Veterans Aging Cohort Study (VACS): Overview and Description : Medical Care (original) (raw)

Original Article

Overview and Description

Justice, Amy C. MD, PhD*; Dombrowski, Elizabeth MBA†; Conigliaro, Joseph MD, MPH‡; Fultz, Shawn L. MD, MPH*; Gibson, Deborah MA*; Madenwald, Tamra MPH§; Goulet, Joseph PhD, MS*; Simberkoff, Michael MD¶; Butt, Adeel A. MD∥; Rimland, David MD**; Rodriguez-Barradas, Maria C. MD††; Gibert, Cynthia L. MD‡‡; Oursler, Kris Ann K. MD, ScM§§; Brown, Sheldon MD¶¶; Leaf, David A. MD, MPH∥∥; Goetz, Matthew B. MD∥∥; Bryant, Kendall PhD***

From the *VA Connecticut Healthcare System, West Haven, and Section of General Medicine, Yale University School of Medicine, New Haven, Connecticut; †Department of Internal Medicine, Program on Aging, Yale University School of Medicine, New Haven, Connecticut; ‡University of Kentucky Medical Center, Lexington, Kentucky; §Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut; ¶VA New York Harbor Healthcare System and New York University School of Medicine, New York, New York; ∥VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, Pennsylvania; **VA Medical Center and Emory University School of Medicine, Atlanta, Georgia; ††Michael E. DeBakey VAMC and Baylor College of Medicine, Houston, Texas; ‡‡VA Medical Center and George Washington University Medical Center, Washington, DC; §§Baltimore VA Medical Center and University of Maryland School of Medicine, Baltimore, Maryland; ¶¶ Bronx VA Medical Center and Mt. Sinai School of Medicine, New York, New York; ∥∥VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, California; and ***HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland.

Primary Funding Sources for VACS: National Institute on Alcohol Abuse and Alcoholism (U01 AA 13566) and the Veterans Health Administration Office of Research and Development and Public Health Strategic Health Care Group. Primary Funding Source for VACS 5: An Interagency Agreement between National Institute on Aging, National Institute of Mental Health and the Veterans Health Administration Office of Research and Development and Public Health Strategic Health Care Group.

Reprints: Amy C. Justice, MD, PhD, VA Connecticut Healthcare System, Bldg 35A, Room 212, 950 Campbell Ave (11-ACLSG), West Haven, CT 06516. E-mail: [email protected].

Abstract

Background:

The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study.

Objectives:

We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample.

Research Design:

We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection.

Measures:

Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA “paperless” electronic medical record system.

Results:

More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age–race–site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control.

Conclusions:

VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions.