Accession Number : ADA580437


Title :   A Comparison of HAART Outcomes between the US Military HIV Natural History Study (NHS) and HIV Atlanta Veterans Affairs Cohort Study (HAVACS)


Descriptive Note : Journal article


Corporate Author : UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD


Personal Author(s) : Guest, Jodie L ; Weintrob, Amy C ; Rimland, David ; Rentsch, Christopher ; Bradley, William P ; Agan, Brian K ; Marconi, Vincent C


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a580437.pdf


Report Date : 01 May 2013


Pagination or Media Count : 9


Abstract : Introduction: The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide comprehensive HIV treatment and care to their beneficiaries with open access and few costs to the patient. Individuals who receive HIV care in the VA have higher rates of substance abuse, homelessness and unemployment than individuals who receive HIV care in the DoD. A comparison between individuals receiving HIV treatment and care from the DoD and the VA provides an opportunity to explore the impact of individual-level characteristics on clinical outcomes within two healthcare systems that are optimized for clinic retention and medication adherence. Methods: Data were collected on 1065 patients from the HIV Atlanta VA Cohort Study (HAVACS) and 1199 patients from the US Military HIV Natural History Study (NHS). Patients were eligible if they had an HIV diagnosis and began HAART between January 1, 1996 and June 30, 2010. The analysis examined the survival from HAART initiation to all-cause mortality or an AIDS event. Results: Although there was substantial between-cohort heterogeneity and the 12-year survival of participants in NHS was significantly higher than in HAVACS in crude analyses, this survival disparity was reduced from 21.5% to 1.6% (mortality only) and 26.8% to 4.1% (combined mortality or AIDS) when controlling for clinical and demographic variables. Conclusion: We assessed the clinical outcomes for individuals with HIV from two very similar government-sponsored healthcare systems that reduced or eliminated many barriers associated with accessing treatment and care. After controlling for clinical and demographic variables, both 12-year survival and AIDS-free survival rates were similar for the two study cohorts who have open access to care and medication despite dramatic differences in socioeconomic and behavioral characteristics.


Descriptors :   *COMPARISON , *HUMAN IMMUNODEFICIENCY VIRUSES , *SURVIVAL(GENERAL) , CLINICAL MEDICINE , DEMOGRAPHY , DEPARTMENT OF DEFENSE , DIAGNOSIS(GENERAL) , STATISTICAL ANALYSIS , VETERANS(MILITARY PERSONNEL)


Subject Categories : Medicine and Medical Research
      Military Forces and Organizations


Distribution Statement : APPROVED FOR PUBLIC RELEASE