Gypsyamber D'Souza

• PhD, MS, MPH
• Johns Hopkins Bloomberg School of Public Health

Background Epidemiologists frequently employ right censoring to handle missing outcome, covariate, or exposure data incurred when participants have large gaps between study visits or stop attending study visits entirely. But, if participants who are censored are more or less likely to experience outcomes of interest than those not censored, such ce...

We studied cervicovaginal β-/γ-human papillomavirus (HPV) and their relationship to cervical precancer in women with HIV (WWH); having previously reported strong positive associations of β-/γ-HPV with incident head and neck cancer in the general population. Cases (N=124) had cervical intraepithelial neoplasia (CIN)-3 or CIN-2. Controls (N=247) were...

Objectives To understand the extent of racial disparities in SARS-CoV-2 vaccination among PWH and those vulnerable to HIV infection and to estimate the contributions of medical mistrust and vaccine-hesitant attitudes to these disparities. Design Quantitative data analyses in a racially and gender diverse, mixed-serostatus prospective cohort, the M...

Methylation quantitative trait loci (meQTLs) quantify the effects of genetic variants on DNA methylation levels. However, most published studies utilize bulk methylation datasets composed of different cell types and limit our understanding of cell-type-specific methylation regulation. We propose a hierarchical Bayesian interaction (HBI) model to in...

Background People aging with HIV (PAWH) experience greater impairment in physical and pulmonary function than individuals aging without HIV. We examined whether baseline physical function was associated with subsequent pulmonary impairments. Methods Associations of frailty and physical function (gait speed [m/sec], grip strength [kg]) with pulmona...

Background Frailty is associated with obesity-related comorbidities, but the relationship with non-alcoholic fatty liver disease (NAFLD) in people with HIV (PWH) has been incompletely described. Our objective was to assess the associations between NAFLD and frailty. Methods Cross-sectional and longitudinal analysis of men in the Multicenter AIDS C...

Background The effect of initial antiretroviral therapy (ART) class on cancer risk in people with HIV (PWH) remains unclear. Setting Cohort study of 36,322 PWH enrolled (1996-2014) in the North American AIDS Cohort Collaboration on Research and Design. Methods We followed individuals from ART initiation (protease inhibitor [PI]-, non-nucleoside r...

Background Methylation Quantitative Trait Loci (meQTLs) are chromosomal regions that harbor genetic variants affecting DNA methylation levels. The identification of meQTLs can be accomplished through quantifying the effects of single nucleotide polymorphisms (SNPs) on DNA methylation levels, and these inferred meQTLs can shed light on the complex i...

Background Estimating the medical complexity of people aging with HIV can inform clinical programs and policy to meet future healthcare needs. The objective of our study was to forecast the prevalence of comorbidities and multimorbidity among people with HIV (PWH) using antiretroviral therapy (ART) in the United States (US) through 2030. Methods a...

Background We investigated whether there exists an association between dietary acid load and kidney function decline in women living with HIV (WLWH) receiving antiretroviral therapy (ART). Setting One thousand six hundred eight WLWH receiving ART in the WIHS cohort with available diet data and a baseline estimated glomerular filtration rate (eGFR)...

An estimated 38 million people live with human immunodeficiency virus (HIV) worldwide and are at excess risk for multiple cancer types. Elevated cancer risks in people living with HIV (PLWH) are driven primarily by increased exposure to carcinogens, most notably oncogenic viruses acquired through shared transmission routes, plus acceleration of vir...

Background Altered gut microbiota has been associated with cognitive dysfunction and Alzheimer’s disease, but little is known among people living with HIV. Objective To examine associations between gut microbiota and cognitive impairment among women with or without HIV. Methods This is a cross-sectional study of 446 women (302 HIV+) who had compl...

Background: Sleep-disordered breathing (SDB) is a known risk factor for hypertension. Despite the well-established link between HIV infection and hypertension, it remains to be determined whether HIV infection modifies the association between SDB and hypertension,. Setting: The Multicenter AIDS Cohort Study. Methods: SDB was assessed using in-...

Background: Cervical cancer oncogenesis starts with human papillomavirus (HPV) cell entry after binding to host cell surface receptors; however, the mechanism is not fully known. We examined polymorphisms in receptor genes hypothesized to be necessary for HPV cell entry and assessed their associations with clinical progression to pre-cancer. Meth...

Background Human papillomavirus (HPV)‐related oropharyngeal cancer screening is being explored in research studies, but strategies to identify an appropriate population are not established. The authors evaluated whether a screening population could be enriched for participants with oncogenic HPV biomarkers using risk factors for oral HPV. Methods...

Objective: Hypertension is a critical cause of cardiovascular disease, and women with HIV have a higher prevalence of hypertension compared to women without HIV. The relationship between hypertension and mortality has not been well characterized in women with treated HIV. Here, we estimate the effect of hypertension on one-year risk of all-cause m...

Background Racial/ethnic disparities during the first six months of the COVID-19 pandemic led to differences in COVID-19 testing and adverse outcomes. We examine differences in testing and adverse outcomes by race/ethnicity and sex across a geographically diverse and system-based COVID-19 cohort collaboration. Methods Observational study among adu...

Purpose Comparison of anal pre-cancer screening strategies in men who have sex with men (MSM). Methods MSM in the Multicenter AIDS Cohort Study underwent repeated anal cytology (aCyt), oncogenic human papillomavirus (oncHPV) testing. A subset received High-Resolution Anoscopy (HRA). We evaluated three screening strategies for their ability to pred...

Importance: Estimating the medical complexity of people aging with HIV can inform clinical programs and policy to meet future healthcare needs. Objective: To project the prevalence of comorbidities and multimorbidity among people with HIV (PWH) using antiretroviral therapy (ART) in the US through 2030. Design: Agent-based simulation model Setting:...

Background Data on the prevalence of sleep-disordered breathing (SDB) in people with human immunodeficiency virus (HIV) are limited. Moreover, whether the associations between SDB and age or body mass index differ by HIV status is unknown. Research Question Is SDB more prevalent in men with HIV than without HIV, and do the predictors of SDB differ...

Purpose: We examined the associations between pulmonary impairments and physical function and whether age, HIV serostatus, or smoking modified these relationships. Methods: Using Multicenter AIDS Cohort Study data, we examined associations between pulmonary function (diffusing capacity for carbon monoxide [DLCO], one-second forced expiratory vol...

Background: Human papillomavirus-associated oropharynx squamous cell carcinoma (HPV-OPSCC) has no known pre-malignant lesion. While vaccination offers future primary prevention, there is current interest in secondary prevention. The feasibility of clinical evaluation of individuals at increased risk for HPV-OPSCC is unclear. Methods: Individuals...

Background: Smoking contributes to significant morbidity and mortality in people with HIV (PWH). PWH have relatively high nicotine metabolism rates, as measured by the nicotine metabolite ratio (NMR, 3-hydroxycotinine/cotinine). Higher NMR is associated with difficulty quitting smoking. We hypothesized that HIV infection might upregulate nicotine...

Background: The association between HIV and asthma prevalence and manifestations remains unclear, with few studies including women. Setting: Retrospective observational cohort study from the Multicenter AIDS Cohort Study and Women's Interagency HIV. Methods: Asthma was defined in two ways: (1) self-report, and (2) robust criteria requiring all...

Background Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programmes but has not been systematically characterised. Methods We reanalysed data from 34 studies with 16 164 individuals in six risk groups defined by HIV status, gender, and male sexuality: men who...

Objectives Along with multiple chronic comorbidities, sleep disorders are prevalent in people living with human immunodeficiency virus (HIV) infection. The goal of this study was to establish methods for assessing sleep quality and breathing-related disorders using self-applied home polysomnography in people with and without HIV. Methods Self-appl...

This cross-sectional analysis examines whether circulating tumor human papillomavirus DNA is detectable in the plasma of healthy participants at risk for oral human papillomavirus infection and the agreement with oral rinse and serum biomarkers.

Aims: Currently, there is no data available assessing the association between body mass index (BMI) and periodontitis among women living with HIV (WLWH). This study aims to investigate this association among WLWH and women at risk for HIV (WRH) in the United States. Methods and results: Data from 351 WLWH and 52 WRH participants from the Women's...

Background: It is not definitively known if people with HIV (PWH) are more likely to be SARS-CoV-2 tested or test positive than people without HIV (PWoH). We describe SARS-CoV-2 testing and positivity in 6 large geographically and demographically diverse cohorts of PWH and PWoH in the United States. Setting: The Corona-Infectious-Virus Epidemiol...

Background: Human papillomavirus (HPV) is responsible for a growing proportion of oropharyngeal squamous cell carcinomas (OPSCCs) among men and White individuals. Whether similar trends apply to women, non-Whites, and non-oropharyngeal squamous cell carcinomas (non-OPSCCs) is unknown. Methods: This is a cross-sectional analysis combining 2 multi...

Background: The US Preventive Services Task Force (USPSTF) 2021 updated recommendations on lung cancer screening with chest computed tomography to apply to individuals 50-80 years of age (previously 55-80), with a ≥20 pack-year history (previously ≥30), whether currently smoking or quit ≤15 years ago. Despite being at higher risk for lung cancer,...

Background While cervicovaginal microbiome has been associated with cervical human papillomavirus (HPV) infection, little is known regarding the association of oral microbiome with oral HPV, a cause of oropharyngeal cancer. Methods A cross-sectional analysis of 495 participants from the Men and Women Offering Understanding of Throat HPV study was...

We sought to determine effects of age, HIV serostatus, and smoking on the associations between pulmonary function and physical function impairments using Multicenter AIDS Cohort Study data. Associations between physical function outcomes gait speed (m/sec) and grip strength (kg) with normalized pulmonary function tests (diffusion capacity for carbo...

Objectives Many patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) have the option of radiation- or surgery-based therapy, and would benefit from a treatment decision aid (DA) to make decisions congruent with their personal values. Our objective was to develop a patient-centered DA for patients with OPSCC that is comprehensible,...

Background At the start of the COVID-19 pandemic, HIV experts suggested that an increase in mental health diagnoses and substance use among people living with HIV (PLHIV) may be an unintended consequence of COVID-19 mitigation efforts (e.g., limiting social contact). We evaluated short-term trajectories in binge drinking, marijuana, and recreationa...

Importance Human papillomavirus (HPV)–positive status in patients with oropharyngeal squamous cell carcinoma (OPSCC) is associated with improved survival compared with HPV-negative status. However, it remains controversial whether HPV is associated with improved survival among patients with nonoropharyngeal and cervical squamous cell tumors. Objec...

Objective: Young adult tobacco users are at an increased risk for using non-cigarette tobacco products and have high poly-use rates. We interviewed poly-tobacco-using young adults from an urban community to explore characteristics associated with their poly-tobacco use, perceived barriers to tobacco cessation, and recommendations for and interest i...

Objective: To understand the relationship between cardiovascular disease (CVD) risk and frailty among men (MWH) and women living with HIV (WWH), or at risk for HIV. Design: We considered 10-year coronary heart disease and atherosclerotic CVD risk by Framingham risk score (FRS, 2001 National Cholesterol Education Program Adult Treatment Program I...

Objectives Tumor HPV status is an established independent prognostic marker for oropharynx cancer (OPC). Recent studies have reported that tumor estrogen receptor alpha (ERα) positivity is also associated with prognosis independent of HPV. Little is known about the biologic and behavioral predictors of ERα positivity in head and neck squamous cell...

Objectives: To define a smoking cessation "cascade" among US women with and without HIV and examine differences by sociodemographic characteristics. Design: Observational cohort study using data from smokers participating in the Women's Interagency HIV Study between 2014 and 2019. Methods: We followed 1165 women smokers with and without HIV fr...

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19) symptoms among people living with HIV (PLWH) are not well described. Setting: Longitudinal survey within the MACS/WIHS Combined Cohort Study (MWCCS) of PLWH compared with similar HIV-seronegative (SN) individuals. Methods:...

Objectives: This study describes prevention behavior and psychosocial health among people living with HIV (PLHIV) and HIV-negative people during the early wave of the coronavirus disease 2019 (COVID-19) pandemic in the United States. We assessed differences by HIV status and associations between social disruption and psychosocial health. Design:...

Importance Oropharynx cancer (OPC) incidence has increased for several decades in the US. It is unclear when and how this trend will be affected by current HPV vaccination trends. Objective To assess the association of HPV vaccination with future OPC incidence in the US. Design, Setting, and Participants This population-based age-period-cohort an...

This study investigated if homophobic and racist discrimination increased depressive symptoms among 960 middle-aged and older men who have sex with men (MSM) and how resilience moderated these relationships. We used five waves of longitudinal data from the Healthy Aging sub-study of the Multicenter AIDS Cohort Study (MACS). We used linear regressio...

Background: Understanding advances in the care and treatment of adults with HIV as well as remaining gaps requires comparing differences in mortality between persons entering care for HIV and the general population. Objective: To assess the extent to which mortality among persons entering HIV care in the United States is elevated over mortality...

Background Recursive partitioning analysis (RPA) from the Radiation Therapy Oncology Group (RTOG)‐0129 has identified a low‐risk group of patients with oropharynx cancer (OPC) who might benefit from therapeutic de‐intensification. These risk groups have not yet been reproduced in an independent cohort treated heterogeneously. Therefore, the objecti...

Background Current U.S. cervical cancer screening guidelines recommend a stop to screening at age 65 years provided women have adequate prior screening and no history of precancer. Women living with the human immunodeficiency virus (HIV) are at higher risk for cervical cancer than uninfected women, but data a few to quantify risk among women who ot...

IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in women living with HIV (WLH) from the Women’s Interagency HIV...

Objectives People living with HIV (PLWH) have increased risk of chronic disease and poor mental health. We aimed to explore HIV disease indicators, comorbidity, and risk behavior of recent antiretroviral therapy (ART) initiators to inform current needs of PLWH. Methods Men who have sex with men (MSM) in the Multicenter AIDS Cohort Study (MACS) who...

In 2019, NIH combined the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study into the MACS/WIHS Combined Cohort Study (MWCCS). Participants completing a visit October 2018-September 2019 (targeted for MWCCS enrollment) are described by HIV serostatus and compared to people living with HIV (PLWH) in the U.S. Participants include 211...

Background Case‐control studies from the early 2000s demonstrated that human papillomavirus–related oropharyngeal cancer (HPV‐OPC) is a distinct entity associated with number of oral sex partners. Using contemporary data, we investigated novel risk factors (sexual debut behaviors, exposure intensity, and relationship dynamics) and serological marke...

Background Studies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study particip...

Oropharyngeal squamous cell cancer (OPSCC) is now the most common site of head and neck squamous cell cancer. Despite the focus on treatment deintensification in clinical trials, little is known about the preferences, experiences and needs of patients with OPSCC when deciding between surgery and radiation therapy as primary treatment with curative...

Objectives Testosterone usage (T‐use) may alter risk factors for sudden cardiac death in men living with HIV (MLWH). Electrocardiographic QT interval prolongation, which could potentiate ventricular arrhythmias, has previously been associated with HIV infection and, separately, with low testosterone levels. We investigated whether T‐use shortens th...

Background SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described. Objective To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS). Methods A telephone survey was collected April-June 30, 2020. Symptom and tes...

Background Primary human papillomavirus (HPV) screening (PHS) utilizes oncogenic human papillomavirus (oncHPV) testing as the initial cervical cancer screening method and typically, if positive, additional reflex-triage (e.g., HPV16/18-genotyping, Pap testing). While US guidelines support PHS usage in the general population, PHS has been little stu...

Cancer of the oropharynx has attracted considerable attention in recent years given: (1) an increasing incidence in selected populations over the past three decades; (2) the discovery of human papillomavirus (HPV) infection as the driver of the increase, as opposed to the traditional risk factors such as tobacco (smoking and chewing) and alcohol; a...

Background: Persons living with HIV (PLWH) experience a high burden of cancer. It remains unknown which cancer types are reduced in PLWH with earlier initiation of antiretroviral therapy (ART). Methods: We evaluated AIDS-free, ART-naive PLWH during 1996-2014 from 22 cohorts participating in the North American AIDS Cohort Collaboration on Researc...

The incidence of oral tongue cancer, the majority subsite of oral cavity cancer, is rising among young people with less exposure to tobacco and alcohol. Viral causes have been proposed, including Merkel cell polyomavirus (MCPyV). We evaluated patient and tumor characteristics among 126 incident oral cavity cancers (OCCs). Consistent with generation...

Background HPV-related oropharyngeal cancer (HPV-OPC) incidence is increasing but the natural history of the precursor, oral HPV, has not been well described. Methods This observational cohort study of people living with HIV and at-risk HIV uninfected people evaluated participants semi-annually using 30-second oral rinse/gargle specimens over 7 ye...

Background/Purpose: Polyuse of tobacco products is increasing among urban young adults. Understanding different use profiles and the obstacles that this population faces in an attempt to quit smoking is important to inform effective cessation programs. We explored perceived barriers to tobacco cessation and recommendations for/interest in cessation...

Objectives: Initial studies suggest HIV-positive persons may be at increased risk for chronic lung diseases such as chronic obstructive pulmonary disease, but have commonly relied on single-center designs, lacked HIV-negative controls, or assessed lung function with only spirometry. We tested differences in spirometry and single-breath diffusing c...

Background: Human papillomavirus (HPV)-positive oropharyngeal cancer (HPV-OPC) is distinct from HPV-unassociated head and neck cancer. However, whether risk factors for HPV-positive oropharyngeal and nonoropharyngeal squamous cell cancer are the same is unclear. Methods: Incident cases of HPV-positive head and neck cell cancer and matched non-ca...

Objectives: There are no uniform screening recommendations for anal cancer. Medical practice guidelines are now available on the use of Digital Anal Rectal Examinations (DARE) for the detection of anal cancer; however, because screening can result in more harm than benefit, our objective was to assess the evidence for use of DARE as a public healt...

Human papillomavirus (HPV) is a principal driver for most oropharyngeal squamous cell carcinomas (OPSCCs), where it is strongly associated with improved survival. HPV is much less frequently detected in squamous cell carcinomas arising in nonoropharyngeal sites (non-OPSCCs), and its pathogenic role and prognostic value in these tumors is unclear. W...

Background: HPV-positive oropharynx squamous cell cancer (HPV-OPC) patients were initially described as younger, however incidence has increased among older age-groups. It is unknown why some patients present at a younger age and others at a later age. Methods: Multi-institutional prospective study of HPV-OPC cases (n = 163) and matched controls...

Head and neck cancer (HNC) risk prediction models based on risk factor profiles have not yet been developed. We took advantage of the large database including 14 studies (1981-2010) in the US from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium to develop risk prediction models. Seventy percent of the data were used to deve...

Background: People living with human immunodeficiency virus (HIV+) have greater risk for sudden arrhythmic death than HIV-uninfected (HIV-) individuals. HIV-associated abnormal cardiac repolarization may contribute to this risk. We investigated whether HIV serostatus is associated with ventricular repolarization lability by using the QT variabilit...

Infection by human papillomavirus (HPV) type 16, the most oncogenic HPV type, was found to be the least affected by HIV‐status and CD4 count of any of the approximately 13 oncogenic HPV types. This relative independence from host immune status has been interpreted as evidence that HPV16 may have an innate ability to avoid the effects of immunosurve...

Background: Oropharyngeal cancer incidence is rapidly rising due to human papillomavirus (HPV) type 16 infection. The dearth of data on effectiveness of national female-only vaccination programs in preventing oral HPV infection and potential herd immunity in unvaccinated males has resulted in considerable controversy regarding the need to vaccinat...

Background The total QT interval comprises both ventricular depolarization and repolarization currents. Understanding how HIV serostatus and other risk factors influence specific QT interval subcomponents could improve our mechanistic understanding of arrhythmias. Methods Twelve‐lead electrocardiograms (ECGs) were acquired in 774 HIV‐infected (HIV...

Objective: We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting. Methods: Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessat...

Performance of commercially available HPV assays (approved for cervical HPV detection) is unknown for detecting HPV-related oropharyngeal cancer (HPV-OPC). Assays for detection of HPV DNA (enzyme-linked immunosorbent assay [DEIA] and Cobas), and RNA (Aptima) in oral rinse samples, and serum oncogene antibodies were evaluated. Sensitivity and specif...

Introduction: Little is known regarding how human papillomavirus-positive oropharyngeal cancer (HPV-OPC) patient goals change with treatment. This study evaluates whether patient ranking of non-oncologic priorities relative to cure and survival shift after treatment as compared to priorities at diagnosis. Materials and methods: This is a prospec...

Polypharmacy is the concurrent use of five or more medications. We used group-based trajectory analysis to identify groups of non-HIV medication polypharmacy and investigate associated risk factors among HIV-positive and HIV-negative men in the Multicenter AIDS Cohort Study (MACS) from 2004 to 2016. Each participant was assigned to mutually exclusi...

Objectives: This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as int...

We compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. We analyzed cohort data from the International Epidemiology Databases to Evaluate AIDS (IeDEA) and the Collaboration of Observational HIV Epidemiolo...

Objectives/Hypothesis To describe patients with delayed diagnosis of human papillomavirus–positive oropharyngeal squamous cell carcinoma (HPV‐OPC) after initial incorrect diagnosis of branchial cleft cyst or nondiagnostic workup of unilateral neck mass. Study Design Retrospective case series. Methods Patients with delayed diagnosis of HPV‐OPC aft...

Objectives: Despite treatment-related improvements in morbidity and mortality, HIV-1-infected (HIV+) individuals continue to face a wide range of HIV-associated medical and HIV-associated neurocognitive disorders. Little is known about the impact of cognitive impairment on patients' health-related quality of life (HRQoL). To address this, the curr...

Background: Research is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer in people living with HIV. We aimed to identify key CD4 count and HIV RNA (viral load) predictors of risk for non-Hodgkin lymphoma, overall and by subtype. Methods: We studied people living w...

The incidence of human papillomavirus (HPV)-associated head and neck cancers is rising, particularly among men. Whether observed epidemiological differences in sex are explained by differences in sexual exposure and/or by immune response is unclear. In this cross-sectional, multi-institutional study, seroprevalence of antibodies to HPV L1 capsid an...

Background In the era of deintensification, little data are available regarding patients’ treatment preferences. The current study evaluated treatment‐related priorities, concerns, and regret among patients with head and neck squamous cell cancer (HNSCC). Methods A total of 150 patients with HNSCC ranked the importance of 10 nononcologic treatment...

Objective: In this study, we sought to understand why young adults from urban low-income regions discontinue using e-cigarettes. Methods: We recruited 97 tobacco users aged 18-26 years from Baltimore, Maryland to participate in 17 focus groups. Qualitative data were analyzed using framework analysis. Results: Being less satisfying than combust...

Background: HIV infection is associated with increased susceptibility to common pathogens, which may trigger chronic antigenic stimulation and hyperactivation of B cells, events known to precede the development of AIDS-associated non-Hodgkin lymphoma (AIDS-NHL). Methods: To explore whether cumulative exposure to infectious agents contributes to...

Objective HIV-infected (HIV+) individuals may be at increased risk for sudden arrhythmic cardiac death. Some studies have reported an association between HIV infection and prolongation of the electrocardiographic QT interval, a measure of ventricular repolarisation, which could potentiate ventricular arrhythmias. We aimed to assess whether HIV+ men...

Frequent Pap testing is recommended among women living with HIV (WLWH) due to their elevated risk for cervical cancer. However, there are few recent longitudinal evaluations of utilization and determinants of Pap testing among WLWH. Medical and pathology records of WLWH seen at Johns Hopkins Hospital between 2005 and 2014 were assessed using Prenti...

The population of survivors with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) is rising. The improved prognosis of this etiologic subset is reflected in new staging guidelines as well as ongoing deintensification trials aiming to preserve excellent survival while decreasing treatment-related toxicities. However,...

Background: HIV-positive women are at substantial risk of HPV-associated cervical neoplasia caused by high-risk (HR) HPVs. Methylation of the HPV genome is associated with cervical intraepithelial neoplasia grade 3 (CIN3) in HIV-negative women, yet it is unknown whether this holds true for HIV-positive women. Methods: We designed a case-control...

Objective: Recent studies reported lower human papillomavirus 16 (HPV16) prevalence in cervical precancer among African American than Caucasian women in the general population. We assessed this relationship in women with HIV. Design: Women living with or at risk for HIV in the Women's Interagency HIV Study were followed semi-annually with Pap te...

Rates of aging-related comorbidities, which require targeted medications to treat, have been shown to be increased among persons living with HIV compared with uninfected counterparts. Polypharmacy is generally defined as the concurrent use of 5 or more medications. We investigated polypharmacy prevalence for non-HIV medications over a 12-year perio...

Objective: To evaluate the natural history of treated and untreated cervical intraepithelial neoplasia-2 (CIN2) among HIV-positive women. Methods: Participants were women enrolled in the Women's Interagency HIV Study between 1994 and 2013. 104 HIV-positive women diagnosed with CIN2 before age 46 were selected, contributing 2,076 visits over a me...