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Published in CenterView on May 13, 2013
Dr. Deborah Konkle-Parker, right, meets with members of the Women’s Interagency HIV Study during a site visit May 7 at UMMC.
Dr. Deborah Konkle-Parker, right, meets with members of the Women’s Interagency HIV Study during a site visit May 7 at UMMC.

Infectious diseases division joins national women’s HIV study

By Jack Mazurak

As UMMC joins a nationwide study of women with HIV, paving a path to funding and 20 years of accumulated data, organizers hope more Medical Center researchers will climb aboard.

“Mississippi is the state with the highest case fatality rate in AIDS,” said Dr. Deborah Konkle-Parker, associate professor of infectious diseases. She said Jackson has one of the highest infection rates of metro areas in the country.

“So this is an incredibly ripe location for conducting HIV-related research.”

This year, Konkle-Parker received a $3 million, five-year award to join the Women’s Interagency HIV Study. WIHS is a 20-year-running project with

approximately 4,000 participants through multiple centers throughout the country.

The National Institutes of Health funds WIHS, which broadly examines how being HIV-positive affects women’s health over time. New recruits from Mississippi and other Southern states would help the study’s cohort reflect demographics in states with heavy HIV burdens.
Konkle-Parker’s grant is a subcontract through the University of Alabama at Birmingham, which has a thriving enterprise in its Center for AIDS Research.

“My hope is that through this WIHS study, people who are involved in other areas of research, like cardiovascular disease, hypertension, stress, social and behavioral conditions, will be interested,” she said. “There are a lot of those effects in people with HIV.”

With data going back two decades and a repository of 1.9 million specimens, WIHS offers researchers mountains of information they can mine for their own investigations under the WIHS umbrella.

Along with UAB and UMMC, the NIH also added the University of North Carolina-Chapel Hill, Emory University and the University of Miami to the study.

“The epidemic has changed in that the disease affects lower-income minority women more so, with sexual orientation playing less of a role than other demographics,” Konkle-Parker said. “And understanding the impact of that is really important.

“Adding sites in the South will reflect the demographics and environment of what it’s actually like where the epidemic is the most severe.”

The African-American community in Mississippi is disproportionately affected by HIV and AIDS. A recent study by the Mississippi State Department of Health found that African-Americans represent 37 percent of the population, but account for 78 percent of new infections.

Representatives of the National Institute of Allergy and Infectious Diseases, and investigators from Johns Hopkins University and UAB, met May 7 at UMMC for a site visit. Dr. Stephen Gange, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health, oversees the WIHS data management and analysis center.

“WIHS is a big cohort with 4,000 to 5,000 to begin with,” Gange said. “We’re adding a substantial number of women and, as they age, their contributions will be increasingly important.”

The current cohort’s average age is the late 40s. As members move through menopause and into their 50s, researchers want to see what the effects are in a multitude of areas, including cardiovascular disease, diabetes and neurocognitive function as compared to HIV-negative women.

“It’s very difficult to tease apart the effects of HIV from other effects,” Gange said, indicating why a larger and more representative cohort may help unravel those complexities.

Moreover, with approximately 80 percent of the cohort treated, long-term influences of HIV may be more subtle. In the South, a higher incidence of poverty, stigma and access-to-care issues could more overtly mar a woman’s long-term health.

Konkle-Parker aims to submit the plans later this month to the UMMC Institutional Review Board, which oversees human-involved research. If approved, she and her collaborators hope to start recruiting in July to enroll 100 women, about 75 HIV positive, the remainder negative. UAB would contribute the same.

Recruits can be ages 25-60 and from rural or urban areas statewide. They would need to come to Jackson every six months for a medical exam, interview, pelvic exam and pap smear.

“The study is not to tell us how the demographics are different, but how environments impact biological and psychological health,” Konkle-Parker said. “That may be very different in the North than in the South.

“At the Medical Center, we’re very much hoping that we can gain interest from scientists all over the campus in different disciplines to be able to use the data.”