Women HIV Cohort Study: HIV infection and treatment among women of reproductive age

摘要 在美国110万艾滋病毒携带者中，近四分之一是女性，有 对美国南部种族/少数民族妇女的不成比例的影响。活着的育龄妇女 艾滋病毒携带者受艾滋病毒不良结局的影响很大，这可能是由于结构、心理社会和生物学原因 各种因素。不幸的是，尽管经历了糟糕的结局和面临着独特的挑战，但生育年龄 妇女妇女在艾滋病毒研究中的代表性严重不足。妇女机构间艾滋病毒研究(WIHS)是一项大型、 1993年开始的一项全面的前瞻性队列研究，包括近4,000名接受 两年一次的研究访问，包括详细的结构化访谈、体检和妇科检查、实验室 测试和标本生物库。WIHS在南部有5个站点(亚特兰大、伯明翰/杰克逊、 教堂山、迈阿密和华盛顿特区)。今年，WIHS与多中心艾滋病队列联合 男同性恋者和双性恋者研究(MACS)，形成MACS/WIHS联合队列研究(MWCCS)。这个 妇女艾滋病毒队列研究(WHCS)将在这5个南方MWCCS(以前的WIHS)地点进行，并 将利用MWCCS结构，包括接触参与者、标准化评估、样本 收集、数据管理、领导委员会、社区咨询委员会和科学工作 小组应达到以下具体目标。首先，我们将招募和保留2000名育龄妇女 将南方疫情的代表性纳入一项纵向队列研究，以解决艾滋病毒和艾滋病的影响 在这个年龄段接受艾滋病毒治疗。第二，我们将利用WIHS的科学实力整合高优先级 与生殖年龄妇女生殖健康高度相关的关键主题领域的科学。我们将严格提供 收集社会行为、临床和结果数据以及生物样本 WIHS网站，促进多学科艾滋病毒/艾滋病研究。第三，我们将利用这个队列来实现 统一多学科研究，以满足育龄妇女的独特健康需求。至 为此，我们将在抑郁症领域实施科学，这是健康和艾滋病毒治疗的关键媒介 与生殖年龄、妇女生殖健康和口腔健康领域特别相关的结果。通过这件事 科学和所描述的让科学家参与广泛相关学科的计划， WHCS有可能最终改善年轻妇女的健康，优化抗逆转录病毒治疗的成果，以及 为消除美国所有人口中的艾滋病毒作出贡献。

Abstract Nearly one quarter of the 1.1 million individuals living with HIV in the US are women, and there is a disproportionate impact on racial/ethnic minority women in the Southern US. Reproductive age women living with HIV (WLH) are highly affected by poor HIV outcomes, likely due to structural, psychosocial, and biological factors. Unfortunately, despite experiencing poor outcomes and facing unique challenges, reproductive age WLH are grossly underrepresented in HIV research. The Women's Interagency HIV Study (WIHS) is a large, comprehensive, prospective cohort study which began in 1993 and comprises almost 4,000 WLH who undergo biannual study visits with detailed structured interviews, physical and gynecologic examinations, laboratory testing, and specimen biobanking. The WIHS has 5 sites located in the South (Atlanta, Birmingham/Jackson, Chapel Hill, Miami, and Washington DC). This year, the WIHS combined with the Multicenter AIDS Cohort Study (MACS) of gay and bisexual men, to form the MACS/WIHS Combined Cohort Study (MWCCS). The Women HIV Cohort Study (WHCS) will be conducted in these 5 Southern MWCCS (previous WIHS) sites and will leverage the MWCCS structure, including access to participants, standardized assessments, specimen collections, data management, leadership committees, community advisory boards, and scientific working groups to address the following specific aims. First, we will recruit and retain 2,000 reproductive age WLH representative of the Southern epidemic into a longitudinal cohort study that will address the effects of HIV and HIV treatment in this age group. Second, we will use the scientific strength of WIHS to integrate high priority science in key thematic areas that are highly relevant for reproductive age WLH. We will provide rigorously collected sociobehavioral, clinical, and outcome data and biological specimens to scientific experts across all WIHS sites to promote multidisciplinary HIV/AIDS research. Third, we will utilize this cohort to implement unifying multidisciplinary research that is responsive to the unique health needs of reproductive age WLH. To do so, we will implement science in the area of depression, a critical mediator of health and HIV treatment outcomes of particular relevance to reproductive age WLH, and in the area of oral health. Through this science and the described plan for engagement of scientists across a broad range of relevant disciplines, the WHCS has the potential to ultimately improve the health of young WLH, optimize the gains of ART, and contribute to ending HIV across populations in the United States.