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.
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.
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