Brooklyn Women's Interagency HIV Study (WIHS) V

描述（由申请人提供）：随着艾滋病毒流行进入第三个十年，它越来越多地成为老年妇女的一种疾病，她们有与年龄相关的合并症，同时长期暴露于病毒、抗逆转录病毒治疗以及感染和治疗的代谢后果。总的来说，WIHS，特别是布鲁克林的站点，非常适合解决与老年女性群体相关的最突出问题。我们提出三个项目，涵盖老年妇女中艾滋病毒流行的重要方面。每个项目都包含有自己的目标和假设的特定研究。项目1主要研究HIV的神经认知、代谢和血管因素，包括三个方面的研究：1。脂肪组织、遗传易感性和神经认知；2. hiv -神经影像学倡议；3. 血管因子和神经认知。项目2侧重于HIV中的衰老生物标志物，包括两项研究：1。衰弱——衰老的生理、功能和神经认知方面；2. 生殖老化和端粒。项目3侧重于行为和实施科学方法来理解和促进艾滋病毒的成功衰老。它包括三个研究：1。生命历程过渡和护理参与；2. 采取干预措施，增加遭受童年性虐待的妇女的依从性；3. 加强戒烟的干预措施。布鲁克林校区是最大的WIHS校区，在学员保留率以及参与WIHS领导和子研究方面有着卓越的记录。我们通过扩大我们的共同调查人员和生物统计学家骨干队伍，使其包括具有与上述项目和研究相匹配的专业知识的人员，进一步加强我们的WIHS-V活动。Minkoff博士十多年来一直担任WIHS委员会主席，她将与神经流行病学家Deborah Gustafson博士一起担任双重pi领导职务，Deborah Gustafson博士曾在瑞典和阿根廷与老年人一起工作。在众多新的合作者中，有纽约大学妇产科主任、全国生殖衰老研究的领军人物之一大卫·基夫博士，以及曾在美国国立卫生研究院从事衰老相关研究的理查德·哈夫利克博士。我们还将与Michael Weiner博士领导的阿尔茨海默病神经影像学倡议合作。这些和其他新调查员将加入一系列现有的现场调查员，包括领导WIHS行为工作组的特蕾西·威尔逊博士，拥有与WIHS相关的R01的神经学家霍华德·克里斯托博士和许多其他人，以确保该网站的科学生产力。我们还建立了一个生物统计核心，其成员的专业知识符合我们的项目需求，包括博士。Lanza和Yang（宾夕法尼亚州立大学）以及Wilson博士（纽约州立大学）对行为项目的分析；Drs。Gustafson（纽约州立大学），Nalls（美国国立卫生研究院NIA分子遗传学科），Donahue（加州大学圣地亚哥分校）和Weedon（纽约州立大学）进行神经认知，神经成像和遗传分析；和Wu博士（宾夕法尼亚州立大学）进行端粒分析。鉴于我们迄今为止堪称典范的业绩记录，再加上新的和经验丰富的调查人员的创新融合，以及充满活力的统计核心，我们期待着与WIHS的同事们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.