With the HIV Prevention Treatment Network 052 study proving that early antiretroviral (ART) initiation reduces rates of HIV sexual transmission and clinical events, and with women making up 50% of people living with HIV globally, a better understanding of how women with HIV start, stay on and respond to ART and how this therapy impacts prevention, treatment, and care/cure of HIV/AIDS is needed. African American women continue to bear the largest burden of HIV disease among women, with disproportionately higher rates of new HIV infections, AIDS diagnoses, and mortality. The major goal of this proposal is to continue the high level of productivity of the Chicago WIHS Consortium (CWC) as both a clinical research site and as a consortium of scientific leaders with a track record of advancing our understanding of the evolving HIV epidemic in US women. We will continue to rapidly recruit and retain a representative cohort of women with and at risk for HIV, to collect th highest quality data in order to lead and pursue innovative epidemiologic analyses, and multidisciplinary investigations to characterize treated HIV disease in women. Over the WIHS-V five year period, we will continue to design, implement, synthesize, and disseminate findings from investigations which explore the dynamic and complex relationships between HIV, ART, viral suppression, sociodemographics, behaviors, mental illness, immune biomarkers, menopausal stage, and comorbidities rather than focusing on the impact of any one single factor. The CWC investigative team proposes to expand and retain the Chicago cohort and to apply analytic modeling to longitudinal social/behavioral, clinical, neurocognitive, and pathogenesis data to develop and test a gender specific prognostic index (""""""""WIHS Index"""""""").
We aim to identify psychological, neuroendocrine, genetic, and immunologic predictors of HIV disease phenotypes, including those characterized by inflammation, activation, and cellular senescence and determine the association with clinical and pre-clinical measures of HIV associated non AIDS (HANA) co-morbidities. Since evidence suggests that potentially modifiable factors, such as untreated mental illness, chronic life stress, and use of addictive substances can contribute to inflammation and accelerate telomere shortening, a key molecular marker of cellular senescence, we will explore the interactions between psychiatric diagnoses, hormonal patterns, and markers of the innate and adaptive immune system. Given the high rates of these modifiable factors in our cohort, we propose a multi-site randomized controlled trial to test an evidence based computerized tailored intervention based on the Transtheoretical Model to address risk behaviors concurrently aimed at smoking cessation, improving ART adherence, and effectively managing stress, depression, and weight. Through these WIHS V efforts, we hope to identify new tools that can be used at all levels of HIV care (community, clinic, and laboratory) to empower clinicians and their female patients to improve the prognosis and lives of women with HIV.

Public Health Relevance

Recent studies have proven that starting antiretroviral (ART) early in the course of HIV illness reduces rates of sexual transmission and clinical events. Women now make up more than half of all those living with HIV globally. Therefore, it is a public health imperative to better understand how women with HIV start, stay on and respond to ART and how this therapy impacts prevention, treatment, and care/cure of HIV/AIDS. In the United States, African American women continue to bear the largest burden of HIV disease among women, with disproportionately higher rates of new HIV infections, AIDS diagnoses, and mortality. The major goal of this proposal is to continue the high level of productivity of the Chicago WIHS Consortium (CWC) and rapidly recruit and retain a representative cohort of women with and at risk for HIV. Over the WIHS-V five year period, we will continue to design, implement, synthesize, and disseminate findings from investigations which explore the dynamic and complex relationships between HIV, ART, viral suppression, sociodemographics, behaviors, mental illness, immune biomarkers, menopausal stage, and comorbidities rather than focusing on the impact of any one single factor. The CWC investigative team proposes to expand and retain the Chicago cohort and to apply analytic modeling to the longitudinal social/behavioral, clinical, neurocognitive, genetic and pathogenesis data to develop and test a gender specific prognostic index (WIHS Index). We aim to identify psychological, neuroendocrine, and immunologic predictors and consequences of HIV disease. We propose to test an evidence based computerized tailored intervention based on the transtheoretical model of behavior change to encourage smoking cessation and improve ART adherence, and effectively manage stress, depression, and weight. Through these WIHS V efforts, we hope to identify new tools that can be used at all levels of HIV care (community, clinic, and laboratory) to empower clinicians and patients to improve the prognosis and lives of women with HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01AI034993-20S1
Application #
8699959
Study Section
Special Emphasis Panel (ZAI1-RB-A (S1))
Program Officer
Williams, Carolyn F
Project Start
1994-01-01
Project End
2017-12-31
Budget Start
2013-08-02
Budget End
2013-12-31
Support Year
20
Fiscal Year
2013
Total Cost
$21,651
Indirect Cost
Name
Hektoen Institute for Medical Research
Department
Type
DUNS #
068625136
City
Chicago
State
IL
Country
United States
Zip Code
60612
Butterfield, Tiffany R; Hanna, David B; Kaplan, Robert C et al. (2016) Increased glucose transporter-1 expression on intermediate monocytes from HIV-infected women with subclinical cardiovascular disease. AIDS :
Norris, Philip J; Zhang, Jinbing; Worlock, Andrew et al. (2016) Systemic Cytokine Levels Do Not Predict CD4(+) T-Cell Recovery After Suppressive Combination Antiretroviral Therapy in Chronic Human Immunodeficiency Virus Infection. Open Forum Infect Dis 3:ofw025
Kuniholm, Mark H; Ong, Edgar; Hogema, Boris M et al. (2016) Acute and Chronic Hepatitis E Virus Infection in Human Immunodeficiency Virus-Infected U.S. Women. Hepatology 63:712-20
Baxi, Sanjiv M; Scherzer, Rebecca; Jotwani, Vasantha et al. (2016) Changes in Urinary Biomarkers over 10 Years is Associated with Viral Suppression in a Prospective Cohort of Women Living with HIV. J Acquir Immune Defic Syndr :
Althoff, Keri N; Rebeiro, Peter F; Hanna, David B et al. (2016) A picture is worth a thousand words: maps of HIV indicators to inform research, programs, and policy from NA-ACCORD and CCASAnet clinical cohorts. J Int AIDS Soc 19:20707
Rubin, Leah H; Pyra, Maria; Cook, Judith A et al. (2016) Post-traumatic stress is associated with verbal learning, memory, and psychomotor speed in HIV-infected and HIV-uninfected women. J Neurovirol 22:159-69
Turan, Bulent; Smith, Whitney; Cohen, Mardge H et al. (2016) Mechanisms for the Negative Effects of Internalized HIV-Related Stigma on Antiretroviral Therapy Adherence in Women: The Mediating Roles of Social Isolation and Depression. J Acquir Immune Defic Syndr 72:198-205
Klein, Marina B; Althoff, Keri N; Jing, Yuezhou et al. (2016) Risk of End-Stage Liver Disease in HIV-Viral Hepatitis Coinfected Persons in North America From the Early to Modern Antiretroviral Therapy Eras. Clin Infect Dis 63:1160-1167
Koethe, John R; Jenkins, Cathy A; Lau, Bryan et al. (2016) Higher Time-Updated Body Mass Index: Association With Improved CD4+ Cell Recovery on HIV Treatment. J Acquir Immune Defic Syndr 73:197-204
Sharma, Anjali; Hoover, Donald R; Shi, Qiuhu et al. (2016) Falls among middle-aged women in the Women's Interagency HIV Study. Antivir Ther :

Showing the most recent 10 out of 529 publications