MSM and Substances Cohort at UCLA Linking Infections Noting Effects (MASCULINE)

描述（由申请人提供）：本申请是对NIDA PAR 12-222 HIV/AIDS和物质使用队列研究（U 01）的回应，旨在利用加州大学洛杉矶的广泛现有基础设施和队列，启动一个新的使用物质的少数民族（黑人或西班牙裔）男男性行为者（MMSM）队列。美国和当地洛杉矶县（LAC）MMSM中HIV流行可能是由药物使用对治疗方案依从性和生物行为预防的影响驱动的，并由高流行网络增强。拟议的研究人员领导科学研究非注射药物使用，风险行为和传染病之间的关联MSM，并贡献了从免疫学和基础科学到流行病学，预防和治疗的跨学科工作的广泛组合。拟议的工作利用了现有的队列，包括多中心艾滋病队列（MACS）和现有的知识库，并建立在初步工作的基础上，以指导一个队列的组装，用于研究积极使用药物并承担传播风险的年轻MMSM的基本和行为因素。建立一个年轻的活性物质使用者，特别是兴奋剂使用者，谁有抗逆转录病毒治疗（ART）的依从性差的历史，标志着可测量的和临床相关的血浆病毒载量（PVL）将使重要的测试物质对免疫功能的生物学影响MMSM。这一队列是预防和治疗工作的核心，将提供充分表征的、广泛的储存库样本，供其他队列、网络和个人研究使用。MMSM将是：（i）HIV阳性，病毒载量>5000拷贝/毫升，或（ii）HIV阴性，HIV感染风险高（过去6个月内无保护肛交）。这一独特的队列将促进对物质使用与艾滋病毒进展和/或传播之间相互作用的研究，这具有重要的公共卫生意义。该MMSM队列将表征：（i）物质使用对暴露和感染MMSM的行为和网络水平风险的影响，这些风险是获得HIV和其他性传播感染（STI：淋病、衣原体、梅毒、丙型肝炎（HCV））;以及（ii）与非药物使用MMSM相比，MMSM中物质使用促进传播HIV行为的程度。该申请还建议开发和维护一个符合HIPAA标准的生物储存库，该储存库具有最新的技术和DAIDS网络接口，其中包括一个科学咨询委员会。该队列将包括620例重复数据访视的MMSM（来自1，080例MMSM）。这些MMSM中至少有一半是活跃物质使用者，年龄小于30岁。

DESCRIPTION (provided by applicant): This application in response to NIDA PAR 12-222 Cohort Studies of HIV/AIDS and Substance Use (U01) seeks to leverage extensive existing infrastructure and cohorts at the University of California, Los Angeles to launch a new cohort of substance using minority (Black or Hispanic) men who have sex with men (MMSM). The epidemic of HIV among MMSM in the US and locally in Los Angeles County (LAC) may be driven by effects of substance use on adherence to treatment regimens and bio-behavioral prevention and enhanced by high prevalence networks. Proposed investigators lead the science on studying associations between non-injection drug use, risk behaviors and infectious disease among MSM, and contribute a broad portfolio of inter-disciplinary work from immunology and basic science to epidemiology, prevention and treatment. The work proposed leverages existing cohorts including the Multicenter AIDS Cohort (MACS) and existing repositories and builds on preliminary work to guide assembly of a cohort for the study of basic and behavioral factors in younger MMSM who actively use substances and engage transmission risks. Establishing a cohort of young active substance users, particularly stimulant users, who have poor histories of antiretroviral treatment (ART) adherence as marked by measurable and clinically relevant Plasma Viral Load (PVL) will enable important tests of biological influences of substances on immune function in MMSM. This cohort is central to prevention and treatment efforts and will provide well-characterized, extensive repository samples for leveraged use with other cohorts, networks' and individual's studies. The MMSM will be: (i) HIV-positive with viral load >5000 copies/ml or (ii) HIV-negative at high risk for HIV infection (unprotected anal intercourse in the past 6 months). This unique cohort will facilitate studies on interactions between substance use and HIV progression and/or transmission, which are of critical public health significance. This cohort of MMSM will characterize: (i) effects substance use on behavioral and network level risk in exposed and infected MMSM on acquisition of HIV and other sexually transmitted infections (STIs: gonorrhea, Chlamydia, syphilis, Hepatitis C (HCV)); and (ii) the extent to which substance use in MMSM facilitates behaviors that transmit HIV compared to non-drug using MMSM. The application also proposes to develop and maintain a bio repository that is HIPAA-compliant, technologically-current and DAIDS Network interfaced that includes a scientific advisory committee. This cohort will comprise 620 MMSM with repeated data visits (from 1,080 MMSM). At least half of these MMSM will be active substance users and younger than age 30.