Pilot Award

The Women's Interagency HIV Study (WIHS) is a longitudinal cohort study of women with HIV, and a risk-set match control group; the women enrolled are primarily African American and Latina, with a small number of Asian and Caucasian non-Hispanic women. In Fall of 2011, the WIHS National Community Advisory Board (NCAB) requested to receive their individual estimates of ancestry admixture that are being used as covariates in genomic studies.

The increasing call for community-level evaluation of "combination HIV prevention" (packages of our best evidence-based HIV prevention interventions) has brought to the forefront the need to develop novel methods of both evaluating these combinations of interventions in aggregate and estimating the relative contributions of individual components of the combined intervention. However, such comprehensive methods do not exist.

Chronic immune activation is a significant determinant of HIV-mediated CD4+ T cell loss and disease progression. Despite effective viral suppression, chronic inflammation persists at levels higher than in uninfected people, yet the inflammatory stimuli and the mechanisms by which inflammation persists and promotes disease pathology are not completely understood. Many mechanisms likely contribute to chronic immune activation including persistent antigenemia, depletion of T regulatory cells (Tregs), and stimulation of toll-like receptors.

My research has consistently focused on the effects of poverty and of social/cultural context on the health of our most disadvantaged youth, particularly homeless youth in San Francisco and street children in Kisumu, Kenya. Through my work in San Francisco since 2001, I demonstrated the feasibility of longitudinal epidemiological work with street youth, demonstrated the role of street culture, social networks and race in HIV risk of street youth, and developed a community collaborative project for street-based STI testing of street youth.

As the prevalence of metabolic syndrome and obesity rises, and as more effective HCV treatments become available, fatty liver disease will likely become a leading cause of liver disease in persons living with HIV. The purpose of this study is to determine the association of metabolic, host genetic, and viral factors with hepatic steatosis (Aim 1) and hepatic fibrosis (Aim 2) in HIV-infected adults with and without HCV coinfection.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

HIV treatment can improve health and longevity and prevent transmission to sexual and injection drug contacts of persons with HIV. However, realizing the benefits of treatment requires consistent engagement in clinical care and adherence to anti-retroviral medication. Both HIV infection and aging are associated with neurocognitive decline. There may also be synergistic effects between HIV infection and aging that accelerate declines in cognitive function. Cognitive impairment may limit individuals? ability to engage in care, particularly in populations where co-morbidities are common.

HIV treatment can improve health and longevity and prevent transmission to sexual and injection drug contacts of persons with HIV. However, realizing the benefits of treatment requires consistent engagement in clinical care and adherence to anti-retroviral medication. Both HIV infection and aging are associated with neurocognitive decline. There may also be synergistic effects between HIV infection and aging that accelerate declines in cognitive function. Cognitive impairment may limit individuals? ability to engage in care, particularly in populations where co-morbidities are common.

There is a fundamental lack of knowledge in identifying HIV infected individuals at high risk of fracture, and determining the effectiveness of treatment. Osteoporosis is usually diagnosed using DXA that provides an estimate of areal bone mineral density (BMD) computed for skeleton sites prone to fracture such as the femoral neck and the lumbar vertebrae.