Should screening and treatment strategies for unhealthy alcohol misuse in HIV-infected persons vary with smoking, depression, and substance abuse?

项目概要/摘要： 一项新的研究表明，不健康的酒精使用物质，吸烟， 抑郁症往往同时发生在艾滋病毒感染者身上。在一项大型多点观察性研究中， 老龄化和艾滋病毒，不健康的酒精使用，物质使用吸烟和抑郁症是常见的 在艾滋病毒感染者中，表现出惊人的时间一致性，通常是缓解性的， 一起重现。例如，更多的酒精使用会降低戒烟的几率。 虽然不健康的酒精使用，物质使用，吸烟和抑郁症往往同时发生，但他们的 筛查和治疗没有。这些疾病的筛查和治疗策略是 由于多种因素通常单独规定和单独颁布， 包括不同的临床指南，这些指南背后的证据强度不同 以及用于治疗每种病症的不同提供者和方案。因此，患者 接受一种筛查的人可能不会接受另一种筛查，接受治疗的患者 一个人不能为另一个人治疗。 我们建议开发一个决策分析模型来评估有益的影响， 综合筛查和治疗的潜在有害影响和资源影响。

Project Summary/Abstract: An emerging body of work shows that unhealthy alcohol use substance use, smoking, and depression often co-occur in HIV-infected patients. In a large multisite observational study of aging and HIV, unhealthy alcohol use, substance use smoking, and depression were common among those with HIV and exhibited striking temporal concordance, often remitting and recurring together. For example, greater alcohol use decreases the odds of smoking cessation. While unhealthy alcohol use, substance use, smoking, and depression often co-occur, their screening and treatment does not. Screening and treatment strategies for these conditions are typically specified separately and enacted separately because of a multitude of factors, including distinct clinical guidelines, varying strength of evidence underlying those guidelines and distinct providers and programs for the treatment of each condition. As a result, patients who are screened for one may not be screened for another, and patients who are treated for one may not be treated for another. We propose developing a decision-analytic model to evaluate beneficial effects as well as potentially harmful effects and resource implications of integrated screening and treatment.