Alcohol Research Consortium in HIV: Ending the HIV Epidemic through interventions and Epidemiology at the intersection of the alcohol and HIV care Continua

成立于2011年，酒精研究联盟在艾滋病毒（HIV）进行高影响力的流行病学研究。 和干预研究，解决风险酒精使用和AUD之间的关系，艾滋病毒护理 连续体（HIV-CC）和健康结果。联合国儿童基金会是嵌入式的，并利用了研究， CFAR综合临床系统网络（CNICS）的临床基础设施， 美国各地的大学艾滋病诊所，其中许多诊所位于高度优先地区， 终止艾滋病毒流行（EHE）。拟议的P01的首要主题是扩大科学知识 在酒精护理连续体（Alc-CC）、艾滋病毒-CC和艾滋病毒交叉点的治疗干预措施 在整个酒精使用范围内的相关合并症-特别注意个人背景， 健康的社会决定因素-利用实施和流行病学研究。我们的科学目标是：1） 在威尔斯亲王医院使用酒精的人群中实施循证酒精干预（EBI）。 严格的混合实施有效性设计; 2）了解多层次的背景因素如何 影响酒精使用谱、Alc-CC和HIV-CC、合并症和干预反应， 3）确定最佳的减少酒精摄入目标（如戒酒与低风险饮酒，减少世卫组织 在Alc-CC、HIV-CC和HIV相关合并症的背景下，PWH的风险评分）。这张照片P01 有三个研究项目。我们提出了一个混合型III的有效性实施试验， 酒精EBI进入艾滋病临床护理。这项研究是我们早期研究成果的直接延伸 证明了嵌入在阶梯式护理治疗中的计算机化简短干预的强大效果 为高危饮酒的威尔斯亲王医院而设。我们的第二个项目是一个混合类型1有效性实现 为威尔斯亲王医院发展及测试一项新的预防复发干预措施的先导试验。我们的重要性 我们最近的发现强调了对RPI的关注，即患有AUD的PWH中的任何酒精使用都与 增加的病毒血症和50 - 75%的缓解患者的明确的高复发率。我们 流行病学项目将为干预试验提供结果数据，并检查 酒精使用谱，Alc-CC及其与HIV-CC的关系， 健康的社会决定因素。管理核心提供了结构和流程， * 支持联合国毒品和犯罪问题办公室各项目和调查人员之间的协作和协同增效。生物统计学和方法核心 支持三个项目的分析和开发新的分析方法。跨学科小组 的调查带来了深度和广度的专业知识，这一计划。基于十年的合作 研究进展和管理结构，并利用CNICS的广泛资源， 该P01提案涉及与美国结束艾滋病流行的目标和办公室高度相关的问题 艾滋病研究的优先事项，包括艾滋病毒治疗作为预防，艾滋病毒相关的合并症和差异。

Established in 2011, the Alcohol Research Consortium in HIV (ARCH) conducts high impact epidemiological and intervention studies that address relationships between at-risk alcohol use and AUD, the HIV Care Continuum (HIV-CC) and health outcomes. ARCH is embedded in and has capitalized on the research and clinical infrastructure of the CFAR Network of Integrated Clinical Systems (CNICS), an eight site clinical cohort of university-based HIV clinics across the US, with many of these clinics located in high priority regions for Ending the HIV Epidemic (EHE). The overarching theme of the proposed P01 is to expand scientific knowledge and treatment interventions at the intersection of the Alcohol-Care Continuum (Alc-CC), HIV-CC and HIV related comorbidities across the full spectrum of alcohol use -- with particular attention to individual context and social determinants of health -- using implementation and epidemiological research. Our scientific goals are: 1) To implement evidence-based alcohol interventions (EBI) across the alcohol use spectrum among PWH using rigorous hybrid-implementation effectiveness designs; 2) To understand how multi-level contextual factors impact the alcohol use spectrum, the Alc-CC and HIV-CC, comorbidities, and intervention responses among PWH; 3) To determine optimal alcohol reduction targets (e.g. abstinence v low-risk drinking, reduction in WHO risk score) among PWH in the context of the Alc-CC, HIV-CC and HIV-related comorbidities. This ARCH P01 has three research projects. We are proposing a Hybrid Type III effectiveness-implementation trial integrating alcohol EBIs into HIV clinical care. This study is a direct extension of our earlier research findings demonstrating a robust effect of a computerized brief intervention embedded in a stepped care treatment approach for PWH with at-risk drinking. Our second project is a Hybrid Type1 effectiveness-implementation pilot trial developing and testing a novel relapse prevention intervention (RPI) for PWH. The importance of our focus on RPI is highlighted by our recent finding that any alcohol use among PWH with AUD is associated with increased viremia and the well-established high relapse prevalence of 50 – 75% of persons in remission. Our epidemiological project will provide outcomes data for the intervention trials as well as examine the full spectrum of alcohol use, the Alc-CC and their relationship to HIV-CC, comorbidities and co-infections in the context of social determinants of health. An administrative core provides the structure and processes to support collaboration and synergy across ARCH projects and investigators. A biostatistics and methods core supports analyses for the three projects and development of novel analytic methods. A transdisciplinary group of investigators brings depth and breadth of expertise to this program. Building on a decade of collaborative research progress and administrative structure in ARCH and capitalizing on the extensive resources of CNICS, this P01 proposal addresses issues of high relevance to the US goal of ending the HIV epidemic and the Office of AIDS Research priorities, including HIV Treatment as Prevention, HIV related comorbidities and disparities.