Administrative Supplement: Population-Based Study of Social Determinants of Health and Quality of Cancer Care in HIV-Associated Cancers

项目总结/摘要 抗逆转录病毒疗法的进展已将艾滋病毒转变为一种慢性疾病。由于艾滋病毒的死亡 艾滋病毒感染者（PLWH）的死亡率下降，其他慢性衰老疾病，特别是非慢性衰老疾病， 艾滋病定义的癌症（NADC）显著增加。Winship癌症研究所P30癌症中心 支助赠款及其社区外展和参与组成部分已将艾滋病毒携带者和艾滋病患者确定为“特别 人口”，在我们的格鲁吉亚集水区经历了显着的癌症差异。多重回顾性 数据库分析报告称，PLWH与HIV之间的癌症结局（包括生存率）更差- 人群，但解释癌症护理和生存结果显着差异的根本原因更多 完全有待阐明。我们提出了两个具体的目标，这个探索性的补充：1）产生一个 来自格鲁吉亚的年龄和分期匹配的HIV+和HIV- NHL患者的基于人群的队列 癌症登记处;和2）使用已建立的登记方案联系该队列并评估可行性， 接受经验证的工具和方法来调查健康的社会决定因素和多层次因素 （患者、临床、设施、提供者、系统），可能影响艾滋病毒+ 和HIV-癌症病例通过混合方法研究设计。这些目标与NIH OAR一致 与HIV相关的合并症、合并感染和并发症相关的研究优先事项， 增加对艾滋病毒相关恶性肿瘤的原因、频率和临床结果的了解， 作为研究，以减少健康差距.在治疗结果的艾滋病毒携带者。这些目标的实现将导致 一个校外拨款申请，以扩大初步数据到其他NADC。

PROJECT SUMMARY/ABSTRACT Advances in anti-retroviral therapy have transformed HIV into a chronic disease. As death from HIV has decreased for people living with HIV (PLWH), mortality from other chronic diseases of aging, particularly non- AIDS defining cancers (NADC), has significantly increased. Winship Cancer Institute’s P30 cancer center support grant and its Community Outreach and Engagement component have identified PLWH as a “Special Population”, experiencing significant cancer disparities in our catchment area of Georgia. Multiple retrospective database analyses have reported worse cancer outcomes, including survival, between PLWH vs HIV- populations, but underlying reasons to explain significant differences in cancer care and survival outcomes more fully remain to be elucidated. We propose two Specific Aims for this exploratory supplement: 1) generate a population-based cohort of age- and stage-matched HIV+ and HIV- NHL patients derived from the Georgia cancer registry; and 2) contact this cohort using established registry protocols and evaluate feasibility and acceptability of validated tools and methods to investigate social determinants of health and multi-level factors (patient, clinical, facility, provider, system) that might impact diagnosis, treatment and outcomes for both HIV+ and HIV- cancer cases through a mixed methods study design. These Aims are in alignment with the NIH OAR research priorities related to HIV-Associated Comorbidities, Coinfections, and Complications that contributes to increasing understanding of the causes, frequency, and clinical outcomes of HIV-related malignancies, as well as research to reduce Health Disparities … in treatment outcomes of PLWH. Completion of these Aims will lead to an extramural grant application to expand preliminary data to other NADC.