The Comparative Outcomes and Service Utilization Trends (COAST) Study is a population-based cohort that includes data on all known adult people living with HIV (PLHIV) in BC (n=13,907) and a 10% random sample of individuals from the general population (n=516,340) from 1996-2013, with an update to include data from the years 1992-2018 in progress. Unlike traditional observational datasets, which are limited in size, scope, and sample by their original questionnaire, the COAST database is comprised of linked administrative health records that are population-based, evolving, and complex. In addition to administrative health data, COAST contains clinical data, as well as questionnaire data on behavior, social, and structural determinants of health. COAST data were assembled via linkages between 10 datasets housed at two provincial data sources: the BC-CfE Drug Treatment Program (DTP) and PopData BC. The DTP centrally manages the distribution of antiretroviral therapy (ART) to all PLHIV in BC and collects data on HIV-related outcomes.
Population Data BC facilitates research access to an extensive range of individual-level, de-identified, longitudinal data on BC's residents. COAST provides a unique opportunity for rich longitudinal analyses to: (1) evaluate determinants and predictors of health outcomes and healthcare services use among PLHIV, and (2) model complex interactions between HIV and comorbidities to understand health and economic impacts of long-term survival with HIV.
COAST has the potential for future linkages with diverse datasets, including data on localized weather events (e.g., precipitation), HIV phylogenetics, and detailed survey data on populations at higher risk of poor HIV-related outcomes (e.g. gay, bisexual and other men who have sex with men, women, Indigenous persons), which will allow us to elucidate new relationships between environmental, social, and genetic factors and outcomes relevant to PLHIV. Such information will provide insights into potential targets for interventions to improve malignancy screening and prevention, retention in care, and early ART initiation.
The webinar will provide an overview of the key features associated with the COAST database. Presenters will also identify the unique research opportunities associated with population-level longitudinal analyses exploring health outcomes in people living with HIV compared to the general population in BC.
View recorded presentation below.
Andreea Bratu, MSc, is a Research Coordinator for the Comparative Outcomes and Service Utilization (COAST) Study at the BC Centre for Excellence in HIV/AIDS in Vancouver. She has an MSc in Public Health (London School of Hygiene and Tropical Medicine) and has been involved in various epidemiological studies focused on health service utilization and health outcomes among people living with HIV in BC.
Andreea has contributed to the development and implementation of quality improvement guides, practices and processes related to administrative health data research. She is passionate about research examining the impact of environmental and socio-behavioural risk factors on the health of underserved populations at a local and global level.
Hailing from the island of Bali, Indonesia, Ni Gusti Ayu (Ditha) Nanditha is currently a PhD student at the University of British Columbia’s Experimental Medicine program and a graduate research assistant at the British Columbia Centre for Excellence in HIV/AIDS. Her research interest lies in the intersection between HIV, aging and chronic comorbidities. She specializes on the use of large health administrative databases in the context of population-based cohort study and on longitudinal analysis of these observational data.
Ultimately, Ditha hopes her work can contribute data-driven evidence to formulate policies which address the present and future impact of HIV and comorbidities, and ensure healthy living and successful aging of people living with HIV in British Columbia and beyond.