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.

Public Health Relevance

Brooklyn WIHS V is a cohort study of the treated history of HIV in women with an increased focus on cognition, metabolic, and vascular factors, aging biomarkers and behaviors associated with successful aging. The findings from this research will help improve the care of women with HIV who can expect to live longer in an era of effective antiretroviral therapy.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01AI031834-21
Application #
8432733
Study Section
Special Emphasis Panel (ZAI1-RB-A (S1))
Program Officer
Roe, Joanad'Arc C
Project Start
1992-03-01
Project End
2017-12-31
Budget Start
2013-01-01
Budget End
2013-12-31
Support Year
21
Fiscal Year
2013
Total Cost
$2,050,003
Indirect Cost
$854,827
Name
Suny Downstate Medical Center
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
040796328
City
Brooklyn
State
NY
Country
United States
Zip Code
11203
Ghosh, Mimi; Daniels, Jason; Pyra, Maria et al. (2018) Impact of chronic sexual abuse and depression on inflammation and wound healing in the female reproductive tract of HIV-uninfected and HIV-infected women. PLoS One 13:e0198412
Rice, Whitney S; Logie, Carmen H; Napoles, Tessa M et al. (2018) Perceptions of intersectional stigma among diverse women living with HIV in the United States. Soc Sci Med 208:9-17
Kelso-Chichetto, N E; Okafor, C N; Cook, R L et al. (2018) Association Between Depressive Symptom Patterns and Clinical Profiles Among Persons Living with HIV. AIDS Behav 22:1411-1422
Adams, Leah M; Wilson, Tracey E; Merenstein, Daniel et al. (2018) Using the Center for Epidemiologic Studies Depression Scale to assess depression in women with HIV and women at risk for HIV: Are somatic items invariant? Psychol Assess 30:97-105
Galárraga, Omar; Rana, Aadia; Rahman, Momotazur et al. (2018) The effect of unstable housing on HIV treatment biomarkers: An instrumental variables approach. Soc Sci Med 214:70-82
Enkhmaa, Byambaa; Anuurad, Erdembileg; Zhang, Wei et al. (2018) Effect of antiretroviral therapy on allele-associated Lp(a) level in women with HIV in the Women's Interagency HIV Study. J Lipid Res 59:1967-1976
Rubin, Leah H; Benning, Lorie; Keating, Sheila M et al. (2018) Variability in C-reactive protein is associated with cognitive impairment in women living with and without HIV: a longitudinal study. J Neurovirol 24:41-51
Belenky, Nadya; Pence, Brian W; Cole, Stephen R et al. (2018) Associations Between Medicare Part D and Out-of-Pocket Spending, HIV Viral Load, Adherence, and ADAP Use in Dual Eligibles With HIV. Med Care 56:47-53
Ascher, Simon B; Scherzer, Rebecca; Estrella, Michelle M et al. (2018) Association of Urinary Biomarkers of Kidney Injury with Estimated GFR Decline in HIV-Infected Individuals following Tenofovir Disoproxil Fumarate Initiation. Clin J Am Soc Nephrol 13:1321-1329
Hanna, David B; Moon, Jee-Young; Haberlen, Sabina A et al. (2018) Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men. AIDS 32:2393-2403

Showing the most recent 10 out of 629 publications