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）：越来越多的美国艾滋病毒感染女性来自美国东南部。与美国南部地区的所有其他州相比，佛罗里达州的艾滋病毒感染者数量和艾滋病毒传播率最高。迈阿密戴德县是女性新增感染率最高的县之一，在对美国 21 个震中城市进行的一项全国性研究中，女性艾滋病毒感染率位居最高之一。异性性传播和静脉吸毒是感染的主要危险因素。使这些问题更加复杂的是，迈阿密戴德县的社会和经济困境指标在美国地区中名列前茅。 妇女机构间艾滋病毒研究 (WIHS) 旨在扩大努力，通过在美国南部地区确定新的研究地点，更好地了解当前妇女艾滋病毒感染的流行病学。迈阿密 WIHS 处于有利地位，可以吸引艾滋病毒感染者和处于艾滋病毒感染风险的妇女，这些妇女代表了该地区和艾滋病毒流行不断变化的人口统计数据，并解决了当前重要的治疗结果和艾滋病毒流行的影响。 对难以接触到的人群（例如药物滥用者）的护理脱离。迈阿密位于加勒比海和中南美洲的门户，由于来自这些地区的移民率很高；感染艾滋病毒的妇女属于广泛而多样化的人群。此外，迈阿密女性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个 PI 项目。我们将寻求招募由 300 名青年、青年和成年女性组成的多元化队列，包括有感染艾滋病毒风险的女性、疾病进展有限的女性、新发现的感染者、未接受过抗逆转录病毒治疗和经历过抗逆转录病毒治疗的参与者，以及正在接受护理、间歇性接受护理和未接受护理的女性。为了确保该计划的成功，我们组建了一支经验丰富且多元化的研究人员团队，其中包括与社区密切联系的临床科学家、基础科学家和行为/社会科学家。概述的具体目标直接响应 WIHS 的总体科学目标，并推进和扩展 WIHS 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迈阿密 WIHS 研究人员的经验和专业知识来研究极其重要且科学严谨的研究问题。拟议的研究项目将研究衰老对免疫功能的影响；感染艾滋病毒/艾滋病的青年和成年妇女的生殖决策；增加病毒多样性以及 HIV-1 非 B 亚型感染对 HIV 临床病程和治疗反应的影响；强效可卡因的使用与相关同时发生的流行病（心理健康、贫困、失业和人际暴力与采用最佳抗逆转录病毒治疗以及参与和保留护理之间的相互作用）。 通过将艾滋病毒感染者和高危女性的多样化人口基础与艾滋病毒/艾滋病研究领域公认的优势结合起来，迈阿密 WIHS 完全有能力推进 WIHS 的整体科学议程，确定女性一生中的临床结果，包括抗逆转录病毒治疗的采用；使用和保留艾滋病毒初级保健和其他辅助服务；病毒抑制、免疫恢复、艾滋病毒影响正常化和疾病发病机制的治疗结果，以及促进和推进当地科学研究目标。