC and Johns Hopkins HIV Cohorts.

• DOI: 10.1093/ofid/ofab338
• 发表时间: 2021-08
• 期刊: Open forum infectious diseases
• 影响因子: 4.2
• 作者: Monroe AK;Levy ME;Greenberg AE;Keruly JC;Moore RD;Horberg MA;Kulie P;Mohanraj BS;Kumar PN;Castel AD;DC Cohort Executive Committee
• 通讯作者: DC Cohort Executive Committee

Risk of Severe COVID-19 Disease and the Pandemic's Impact on Service Utilization Among a Longitudinal Cohort of Persons with HIV-Washington, DC.

• DOI: 10.1007/s10461-022-03662-0
• 发表时间: 2022-10
• 期刊: AIDS AND BEHAVIOR
• 影响因子: 4.4
• 作者: Monroe, Anne K.;Xiao, Jiayang;Greenberg, Alan E.;Levy, Matt E.;Temprosa, Marinella;Resnik, Jenna B.;Castel, Amanda D.
• 通讯作者: Castel, Amanda D.

An mHealth Platform for People With HIV Receiving Care in Washington, District of Columbia: Qualitative Analysis of Stakeholder Feedback.

• DOI: 10.2196/48739
• 发表时间: 2023-09-19
• 期刊: JMIR FORMATIVE RESEARCH
• 影响因子: 2.2
• 作者: Caldwell, Sylvia;Flickinger, Tabor;Hodges, Jacqueline;Waldman, Ava Lena D.;Garofalini, Chloe;Cohn, Wendy;Dillingham, Rebecca;Castel, Amanda;Ingersoll, Karen
• 通讯作者: Ingersoll, Karen

Association of Substance Use Disorders with Engagement in Care and Mortality among a Clinical Cohort of People with HIV in Washington, DC.

• DOI: 10.1007/s10461-021-03157-4
• 发表时间: 2021-07
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Doshi RK;Byrne M;Levy M;Varga L;Kuo I;Horberg MA;Castel AD;Monroe AK;DC Cohort Executive Committee
• 通讯作者: DC Cohort Executive Committee

Integrase Strand Transfer Inhibitors and Weight Gain in Children and Youth With Perinatal Human Immunodeficiency Virus in the DC Cohort.

• DOI: 10.1093/ofid/ofab308
• 发表时间: 2021-07
• 期刊: Open forum infectious diseases
• 影响因子: 4.2
• 作者: Koay WLA;Dirajlal-Fargo S;Levy ME;Kulie P;Monroe A;Castel AD;Rakhmanina NY;DC Cohort Executive Committee
• 通讯作者: DC Cohort Executive Committee