Alcohol and Multisubstance Use in the Veterans Aging Cohort Study

描述（由申请人提供）：退伍军人老龄化队列研究（VACS）是北美最大的HIV感染者（HIV+）临床队列研究，包括8个地点（VACS 8） 7,312名HIV+/-退伍军人7年的酒精、多物质使用（MSU）和结果的深度、纵向数据。我们观察到，在HIV阳性饮酒者中，MSU是常态（64%也使用烟草、阿片类药物或可卡因），但我们不知道它对酒精治疗的影响。作为改善艾滋病毒/艾滋病、酒精、衰老和多种物质使用（COMpAAAS）结果的联盟中的自然观察研究，我们建议在VACS之前的工作基础上，为我们的联盟使命做出贡献，“通过协调、整合和外部验证的观察、运筹学（OR）建模和干预研究，建立和传播优化酒精、MSU、HCV和抑郁症对艾滋病毒阳性患者的健康护理所需的证据。”在本提案中，我们试图描述酒精和MSU的长期（bb0 - 10年）纵向模式和后果。这些信息对我们的任务至关重要，将为U01的所有三个项目提供信息。我们使用这些数据来探索与减少酒精使用的通用建议相比，针对酒精和密歇根州立大学风险量身定制的健康信息是否会增加改变的动机。为此，我们开发并在国际上验证了VACS指数（基于临床生物标志物），并创建了VACS指数计算器原型。虽然VACS分析对COMpAAAS的使命至关重要，但我们对酒精的资助将于2011年9月结束。如果没有额外的随访，我们在重要亚组中描述酒精和MSU的长期纵向模式和后果的能力将受到限制。此外，我们希望在那些开始治疗的人群中研究酒精和MSU的当代模式和后果，因为处方阿片类药物（NMU）的非医疗使用增加和ART的变化可能正在改变模式和后果。最后，时间线追踪数据（TLFB）是酒精研究的黄金标准，但很难收集。通过将调查收集转换为基于网络的格式，我们将能够收集有关酒精和MSU的TLFB数据，并开始将VACS从临床队列转变为交互式基于网络的实验室。

DESCRIPTION (provided by applicant): The Veterans Aging Cohort Study (VACS) is the largest clinical cohort of HIV infected Individuals (HIV+) in North America and includes in depth, longitudinal data on alcohol, multisubstance use (MSU), and outcomes over 7 years on 7,312 HIV+/- veterans at 8 sites (VACS 8). We have observed that among HIV+ drinkers, MSU is the norm (64% also use tobacco, opioids, or cocaine), but we do not know its implications for alcohol treatment. As the naturalistic observation study in the Consortium to improve OutcoMes in hiv/Aids, Alcohol, Aging, and multi-Substance use (COMpAAAS), we propose to build on the prior work of VACS to contribute to our consortium mission, "to build and disseminate the evidence needed to optimize health care for HIV+ harmed by alcohol, MSU, HCV, and depression through coordinated, integrated, and externally validated observation, operations research (OR) modeling, and intervention studies." In this proposal we seek to characterize long-term (>10 year) longitudinal patterns and consequences of alcohol and MSU. This information that is essential to our mission and will inform all three U01 projects. We use this data to explore whether individually tailored health information on risks of alcohol and MSU increases motivation to change compared to generic advice to curtail alcohol use. To this end, we have developed and internationally validated the VACS Index (based on clinical biomarkers) and created a prototype VACS Index Calculator. While VACS analyses are essential to the COMpAAAS mission, our alcohol funding ends September 2011. Without additional follow up, our ability to characterize long-term longitudinal patterns and consequences of alcohol and MSU within important subgroups will be limited. Further, we hope to study contemporary patterns and consequences of alcohol and MSU among those initiating care since increased non medical use of prescription opioids (NMU) and changes in ART may be altering both patterns and consquences. Finally, Time Line Follow Back data (TLFB) are the gold standard for alcohol research but difficult to collect. By transitioning survey collection to a Web-Based format we will be able to collect TLFB data on alcohol and MSU and begin the transformation of VACS from a clinic cohort to an Interactive Web-Based Laboratory.