The New York City Collaborative Working Group on HIV infection in women (NYCCWG) proposes to participate in a multisite longitudinal cohort study to investigate the natural history of HIV in women. This project is designed to be implemented in the context of ongoing smoothly functioning primary care clinics in the three collaborating institutions: Bronx Lebanon Hospital Center (BLHC), Mount Sinai Medical Center (MSMC), Beth Israel Medical Center (BIMC). These three sites collectively provide comprehensive HIV primary care services to more than 1300 HIV-infected women, and several hundred known high risk HIV uninfected women. The goal of the study is to determine the natural history of HIV in women, including gynecologic manifestations, nongynecologic manifestations, and behavioral factors which are related to HIV disease progression. The cases of study include defining the relatively frequencies of specific AIDS defining illnesses, the relationship of surrogate markers to disease progression, the causes of morbidity and mortality, and correlates on long term survival. Subjects will be recruited to the study by their primary care providers and research activities will be conducted within the context of the subjects, ongoing gynecologic screening care. Research visits will occur every six months and will include collection of historical data, a physical examination including pelvic, and collection of multiple blood and gynecologic specimens. Additional information will be obtained by review of inpatient as well as primary care charts, and through laboratory and autopsy findings.
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