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

随着更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感染艾滋病毒的人将经历与衰老相关的共同疾病。作为艾滋病毒感染或其治疗并发症的直接结果，其中一些情况似乎更常见或更严重地发生在艾滋病毒感染者身上。目前，关于艾滋病毒感染及其治疗对现在或以前的吸毒者或其他老年人的老年病的可能影响知之甚少。在这些疾病中，通常影响老年人的突出问题是动脉粥样硬化性疾病和骨质疏松症。为了解决这些问题，我们将在纽约市布朗克斯区进行一项为期五年的前瞻性研究，研究50岁或50岁以上有艾滋病毒感染风险或有艾滋病毒感染风险的男性的老龄化、动脉粥样硬化、骨量丢失和药物使用。一批现在或以前的吸毒者将从一项纵向研究，即布朗克斯HERO(艾滋病毒流行病学研究结果)研究中招募，并从药物滥用治疗计划、我们机构的其他临床护理地点和周围社区招募。我们将利用正在进行的对老年女性吸毒者和其他感染艾滋病毒或有艾滋病毒感染风险的妇女进行的纵向研究，该研究正在使用类似的方法，以评估性别在这些情况下的作用。该项目的具体目的是：1.确定HIV感染和高效抗逆转录病毒治疗(HAART)对动脉粥样硬化性疾病的发生率和危险因素的影响。要考虑的危险因素包括血脂异常、胰岛素抵抗、肥胖、饮食和药物以及非法药物和酒精的使用。2.确定HIV感染和HAART对年龄相关性骨量丢失的影响。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.利用正在进行的一项对老年妇女队列的研究，该研究使用类似的方法处理类似的问题，以便比较男性和女性的动脉粥样硬化、骨丢失以及药物使用和性行为。

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.