A growing proportion of U.S. women with HIV infection are from the Southeastern United States. Compared to all other states in the Southern region of the U.S., Florida has the highest number of HIV-infected individuals and the highest rates of HIV transmission. Miami-Dade County has one of the highest rates of new infections among women and the prevalence of HIV among women was among the highest in a national study of 21 epicenter cities in the U.S. Heterosexual transmission and intravenous drug use were the major risk factors for infection. Compounding these issues, Miami-Dade County ranks high among U.S. areas in measures of social and economic distress. The Women's Interagency HIV Study (WIHS) seeks to expand its efforts to better understand the current epidemiology of HIV infection in women with the identification of new sites from the Southern region of the U.S. The Miami WIHS is well positioned to engage women with HIV infection and at risk for HIV infection that are representative of this region and the changing demographics of the HIV epidemic, as well as addressing important current treatment outcomes and the impact of disassociation from care among hard-to-reach populations (e.g. substance abusing individuals). Miami sits at the portal to the Caribbean and Central and South America and, as a result of the high rates of immigration from these regions;the women infected with HIV belong to a wide, diverse population. In addition, the HIV-infected population of women in Miami spans generational boundaries from pediatrics through to the elder. This project is a multiple PI project between the University of Miami Miller School of Medicine and the Columbia University Mailman School of Public Health with collaboration from the University of Florida. We will seek to enroll a diverse cohort of 300 youth, young adult and adult women, including women who are at-risk for HIV, those with limited disease progression, those with newly recognized infection, who are antiretroviral treatment na?ve and antiretroviral treatment experienced participants, and who are in care, intermittently in care and not in care. A highly experienced and diverse team of researchers has been assembled to ensure the success of this program, including clinical, basic and behavioral/social scientists, with strong ties to th community.
The specific aims outlined respond directly to the overall WIHS scientific goals and advance and expand the WIHS basic, clinical and epidemiologic/behavioral/social science research agenda. The proposed scientific agenda taps into the experience and expertise of the Miami WIHS researchers to examine critically important and scientifically rigorous research questions. The proposed research projects will examine the impact of aging on immune functionality;reproductive decision making among young adult and adult women living with HIV/AIDS;increasing viral diversity and the impact of HIV-1 non-B subtype infections on the clinical course of HIV and response to therapy;and the interplay of crack cocaine use and associated co-occurring epidemics (mental health, poverty, unemployment and interpersonal violence with uptake of optimal antiretroviral therapy and engagement and retention in care. By coupling the diverse population base of HIV-infected and at risk women with the recognized strengths in HIV/AIDS research, the Miami WIHS is perfectly situated to advance the overall WIHS scientific agenda of defining clinical outcomes among women across their lifespan, including the uptake of antiretroviral therapy;use and retention of HIV primary care and other ancillary services;treatment outcomes on viral suppression, immune recovery and normalization of the effects of HIV, and disease pathogenesis, as well as, promoting and advancing local scientific research goals.

Public Health Relevance

The purpose of the Miami Women's Interagency HIV Study is to recruit and retain new women who are representative of the HIV epidemic in Miami into the WIHS cohort and to provide insight into the changing demographics of the HIV epidemic among women in the United States.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AI103397-02
Application #
8601169
Study Section
Special Emphasis Panel (ZAI1-RB-A (S1))
Program Officer
Roe, Joanad'Arc C
Project Start
2013-01-01
Project End
2017-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
2
Fiscal Year
2014
Total Cost
$1,522,881
Indirect Cost
$414,457
Name
University of Miami School of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Massad, L Stewart; Hessol, Nancy A; Darragh, Teresa M et al. (2017) Cervical cancer incidence after up to 20 years of observation among women with HIV. Int J Cancer 141:1561-1565
Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar et al. (2017) Life begins at 60: Identifying the social support needs of African American women aging with HIV. J Health Care Poor Underserved 28:389-405
Haley, Danielle F; Haardörfer, Regine; Kramer, Michael R et al. (2017) Associations between neighborhood characteristics and sexual risk behaviors among HIV-infected and HIV-uninfected women in the southern United States. Ann Epidemiol 27:252-259.e1
Edmonds, Andrew; Ludema, Christina; Eron Jr, Joseph J et al. (2017) Effects of Health Insurance Interruption on Loss of Hypertension Control in Women With and Women Without HIV. J Womens Health (Larchmt) 26:1292-1301
Ludema, Christina; Cole, Stephen R; Eron Jr, Joseph J et al. (2017) Health Insurance Type and Control of Hypertension Among US Women Living With and Without HIV Infection in the Women's Interagency HIV Study. Am J Hypertens 30:594-601
Burke-Miller, Jane K; Weber, Kathleen; Cohn, Susan E et al. (2017) Measurement of Neighborhood Context in an Urban Cohort of HIV-infected or at risk Low-Income Women. J Poverty 21:80-96
Price, Jennifer C; Ma, Yifei; Scherzer, Rebecca et al. (2017) Human immunodeficiency virus-infected and uninfected adults with non-genotype 3 hepatitis C virus have less hepatic steatosis than adults with neither infection. Hepatology 65:853-863
Lesko, Catherine R; Todd, Jonathan V; Cole, Stephen R et al. (2017) Mortality under plausible interventions on antiretroviral treatment and depression in HIV-infected women: an application of the parametric g-formula. Ann Epidemiol 27:783-789.e2
Reid, Michael; Ma, Yifei; Scherzer, Rebecca et al. (2017) Higher CD163 levels are associated with insulin resistance in hepatitis C virus-infected and HIV-infected adults. AIDS 31:385-393
Haddad, Lisa B; Wall, Kristin M; Mehta, C Christina et al. (2017) Trends of and factors associated with live-birth and abortion rates among HIV-positive and HIV-negative women. Am J Obstet Gynecol 216:71.e1-71.e16

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