Developing a collaborative research system for Aboriginal health

The definitive version may be found at www.wiley.comObjectiveInvestigator-driven research and the use of peer review are contentious in community-based research and are particularly problematic in Indigenous research. In this project, we conducted a qualitative study among stakeholders in an Australian Aboriginal majority-controlled research-funding organisation to examine the research funding process.MethodsA steering group guided the project and contributed to the research findings. In-depth interviews (n=18) with stakeholders in the Cooperative Research Centre for Aboriginal Health were conducted to canvass views on the research funding process and options for alternate processes. A discussion document, supported by an extensive literature review, was provided prior to interview. This research was an iterative process where the discussion document and interview schedule were revised as the research findings informed the project.FindingsParticipants overwhelmingly endorsed a move to a more collaborative research culture, although the form the culture might take varied. Suggested elements included involvement of grant funding bodies as brokers in building collaborative networks and the substitution of named 'critical friends' for blinded peer review. Barriers to changing the research culture to a more collaborative model were described.Conclusions and implicationsA collaborative structure with targeted project development would permit redistribution of the time and effort (previously expended on peer review) into research development and would increase community participation in decision-making in the research funding process.Jackie Street, Fran Baum, Ian Anderso

Sex and Racial/Ethnic Differences in Premature Mortality Due to HIV: Florida, 2000–2009

OBJECTIVE: This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment. METHODS: Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables. RESULTS: Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5); for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9; 294.3, 95% CI 239.8, 354.9; and 295.0, 95% CI 242.9, 352.5, respectively); and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7; 210.6, 95% CI 174.3, 250.8; and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for individual factors, NHB race was associated with YPLL due to HIV/AIDS for women (p=0.04) and men (p<0.001). CONCLUSION: Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups