Georgia Consortium to Eliminate Cervical Cancer in Women Living with HIV (GaCECC-WLWH)

项目总结/摘要 与妇女相比，感染艾滋病毒的妇女（WLWH）患宫颈癌的风险大大增加 没有感染艾滋病毒（1）。格鲁吉亚是美国第二大艾滋病毒感染者， 发病率是全国发病率的1.9倍（2）。与此同时，格鲁吉亚的宫颈癌发病率明显高于 高于全国平均水平，2015-2019年期间每10万名妇女中有8.0人被诊断出（3）。黑人女性 在格鲁吉亚，艾滋病毒（4）和宫颈癌（5）的影响不成比例， 在宫颈癌筛查异常后失访，未接受阴道镜检查或治疗 与白色女性相比（6）。因此，格鲁吉亚必须成为务实临床试验的焦点 在面临健康差距的妇女、寡妇和孤儿中解决宫颈癌筛查和治疗问题。格鲁吉亚号 消除艾滋病毒感染妇女宫颈癌联合会（GaCECC）包括已建立的，良好的- 在格鲁吉亚资助的项目，服务WLWH，并准备进行“级联”网络临床 审判GaCECC包括埃默里大学艾滋病研究和临床网络，城市和农村瑞安白色 资助的诊所，莫尔豪斯医学院（MSM）广泛的社区网络，格鲁吉亚癌症中心 在格雷迪卫生系统（GCCE）的卓越，并尊重艾滋病毒和妇女的健康社区为基础的 在格鲁吉亚。GaCECC可以通过各个临床中心获得数千个WLWH， 在2020-2021年期间，为9，000多名WLWH提供服务，并在两个地区进行了5，000多次宫颈癌筛查 格鲁吉亚的城市和农村地区。这些网站为高比例的黑人妇女提供服务， 不成比例地受到健康的社会决定因素的影响。GaCECC经验丰富的客户导航 服务将致力于优化参与者获得和完成推荐的筛查和治疗 序列的GaCECC招聘和保留团队将确保阳性和阴性之间的护理无缝链接。 在社区诊所进行筛查，在GCCE进行阴道镜检查。格雷迪纪念医院将提供其格雷迪移动的 健康中心车辆，为无法前往GCCE的妇女提供阴道镜检查。埃默里大学， 男男性接触者和AAPHC合作伙伴妇科医生将提供'级联'网络协议为基础的治疗， GCCE、庞塞传染病诊所和与AAPHC有关的农村妇科诊所。经历 HIV和HPV临床试验的研究人员和研究人员将熟练执行临床试验方案 并确保最佳保留。GaCECC将利用每个合作者的优势和资源 在这个联盟中，为WLWH解决宫颈癌预防问题。总之，GaCECC将利用其临床 艾滋病毒护理和宫颈癌预防的研究领导（目标1），以推进宫颈癌的研究 通过“CASCADE”网络临床试验，在WLWH中预防癌症（目的2）， 在所有四个科学重点领域（目标3）开展宫颈癌预防的临床试验，并利用其网络 社区伙伴关系，以招收和保留WLWH，强调公平和多样性。

PROJECT SUMMARY/ABSTRACT Women living with HIV (WLWH) have a substantially increased risk for cervical cancer when compared to women without HIV infection (1). Georgia has the second largest population of people living with HIV in the US, with a prevalence of 1.9 times the national rate (2). Simultaneously, Georgia’s rates of cervical cancer are notably higher than the national average with 8.0 per 100,000 women diagnosed between 2015-2019 (3). Black women are disproportionately impacted by HIV(4) and cervical cancer in Georgia (5) and have significantly higher rates of being lost to follow-up and not undergoing colposcopy or treatment after an abnormal cervical cancer screen when compared to white women (6). It is thus imperative that Georgia is a focal point of pragmatic clinical trials to address cervical cancer screening and treatment among WLWH who face health disparities. The Georgia Consortium to Eliminate Cervical Cancer in Women Living with HIV (GaCECC) encompasses established, well- funded programs in Georgia that service WLWH and are primed to conduct the ‘CASCADE’ Network clinical trials. The GaCECC includes Emory University HIV research and clinical networks, urban and rural Ryan White funded clinics, Morehouse School of Medicine’s (MSM’s) extensive community networks, Georgia Cancer Center for Excellence at Grady Health System (GCCE), and respected HIV and women’s health community-based organizations in Georgia. The GaCECC has access to thousands of WLWH through various clinical sites that served over 9,000 WLWH and performed over 5,000 cervical cancer screenings between 2020-2021 in both urban and rural settings across Georgia. These sites serve high proportions of Black women who are disproportionately affected by social determinants of health. The GaCECC’s experienced client navigation services will work to optimize participant access to and completion of recommended screening and treatment sequences. The GaCECC recruitment and retention team will assure seamless linkage of care between positive screens at community clinics and colposcopy at the GCCE. Grady Memorial Hospital will provide its Grady Mobile Health Center Vehicle to bring colposcopy to women who are unable to travel to the GCCE. Emory University, MSM, and AAPHC partner gynecologists will deliver ‘CASCADE’ Network protocol-based treatment at the GCCE, Ponce Infectious Disease Clinic, and rural gynecology offices associated with AAPHC. Experienced investigators and research staff in HIV and HPV clinical trials will proficiently implement clinical trials protocols and ensure optimal retention. The GaCECC will use the strengths and resources leveraged by each collaborator in this consortium to address cervical cancer prevention for WLWH. In sum, the GaCECC will harness its clinical and research leadership in HIV care and cervical cancer prevention (Aim 1) to advance research in cervical cancer prevention among WLWH through the ‘CASCADE’ Network clinical trial, (Aim 2) to implement pragmatic clinical trials in cervical cancer prevention across all four scientific focus areas (Aim 3) and to utilize its network of community partnerships to enroll and retain WLWH with an emphasis on equity and diversity.