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Integrating molecular and social exposures to understand accelerated aging in cancer patients with HIV in the Southeastern US

Award Number: R01MD021106
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/04/2026
PERIOD OF PERFORMANCE END DATE: 12/31/2030

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Integrating molecular and social exposures to understand accelerated aging in cancer patients with HIV in the Southeastern US - MODIFIED PROJECT SUMMARY/ABSTRACT SECTION As a result of effective HIV therapy, the proportion of people with HIV (PWH) living to at least 50 years of age increased from 27% in 2006 to 58% in 2020. An unintended consequence of this aging is that chronic diseases such as cancer are now increasingly common. In the US, PWH with cancer are over twice as likely to die due to cancer compared to cancer patients without HIV, with a disproportionate impact of the US HIV epidemic in the Southeastern US. Herein, we posit that HIV-associated cancer outcomes differences are driven in part by biological changes resulting from exposure to individual-level (e.g., perceived job stress) and neighborhood-level (e.g., proportion of residents below national poverty line) factors (referred to collectively as multi-level stressors). Recent data from our study team demonstrate that, compared to cancer patients without HIV, PWH with cancer have epigenetic (DNA methylation) patterns indicative of accelerated aging and a higher prevalence of somatic mutations that clonally expand in the hematopoietic compartment as individuals age (clonal hematopoiesis). Importantly, each of these genomic aging biomarkers have been associated with inferior survival among PWH with cancer, but their association with multi-level stressors remains unexplored among PWH. We propose to address this research gap, specifically the lack of empirical evidence testing the hypothesis that accelerated aging, stemming from exposure to multi-level stressors, is a mediator of poor cancer outcomes among PWH and cancer in the US. To accomplish this, we will leverage existing infrastructure to prospectively identify 500 cancer patients (250 PWH, 250 people without HIV [PWoH]) from Moffitt Cancer Center and 250 PWH without cancer from an existing partnership with the HIV FIGHTER registry at the University of South Florida. The inclusion of PWH without cancer from FIGHTER, as well as cancer patients without HIV from Moffitt, will help elucidate whether the impact of multi-level social stressors on the genomic aging process is uniquely exacerbated by the presence of both chronic HIV infection and a cancer diagnosis. Our aims are: Aim 1. Examine the association between multi-level stressors and epigenetic age acceleration in the presence of HIV and cancer; Aim 2. Examine the association between multi-level stressors and the prevalence of age-related clonal hematopoiesis in the presence of HIV and cancer; and Aim 3. Estimate direct and indirect effects of multi-level stressors on mortality among PWH and cancer, accounting for the mediating role of accelerated aging. The successful completion of our project will: (1) provide descriptions of the magnitude of the association between multi-level stressors and mortality among PWH with cancer in the US Southeast, which is currently unavailable; (2) elucidate biological mechanisms (accelerated genomic aging) through which multi-level stressors contribute to poor cancer outcomes among PWH; and (3) create a clinic-based cohort with biological specimens, augmented with contextual individual and neighborhood-level data, to support studies on cancer and aging among PWH.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $811,939 )
2026	2026	H. LEE MOFFITT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL, INC.	12902 USF MAGNOLIA DR	TAMPA	FL	33612	HILLSBOROUGH	USA	Minority Health and Health Disparities Research	000	1	8/5/2026	NEW	$811,939
														Subtotal = $811,939

Grand Total All Awards = $811,939

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Integrating molecular and social exposures to understand accelerated aging in cancer patients with HIV in the Southeastern US

Award Number: R01MD021106

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/04/2026

PERIOD OF PERFORMANCE END DATE: 12/31/2030

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