UAB-MISS WIHS Cohort

UAB-MISS WIHS 队列

• 批准号: 8432693
• 负责人: Michael S. Saag
• 金额: $ 150万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-10 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8432693
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Age; Alabama; Anti-Retroviral Agents; Area; Back; Behavioral; Body fat; Cardiovascular Diseases; Caring; Cervical dysplasia; Cessation of life; Chronic; Cohort Studies; Communities; Country; Deep South; Diagnosis; Education; Epidemic; Event; Fatigue; Genetic; HIV; HIV Infections; HIV-1; Health Services Accessibility; Healthcare; Heart; Human; Human Papillomavirus; Immune; Income; Infection; Inflammation; Life; Link; Longevity; Malignant Neoplasms; Medical center; Mental Depression; Metabolic; Metabolic syndrome; Metric; Minority; Mississippi; Morbidity - disease rate; Newly Diagnosed; Nutritional; Obesity; Outcome; Patient Care; Patients; Positioning Attribute; Poverty; Prevalence; Race; Recording of previous events; Recruitment Activity; Regimen; Research; Research Personnel; Research Project Grants; Resources; Role; Rural; Scientist; Services; Site; Social support; Socioeconomic Status; Southeastern United States; System; Testing; United States; Universities; Vagina; Viral; Viral Load result; Woman; Women' s Health; Zoonotic Infection; antiretroviral therapy; behavior test; clinical care; clinical practice; cohort; comparative effectiveness; data management; experience; hormonal contraception; immune activation; immunosenescence; innovation; meetings; microbiome; mortality; outreach; psychosocial; public health relevance; response; senescence; social stigma

DESCRIPTION (provided by applicant): As the AIDS epidemic has matured a disproportionate number of new infections are occurring in the Southeastern US. As such, the Women's Interagency HIV Study (WIHS) cohort is expanding to include a new site in the Southeast to make the cohort more representative. Alabama and Mississippi are located in the heart of the Deep South and have some of the highest rates of new HIV cases annually, especially among minority women. Barriers to access to care are among the worst in the US, and the prevalence of obesity, cardiovascular disease, cancer, and health care disparities most pronounced. Therefore, establishing a new WIHS site in this area of the country will provide the opportunity to assess the 'new' epidemic of AIDS as it is emerging today. The University of Alabama at Birmingham (UAB) has a rich tradition of AIDS research, dating back to the mid-1980s. As the epidemic has matured, UAB scientists have established expertise in the socio-behavioral factors that propagate the epidemic, including barriers to testing, linkage to care, retention in care, and stigma. UAB scientists have emerged as leaders in innovative cohort research that evaluate the long term outcomes and comparative effectiveness of regimens via multisite cohort studies (e.g., CNICS, NA-ACCORD, ART-CC, and FRAM). By creating a linkage to the University of Mississippi Medical Center (UMMC) as a subunit partner, we take full advantage of their years of expertise in HIV clinical care, outreach, and cohort research. Collectively, we represent an ideal addition for WIHS both in terms of scientific expertise and representation of the current HIV epidemic in the US. The Specific Aims for our new WIHS site are: 1. To assess psychosocial barriers to HIV prevention behaviors, testing, linkage to care, and retention in care among recently diagnosed women in the Deep South. 2. To evaluate the influence of hormonal contraception and body fat mass on immune hyperactivation and accelerated immunosenescence in HIV-1 infected women. 3. To determine the interplay between co-existing HPV subspecies and the vaginal microbiome in creating conditions favorable to the expression of cervical dysplasia and malignancy 4. To explore changes in the gut microbiome ('dysbiosis') occurring as a consequence of chronic HIV infection and its treatment. 5. To elucidate nutritional, host genetic, metabolic, and cultural factors that are contributing to the rapid emergence of obesity as a highly prevalent condition among HIV infected women 6. To recruit and retain a cohort of 300 women, half of whom are HIV seropositive and half well-matched HIV-negative controls, who are strategically selected to enable the conduct of the research projects proposed above while simultaneously meeting the needs of the WIHS cohort.

描述（由申请人提供）：随着艾滋病流行的成熟，美国东南部出现了不成比例的新感染病例。因此，妇女机构间艾滋病毒研究 (WIHS) 队列正在扩大，以纳入东南部的一个新站点，以使该队列更具代表性。阿拉巴马州和密西西比州位于南方腹地的中心地带，每年新发艾滋病毒病例率最高，尤其是少数族裔妇女。在美国，获得医疗服务的障碍是最严重的，其中肥胖、心血管疾病、癌症的患病率和医疗保健差距最为明显。因此，在该国这一地区建立一个新的 WIHS 站点将为评估当今正在出现的“新”艾滋病流行提供机会。阿拉巴马大学伯明翰分校 (UAB) 拥有丰富的艾滋病研究传统，其历史可以追溯到 20 世纪 80 年代中期。随着流行病的成熟，阿拉巴马大学的科学家们已经在传播流行病的社会行为因素方面建立了专业知识，包括检测障碍、与护理的联系、保留护理和耻辱。 UAB 科学家已成为创新队列研究的领导者，这些研究通过多中心队列研究（例如 CNICS、NA-ACCORD、ART-CC 和 FRAM）评估治疗方案的长期结果和比较有效性。通过与密西西比大学医学中心 (UMMC) 作为子单位合作伙伴建立联系，我们充分利用他们在艾滋病毒临床护理、推广和队列研究方面多年的专业知识。总的来说，无论是在科学专业知识还是在美国当前艾滋病毒流行的代表性方面，我们都是 WIHS 的理想补充。我们新的 WIHS 网站的具体目标是： 1. 评估南方腹地最近被诊断出的女性艾滋病毒预防行为、检测、与护理的联系以及保留护理的社会心理障碍。 2. 评估激素避孕和体脂量对 HIV-1 感染女性免疫过度激活和加速免疫衰老的影响。 3. 确定共存的 HPV 亚种与阴道微生物群之间的相互作用，从而创造有利于宫颈发育不良和恶性肿瘤表达的条件。 4. 探讨慢性 HIV 感染及其治疗导致的肠道微生物群变化（“菌群失调”）。 5. 阐明营养、宿主遗传、代谢和文化因素导致肥胖迅速成为艾滋病毒感染妇女中高度普遍的病症。 6. 招募并保留 300 名女性群体，其中一半为艾滋病毒血清阳性，一半为完全匹配的艾滋病毒阴性对照，她们经过战略性挑选，以便能够开展上述提出的研究项目，同时满足 WIHS 队列。