HIV/AIDS Treatment Adherence, Health Outcomes and Cost Study
In FY 1998, the Substance Abuse and Mental Health Services Administration, the National Institutes of Health, and the Health Resources and Services Administration collaborated in the development and funding of this five-year cooperative research program. The study targeted individuals aged 18 and older living with HIV/AIDS who also have mental and substance abuse disorders diagnosed using DSM-IV criteria. It was the first Federal initiative designed to study integrated mental health, substance use and primary medical HIV treatment interventions. Cooperative agreements were awarded to eight sites, including universities, research institutions, and hospitals. JBA was awarded a cooperative agreement to serve as the Coordinating Center for all activities undertaken as part of the study. JBA designed and managed the collection and analysis of extensive demographic, socio-economic, clinical status and service utilization data on more than 1,100 people living with HIV/AIDS who also met study inclusion criteria for mental illness and drug or alcohol dependence (DSM-IV). A majority of the participants in the study were minority clients. In addition to documenting participants' complex co-morbidities, measuring baseline status and changes in adherence to HIV medications and utilization of HIV primary care and behavioral health services, extensive data were collected on services such as peer outreach, HIV education, and medication adherence support. These are all elements of contemporary HIV care that are known to be crucial from practical experience but for which quality research data are rare. This unique study resulted in a robust public-use database in which a typical case record contains more than 2,000 items collected over a 15-month observation period.