WIHS conducts research on a number of topics related to HIV/AIDS within several sites across the country. Available in this section are profiles of our DC WIHS collaborators, information about our ongoing research projects, the abstracts from some selected publications, and other resources that researchers may find useful.
Current Scope of WIHS Research
As addressed by the NIH in the current request for funding application (RFA), the topics of interest within the WIHS scope of research include:
The composition of the WIHS cohort reflects ART use patterns representative of the female HIV-positive population in the U.S. ART use in the cohort is therefore likely to be diverse, and differences in therapy exposure, effectiveness, and program delivery are of interest.
Research addresses the long-term natural and treated history of HIV infection in women with the particular aim of evaluating the effect of antiretroviral therapy on the clinical course of HIV disease. Response to HIV therapy, including demographic, genetic, psychological, behavioral, virologic resistance, and immunologic predictors of response is useful in defining exposure to therapy in women, and is obtained via adherence and pharmacokinetic studies. Additional research includes sociobehavioral factors that affect HIV transmission and disease progression.
Research in WIHS is able to maximize use of the WIHS cohort, specimens and data repository to account for the complex interrelationship between covariates, for example, genetics, co-infections, co-morbidities, therapy, behavior, and aging. WIHS research includes studies on: the short and long term effects of HIV and HIV therapy exposure on organ systems; the effects of aging on the clinical course of both HIV and HIV therapy; optimal methods to improve health behaviors among women with HIV; characteristics of concomitant infections and other acute clinical events as they affect and are affected by HIV disease progression; the impact of menopause on hormone levels in women with HIV and those who are undergoing treatment.
Current or historical use of alcohol, tobacco, illicit drugs and other substances is high among the WIHS cohort. Substance use also relates to other behavioral issues for the cohort including abuse, mental health status, and educational level. Research in all areas of the WIHS scientific agenda should take into account the impact of substance use, in both integrated and specifically focused research studies. Both the determinants and the consequences of substance use are of interest to the extent that they may help explain substance use effects related to HIV, its treatment and its biologic, clinical and/or behavioral outcomes.
Research can take advantage of reposited specimens collected across key time points. Generated data from participants includes genetic and longitudinal data on immune markers, or may be prospective in nature requiring additional specimen collection and testing.
The incidence of many cancers is likely to increase in the next five years of WIHS follow-up. WIHS investigators have access to bio-reposited specimens to study predictive biomarkers prior to the diagnosis of cancer. WIHS researchers also contribute specimens to the AIDS cancer and specimen repository biobank. Furthermore, WIHS also collaborates with other HIV studies to ensure sufficient statistical power to address rare cancers.
Epidemiologic and Statistical Methods
Innovative methodological approaches for the conduct, design and analysis of cohort studies of HIV/AIDS are devised to maximize the use of observational data to inform on health outcomes. Novel ways to improve the quality of self-reported data, to improve linkages between health care data (clinical care and pharmacy data), and standardize collection techniques and harmonize data bases are needed to improve research. Development of new statistical approaches to account for the complexity of WIHS data is also encouraged.