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

摘要 在美国110万艾滋病毒感染者中，近四分之一是女性， 对美国南部种族/少数民族妇女的影响不成比例。育龄妇女 艾滋病毒感染者（WLH）受艾滋病毒结果不佳的影响很大，可能是由于结构性、心理社会和生物学原因， 因素不幸的是，尽管经历了不好的结果，并面临着独特的挑战， WLH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）是一个大型的， 全面的前瞻性队列研究始于1993年，包括近4，000名接受WLH治疗的患者 一年两次的研究访问，包括详细的结构化访谈、身体和妇科检查、实验室检查 测试和样本生物库。WIHS有5个站点位于南部（亚特兰大，伯明翰/杰克逊， 查佩尔山、迈阿密和华盛顿特区）。今年，WIHS与多中心艾滋病队列研究相结合， 研究（MACS）的男同性恋和双性恋男子，形成MACS/WIHS联合队列研究（MWCCS）。的 妇女艾滋病毒队列研究（WHCS）将在这5个南方MWCCS（以前的WIHS）研究中心进行， 将利用MWCCS结构，包括访问参与者，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 为实现以下具体目标，首先，我们将招募和保留2，000名育龄妇女 将南方流行病的代表纳入一项纵向队列研究，该研究将解决艾滋病毒的影响， 艾滋病治疗在这个年龄段。第二，我们将利用WIHS的科学力量， 在与生殖年龄WLH高度相关的关键主题领域开展科学研究。我们将严格提供 收集社会行为，临床和结果数据和生物标本，以科学专家在所有 WIHS网站，以促进多学科的艾滋病毒/艾滋病研究。第三，我们将利用这一群体来实施 统一多学科研究，以应对育龄妇女的独特健康需求。到 这样做，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 特别是与生殖年龄WLH和口腔健康领域相关的结果。通过这个 科学和所描述的计划，科学家参与广泛的相关学科， WHCS有可能最终改善年轻WLH的健康，优化ART的收益， 为结束美国人口中的艾滋病做出贡献。

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.