# Baltimore Oral Epidemiology, Disease Effects, and HIV Evaluation Study (BEEHIVE)

> **NIH NIH R01** · UNIVERSITY OF MARYLAND BALTIMORE · 2020 · $903,089

## Abstract

Since the advent of antiretroviral therapy (ART), the life expectancy of persons living with HIV (PLWH) has
steadily increased in the United States. PLWH are now more likely to develop co-morbid age-related non-
communicable diseases (NCDs) than are similarly-aged HIV-uninfected persons, and the morbidity and
mortality of NCD and age-related conditions is paramount. The age-adjusted rates of multiple NCDs are higher
among PLWH than among persons who are HIV negative. In addition, PLWH experience higher prevalence
and severity of oral diseases, particularly related to the periodontium, although the factors that explain these
disparities remain unclear. For example, is HIV-related immune suppression or viremia primarily responsible
for these differences? Are lifestyle factors and access to dental care important determinants? Is the
microbiome signature in PLWH unique and does it change over time? Since 1988, the AIDS Linked to the
Intravenous Experience (ALIVE) study has successfully followed a lower-income, predominantly African
American population of HIV-infected and at-risk persons with a history of injecting drugs (PWID) in a
community-based cohort in Baltimore. Over three decades, ALIVE has characterized risk factors of incident
HIV and progression to AIDS or death, described patterns of risk behaviors, identified barriers to optimal HIV
care, and provided important insights into the natural and treated course of HIV among PWID. In recent years,
ALIVE has transitioned to exploring the impact of aging with HIV, focusing on phenotypes and organ-specific
non-communicable diseases (NCD) (e.g., liver, lung, cardiovascular, bone, kidney, neurocognitive and
metabolic NCDs). The proposed project leverages the ALIVE platform to focus on the combined effects of HIV
and NCDs on oral health at the health care-seeking, clinical, and microbiological levels. The specific aims of
the proposed project are to: 1) determine to what extent HIV status influences access to and utilization of oral
health care services; 2) determine to what extent HIV status affects self-reported and clinical oral health status;
3) determine to what extent HIV status influences the progression of periodontitis; and 4) determine to what
extent HIV status impacts the periodontitis-associated oral microbiome signature. The first three specific aims
include sub-aims that define the extent to which comorbid NCDs act as effect modifiers. For specific aim 4, one
sub-aim describes the extent to which HIV influences the oral microbiome and a second sub-aim defines how
longitudinal changes in the oral microbiome signature affect periodontitis progression. To achieve these aims,
we build upon biannual ALIVE study visits with interview, clinical examination, and biospecimen components,
supplemented by medical record review and registry linkages. The key impact of these aims is to illuminate
social and individual-level mechanisms, identify modifiable risk factors, and produce novel insights to in...

## Key facts

- **NIH application ID:** 9985345
- **Project number:** 1R01DE029643-01
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** Gregory D Kirk
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $903,089
- **Award type:** 1
- **Project period:** 2020-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985345

## Citation

> US National Institutes of Health, RePORTER application 9985345, Baltimore Oral Epidemiology, Disease Effects, and HIV Evaluation Study (BEEHIVE) (1R01DE029643-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9985345. Licensed CC0.

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