Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies

在华盛顿特区大都市的艾滋病毒流行 (S/HE) 中生存 - 通过队列研究增进知识

• 批准号: 10219632
• 负责人: SEBLE G KASSAYE
• 金额: $ 5.45万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10219632
• 关键词: Address; Adolescent; Adult; Affect; Age; Aging; Anti-Retroviral Agents; Area; Behavioral; Behavioral Research; Biological Factors; Biological Markers; Blood Vessels; Capital; Cardiovascular Diseases; Chronic; Cohort Studies; Collaborations; Communities; Complex; Continuity of Patient Care; Death Rate; Diagnosis; Disease; Disease Outcome; District of Columbia; Dyslipidemias; Enrollment; Ensure; Epidemic; Failure; Funding; Geographic Factor; Geography; Goals; HIV; HIV Infections; Health; Health Personnel; Healthcare Systems; Hearing problem; Immunologics; Impairment; Individual; Intervention; Knowledge; Lead; Leadership; Life; Malignant Neoplasms; Maryland; Measures; Mediating; Mental disorders; Metabolic; Morbidity - disease rate; Neurocognitive Deficit; Newly Diagnosed; Outcome; Participant; Play; Population; Positioning Attribute; Prevalence; Prevention; Prevention Guidelines; Preventive screening; Protocols documentation; Research; Research Personnel; Risk; Risk Factors; Role; Savings; Science; Site; Socioeconomic Status; Surveys; The Multicenter AIDS Cohort Study; Translating; Treatment Effectiveness; Treatment Protocols; United States; Viral; Virus; Washington; Woman; Women’s Interagency HIV Study; aged; antiretroviral therapy; base; behavioral study; cardiovascular disorder risk; cardiovascular risk factor; cohort; comorbidity; coping; data acquisition; effective therapy; equilibration disorder; glucose metabolism; health seeking behavior; healthy aging; high risk; immune activation; improved; innovation; lifetime risk; male; men; men' s group; metropolitan; microbiome; mortality; novel; optimal treatments; outcome prediction; pre-clinical; prevent; protocol development; psychosocial; racial difference; recruit; research study; resilience; service delivery; side effect; social; social determinants; success; tool; transmission process; treatment adherence; treatment guidelines; uptake; virology

ABSTRACT About 1.1 million people are living with HIV (PLWH) in the US, with an estimated 39,782 individuals newly diagnosed with HIV in 2016. The Multicenter AIDS Cohort Study (MACS) and the Women’s Interagency HIV Study (WIHS) are two of the longest standing HIV cohort studies in the United States. Established in 1984 and 1993, respectively, these US-based cohorts currently follow 2,235 men and 2,304 women living with HIV, alongside high-risk but uninfected controls. HIV is at epidemic proportions in the nation’s capital, with overall HIV prevalence of 1.9% among the District of Columbia (DC) adult and adolescent residents. Approximately 3.7% of DC residents aged 40 to 49 years and 5.2% of residents aged 50 to 59 years are living with HIV. The highest life time risk of acquiring HIV in the U.S. is highest in DC with an estimated 1 in 17 individuals anticipated to acquire HIV in their lifetime, followed by 1 in 56 risk among the neighboring Maryland residents. Continuing to follow the women we have recruited and expanding our cohort to include a representative group of men and women is imperative in this region with epidemic levels of HIV. Our research will be focused on understanding the behavioral and social determinants that contribute to long term treatment success and failure, with a focus on identifying key resilience factors that may translate into innovative interventions to achieve the global goals of the HIV care continuum, to improve treatment uptake and viral suppression to decrease morbidity and mortality. We have four aims to achieve our goals. (1) To continue our strong collaborative relationship with the national MACS/WIHS CCS in protocol development, implementation, participant enrollment, retention, data acquisition, and sub-study participation; (2) To lead the CCS-wide effort to understand the psychosocial and behavioral determinants that contributes to treatment adherence, virologic suppression, and healthy coping among PLWH in the US; (3) To determine the effectiveness of treatment and prevention guidelines and identify disparities in service delivery for common morbidities with high associated mortality; and (4) To explore HIV, aging, and associated co-morbidities, including the role of microvascular/vascular function, the microbiome, neurocognitive decline in the context of contemporary antiretroviral treatment regimens, and hearing and balance disorders among men and women. Our long-term goal is to improve the health of people living with HIV and to help prevent those without HIV from seroconverting.

摘要 在美国，大约有110万人感染艾滋病毒（PLWH），估计有39，782人是新感染者。 2016年被诊断出感染艾滋病毒。多中心艾滋病队列研究（MACS）和妇女机构间艾滋病毒 研究（WIHS）是美国历史最悠久的两项HIV队列研究。成立于1984年， 分别于1993年，这些以美国为基础的队列目前跟踪了2，235名男性和2，304名女性艾滋病毒感染者， 与高风险但未受感染的对照组一起。艾滋病毒在该国首都已达到流行病的程度， 哥伦比亚特区（DC）成人和青少年居民的艾滋病毒感染率为1.9%。约 40至49岁的哥伦比亚特区居民中有3.7%和50至59岁的居民中有5.2%感染艾滋病毒。的 在美国，获得艾滋病毒的最高终生风险在华盛顿特区最高，估计每17个人中就有1人 预计在他们的一生中获得艾滋病毒，其次是在邻近的马里兰州居民中的56个风险中有1个。 继续跟踪我们招募的女性，并扩大我们的队列，包括一个有代表性的群体 在这个艾滋病毒流行程度很高的地区，男女的平等至关重要。我们的研究将集中在 了解有助于长期治疗成功的行为和社会决定因素， 失败，重点是确定可能转化为创新干预措施的关键复原力因素， 实现艾滋病毒护理连续体的全球目标，以改善治疗的接受和病毒抑制， 降低发病率和死亡率。我们有四个目标来实现我们的目标。(1)继续我们的强大 与国家MACS/WIHS CCS在方案制定、实施、 参与者招募、保留、数据采集和子研究参与;（2）领导CCS范围内的工作 了解有助于治疗依从性的社会心理和行为决定因素，病毒学 抑制，和健康的应对PLWH在美国;（3）以确定治疗的有效性， 预防指南，并确定在为与高相关性的常见疾病提供服务方面的差距 死亡率;（4）探讨艾滋病毒、衰老和相关的合并症，包括 微血管/血管功能，微生物组，当代背景下的神经认知下降 抗逆转录病毒治疗方案以及男女听力和平衡障碍。我们的长期 目标是改善艾滋病毒感染者的健康，并帮助预防那些没有感染艾滋病毒的人 血清转化。