Prevalence of DSM-IV Disorders in an Multi-Center HIV+ Women's Cohort

多中心 HIV 女性队列中 DSM-IV 疾病的患病率

• 批准号: 7840217
• 负责人: JUDITH A COOK
• 金额: $ 59.2万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-19 至 2015-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7840217
• 关键词: Address; Adherence; Adult; African American; Age-Years; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Area; Caring; Chicago; Cocaine Abuse; Cocaine Dependence; Cohort Studies; Comorbidity; Consent; Crack Cocaine; DSM-IV; Data; Dependence; Development; Diagnosis; Diagnostic; Disease; Disease Progression; District of Columbia; Drug usage; Epidemiology; Evaluation Studies; Frequencies; Funding Applicant; Genomics; Gold; HIV; HIV Seropositivity; HIV-1; Half-Life; Health; Highly Active Antiretroviral Therapy; Immune; Immunologics; Individual; International; Interview; Interviewer; Knowledge; Latina; Link; Los Angeles; Measures; Medical; Mental Depression; Mental Health; Mental disorders; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; National Institute of Child Health and Human Development; National Institute of Drug Abuse; Nature; Neurocognitive; Outcome; Outcome Study; Patient Self-Report; Pelvic Examination; Pharmaceutical Preparations; Population; Poverty; Prevalence; Process; Public Health; Recovery; Regimen; Research; Research Personnel; Salivary; Sampling; San Francisco; Serological; Severities; Site; Street Drugs; Structure; Study Subject; Substance Use Disorder; Substance abuse problem; Training; Travel; Visit; Woman; World Health Organization; addiction; alcohol abuse therapy; antiretroviral therapy; behavioral health; cohort; cooking; depressive symptoms; high school; laptop; member; men; mortality; prospective; psychosocial; public health relevance; reconstitution; service utilization; therapy adherence

DESCRIPTION (provided by applicant): Funded by NIAID, NIDA, NCI, and NICHD, the Women's Interagency HIV Study (WIHS) is a multi-site cohort study of HIV disease progression in 1,508 HIV-positive women at 6 sites in the U.S. including Brooklyn, Bronx, Chicago, Los Angeles, San Francisco/Bay Area, and Washington, DC. Since 1994, women have participated in bi-annual study visits that include physical and gynecological exams, serologic and salivary samples, and administration of an extensive battery of measures regarding health, psychosocial status, service utilization, and demographic features. The cohort is primarily African American (72%) and Latina (27%); half live in poverty (52%); two-thirds are not employed (66%); a substantial proportion did not complete high school (40%); and women average 45 years of age. To date, assessment of mental health and substance use in the WIHS has been limited to self- reported symptoms of depression and anxiety, and self-reported use of alcohol and street drugs. The purpose of this study is to administer to the WIHS cohort the gold standard in structured diagnostic interviews for behavioral health epidemiology, the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI). The first study aim is to determine the prevalence, type, and severity of mental health and substance use disorders (MH/SUD) in the cohort. The second aim is to conduct analyses addressing associations between 2 specific MH/SUDs -- depression and crack cocaine abuse/dependence - and immunological and virological components of disease progression and immune reconstitution, AIDS-defining illnesses, mortality, and HAART use and adherence. This will involve administering the WMH-CIDI to members of the WIHS cohort at each of its 6 sites in 2010 and 2011, and linking their diagnostic data to WIHS core data. These core data will provide 6-month and 12-month outcomes assessing disease progression (e.g., HIV1-RNA, CD4, AIDS-defining illnesses) and AIDS-related mortality. The WMH-CIDI will be administered at a separate study visit by WIHS interviewers who have been trained and certified in laptop CIDI administration by World Health Organization-sponsored trainers. Study subjects will undergo a separate consent process, and will receive a research honorarium along with travel stipends. Given the paucity of our knowledge about co-morbidity of HIV and MH/SU disorders in large cohorts of HIV+ individuals, this study has the potential to enhance our knowledge about how behavioral health factors impact recovery and long- term survival. WMH-CIDI data will also be made available to investigators in the larger WIHS, enabling them to examine the impact of MH/SUD in their ongoing neurocognitive, genomic, virologic, and immunologic studies. PUBLIC HEALTH RELEVANCE: Rates of co-occurrence of HIV disease with psychiatric and substance use disorders are high among HIV-positive adults, and evidence suggests that these disorders interfere with the initiation and continued use of effective antiretroviral therapies. Prior research also shows that certain mental health disorders, such as depression, occur at higher rates in HIV+ women than men, and that addictive disorders, such as crack cocaine abuse/dependence, have a particularly deleterious effect on women's HIV disease progression and mortality. This study's focus on how mental illness and addiction impact treatment for HIV, disease progression, and mortality has the potential to produce knowledge that will greatly enhance our nation's public health.

描述（由申请人提供）：由NIAID，NIDA，NCI和NICHD资助，妇女的机构间HIV研究（WIHS）是一项多站点的同类研究，对美国6个地点的1,508名HIV阳性妇女的HIV疾病进展研究包括美国6个地点布鲁克林，布朗克斯，芝加哥，洛杉矶，旧金山/湾区和华盛顿特区。自1994年以来，妇女参加了两年一次的研究访问，包括身体和妇科考试，血清学和唾液样本，以及对健康，社会心理状况，服务利用和人口统计特征进行大量措施。该队列主要是非裔美国人（72％）和拉丁裔（27％）；一半生活在贫困中（52％）；三分之二不使用（66％）；很大一部分没有完成高中（40％）；妇女平均45岁。迄今为止，WIHS中心理健康和药物使用的评估仅限于自我报告的抑郁症和焦虑症状，以及自我报告的酒精和街头药物的使用。这项研究的目的是为WIHS队列管理行为健康流行病学的结构化诊断访谈中的黄金标准，世界心理健康复合国际诊断访谈（WMH-CIDI）。第一个研究的目的是确定队列中精神健康和药物使用障碍（MH/SUD）的患病率，类型和严重程度。第二个目的是进行分析，以解决2种特定的MH/SUD之间的关联 - 抑郁和可卡因滥用/依赖性 - 疾病进展和免疫重建的免疫学和病毒学成分，定义疾病，死亡率以及HAART使用和依从性。这将涉及在2010年和2011年的6个站点中的每个站点中的每个站点中对WMH-CIDI管理WMH-CIDI，并将其诊断数据与WIHS核心数据联系起来。这些核心数据将提供6个月和12个月的结果，以评估疾病进展（例如HIV1-RNA，CD4，艾滋病定义疾病）和与艾滋病相关的死亡率。 WMH-CIDI将在WIHS访调员的另一项研究访问中进行管理，WIHS访问者已通过世界卫生组织赞助的培训师在笔记本电脑CIDI管理方面的培训和认证。研究对象将经历单独的同意程序，并将与旅行津贴一起获得研究酬金。鉴于我们对大量HIV+个体中HIV和MH/SU疾病的合并症的了解很少，因此这项研究有可能增强我们对行为健康因素如何影响恢复和长期生存的知识。 WMH-CIDI数据还将提供给较大的WIH的研究人员，从而使他们能够检查MH/SUD对持续的神经认知，基因组，病毒学和免疫学研究的影响。 公共卫生相关性：HIV阳性成年人的HIV疾病与精神病和药物使用障碍的共同发生率很高，并且证据表明这些疾病会干扰和继续使用有效的抗逆转录病毒疗法。先前的研究还表明，某些心理健康障碍（例如抑郁症）比男性的艾滋病毒+女性比男性更高，而上瘾的疾病（例如可卡因滥用/依赖性）对妇女的艾滋病毒疾病进展和死亡率具有特别有害的影响。这项研究的重点是精神疾病和成瘾如何影响艾滋病毒，疾病进展和死亡率的治疗方法有可能产生知识，从而大大增强我们国家的公共卫生。