Research Training Program in Adolescent HIV in Haiti

这项提议建立在美国国立卫生研究院三十年来在海地建立的基础之上 对海天病毒感染小组的研究和培训支持 Opportunistes(GHESKIO)和Weill Cornell Medicine(WCM)以应对蓬勃发展的 海地青少年艾滋病毒流行。这一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)的健康状况。一位少校 重点是研究-培训，将青少年艾滋病毒服务从诊所扩展到 社区。有证据表明，在社区提供服务可以改善服务的可及性， 社会可接受性、成本效益，并最终产生大规模影响。 该计划通过建立海地第一个博士学位来扩展海地的研究生水平培训 公共卫生专业。我们在海地与前福格蒂建立的公共卫生计划的基础上 支持。一个由8名海地长期受训人员组成的干部将接受研究培训--4人将接受 1个公共卫生硕士和4个公共卫生硕士将获得博士学位--第一批接受过博士级别公共卫生培训的人 海地。研究性培训将侧重于1)艾滋病毒预防领域的青少年健康，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。受训人员将被培养成 成为GHESKIO和海地卫生部青少年健康研究的未来领导者 健康。该方案还将包括对研究人员的中期培训(6-12个月)。 包括心理学家(4名)、数据管理员(4名)和社区卫生工作者(4名)，以建立 基于社区的研究团队。 在海地，50%的艾滋病毒新感染者是青少年，其中80%是青少年。 是贫穷和被污名化的女性。联合国儿童基金会宣布青少年为青少年的中心。 “艾滋病毒流行”。感染艾滋病毒的青少年和青年的抗逆转录病毒治疗很差 结果：一年后只有50%的人留在护理中，相比之下， 成年人。10年至24年是结核病感染和感染的高峰期 疾病。此外，感染艾滋病毒的青少年中只有40%的人患有培养阳性结核病 顺利完成治疗。最后，青少年早发性高血压的比率 海地的年轻人比同龄的美国黑人多12%-3倍。 开发和验证基于社区的方法，以识别、参与和 将青少年和青年留在照料中心将导致健康状况的可持续改善 在海地。该方案响应海地卫生部的优先事项，并将培训 海地下一代领导人参与了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.