In the era of highly active antiretroviral therapy (HAART), Human Immunodeficiency Virus (HlV)-related morbidity and mortality have declined. Adults living with HIV as a chronic disease now face physical, cognitive, and social challenges not previously seen in the pre-HAART era. Given that more than 60,000 Americans aged 50 or older are living with HIV, attention to disability has prompted studies to use people's functioning in the presence of disease as health outcomes rather than disease onset and mortality. Data on the epidemiology of disability among older HIV- and HIV/Hepatitis C Virus (HCV)-coinfected women of color are particularly scarce. Nested as a cross-sectional study within a prospective cohort study, the Women's Interagency HIV Study (WIHS), the proposed study will characterize functional limitation and disability during a semi-annual visit in Fall of 2005. Functional limitation measures include hand grip strength and timed-gait tests. Disability measures include Activities of Daily Living and Instrumental Activities of Daily Living. Prevalence and severity will be compared across groups of women by HIV, HCV, and illicit drug use status. Infected women with HIV and/or HCV will also be compared to HIV-uninfected WIHS participants and HIV-uninfected 'external' women from the Cardiovascular Health Study and the Women's Health and Aging Study. Among HIV-infected WIHS particpants, independent predictors and effect modifiers of functional limitation and disability will be identified. Epidemiologic associations will be based on over 3000 WIHS women, representing the domestic epidemiology of HIV/AIDS in women. Logistic regression analyses will be conducted using HIV, HCV, drug use, and age-related predictors. Results will provide vital, comprehensive data on the prevalence and severity among HIV- and HIV/HCV-coinfected women. Findings will likely generate inferences regarding the etiology of particular functional limitations and disabilities. This proposed study will advance the prevention of disability by identifying subgroups at highest risk of functional decline and disability, providing a benchmark for future evaluations, and informing services that seek to modify factors via prevention and treatment strategies. This ross-sectional study proposes to characterize and identify predictors of physical disability among HIV and HIV/HCV-coinfected women. Providing a benchmark for future evaluations, this study will inform planning services and advance the prevention of disability.
| Gustafson, Deborah R; Shi, Qiuhu; Holman, Susan et al. (2017) Predicting death over 8 years in a prospective cohort of HIV-infected women: the Women's Interagency HIV Study. BMJ Open 7:e013993 |
| Gustafson, D R; Shi, Q; Thurn, M et al. (2016) Frailty and Constellations of Factors in Aging HIV-infected and Uninfected Women--The Women's Interagency HIV Study. J Frailty Aging 5:43-8 |
| Terzian, Arpi S; Holman, Susan; Nathwani, Niyati et al. (2009) Factors associated with preclinical disability and frailty among HIV-infected and HIV-uninfected women in the era of cART. J Womens Health (Larchmt) 18:1965-74 |
