The adolescent medicine HIV/AIDS research networkThe REACH (Reaching for Excellence in Adolescent Care and Health) project: study design, methods, and population profile
Section snippets
Cohort identification, enrollment, and retention
The study design for the REACH project called for recruitment of both HIV infected youth and high-risk HIV uninfected youth between the ages of 12 through 18 years. Youth were to be enrolled at comprehensive, adolescent-specific medical care centers to manage any of the co-morbidities, biomedical complications or psychosocial issues that would be uncovered through the study. HIV infected youth were to have been those infected through risk behaviors, i.e., sexual activity or intravenous drug
Study measures and data collection
The REACH base protocol required extensive data collection to meet the primary study objectives. Five methods of data collection were used to accomplish these objectives: direct face-to-face interview, Audio Computer-Assisted Self-Administered Interview (ACASI), medical record abstraction, and physical and laboratory examinations. Both HIV infected and HIV uninfected subjects were seen every 3 months for data collection although the extent and depth of visits varied to minimize subject burden.
Selected baseline characteristics of the cohorts within REACH
All analyses in this issue of the Journal used the dataset that was established in September 1999. Enrollment in REACH remained open until December 1999, and thus the final REACH cohort was minimally different than that reported here. As of September 1999, there were 242 HIV infected females, 83 HIV infected males, 131 HIV uninfected females, and 40 HIV uninfected males who had completed a baseline visit. Selected baseline demographic and risk behavior characteristics of the cohorts are shown
Seroconversions
Four of the HIV uninfected youth enrolled in the REACH protocol seroconverted during the study period. All 4 of these youth were male and self-identified as homosexual. There were a total of 25 HIV uninfected males enrolled in REACH who self-identified as homosexual or bisexual. We used data through September 2000 to obtain an estimate of the total time of observation of this homosexual/bisexual cohort (51.7 person-years). Thus the seroconversion rate in this group of high risk
Summary
The HIV infected cohorts in REACH as described here are believed to be sociodemographically representative of the HIV epidemic in adolescents in the United States, i.e., predominantly female and predominantly minority with sexual risk behaviors as the main mode of acquisition, heterosexual for females and homosexual or bisexual for males. As such, the biomedical, psychosocial and behavioral assessments completed within the REACH project are directly informative for future interventional
Acknowledgements
The excellent retention rates of these generally disenfranchised youth in this multi-year, complex, and demanding study reflect on the efforts of the well-staffed, organized, and dedicated research teams at the participating institutions. We gratefully recognize the contributions of all REACH personnel, and the study coordinators in particular, as well as the invaluable contributions of those youth who participated in this study.
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Toll-like receptor gene variants associated with bacterial vaginosis among HIV-1 infected adolescents
2012, Journal of Reproductive ImmunologyCitation Excerpt :Briefly, REACH consisted of HIV-1 infected and comparable at risk HIV-1 negative adolescent males and females between the ages of 13 and 18 years old enrolled at 15 locations in 13 US cities between 1996 and 2000. HIV related risk factors and clinical data were collected longitudinally at quarterly intervals and other clinical and infectious disease related variables were measured biannually (Rogers et al., 1998; Wilson et al., 2001). The REACH study consisted of 75% females and 75% African Americans.
Transmitted HIV-1 drug resistance among young men of color who have sex with men: A multicenter cohort analysis
2011, Journal of Adolescent HealthCorrelates of sexual activity and sexually transmitted infections among human immunodeficiency virus-infected youth in the LEGACY cohort, United States, 2006
2011, Pediatric Infectious Disease Journal