Brooklyn Women's Interagency HIV Study (WIHS) V

描述(申请人提供)：随着艾滋病毒流行进入第三个十年，它越来越成为老年妇女的一种疾病，她们有与年龄有关的共病，并伴随着长期接触病毒、抗逆转录病毒药物以及感染和治疗的新陈代谢后果。总体而言，WIHS，特别是布鲁克林的网站，非常适合解决与老龄化女性群体相关的最突出的问题。我们提出了三个项目，以捕捉老年妇女艾滋病毒流行的重要方面。每个项目都包含有各自的目标和假设的具体研究。项目1专注于HIV中的神经认知、代谢和血管因素，包括三项研究：1.脂肪组织、遗传易感性和神经认知；2.艾滋病毒-神经成像倡议；3.血管因素和神经认知。项目2专注于艾滋病毒中的衰老生物标记物，包括两项研究：1.衰老的脆弱--身体、功能和神经认知方面；2.生殖衰老和端粒。项目3侧重于了解和促进艾滋病毒成功老龄化的行为和实施科学方法。它包括三项研究：1.生命过程的转变和关爱参与；2.在经历过儿童期性虐待的女性中提高依从性的干预；3.促进戒烟的干预。布鲁克林的网站是WIHS最大的网站，在队列保留以及参与WIHS领导力和子研究方面有着非凡的记录。我们通过扩大我们的合作调查员和生物统计学家队伍，包括那些具有与上述项目和研究相匹配的专业知识的人，进一步加强了我们为WIHS-V开展的活动。明科夫博士已经担任WIHS EC主席十多年，他将与神经流行病学家黛博拉·古斯塔夫森博士一起担任双重PI的领导角色，古斯塔夫森博士曾与瑞典和阿根廷的老年人群一起工作。在众多新的合作者中，包括纽约大学妇产科主席、美国生殖老龄化领域的领导者之一大卫·基夫博士，以及曾在美国国立卫生研究院从事与衰老相关研究的理查德·哈夫利克博士。我们还将与迈克尔·韦纳博士领导的阿尔茨海默病神经成像倡议合作。这些和其他新的调查人员将加入一系列老牌现场调查人员的行列，其中包括WIHS行为工作组的负责人特蕾西·威尔逊博士、神经学家霍华德·克里斯托博士，他拥有与WIHS相关的R01和许多其他基因，以确保该地点的科学生产力。我们还建立了生物统计学核心，其成员的专业知识与我们的项目需求一致，包括Lanza和Yang博士(宾夕法尼亚州立大学)和Wilson博士(纽约州立大学)，用于行为项目分析；Gustafson博士(纽约州立大学)、Nalls博士(NIA，NIH)、Donahue博士(加州大学洛杉矶分校)和Weedon(纽约州立大学)，负责神经认知、神经成像和基因分析；以及Wu博士(宾夕法尼亚州立大学)，用于端粒分析。鉴于我们迄今堪称典范的记录，加上新的和经验丰富的研究人员的创新融合，以及充满活力的统计核心，我们期待着与WIHS的同事继续保持富有成效的关系。

DESCRIPTION (provided by applicant): As the HIV epidemic moves into its third decade it is increasingly a disease of older women who have age-related co-morbidities, and concomitant prolonged exposure to the virus, to ART, and to the metabolic consequences of both infection and therapy. The WIHS in general, and the Brooklyn site in particular, are ideally suited to address the most salient questions related to an aging female cohort. We propose three projects that capture important aspects of the HIV epidemic in aging women. Each project contains specific studies with their own sets of aims and hypotheses. Project 1 focuses on neurocognition, metabolic, and vascular factors in HIV and includes three studies: 1. Adipose tissue, genetic susceptibility, and neurocognition; 2. The HIV-Neuroimaging Initiative; 3. Vascular factors and neurocognition. Project 2 focuses on aging biomarkers in HIV and includes two studies: 1. Frailty-Physical, functional and neurocognitive aspects of aging; 2. Reproductive aging and telomeres. Project 3 focuses on behaviors and implementation science approaches to understanding and promoting successful aging in HIV. It includes three studies: 1. Life course transitions and care engagement; 2. An intervention to increase adherence among women who have experienced childhood sexual abuse; 3. An intervention to enhance smoking cessation. The Brooklyn site, the largest WIHS site, has an exceptional record in cohort retention as well as participation in WIHS leadership and substudies. We further energize our activities for WIHS-V by expanding our cadre of co-investigators and biostatisticians to include those with expertise matched to the aforementioned projects and studies. Dr. Minkoff, who has been chair of the WIHS EC for over a decade, will be joined in a dual-PI leadership role by Dr. Deborah Gustafson, a neuroepidemiologist who has worked with aging cohorts in Sweden and Argentina. Among the many new collaborators are Dr. David Keefe, Chair of OB/GYN at NYU and one of the nation's leaders in reproductive aging, and Dr. Richard Havlik who has served at the NIH in research related to aging. We will also collaborate with the Alzheimer's Disease Neuroimaging Initiative, led by Dr. Michael Weiner. These and other new investigators will join an array of established site investigators, including Dr. Tracey Wilson who heads the WIHS behavioral working group, Dr. Howard Crystal, a neurologist who has a WIHS-linked R01 and many others, to assure the scientific productivity of the site. We have also established a biostatistical core, with members whose expertise corresponds to our project needs, including Drs. Lanza and Yang (Penn State) and Dr. Wilson (SUNY) for analysis of the behavioral projects; Drs. Gustafson (SUNY), Nalls (Molecular Genetics Section, NIA, NIH), Donahue (UCSD) and Weedon (SUNY) for neurocognitive, neuroimaging, and genetic analyses; and Dr. Wu (Penn State) for telomere analysis. Given our exemplary track record to date, in conjunction with an innovative fusion of new and seasoned investigators, and an invigorated statistical core, we look forward to a continued productive relationship with our colleagues in WIHS.