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In 1988, the UAB CFAR became one of seven original Centers established by NIAID. For over 30 years, the Center has played a vital role in supporting cutting-edge research activities among its members, which has led to paradigm-shifting discoveries including the discovery of HIV-1 quasispecies diversity (Nature 1988), detection of HIV-1 RNA in plasma (Science 1993), viral dynamics in acute and chronic infection (NEJM 1991; Nature 1995), HIV-1 escape from cytotoxic T-cells (Nat Medicine 1997) and neutralizing antibodies (Nature 2003), first-in-human phase 1 clinical studies of 7 currently approved therapies (NEJM 1993; Nat Medicine 1998; JAMA 2006), the zoonotic origins of HIV-1 (Nature 1999; Nature 2006; Science 2006), and the identification of the transmitted HIV-1 envelope and complete genome/proteome responsible for HIV infection (PNAS 2008). The multidisciplinary base of the Center ensures the rapid translation of fundamental knowledge about AIDS and its related disorders into clinical treatment or community prevention programs. The CFAR provides infrastructure, designated research space, 5 research core facilities with specialized equipment and trained personnel, and access to developmental research funds to over 185 active HIV investigators at UAB and others from the research community. The CFAR cores, services and resources applicable to this study include:

UAB CFAR Administrative Core (Core A) (M Saag, Director): The Administrative core provides financial management services to many CFAR members and other investigators. In addition, it provides communication, strategic planning, and implementation of the strategic plan with a special focus on younger Investigators who often lack financial support. 
UAB CFAR Developmental Core (Core B) (P Goepfert, Director): The purpose of the Developmental Core is to serve as a platform serving CFAR members in the capacity of mentoring, innovation and research integration. The Developmental Core is a resource for the UAB CFAR to translate its vision into basic, translational, behavioral, clinical and community-engaged research. 
UAB CFAR Clinical Core (Core C) (M Mugavero, Director): The mission of the Clinical Core is to support interdisciplinary investigators at UAB with a readily available clinic-based database, specimen repository, study coordination services, and biostatistical and epidemiological services necessary for cutting-edge research. 
UAB CFAR Basic Research Core (Core H) (O Kutsch, Director): The Basic Research Core is designed to assist users with cutting edge technology and systems biology services available on the UAB campus to support HIV research. 
UAB CFAR Behavioral and Community Science Core (Core J) (J Turan, Director): This core serves to advances science through continued support for the growth of HIV research agendas essential to ending disparities in HIV-related health; mentorship of translational, transitional, and junior investigators; community capacity building; and behavioral methodologies. 
UAB CFAR Ending HIV in Alabama Scientific Working Group (SWG) (J Marrazzo, Director): This scientific working group leverages the expertise of the UAB CFAR members including clinical and behavioral investigators, epidemiologists, and biostatisticians, while also relying on and strengthening community and public health partnerships to advance the implementation of evidence-based interventions with the goal of achieving the UNAIDS 90-90-90 targets in Alabama in accordance with the National HIV/AIDS Strategy. 

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CNICS was created to better define the relationship between patient and treatment factors and long-term clinical outcomes among HIV-infected patients in the HAART era. There are 8 CNICS sites at existing CFARS, The University of Alabama at Birmingham (UAB), University of Washington (UW), Case Western Reserve University (CWRU), University of California, San Francisco (UCSF), University of California, San Diego (UCSD), Fenway Community Health Center of Harvard University, Johns Hopkins University (JHU), and University of North Carolina (UNC). The ultimate goal of the CNICS project is to integrate clinical data from the diverse population of HIV-infected persons receiving care at the 8 CNICS sites to investigate questions related to HIV disease management that cannot be readily addressed through traditional clinical trials and cohort studies. CNICS utilizes a point-of-care electronic medical record system (EMR) with the dual purpose of providing real-time clinical information to facilitate the delivery of HIV care and capture standardized clinical data to support population-based HIV research. The CNICS cohort includes HIV-infected individuals aged 18 years or older who initiated primary care at CNICS sites after January 1, 1995; including data on >34,000 patients, the vast majority of whom have been under care in the HAART era, over >35 million clinical observations and >200,000 person-years of follow-up.

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For the last 30 years, the 1917 Clinic has provided outpatient services to over 12,000 patients with HIV disease in the state of Alabama and surrounding states. The Clinic’s mission is to provide comprehensive and compassionate healthcare for people with HIV infection by delivering world-class HIV treatment with specialty clinics in dermatology, oncology, neurology, addiction recovery, and palliative care. The 1917 clinic is the location of many clinical trials including the NIAID AIDS Clinical Trials Group (ACTG), HIV Vaccine Trials Network, HIV Prevention Network, Microbicide Trials Network (MTN), and industry-sponsored trials. This is also the location of the UAB Women’s Interagency HIV Study (WIHS).

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In 2014, the 1917 Clinic began offering HIV PrEP (Pre-Exposure Prophylaxis) services to individuals at high-risk for HIV infection. The 1917 PrEP Clinic represents an interdisciplinary effort including educational staff, social work, nursing, and medical providers and has brought prevention and educational services closer to the medical services provided through the 1917 Clinic proper. Since implementation, 244 individuals have been screened. 178 individuals attended at least an orientation visit and 81 individuals are currently receiving services. Plans for growing the PrEP clinical cohort include an increased focus on recruiting individuals from populations known to be at greater risk for HIV acquisition (i.e. young, black men who have sex with men and heterosexual black women).

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The UAB 1917 Clinic Cohort is a prospective, observational HIV clinical cohort study established in 1992 as a component of the CFAR Clinical Core that includes well-characterized patients engaged in medical care at the UAB 1917 HIV/AIDS Clinic. Detailed socio-demographic, psychosocial, clinical and administrative data are available for patients treated at the clinic since 1988. All information collected by an EMR system resides within an infrastructure that meets national standards and guidelines for data security (e.g., National Institute of Standards and Technology).

The AQMG is a consortium of representatives from all Ryan White Part C and D clinics in the State of Alabama, formed in response to the National HIV/AIDS Strategy 2020. The clinic members account for all 67 counties in the state and represent approximately 90% of all HIV+ patients in the state of Alabama. The goal of the AQMG’s collaboration is to enhance data collection and reporting processes to meet the goals of reducing new HIV infections, increasing care and health outcomes, reducing HIV-related disparities, and achieving a coordinated national response to the HIV epidemic. To further engage the communities served, CFAR hosts and participates in quarterly meetings to emphasize quality healthcare through the collaboration of healthcare partners throughout Alabama. The 1917 Clinic and CFAR are represented by Drs. Saag, Mugavero, and Batey.

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The UAB HIV Research and Informatics Service Center (HIV RISC) uses HIV as a model to provide a collaborative infrastructure to develop and test prevention and health management strategies for other infectious diseases and for chronic illness, through a combination of research and informatics expertise. Research core services include study coordination, recruitment and tracking, research assessment, intervention implementation, and research consultation on study design, logistics and implementation. Informatics core services include software development, website design, database design and management, study eligibility queries, generation of analysis-ready datasets via integration and queries of multiple data sources, desktop support, graphic design, and health informatics consultation. 

JHS is considered the Framingham Heart Study for African Americans and was designed to identify the etiologies explaining the high rate of cardiovascular disease among African Americans and to find approaches for reducing this risk. The JHS Hypertension Working Group, chaired by Dr. Muntner (PI) directs hypertension-related research projects in the JHS and provides training opportunities for early-stage investigators with a focus on under-represented minorities. Over the past four years, members of the JHS hypertension working group have published 26 manuscripts, with 25 having a mentee as the first author. 

The UAB Hypertension Center is one of four national centers selected to study high blood pressure as part of the American Heart Association’s Strategically Focused Research Network. The center includes a highly synergistic population, clinical and basic science studies and a training core. The aims of this Center are (1) To generate new evidence on the role of diurnal blood pressure on CVD risk with the mission of decreasing CVD rates, (2) To create and nurture a culture of interdisciplinary hypertension science, and (3) To build capacity by training the next generation of hypertension researchers. 

Now in its 38th consecutive year of funding, this program is designed to advance the science of hypertension and CVD and includes training opportunities in the following Thematic Focus Areas: Basic (fundamental training in vascular injury/inflammation/ atherogenesis and oxidative stress/free radical injury), Clinical, Translational and Population Science. Program Faculty Mentors offer training opportunities in these rapidly evolving areas of research: translational research, including bench-to-clinical trials (T1), clinical trials to wide-spread evidence-based practice (T2); behavioral, epidemiologic, population/prevention research; biostatistics/quantitative sciences; comparative effectiveness research; genomics; health disparities research; other-“Omics”; and regenerative and reparative medicine. 

Since 1985, UAB has served as the Coordinating Center and one of four field centers for the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a population-based observational study of 5115 young African-American and white men and women of diverse socioeconomic status.23 Follow up examinations at years 2, 5, 7, 10, 15, 20, 25 and 30 achieved high retention rates, collected a rich set of high-quality data and stored specimens bearing on the causes of cardiovascular disease (CVD), and led to over 800 peer-reviewed publications. The original objectives of CARDIA were to document levels of risk factors for coronary artery disease and potential determinants of these risk factors in young adults; to study the interrelationships of risk factors and lifestyles and to document behavioral and environmental changes during the transition from young adulthood to middle age; to compare cross-sectional and longitudinal data on age-related trends in cardiovascular disease risk factors; and to compare levels and evolution of risk factors between men and women, blacks and whites, and in groups of differing socioeconomic status. The goals of the study have evolved to emphasize understanding determinants of left ventricular mass, emerging obesity and hypertension, and sequelae of hypertension in pregnancy. The CARDIA study has been used as a control population for studying metabolic changes among people living with HIV in the Study of Fat Redistribution and Metabolic Change in HIV infection. 

Despite a decline in death rates for coronary artery disease since 1970, heart failure (HF) prevalence and mortality have increased. The Basic and Translational Science in Heart Failure (BTSHF) Training Program, designed to specifically mentor clinical and research post-doctoral trainees in broad aspects of HF pathophysiology (disease mechanisms), diagnostics (biomarkers and imaging), therapeutics (pharmacological, biological, devices), epidemiology (population science, personalized medicine, and clinical outcomes), as well as relevant methodologies (disease models, stem cells, ‘omics’ approaches, and biostatistics). At the heart of the training program resides three thematic cores - Cellular and Molecular Mechanisms; New Diagnostics and Therapeutics; and Clinical Epidemiology and Outcomes. In close collaboration with the UAB Office of Postdoctoral Education and Center for Clinical and Translational Science, the 2 to 3-year BTSHF training program has been specifically tailored to foster the development of future translational researchers with scientific interests in HF. This includes a didactic course that exposes trainees to cutting-edge scientific techniques (e.g., non-invasive imaging, translational study design, large data set analysis) and concepts (e.g., cardiometabolics, epigenetics, inflammation, tissue regeneration). 

The Lung Health Center (LHC) is committed to performing research utilizing state-of-the-art, evidence-based management approaches for lung diseases. The LHC research facilities are equipped with pulmonary function laboratories, collection and storage capabilities for blood and saliva samples and for exhaled breath condensate and nitric oxide measurements. The LHC houses cores in Human Pulmonary Function, Recruitment, and Regulatory Support as well as a Biospecimen Repository and is currently conducting more than 20 clinical trials in COPD and asthma. In addition, the LHC provides resources for translational research in statistical genetics, computational biology, biomarker discovery, drug discovery/development, and clinical trials. Areas of focus include the manifestations, diagnosis, risk/prognostic stratification, mechanisms, prevention, and treatment of lung diseases, primarily acute lung injury (ALI), cystic fibrosis (CF), asthma, chronic obstructive lung diseases (COPD), and interstitial lung diseases (ILD). The LHC is also committed to providing a strong environment for training as evidenced by the NIH-funded T32 Training Program in Lung Biology and Translational Medicine at UAB. 

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The Women's Interagency HIV Study (WIHS) began in 1993 to investigate the progression of HIV infection in women in the United States. It is the largest and longest ongoing U.S. observational study of HIV-infected women. UAB is a co-site in the cohort with the University of Mississippi Medical Center and follows over 230 patients, both HIV positive and negative. The UAB WIHS site is housed on the 3^rd floor of the UAB 1917 Clinic.

The ACTU has an established record of ongoing research sponsored by the NIAID HIV clinical trial networks since the unit was consolidated into its present form in 2007. Over the years, this program has established a highly functional research unit that is effective at recruiting and retaining study participants, contributing to the scientific agenda of the affiliated networks, generating high-quality research data, and responding to emerging research areas of focus in a cost-effective manner. Dr. E. Turner Overton, the CTU Director, has carried forward a comprehensive strategy that integrates all facets of HIV clinical and translational research under a single administrative umbrella. The Clinical Trials Unit (CTU) manages all of the HIV/AIDS Clinical Therapeutic (ACTG), Vaccine (HVTN), and Microbicide Network (MSN) efforts in Birmingham, including the IMPAACT and HVTN activities of the affiliated clinical research site (CRS) in Lusaka, Zambia. 

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The CCTS was formed as the result of an NIH/NCATS Clinical and Translational Science Award to UAB and provides a broad range of translational research and educational services and resources to the UAB community. The mission is to address disparities and diseases disproportionately represented within the Deep South and to accelerate discovery to improve human health by providing the foundation for addressing health disparities through collaborative research and training efforts. The CCTS offers access to a number of resources and capacities through its co-leadership of the Clinical Trials Initiative as well as the Research Commons and the Training Academy. Training and grant writing activities are offered through the CCTS for early-stage investigators with an interest in HIV-related research as below.

• Research Commons offers investigators access to research-related services. The Commons provides individualized assistance to all investigators, from trainees to full professors.
• The Training Academy works with investigators to harness their creative imagination as they develop a translational perspective. Research training and career development are offered to investigators to smoothly advance scientific insight across the translational spectrum.
• The Training Academy also sponsors the CCTS Forum, a setting in which significant accomplishments and opportunities in translational research are examined in depth. The Forum spotlights individuals who have already experienced breakthroughs in translational research or whose work shows potential for opening new avenues of inquiry. Of particular interest are collective presentations by invited guests and their UAB colleagues whose collaborative or correlative work has contributed significantly to clinical or population science.
• The CCTS Biostatistics, Epidemiology & Research Design (BERD) unit provides robust methodological support to a broad array of research-critical disciplines. Emily Levitan (Core C) along with other BERD team members seeks to enhance rigor and reproducibility in clinical and translational sciences, provide educational opportunities in BERD techniques, and develop new, cutting-edge methodologies.
• The Clinical Research Unit (CRU) of the CCTS Research Commons provides investigators with a research environment and a broad range of services guided by good clinical practice. The unit equips investigators with essential tools and critical resources while providing a highly efficient and flexible infrastructure that is sustainable through a comprehensive cost-recovery system. The CRU has four private rooms, one semi-private room, and an infusion suite with six infusion chairs. In addition, there is storage space for equipment and/or supplies that are specific to investigator needs. If inpatient care is required, the CRU has access to inpatient beds located on the 8th floor of UAB Hospital. Inpatient utilization focuses on studies requiring hospitalization of participants for proper study activities, ranging from 24-hour sample collection protocols to studies for which participant safety is best served by an inpatient setting.

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The Minority Health & Health Disparities Research Center (MHHRC) is a comprehensive educational, research and community outreach center focused on eliminating the health disparities of racial/ethnic minorities. One of the primary aims is the development and dissemination of research knowledge from the biomedical, behavioral and social science research community to the vulnerable populations locally, regionally, nationally and globally. The center was established in 2002 and has maintained its position as a University-Wide Interdisciplinary Research Center and an NIH funded P60 Center of Excellence. The MHRC supports three specific program-research, training and outreach. The center provides research support through assistance with grant proposals and links UAB investigators with minority communities in the Birmingham area. They further provide training in the areas of cultural competency and in bioethics specifically related to working with minority and underserved populations. 

SR is a not-for-profit research institute and has a Drug Discovery Division that is an active participant and worldwide leader of ongoing drug discovery programs targeting various forms of cancer, a wide variety of neurologic and metabolic diseases, and a host of imminent viral and bacterial infections. SR regularly collaborates with UAB investigators through long-standing formalized partnerships to support NIH-funded research focused on the discovery and development of new drug targets and the identification and the validation of novel small molecules that address unmet medical needs.