Research Training Program in Adolescent HIV in Haiti

这项建议建立在海地国家卫生研究院三十年来建立的基础上 向海地肉瘤和感染研究小组提供研究和培训支助 GHESKIO和Weill Cornell Medicine（WCM），以解决新兴的 海地的青少年艾滋病毒流行。这项培训计划的重点是改善与艾滋病毒有关的 海地青少年（10至19岁）和青年（20至24岁）的健康结果。一个主要 重点是研究培训，将青少年艾滋病毒服务从诊所扩大到 社区有证据表明，在社区提供服务可以改善获得服务的机会， 社会可接受性、成本效益以及最终的大规模影响。 该计划通过建立海地的第一个博士学位来扩展海地的研究生培训 在公共卫生计划。我们建立在一个公共卫生计划建立在海地与前福格蒂 支持.一个由8名海地长期受训人员组成的骨干队伍将接受研究培训，其中4人将接受 一个公共卫生硕士和4个将获得博士学位-第一批博士水平的公共卫生培训， 海地.研究培训将侧重于以下领域的青少年健康：1）艾滋病毒预防，2） 艾滋病毒治疗，3）艾滋病毒和结核病合并感染，以及4）艾滋病毒和非传染性疾病。受训人员将接受培训， 成为GHESKIO和海地卫生部青少年健康研究的未来领导者。 健康该计划还将包括研究人员的中期培训（6-12个月） 包括心理学家（4），数据管理员（4）和社区卫生工作者（4），以建立 社区研究团队。 在海地，50%的新艾滋病毒感染者是青少年，其中80%的人 都是贫穷和受歧视的女性联合国儿童基金会宣布， 艾滋病病毒。感染艾滋病毒的青少年和青年接受抗逆转录病毒治疗的情况较差 结果，1年后只有50%的人仍在接受护理，而90%的人仍在接受护理， 成年人了10至24岁是结核病感染的高峰期， 疾病此外，只有40%的感染艾滋病毒的青少年结核菌培养阳性， 成功完成治疗。最后，青少年早发性高血压的发病率 海地的年轻人比同龄的美国黑人多12% - 3倍。 开发和验证以社区为基础的方法， 让青少年和青年继续接受护理将导致健康成果的可持续改善 在海地。该方案响应海地卫生部的优先事项，将培训 此外，还将继续与海地下一代领导人合作，开展以社区为基础的青少年艾滋病毒研究。

This proposal builds on the foundation established in Haiti during three decades of NIH research and training support to Groupe Haitien d’Etude du Sarcome et des Infections Opportunistes (GHESKIO) and Weill Cornell Medicine (WCM) to address the burgeoning adolescent HIV epidemic in Haiti. The focus of this training program is to improve HIV-related health outcomes of adolescents (10 to 19 years) and youth (20 to 24 years) in Haiti. A major emphasis is research-training to extend adolescent HIV services from the clinic to the community. Evidence demonstrates that providing services in the community improves access, social acceptability, cost-effectiveness, and ultimately large-scale impact. This program extends graduate level training in Haiti by establishing Haiti’s first PhD program in Public Health. We build upon an MPH program established in Haiti with prior Fogarty support. A cadre of 8 Haitian long-term trainees will receive research training – 4 will receive an MPH and 4 will receive a PhD – the first cohort with doctoral level public health training in Haiti. The research training will focus on adolescent health in the areas of 1) HIV prevention, 2) HIV treatment, 3) HIV and TB co-infection, and 4) HIV and NCDs. Trainees will be groomed to be the future leaders of adolescent health research at GHESKIO and the Haitian Ministry of Health. The program will also include medium-term training (6-12 months) of research staff including psychologists (4), data managers (4), and community health workers (4) to establish community-based research teams. In Haiti, 50% of all new HIV infections are in adolescents and youth, and 80% of these are impoverished and stigmatized females. UNICEF has declared adolescents the ‘center of the HIV epidemic’. HIV-infected adolescents and youth have poor antiretroviral treatment outcomes with only 50% remaining in care after 1 year, compared to 90% retention among adults. The period between 10 and 24 years is the peak incidence of TB infection and disease. Furthermore, only 40% of HIV-infected adolescents with culture-positive TB successfully complete therapy. Finally the rate of early onset hypertension in adolescents and youth in Haiti is 12% - 3-fold greater than in similarly aged Black Americans. The development and validation of community-based approaches to identify, engage, and retain adolescents and youth in care will lead to sustainable improvements in health outcomes in Haiti. This program responds to the priorities of the Haitian Ministry of Health and will train the next generation of Haitian leaders in the conduct of community-based adolescent HIV research.