American Women: Assessing Risk Epidemiologically (AWARE - RFA)

While HIV prevention strategies have improved and HIV incidence rates continue to decrease in the United States, a critical need remains to strengthen and advance prevention science where declines appear to have stalled, particularly among women. The most recent surveillance data from the Centers for Disease Control and Prevention demonstrate that as of 2019, about 7,000 of all new HIV diagnoses were identified among women. Traditional demographic and behavioral risk factors are insufficient to identify women who are vulnerable to HIV infection. Recent research on the use of risk algorithms to determine pre-exposure prophylaxis eligibility demonstrated poor predictive power for women. Identifying women who are vulnerable to HIV infection is crucial for the development and deployment of tailored prevention approaches. While the mode of HIV acquisition for women is well known less is known about the other factors (e.g., community, network, and geospatial factors) associated with HIV seroconversion. Nonetheless, identifying the combination of characteristics that predict seroconversion among women has been challenging. To overcome this gap, we propose to harness innovative digital methods to establish a knowledgebase for American women. The knowledgebase will consist of data elements collected from cohort members as well as social and sexual network data, paired with open-source big data that collectivity will contextualize risk to women for acquisition of these infections. Our study team has extensive experience in using digital approaches to recruit study participants through electronic methods and geospatial analytics. Capitalizing on our expertise, we will use the developed knowledgebase to identify theoretically driven correlations of infections. Findings will increase our understanding of women’s vulnerabilities to HIV infection, enhance identification of pre-exposure prophylaxis eligibility, and inform interventions to decrease the incidence of HIV and sexually transmitted infections among women living in the US.