PROJECT SUMMARY This project will establish and implement the Brooklyn Clinical Research Site (Bklyn CRS) of the MACS/WIHS Combined Cohort Study (MACS/WIHS CCS) and support its mission to advance the clinical, behavioral, and epidemiological science of newly diagnosed and chronic HIV infection and associated comorbidities. The Bklyn CRS evolves from and builds upon a 25-year history of scientific innovation accompanied by community engagement that facilitated rigorous implementation of the Brooklyn Women's Interagency HIV Study (WIHS). The Bklyn CRS will rapidly develop a diverse cohort of men and women reflecting the unique characteristics of HIV in our geographic area. We will include continued follow-up of WIHS participants, who contribute a rich longitudinal history of clinical, biologic, genetic, psychosocial and behavioral data derived from midlife and younger ages, informing questions of HIV and aging in an older population. The Bklyn CRS investigators will develop and implement protocols of the MACS/WIHS CCS Unified Science Agenda, contribute to the overall functioning of the administrative infrastructure, and engage a strong and multidisciplinary team of researchers in addressing innovative science. Our specific aims are to: 1) recruit and retain a prospective cohort of 500 men and women living with HIV and matched seronegative controls and implement MACS/WIHS CCS study protocols; 2) engage a multidisciplinary and experienced team of scientists to develop and implement innovative research that aligns with and advances the CCS Unified Science Agenda; and 3) provide training and career development opportunities to support advancement of the next generation of HIV researchers. The Bklyn CRS provides scientific, administrative and collaborative leadership in cardiovascular disease and associated lung and sleep outcomes; aging via physical, functional and molecular assessments; psychological and social environmental aspects of self-management of HIV and associated co-morbidities; and neurocognition and brain aging. As such, the Bklyn CRS will greatly enhance the MACS/WIHS CCS, ensuring the rigor and relevance of study questions and methods to address those questions.