Artherosclerosis/bone loss/drug use/HIV in older men

随着越来越多的人感染人类免疫缺陷病毒（艾滋病毒），这种感染导致的死亡率下降，更多的吸毒者和其他艾滋病毒感染者将生活在与衰老有关的并发症中。 其中一些情况在艾滋病毒感染者中似乎更常见或更严重，这是艾滋病毒感染或治疗并发症的直接结果。 目前，对HIV感染及其治疗对当前或以前的吸毒者或其他老年人的衰老疾病的可能影响知之甚少。 通常影响老年人的这些疾病中突出的是动脉粥样硬化疾病和骨质疏松症。 为了解决这些问题，我们将在纽约市的布朗克斯进行一项为期五年的前瞻性研究，研究对象为50岁或50岁以上的HIV感染或有感染风险的男性。 将从一项纵向研究（布朗克斯HERO（HIV结局流行病学研究）研究）、药物滥用治疗项目、我们机构的其他临床护理站点和周围社区招募一组当前或既往吸毒者。 我们将利用正在进行的一项对老年妇女吸毒者和其他感染艾滋病毒或有感染艾滋病毒风险的妇女的纵向研究，该研究使用类似的方法，以评估性别在这些情况中的作用。该项目的具体目标是：1.确定HIV感染和高效抗逆转录病毒治疗（HAART）对动脉粥样硬化疾病发生率和危险因素的影响。 需要考虑的风险因素包括血脂异常、胰岛素抵抗、肥胖、饮食、药物以及非法药物和酒精的使用。2.确定HIV感染和HAART对年龄相关骨量丢失的影响。3.确定HIV感染和HAART对老年男性高危药物使用和性行为的影响。4.利用一项正在进行的老年女性队列研究，该研究使用可比方法解决了类似的问题，以比较男性和女性的动脉粥样硬化，骨质流失，药物使用和性行为。

As additional persons become infected with human immunodeficiency virus (HIV) an mortality due to this infection declines, more drug users and others with HIV infection will live to experience co-morbid conditions associated with aging. Some of these conditions appear likely to occur more commonly or to be more severe in persons with HIV infection, as a direct result of HIV infection or complications of its treatment. Presently there is little known about the possible effects of HIV infection and its treatments on diseases of aging in current or former drug users or other aging individuals. Prominent among such disorders commonly affecting older individuals are atherosclerotic disease and osteoporosis. To address these issues, we will conduct a five-year prospective study of aging, atherosclerosis, bone mass loss, and drug use in men 50 years or older with or at risk for HIV infection in the Bronx, New York City. A cohort of current or former drug users will be recruited from a longitudinal study, the Bronx HERO (HIV Epidemiological Research on Outcomes) Study, and from substance abuse treatment programs, other clinical care sites at our institutions, and the surrounding community. We will take advantage of an ongoing longitudinal study of older women drug users and other women with or at risk for HIV infection that is using similar methodology, in order to assess the role of gender on these conditions. The specific aims of the project are to: 1. Determine the effect of HIV infection and highly active antiretroviral therapy (HAART) on the rate and risk factors for atherosclerotic disease. Among risk factors to be considered will be dyslipidemia, insulin resistance, obesity, diet, and medication and illicit drug and alcohol use. 2. Determine the effect of HIV infection and HAART on age-related loss of bone mass. 3. Determine the effect of HIV infection and HAART on high-risk drug using and sexual behaviors of older men. 4. Take advantage of an ongoing study of a cohort of older women, which addresses similar issues using comparable methodology, in order to compare atherosclerosis, bone loss, and drug use and sexual behaviors in men and women.