Health Outcomes around Pregnancy and Exposure to HIV/ARV (HOPE): Extending the Reach of PHACS to Examine Women's Health

围绕怀孕和接触 HIV/ARV 的健康结果 (HOPE)：扩大 PHACS 的范围以检查女性健康

• 批准号: 10437910
• 负责人: Ellen Gould Chadwick
• 金额: $ 291.77万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10437910
• 关键词: 18 year old; Address; Adherence; Adolescent; Affect; Age; Anti-Retroviral Agents; Area; Attention; Birth; Caring; Child; Child Health; Child Rearing; Child Support; Clinical; Conceptions; Consequences of HIV; Data; Data Collection; Diagnosis; Disclosure; Disease; Disease Progression; Enrollment; Ensure; Epigenetic Process; Exposure to; Foundations; Future; Genetic; Geography; HIV; HIV Infections; Health; Health Status; Heterosexuals; Inequity; Inflammatory; Infrastructure; Institution; Life Cycle Stages; Link; Longevity; Maternal Health; Mental Depression; Mental Health; Methods; Monitor; Mothers; Newly Diagnosed; Nulliparity; Opioid; Oral health; Outcome; Participant; Pattern; Patterns of Care; Pediatric HIV/AIDS Cohort Study; Perinatal; Persons; Population; Positioning Attribute; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Prevalence; Proteome; Protocols documentation; Public Health; Puerto Rico; Reproductive Health; Research; Research Design; Research Infrastructure; Resources; Site; Social support; Time; Treatment Factor; Treatment-related toxicity; United States; Viral; Viral Load result; Virus; Woman; Women' s Health; antenatal; antiretroviral therapy; biobank; caregiving; clinical care; co-infection; cohort; comorbidity; cost effective; epidemiology study; follow-up; health assessment; health determinants; immune activation; innovation; interest; maternal outcome; microbiome; multidisciplinary; older women; physical conditioning; post pregnancy; postpartum care; pregnant; prenatal exposure; prepregnancy; prospective; psychosocial; racism; recruit; reproductive; social stigma; substance use; therapy adherence; transmission process; virome; young woman

Abstract Over 250,000 women in the United States are living with HIV, but limited research has addressed the physical and mental health outcomes among younger women living with HIV (WLHIV). Because health status in the reproductive years and surrounding pregnancy critically affects lifelong health, understanding health outcomes among young WLHIV of reproductive age before, during, and after pregnancy is of substantial public health importance in the US and worldwide. The maternal outcomes of WLHIV are inextricably linked to the long-term health and survival of their children. The Pediatric HIV/AIDS Cohort Study (PHACS), conducted at 21 sites across the US and Puerto Rico, has been following young WLHIV of reproductive age and their children since 2007, with over 2000 birth mothers and >2800 HIV-exposed uninfected (HEU) children. Mothers with perinatally acquired HIV (PHIV) are of specific interest, and the PHACS network includes >400 such women with PHIV (WPHIV) along with their 251 HEU children. Utilizing the successful and longstanding PHACS research infrastructure and existing cohorts, we will establish the Health Outcomes around Pregnancy and Exposure to HIV/Antiretrovirals (HOPE) cohort, a cohort of 2000 pregnant, non-pregnant or nulliparous WLHIV of reproductive age from geographically diverse, high HIV prevalence areas. Leveraging PHACS, cost-effective and targeted enrollment and follow-up for longitudinal data collection will be achieved; we will also establish a rich biorepository which links WLHIV to their children’s data and biospecimens. Thus, the HOPE research platform will support high impact scientific studies central to the health of young WLHIV. Our scientific aims for the HOPE cohort are: (1) to evaluate the effects of HIV-related disease and treatment factors on reproductive health, non-communicable diseases, and oral health of WLHIV as well as psychosocial determinants of these health outcomes (engagement in care, mental health diagnoses, racism, inequity and stigma, disclosure of HIV, and substance use/misuse), and (2) To assess child health outcomes and their impact on the health of WLHIV, including maternal HIV disease progression, antiretroviral therapy (ART) adherence, engagement in care and maternal mental health. Overall, HOPE will create a platform to explore the multilevel determinants and mechanisms that influence the short and longer-term health of WLHIV during their reproductive years, as well as the health of their children, and will serve as a resource for future multidisciplinary studies in areas such as genetics and epigenetics, microbiome/virome/proteomes and immune activation, to provide better understanding of potential inflammatory and epigenetic processes associated with these outcomes.

抽象的 美国有超过 250,000 名女性感染艾滋病毒，但针对身体问题的研究有限 年轻女性艾滋病毒感染者 (WLHIV) 的健康状况和心理健康结果。 生育年龄和怀孕前后严重影响终生健康，了解健康结果 怀孕前、怀孕期间和怀孕后的育龄青年 WLHIV 具有重大公共卫生意义 WLHIV 对孕产妇的影响与长期影响有着千丝万缕的联系。 儿科艾滋病毒/艾滋病队列研究 (PHACS)，在 21 个地点进行。 美国和波多黎各自 2007 年以来一直在跟踪育龄青年 WLHIV 及其子女， 拥有超过 2000 名亲生母亲和超过 2800 名暴露于艾滋病毒的未感染 (HEU) 儿童。 获得性艾滋病毒 (PHIV) 受到特别关注，PHACS 网络包括超过 400 名患有 PHIV 的此类女性 (WPHIV) 及其 251 名 HEU 儿童利用了成功且长期的 PHACS 研究。 基础设施和现有队列，我们​​将围绕怀孕和暴露建立健康结果 HIV/抗逆转录病毒药物 (HOPE) 队列，该队列由 2000 名怀孕、未怀孕或未生育的 WLHIV 患者组成 利用具有成本效益的 PHACS。 并实现纵向数据收集的定向登记和随访； 丰富的生物储存库将 WLHIV 与其孩子的数据和生物样本联系起来，因此，HOPE 研究。 平台将支持对年轻 WLHIV 健康至关重要的高影响力科学研究。 我们 HOPE 队列的科学目标是：(1) 评估 HIV 相关疾病和治疗的效果 影响 WLHIV 生殖健康、非传染性疾病、口腔健康以及社会心理的因素 这些健康结果的决定因素（参与护理、心理健康诊断、种族主义、不平等和 (2) 评估儿童健康结果及其影响 关于 WLHIV 的健康，包括孕产妇艾滋病毒疾病进展、抗逆转录病毒治疗 (ART) 依从性、 总体而言，HOPE 将创建一个探索多层次的平台。 影响 WLHIV 繁殖期间短期和长期健康的决定因素和机制 以及他们孩子的健康，并将作为未来多学科研究的资源 遗传学和表观遗传学、微生物组/病毒组/蛋白质组和免疫激活等领域，以提供更好的 了解与这些结果相关的潜在炎症和表观遗传过程。