Miami Womens Interagency HIV Study WIHS

迈阿密妇女机构间艾滋病毒研究 WIHS

• 批准号: 8787709
• 负责人: Margaret A Fischl
• 金额: $ 150.21万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8787709
• 关键词: AIDS/HIV problem; Address; Adherence; Adoption; Adult; Age; Aging; Aging-Related Process; Alcohol or Other Drugs use; Anti-Retroviral Agents; Area; Behavioral; Biological; Cardiac; Caribbean region; Caring; Central America; Child; Cities; Clinical; Clinical Data; Cohort Studies; Collaborations; Collection; Communities; County; Coupled; Coupling; Crack Cocaine; Data; Decision Making; Development; Diagnosis; Disease; Disease Outcome; Disease Progression; Distress; Economics; Elderly; Enrollment; Ensure; Epidemic; Epidemiology; Ethnic group; Florida; Future; Genetic Variation; Goals; Grant; Growth; HIV; HIV Infections; HIV-1; Health; Health Services Accessibility; Healthcare; Heterosexuals; High Prevalence; Homelessness; Human Resources; Immigrant; Immigration; Immune; Immunosuppression; Incidence; Individual; Infection; Infection prevention; Inflammation; Institutional Review Boards; Interpersonal Violence; Investigation; Leadership; Life; Longevity; Measures; Mental Health; Mental disorders; Methods; Minority; Monitor; Outcome; Participant; Pathogenesis; Pediatrics; Play; Population; Population Heterogeneity; Populations at Risk; Positioning Attribute; Poverty; Prevalence; Primary Health Care; Public Health Schools; Quality Control; Race; Recovery; Recruitment Activity; Research; Research Infrastructure; Research Personnel; Research Project Grants; Risk; Risk Factors; Role; Sample Size; Scientist; Services; Site; South America; Southeastern United States; Specimen; Treatment outcome; Unemployment; United States; Universities; Viral; Vulnerable Populations; Woman; Youth; antiretroviral therapy; base; behavioral study; behavioral/social science; clinical epidemiology; cocaine use; cohort; demographics; design; experience; flexibility; immune activation; immune function; improved; influenza virus vaccine; innovation; insight; interest; intravenous drug use; medical schools; meetings; metropolitan; middle age; multidisciplinary; novel; population based; programs; reproductive; research study; response; social; social science research; success; transmission process; uptake; young adult

DESCRIPTION (provided by applicant): A growing proportion of U.S. women with HIV infection are from the Southeastern United States. Compared to all other states in the Southern region of the U.S., Florida has the highest number of HIV-infected individuals and the highest rates of HIV transmission. Miami-Dade County has one of the highest rates of new infections among women and the prevalence of HIV among women was among the highest in a national study of 21 epicenter cities in the U.S. Heterosexual transmission and intravenous drug use were the major risk factors for infection. Compounding these issues, Miami-Dade County ranks high among U.S. areas in measures of social and economic distress. The Women's Interagency HIV Study (WIHS) seeks to expand its efforts to better understand the current epidemiology of HIV infection in women with the identification of new sites from the Southern region of the U.S. The Miami WIHS is well positioned to engage women with HIV infection and at risk for HIV infection that are representative of this region and the changing demographics of the HIV epidemic, as well as addressing important current treatment outcomes and the impact of disassociation from care among hard-to-reach populations (e.g. substance abusing individuals). Miami sits at the portal to the Caribbean and Central and South America and, as a result of the high rates of immigration from these regions; the women infected with HIV belong to a wide, diverse population. In addition, the HIV-infected population of women in Miami spans generational boundaries from pediatrics through to the elder. This project is a multiple PI project between the University of Miami Miller School of Medicine and the Columbia University Mailman School of Public Health with collaboration from the University of Florida. We will seek to enroll a diverse cohort of 300 youth, young adult and adult women, including women who are at-risk for HIV, those with limited disease progression, those with newly recognized infection, who are antiretroviral treatment na¿ve and antiretroviral treatment experienced participants, and who are in care, intermittently in care and not in care. A highly experienced and diverse team of researchers has been assembled to ensure the success of this program, including clinical, basic and behavioral/social scientists, with strong ties to th community. The specific aims outlined respond directly to the overall WIHS scientific goals and advance and expand the WIHS basic, clinical and epidemiologic/behavioral/social science research agenda. The proposed scientific agenda taps into the experience and expertise of the Miami WIHS researchers to examine critically important and scientifically rigorous research questions. The proposed research projects will examine the impact of aging on immune functionality; reproductive decision making among young adult and adult women living with HIV/AIDS; increasing viral diversity and the impact of HIV-1 non-B subtype infections on the clinical course of HIV and response to therapy; and the interplay of crack cocaine use and associated co-occurring epidemics (mental health, poverty, unemployment and interpersonal violence with uptake of optimal antiretroviral therapy and engagement and retention in care. By coupling the diverse population base of HIV-infected and at risk women with the recognized strengths in HIV/AIDS research, the Miami WIHS is perfectly situated to advance the overall WIHS scientific agenda of defining clinical outcomes among women across their lifespan, including the uptake of antiretroviral therapy; use and retention of HIV primary care and other ancillary services; treatment outcomes on viral suppression, immune recovery and normalization of the effects of HIV, and disease pathogenesis, as well as, promoting and advancing local scientific research goals.

描述（由申请人提供）：越来越多的美国感染艾滋病毒的妇女来自美国东南部。与美国南部地区的所有其他州相比，佛罗里达是艾滋病毒感染人数最多、艾滋病毒传播率最高的地区。迈阿密-戴德县是妇女新感染率最高的县之一，在美国21个震中城市的全国性研究中，妇女艾滋病毒感染率是最高的。除了这些问题，迈阿密戴德县在美国社会和经济困境方面排名靠前。 妇女机构间艾滋病毒研究（WIHS）旨在扩大其努力，以更好地了解妇女艾滋病毒感染的当前流行病学，并确定美国南部地区的新地点。迈阿密WIHS处于有利地位，可以让艾滋病毒感染妇女和有艾滋病毒感染风险的妇女参与，这些妇女代表了该地区和艾滋病毒流行的人口统计学变化，以及解决目前重要的治疗结果和难以接触到的人群（例如药物滥用者）脱离护理的影响。迈阿密位于通往加勒比和中南美洲的门户，由于来自这些地区的移民比例很高，感染艾滋病毒的妇女属于广泛、多样化的人群。此外，迈阿密的妇女艾滋病毒感染者跨越了从儿科到老年人的代际界限。 该项目是迈阿密大学米勒医学院和哥伦比亚大学梅尔曼公共卫生学院与佛罗里达大学合作的多PI项目。我们将寻求招募300名青年、年轻成年人和成年妇女，包括艾滋病毒高危妇女、疾病进展有限的妇女、新发现感染的妇女、未经抗逆转录病毒治疗的妇女和有抗逆转录病毒治疗经验的参与者，以及接受护理、间歇性接受护理和不接受护理的妇女。一个经验丰富，多元化的研究团队已经组装，以确保该计划的成功，包括临床，基础和行为/社会科学家，与社区的紧密联系。概述的具体目标直接响应WIHS的总体科学目标，并推进和扩大WIHS的基础，临床和流行病学/行为/社会科学研究议程。拟议的科学议程利用了迈阿密WIHS研究人员的经验和专业知识，以研究至关重要和科学严谨的研究问题。拟议的研究项目将审查老龄化对免疫功能的影响;感染艾滋病毒/艾滋病的年轻成年人和成年妇女的生殖决策;病毒多样性的增加以及HIV-1非B亚型感染对艾滋病毒临床过程和治疗反应的影响;以及快克可卡因的使用和相关的共同发生的流行病（精神健康，贫困，失业和人际暴力与接受最佳抗逆转录病毒疗法以及参与和继续接受护理有关。 迈阿密妇女综合健康调查将感染艾滋病毒和面临艾滋病毒风险的妇女这一多样化的人口基础与艾滋病毒/艾滋病研究方面公认的优势结合起来，完全能够推动妇女综合健康调查的总体科学议程，确定妇女一生中的临床结果，包括接受抗逆转录病毒疗法;使用和保留艾滋病毒初级保健和其他辅助服务;在病毒抑制、免疫恢复和艾滋病毒影响正常化以及疾病发病机制方面取得治疗成果，并促进和推进当地的科学研究目标。