Food Insecurity Substudy This study is designed to obtain information to describe the cohort in terms of their access to food (“food security”), as well as their diet, sources of governmental or non-governmental assistance, how subsistence needs compete with health care, and attitudes towards HIV.
Molecular Methods to Improve Cervical Cancer Screening in HIV+ Women
The purpose of the Molecular Methods to Improve Cervical Cancer Screening in HIV+ Women (CCSS) study is to improve how accurately pre-cancer and cancer can be diagnosed in HIV-positive women. WIHS researchers are testing new lab methods for cervical cancer screening that can be done using standard Pap smear samples. For this study, women will have an extra Pap test done, as well as take a brief questionnaire at their Baseline (Entry) visit.
A Longitudinal Study to Evaluate Risk Factors for Liver Disease Progression in HIV and HCV Infection in Women: Comparison of Serum Markers and Measures of Liver Stiffness and Fat Composition
The purpose of the Fibroscan study is to follow liver function over time in women who are either HIV positive, HIV negative, HIV-negative/hepatitis C-positive, or HIV-positive/hepatitis C-positive. This study will use a tool called a “Fibroscan” that is similar to an ultrasound. At a participant’s routine WIHS visit, a small metal device called a probe will be placed on the skin up against the liver to measure scarring and fat within the liver.
HIV and the menopausal transition: effects on musculoskeletal health The purpose of the Musculoskeletal (MSK) substudy is to look at the effect of estrogen on the negative effects of HIV infection on the skeleton in premenopausal women. Women enrolled in this study will have more detailed musculoskeletal studies performed using advanced tests.
POPS: Pilot Oral Papillomavirus Study (POPS) Survey The purpose of the POPS study is to understand how people get HPV in their mouth and how long it takes for these HPV infections to go away. Participants will give oral rinse samples at each WIHS visit. These samples will then be tested to see if there is an oral HPV infection.
The Affordable Care Act, Socioeconomic Context, Spatial Mapping, and the WIHS The purpose of this study is to understand how neighborhood poverty and income inequality makes people’s health worse by blocking off important resources like health care, education, and affordable food and housing. Researchers will use information already taken during WIHS visits about health insurance coverage and yearly income, and census information to look at changes in health outcomes as the Affordable Care Act goes into effect across the country.
Bone Loss and Immune Reconstitution in HIV/AIDS (BLIR-HIV) Other studies have shown that HIV-infection and HAART treatment lead to increased bone loss. The reason for this is not clear. Recent data from animal studies generated by our group suggest bone loss in HIV-infection may be due to imbalance between two proteins (OPG and RANKL) in the body that regulate bone structure. This study will therefore examine whether this is the case in human. We will measure the amount of these proteins in HIV-patients starting treatment with HAART to see if they change over time. We will also examine whether changes in this protein and bone loss can be prevented by bone protective medications.
New Strategies to Assess Anal Cancer Risk in Women (ANCAR-WIHS) The purpose of this study is to explore different strategies to identify women at highest risk for anal cancer. First, we want to study a risk assessment called the Anal Cancer Risk Index; it gives women an overall number score based on risk factors that they may have for anal cancer, such as age, number of sexual partners, or smoking. We want to see whether women with higher Anal Cancer Risk Index scores are more likely to have abnormal results on anal pap smears, HPV tests, or anal biopsies. Next, we want to collect a swab of the cervix and swabs of the anus to study different laboratory tests that could identify women at highest risk of anal cancer: these tests include an anal pap smear and tests that detect HPV types most likely to cause cancer. We want to see which of these laboratory tests do the best job at predicting precancerous lesions in the anus. After we collect these swabs, women will have a procedure called high resolution anoscopy where we look closely at the anus and biopsy any suspicious areas. Finally, we want to look for HPV proteins and changes that HPV can make in cells to see if these tests predict anal lesions. The HPV protein is called E6 and E7 and the cell change test is called CADM1/MAL/miR-124-2. We will measure E6/E7 and CADM1/MAL/miR-124-2 in cervical and anal samples to see if women positive for this marker are more likely to have abnormal results on anal pap smears or anal biopsies.
Women's Adherence and Visit Engagement (WAVE) Study The purpose for the proposed research project is to address the gaps in knowledge relating to HIV-related stigma by leveraging the resources of the national Women’s Interagency HIV Study (WIHS), which has been collecting data on HIV-infected women’s treatment adherence, mental health, and immunologic and virologic outcomes for 20 years. In 2013, WIHS added new sites from the Southern US in response to shifts in the HIV epidemic, for which Emory University is one of the new sites from the Southern USA. The proposed study involves a yearly supplementary visit at three collaborating WIHS sites (n=500) representing different parts of the country – California (San Francisco), the Deep South (Alabama/Mississippi), and the Southeast (Georgia) – to collect additional measures of theoretically important dimensions of stigma, validated measures of hypothesized interpersonal, psychological, and mental health mechanisms, measures of other intersecting stigmas and discrimination (due to race, gender, and socio-economic status), as well as hair samples for assessment of cortisol (a biomarker for chronic stress).