AMP Up aims to define the impact of HIV infection and antiretroviral therapy (ART) on young adults with perinatal HIV infection as they transition into adulthood. A group of perinatally HIV-exposed, -uninfected (PHEU) young adults from a similar sociodemographic background and age distribution will be enrolled for comparison. The primary objectives of this study are: - To identify infectious and non-infectious complications of HIV disease and toxicities resulting from long-term ART, including disease progression, immune dysfunction, viral resistance, end-organ disease, and mortality. - To define the impact of HIV infection and ART on the long-term clinical outcomes of young adults, including: - Metabolic abnormalities and risk factors for cardiovascular disease, including glucose and lipid metabolism, blood pressure, and body composition. - Sexually transmitted infections (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, syphilis, human papillomavirus, genital warts and HSV) among males and females, and cervical HPV-associated pre-cancers and cancers and Mycoplasma genitalium and other vaginal microbiota among females. - Reproductive health, fertility, and pregnancy outcomes including mother-to-child transmission of HIV. - To define the impact of perinatal HIV infection and ART on long-term neurocognitive and behavioral health outcomes, including: - Mental health and neurocognitive functioning. - Health care behaviors, including adherence to ART, participation in health care services, and transition to adult clinical care. - Risk behaviors, including sexual behavior and substance use. - Independent living skills, and vocational and education achievement necessary for successful transition to adult functioning and quality of life.
Perinatally HIV-Infected Cohort Inclusion Criteria: - Perinatal HIV infection as documented in the medical record - At or beyond their 18th birthday at the time of informed consent with no upper age limit - Engaged in medical care and medical records are available - At least one of the following is true: - Previously or currently enrolled in PHACS AMP, or - Previously enrolled in any of the studies included on the list of approved studies for enrollment into AMP Up, or - Available medical record documentation since early childhood of: - ART exposure history - Opportunistic infection prophylaxis exposure history - Viral load and CD4+ cell count history - Major medical events history - Willingness to participate and provide legal written consent Exclusion Criteria: - HIV acquired by other than maternal-child transmission (e.g., blood products, sexual contact, and IV drug use) as documented in the medical record Perinatally HIV-Exposed, -Uninfected Cohort Inclusion Criteria: - Perinatally HIV-exposed, perinatally-uninfected as indicated in the medical record; the PHEU participant may have horizontally-acquired HIV infection - At or beyond their 18th birthday at the time of informed consent with no upper age limit - At least one of the following is true: - Previously or currently enrolled in PHACS AMP, or - Previously or currently enrolled in PHACS SMARTT - Willingness to participate and provide legal written consent Exclusion Criteria: - Have confirmed perinatal HIV infection as documented in the medical record