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）：随着艾滋病的流行日趋成熟，美国东南部出现了不成比例的新感染病例。因此，妇女跨机构艾滋病毒研究（WIHS）队列正在扩大，包括东南部的一个新站点，以使队列更具代表性。阿拉巴马州和密西西比州位于美国南部腹地，每年新发艾滋病病例的比例最高，尤其是在少数族裔妇女中。在美国，获得医疗服务的障碍是最严重的，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艾滋病监测系统站点，将提供机会评估今天正在出现的“新”艾滋病流行病。阿拉巴马大学伯明翰分校（UAB）在艾滋病研究方面有着悠久的传统，可以追溯到20世纪80年代中期。随着该流行病的成熟，UAB科学家已经在传播该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的科学家已经成为创新性队列研究的领导者，通过多站点队列研究（例如，CNICS, NA-ACCORD， ART-CC和FRAM）评估方案的长期结果和比较有效性。通过建立与密西西比大学医学中心（UMMC）作为亚单位合作伙伴的联系，我们充分利用了他们多年来在艾滋病毒临床护理、外展和队列研究方面的专业知识。总的来说，无论是在科学专业知识方面，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。评估美国南方腹地新近确诊妇女在艾滋病预防行为、检测、护理联系和护理保留方面的社会心理障碍。评价激素避孕和体脂量对HIV-1感染妇女免疫过度激活和加速免疫衰老的影响。3. 确定共存的HPV亚种与阴道微生物组在创造有利于宫颈发育不良和恶性肿瘤表达的条件中的相互作用。探索慢性HIV感染及其治疗导致的肠道微生物组变化（“生态失调”）。5. 阐明营养、宿主遗传、代谢和文化因素是导致肥胖迅速出现在艾滋病毒感染妇女中高度流行的原因6。招募和保留300名妇女，其中一半是艾滋病毒血清阳性，一半是匹配良好的艾滋病毒阴性对照，战略性地选择她们，以便能够开展上述研究项目，同时满足艾滋病毒感染者队列的需要。