# The CROWN study: Comprehensive Research on Oral and mental health among WomeN

> **NIH NIH R01** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2023 · $635,251

## Abstract

Abstract. Oral health problems and unmet dental needs are prevalent in women living with HIV (WWH). For
WWH across the lifespan, physiological changes that induce fluctuating hormone levels (e.g., puberty,
pregnancy, aging) can also significantly impact oral health, most commonly through exaggerated periodontal
inflammation. Neglected dental care and negative oral symptomatology can play a significant role in overall
health by impacting everyday function, e.g., eating and engaging in social interactions. Oral health related
quality of life (OHRQOL) is an important multidimensional construct used to evaluate the impact of untreated
dental disease on quality of life and well-being. OHRQOL in WWH is impacted not only by oral health
conditions, but also by the social determinants of health, age, and mental health symptomatology. Mental
health challenges, i.e., depression, anxiety, post-traumatic stress disorder (PTSD), are prevalent in WWH and
are associated with poor health outcomes, including oral health conditions. The co-occurrence of depression
and HIV infection has been associated with impaired self-care (e.g., reduced oral hygiene, neglected
preventive dental treatment), as well as dental side effects from psychotropic medication. Despite the high
prevalence of oral and mental health conditions among WWH, there have been no studies addressing the
relationship between HIV, oral health, and mental health over the lifespan.
 Oral health studies of WWH have primarily been conducted among older women in the Women’s
Interagency HIV Study (WIHS), a national prospective cohort study of WWH and women at risk for HIV, now
named the MACS WIHS Combined Cohort Study (MWCCS). STAR is a prospective national cohort study of
women of reproductive age living with or at risk for HIV, collecting data harmonized with the MWCCS. The
proposed Comprehensive Research on Oral and mental health among WomeN (CROWN) study will leverage
dental and mental health data from these two cohorts utilizing their shared research infrastructure and data
center. CROWN will enroll a smaller cohort of STAR/MWCCS women (N=400) matched on age, HIV status,
and mental health symptomatology. Participants will attend two CROWN study visits consisting of an adapted
dental survey and periodontal examination. Data collected from ongoing STAR/MWCCS study visits and the
CROWN study visits will be analyzed to: 1) evaluate the independent effects of mental health symptomatology
(e.g., depression, anxiety, PTSD) on OHRQOL and the interactive effects of HIV and age on this relationship;
2) to evaluate the independent effects of mental health symptomatology (e.g., depression, anxiety, PTSD) on
oral health clinical outcomes and the interactive effects of HIV and age on this relationship; and 3) to evaluate
the mediational role of oral health clinical outcomes between mental health symptomatology and OHRQOL and
the potential bidirectional relationships among these variables.

## Key facts

- **NIH application ID:** 10670574
- **Project number:** 1R01DE032868-01
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** MARIA LUISA ALCAIDE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $635,251
- **Award type:** 1
- **Project period:** 2023-06-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10670574

## Citation

> US National Institutes of Health, RePORTER application 10670574, The CROWN study: Comprehensive Research on Oral and mental health among WomeN (1R01DE032868-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10670574. Licensed CC0.

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