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 #
5U01AI034993-21
Application #
8604659
Study Section
Special Emphasis Panel (ZAI1-RB-A (S1))
Program Officer
Roe, Joanad'Arc C
Project Start
1994-01-01
Project End
2017-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
21
Fiscal Year
2014
Total Cost
$2,651,955
Indirect Cost
$306,642
Name
Hektoen Institute for Medical Research
Department
Type
DUNS #
068625136
City
Chicago
State
IL
Country
United States
Zip Code
60612
Scherzer, Rebecca; Bacchetti, Peter; Messerlian, Geralyn et al. (2015) Impact of CD4+ lymphocytes and HIV infection on Anti-Müllerian Hormone levels in a large cohort of HIV-infected and HIV-uninfected women. Am J Reprod Immunol 73:273-84
Massad, L Stewart; Xie, Xianhong; D'Souza, Gypsyamber et al. (2015) Incidence of cervical precancers among HIV-seropositive women. Am J Obstet Gynecol 212:606.e1-8
Dale, Sannisha K; Weber, Kathleen M; Cohen, Mardge H et al. (2015) Resilience Moderates the Association Between Childhood Sexual Abuse and Depressive Symptoms Among Women with and At-Risk for HIV. AIDS Behav 19:1379-87
Strickler, Howard D; Martinson, Jeffrey; Desai, Seema et al. (2014) The relation of plasmacytoid dendritic cells (pDCs) and regulatory T-cells (Tregs) with HPV persistence in HIV-infected and HIV-uninfected women. Viral Immunol 27:20-5
Peralta, Ca; Scherzer, R; Grunfeld, C et al. (2014) Urinary biomarkers of kidney injury are associated with all-cause mortality in the Women's Interagency HIV Study (WIHS). HIV Med 15:291-300
Frasco, Melissa A; Karim, Roksana; Van Den Berg, David et al. (2014) Antiretroviral therapy modifies the genetic effect of known type 2 diabetes-associated risk variants in HIV-infected women. AIDS 28:1815-23
Tumusiime, David K; Musabeyezu, Emmanuel; Mutimurah, Eugene et al. (2014) Over-reported peripheral neuropathy symptoms in a cohort of HIV infected and uninfected Rwandan women: the need for validated locally appropriate questionnaires. Afr Health Sci 14:460-7
Meyer, Vanessa J; Little, Deborah M; Fitzgerald, Daniel A et al. (2014) Crack cocaine use impairs anterior cingulate and prefrontal cortex function in women with HIV infection. J Neurovirol 20:352-61
Schwartz, Janice B; Moore, Kelly L; Yin, Michael et al. (2014) Relationship of vitamin D, HIV, HIV treatment, and lipid levels in the Women's Interagency HIV Study of HIV-infected and uninfected women in the United States. J Int Assoc Provid AIDS Care 13:250-9
Dale, Sannisha K; Cohen, Mardge H; Kelso, Gwendolyn A et al. (2014) Resilience among women with HIV: Impact of silencing the self and socioeconomic factors. Sex Roles 70:221-231

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