Mechanisms of HIV-Associated Co-Morbidities Among Health Disparities Populations

NIH Guide Number: RFA-MD-18-002

Council Date: June 6, 2017

Objectives

This initiative will support research to examine how multiple HIV-associated co-morbidities add to the complexity of HIV disease progression and treatment outcomes among health disparities populations.

Description of Initiative

Although the rates of HIV overall are going down, disparities still exist. Reports show that people living with HIV are increasingly experiencing a range of non-AIDS-related co-morbidities as the population ages, compared to HIV negative people. These comorbidities can complicate and accelerate the HIV/AIDS disease process and may contribute to HIV associated disparities among various racial and ethnic minorities in the U.S. The current initiative will support multidisciplinary research to understand the underlying mechanisms and examine how multiple HIV-associated co-morbidities add to the complexity of HIV disease progression and treatment outcomes among HIV positive health disparities populations.

The NIH-designated health disparity populations include Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asians, Native Hawaiians and other Pacific Islanders, socioeconomically disadvantaged populations, sexual and gender minorities and underserved rural populations in the United States.

Areas of research interest include but are not limited to the following:

  • Determine the interactions of multiple HIV-associated co-morbidities and risk factors (e.g., metabolic syndrome, smoking) and the mechanisms through which they result in poor health outcomes in health disparities (HD) populations;
  • Examine how HCV co-infection and liver diseases such as NASH/cirrhosis collectively affect HIV disease progression among health disparity populations;
  • Characterize differences between racial/ethnic groups in immune functioning among individuals with HIV-HCV or other multiple co-infection for mechanisms of immune control and disease outcome;
  • Characterize the mechanisms of how genetic variations, epigenetic alterations, microbiome variations, and social-environmental factors could interact to play a role in disease progression and treatment outcomes for HIV-HCV-CMV positive patients in high risk racial/ethnic populations;
  • Identify the role of health care access and uptake of services in management of comorbidities and treatment outcome among health disparities populations with co-morbidities among HIV infected patients.