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艾滋病毒/艾滋病和药物使用队列研究(U01)的回应，旨在利用加州大学洛杉矶分校广泛的现有基础设施和队列，推出使用少数族裔(黑人或西班牙裔)与男性发生性行为的男性(MMSM)的新药物队列。HIV在美国和洛杉矶县(LAC)MMSM中的流行可能是由药物使用对遵守治疗方案和生物行为预防的影响推动的，并由高流行网络加强。拟议的研究人员领导着研究MSM中非注射药物使用、危险行为和传染病之间关系的科学，并贡献了从免疫学和基础科学到流行病学、预防和治疗的广泛跨学科工作。这项拟议的工作利用了包括多中心艾滋病队列(MACs)和现有知识库在内的现有队列，并建立在初步工作的基础上，以指导组装队列，以研究积极使用物质并存在传播风险的年轻MMSM的基本和行为因素。建立一组年轻的活性物质使用者，特别是兴奋剂使用者，他们有可测量和临床相关的抗逆转录病毒治疗(ART)坚持史，这将使对物质对MMSM免疫功能的生物学影响的重要测试成为可能。这一队列是预防和治疗工作的中心，并将提供具有良好特征的、广泛的资料库样本，以便与其他队列、网络和个人的研究一起使用。MMSM将是：(I)艾滋病毒阳性，病毒载量；5000拷贝/毫升；或(Ii)艾滋病毒阴性，艾滋病毒感染的高风险(过去6个月无保护措施的肛交)。这一独特的队列将有助于研究药物使用与艾滋病毒进展和/或传播之间的相互作用，这对公共卫生具有重要意义。这组MMSM的特点是：(I)在接触和感染MMSM的人中，药物使用对行为和网络层面上感染艾滋病毒和其他性传播感染(性传播疾病：淋病、衣原体、梅毒、丙型肝炎)的风险的影响；以及(Ii)与未使用MMSM的药物相比，MMSM中的物质使用在多大程度上促进了传播艾滋病毒的行为。该应用程序还建议开发和维护一个符合HIPAA、技术最新和DAIDS网络接口的生物信息库，其中包括一个科学咨询委员会。这一队列将包括620名有重复数据访问的MMSM(来自1,080名MMSM)。这些MMSM中至少有一半将是活跃的物质使用者，年龄在30岁以下。

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.