The NYC/Bronx Consortium is the largest of the six sites of the Women's Interagency HIV and ideally situated to continue its highly successful investigations into HIV infection in women, through both its core activities and its ongoing collaborations with the broader scientific community. Our specific goal as a local site is to provide the operational and scientific support necessary to achieve the specific aims and hypotheses proposed in part A of this application. In so far as future WIHS investigations are predicated upon having a high rate of visit compliance and low missed visit rates, the NYC/Bronx WIHS has a proven superior track record. The NYC/Bronx consortium has also played a strong leadership role in promoting the overall WIHS scientific agenda concentrating on long-term clinical outcomes of natural and treated history (Dr. Anastos) and focused virologic investigations through our Co-PIs for virologic studies (Drs Burger and Weiser). It has extended its scientific reach by attracting prominent collaborators in the field. Our role will be especially strong in continuing investigations of several of the specific aims outlined in part A, including Aim 2, many of which will continue to be led by Dr. Anastos, as well as Aims 3 (with leadership from Dr. Justman), 4 and 5. As a specific local research initiative we propose to extend our previous investigations of quantitative HIV-1 RNA in different biologic compartments in HIV-1 infected women; this project intersects with specific aim 5 by investigating the hypothesis that these gender differences in viral pathogenesis are mediated by female hormones, and biologic compartmentalization of immune function. These investigations, performed at the clinical site of the Bronx/Manhattan WIHS, will have specific emphasis on variations in quantitative HIV-1 RNA, co-receptor utilization, and immune function (CTL responses) in the plasma and genital tract occurring with different patterns of exogenous or endogenous hormones. In addition, through a small number of additional specimens, we will investigate the association of women's hormones with HPV.
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