Methods Seminar – Kodi B. Arfer, PhD on Comorbidity and Medical Costs Among Medicare Beneficiaries with HIV in California: A Case Study in Predictive Data Analysis

Kodi B. Arfer. PhD
Postdoctoral Scholar
Center for HIV Identification, Prevention, and Treatment Services, Semel Institute for Neuroscience and Human Behavior, UCLA

Data analysis typically focuses on inference about the unobservable true parameters of a postulated true data-generating model. An alternative is to focus on the model’s accuracy in predicting values on outcome variables. Predictive data analysis allows evaluating a wide variety of models in a straightforward way. It produces measures of predictive accuracy that show how practically useful a model and a set of variables are in predicting an outcome. Using Medicare claims data from HIV-positive Californians, I investigate how comorbidity information—knowing what conditions other than HIV a patient has been diagnosed with—can be used to predict medical costs. I show how difficulties in the data, from highly skewed distributions to the differences between Medicare and Medicaid, can be addressed with predictive strategies. I find that comorbidities are indeed predictively useful, especially for inpatient costs.

The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods.  The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).

Colloquium: “HIV Biomedical Prevention Efforts in Los Angeles County”

February 9, 2017 – Dr. Sonali Kulkarni, Medical Director of the Division of HIV and STD Programs, and Dr. Leo Moore, Associate Medical Director & Clinical Prevention Specialist, both from the Los Angeles County Department of Public Health presented “HIV Biomedical Prevention Efforts in Los Angeles County” at the Los Angeles County Commission on HIV meeting.

2017 February Colloquium Flyer
2017 February Colloquium Slides

 

CHIPTS hosts a monthly HIV Research and Community Colloquia Series in collaboration with the Los Angeles County Commission on HIV to highlight current issues and conversations surrounding HIV. Click here for past lectures and check out the events page for more information on future Colloquia presentations!

National Native HIV/AIDS Awareness Day: Incorporating Culture as Prevention

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Crystal Lee (Navajo)

Written by Crystal Lee (Navajo), Post-Doctoral Fellow at UCLA

March 20th is National Native HIV/AIDS Awareness Day recognizing that Native American/Alaska Natives (Natives) are often “invisible” and face challenges accessing HIV testing, treatment, and care. Although Native HIV prevalence rates are comparable to their 1.7% U.S. population, they have lower survival rates compared to any other racial/ethnic group.

  • Of the estimated 44,073 new HIV diagnoses in the United States in 2014, 1% (222) were among AI/AN. Of those, 77% were men and 22% were women.
  • From 2005 to 2014, the number of new HIV diagnoses increased 19% among AI/AN overall and 63% among AI/AN gay and bisexual men.
  • From 2010 to 2014 Natives had the second highest rates of chlamydia, gonorrhea, and syphilis among all racial/ethnic groups in the U.S.

There are ~572 federally recognized tribes in the U.S. with each tribe possessing their distinct language and cultural practices. However, Natives possess similar cultural philosophies and worldviews. As an enrolled tribal member of the Navajo Nation, I recognize that Native culture is the forefront for prevention of physical and mental health disparities.

The literature review demonstrates that there is lack of HIV evidence-based interventions research for Natives despite numerous research studies in this research discipline. For a pilot research project, I adapted an evidence-based intervention, Becoming A Responsible Teen, for Native adolescents ages 14-18 years old using culture as the foundation. Below are some examples that were included in the adapted curriculum to demonstrate relationships to self, family, community and the natural environment in a cultural context:

Assiniboine Tribe
(This narrative grants the connection between self and Mother Earth)

“…Our Indian religion, the Great spirit; we’re thankful that we’re on this Mother Earth. That’s the first thing when we wake up in the morning, is to be thankful to the Great Spirit for the Mother Earth; how we live, what it produces, what keeps everything alive. I know my old father-died about twenty years ago, almost a hundred years old-he never neglected his thanks early in the morning when he’d be out and the sun came up, shining-that’s the eye of the Great Spirit…No matter what he’s doing, certain times, he looked up, just before it got into the middle of here in the sky-that’s the throne of the Great Spirit. When the sun got about there, noon, he stopped, just for a few seconds, gave thanks for the Great Spirit and asked to be blessed. Then again when the sun was going down, he watched that until it got out of sight. Those are the things I always think are wonderful when we’re talking about our Indian life.”

Apache Tribe
(This narrative explains the connection between an Apache female reaching womanhood during her Apache Sunrise Puberty ceremony to honor her womanhood and the sacredness of womanhood)

“The puberty ceremony may be interpreted as isolating symbolically four critical life-objectives towards which all Apache girls on the threshold of adulthood should aspire. These are physical strength, an even temperament, prosperity, and a sound, healthy-age. To understand why these particular life objectives are emphasized…consider their relation to other aspects of Western Apache culture, powers, the role of women in native economy, the conduct of interpersonal relationships, and the natural environment.…the puberty ceremonial not only defines longevity as a life-objective but also helps the girl attain it.”

NNAAD3

Participants consistently stated that the Native content/activities helped them connect to the intervention because it was specifically made for their culture, helped them feel more connected to their self-identity, and connected culture to making responsible decisions. The participants consistently stated they enjoyed the cultural stories/teachings that were dispersed throughout the intervention. In conclusion, the results demonstrated that the participants liked the adapted intervention, connected to the activities, and felt it was overall culturally appropriate.

 

 

 

Gates Foundation Backs Intarcia Therapeutics’ HIV Drug Pump

Intarcia Therapeutics is developing implantable pump which holds six or 12 months’ supply of medicine.

The Bill & Melinda Gates Foundation is investing as much as $140 million to support development of a tiny implantable drug pump it believes could help prevent people in sub-Saharan Africa and elsewhere from becoming infected with HIV, the virus that causes AIDS.

Please click her for full article.

Addressing the Intersection of Racism and HIV

On December 12, 2016, the City of Los Angeles AIDS Coordinator’s Office, in collaboration with many key img_8164community partners, hosted a one-day event on “Addressing the Intersection of Racism and HIV.” The event discussed important topics such as the role of mass incarceration in the spread of HIV, provision of health care services by jails and police departments to economically disadvantaged people and other individuals who come in contact with law enforcement, and the shifting demographics of HIV and how that impacts the policy decisions being made. Speakers challenged those of us in attendance to reflect on the ways in which organizational practices could have unintended, negative img_8148consequences that disproportionately impact HIV-positive people of color. Additionally, panelists discussed the ways in which the direct criminalization of HIV promulgates stigma and fear among the community. The event was a great success, providing important and relevant information to over 120 frontline staff, including Drug and Alcohol Counselors, MSWs, MFTs, public health professionals, and LCSWs! 

Congratulations to the conference planning committee for coordinating a wonderful event! UCLA Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) is proud to be a co-sponsor of the event.

 

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