Women HIV Cohort Study: HIV infection and treatment among women of reproductive age

Abstract
Nearly one quarter of the 1.1 million individuals living with HIV in the US are women, and there is a
disproportionate impact on racial/ethnic minority women in the Southern US. Reproductive age women living
with HIV (WLH) are highly affected by poor HIV outcomes, likely due to structural, psychosocial, and biological
factors. Unfortunately, despite experiencing poor outcomes and facing unique challenges, reproductive age
WLH are grossly underrepresented in HIV research. The Women's Interagency HIV Study (WIHS) is a large,
comprehensive, prospective cohort study which began in 1993 and comprises almost 4,000 WLH who undergo
biannual study visits with detailed structured interviews, physical and gynecologic examinations, laboratory
testing, and specimen biobanking. The WIHS has 5 sites located in the South (Atlanta, Birmingham/Jackson,
Chapel Hill, Miami, and Washington DC). This year, the WIHS combined with the Multicenter AIDS Cohort
Study (MACS) of gay and bisexual men, to form the MACS/WIHS Combined Cohort Study (MWCCS). The
Women HIV Cohort Study (WHCS) will be conducted in these 5 Southern MWCCS (previous WIHS) sites and
will leverage the MWCCS structure, including access to participants, standardized assessments, specimen
collections, data management, leadership committees, community advisory boards, and scientific working
groups to address the following specific aims. First, we will recruit and retain 2,000 reproductive age WLH
representative of the Southern epidemic into a longitudinal cohort study that will address the effects of HIV and
HIV treatment in this age group. Second, we will use the scientific strength of WIHS to integrate high priority
science in key thematic areas that are highly relevant for reproductive age WLH. We will provide rigorously
collected sociobehavioral, clinical, and outcome data and biological specimens to scientific experts across all
WIHS sites to promote multidisciplinary HIV/AIDS research. Third, we will utilize this cohort to implement
unifying multidisciplinary research that is responsive to the unique health needs of reproductive age WLH. To
do so, we will implement science in the area of depression, a critical mediator of health and HIV treatment
outcomes of particular relevance to reproductive age WLH, and in the area of oral health. Through this
science and the described plan for engagement of scientists across a broad range of relevant disciplines, the
WHCS has the potential to ultimately improve the health of young WLH, optimize the gains of ART, and
contribute to ending HIV across populations in the United States.

Grant Number: 5R01HD101352-05
NIH Institute/Center: NIH
Principal Investigator: MARIA ALCAIDE