Major AIDS Studies to Increase Minority Enrollment, Answer New Questions

The Women's Interagency HIV Study (WIHS) and the Multicenter AIDS Cohort Study (MACS) are the two largest observational studies of HIV/AIDS in women and homosexual or bisexual men, respectively, in the United States. These studies have repeatedly made major contributions to understanding how HIV is spread, how the disease progresses, and how it can best be treated. Now, the National Institute of Allergy and Infectious Diseases (NIAID) is launching a campaign to boost the size of the study groups by 60 percent and increase the number of minority participants. The enlarged groups will focus on contemporary questions regarding HIV infection and treatment.

Since the early days of HIV/AIDS, two key changes have occurred in the United States. First, a disease that initially affected mostly gay, white males has moved into minority populations, striking both men and women. Of newly infected men in the United States, 50 percent are black and 20 percent are Hispanic; of newly infected women, 64 percent are black and 18 percent are Hispanic. Second, highly active antiretroviral therapy, or HAART, has greatly improved treatment.

"Because of HAART, HIV-infected people are living longer without developing AIDS," says NIAID Director Anthony S. Fauci, M.D. "This means that we have new issues to address, such as the safety and benefits of long-term treatment, HIV's effects in older populations, and the nature of both the virus and the immune system during chronic infections. MACS and WIHS are ideal frameworks within which such questions can be answered."

MACS and WIHS were established in 1984 and 1993, respectively. Since their inception, both studies have lost a large number of participants to HIV disease, particularly MACS since many participants enrolled years before today's effective drugs were available. Both studies also require increased minority enrollment to reflect the status of HIV in the United States. The new enrollment will ensure the cohorts remain large enough to address new questions about the disease in a population that best represents people with HIV today.

"One of the important features about MACS and WIHS is their applicability to the general population," explains Carolyn Williams, Ph.D., an epidemiologist in NIAID's Division of AIDS. "By working with the groups most affected by the current epidemic we can gather data on a broad range of questions. The information we collect can then be used to direct future studies on HIV and HAART." MACS and WIHS follow both HIV-infected and uninfected individuals, making it possible to separate out the effects of the virus from other factors. Currently, the two studies are enrolling persons who are HIV-negative or HIV-positive and have never received HIV therapy; or who are HIV-positive and have medical records available from the time they started therapy. Participants who have started therapy must have begun receiving HAART before developing an opportunistic infection.

MACS has sites in Baltimore, Chicago, Los Angeles, and Pittsburgh; additional information is available on the MACS Web site at www.statepi.jhsph.edu/macs/macs.html. WIHS sites are located in Baltimore, Chicago, Hawaii, Los Angeles, New York, San Francisco, and Washington, D.C. The WIHS Web site is located at www.statepi.jhsph.edu/wihs/index.html.

MACS is funded by NIAID and the National Cancer Institute (NCI). WIHS receives funding from NIAID, NCI, the National Institute of Child Health and Human Development, the National Institute of Dental Research, and the National Institute on Drug Abuse. NIAID is a component of the National Institutes of Health (NIH).

NIAID supports basic and applied research to prevent, diagnose, and treat infectious and immune-mediated illnesses, including HIV/AIDS and other sexually transmitted diseases, tuberculosis, malaria, autoimmune disorders, asthma and allergies.

For more information, contact Sam Perdue at (301) 402-1663 or sp189u@nih.gov.