Undetectable and Untransmittable: reducing HIV transmission among young women living with HIV, their partners and children in South Africa

项目摘要 候选人：Toska博士坚定地致力于支持低收入和低收入地区感染艾滋病毒的年轻妇女。 中等收入国家（LMIC）的生存和繁荣，其中包括制定干预措施，使他们能够 坚持ART，参与健康的性关系，并计划安全怀孕。她的职业发展 该计划的重点是：1）培养科学专门知识，以调查性健康和生殖健康的复原力， 为该奖项制定的概念，2）获得为年轻人制定社会行为干预措施的知识 感染艾滋病毒的妇女，以及3）扩大领导和指导技能。这些目标将得以实现 通过经验丰富的导师的支持，他们是研究艾滋病毒的全球科学家， 低收入国家的性健康和生殖健康。通过这个奖项，托斯卡博士将巩固 她的职业目标是成为减少艾滋病毒传播的社会行为干预的全球领导者 在中低收入国家感染艾滋病毒的年轻人中。 研究：减少中低收入国家感染艾滋病毒的年轻妇女的艾滋病毒传播是 通过解决纵向（母婴）和横向（性）传播问题，打破传播循环 传递给合作伙伴。迄今为止，全球艾滋病毒预防工作的重点是支持所有艾滋病毒感染者， 通过病毒抑制阻止HIV的进一步传播（不可检测=不可传播）。越来越多的证据表明， 记录了感染艾滋病毒的年轻妇女如何经历更差的艾滋病毒治疗结果， 意外怀孕和将艾滋病毒传给子女的风险更大。没有干预措施解决这些问题 感染艾滋病毒的年轻妇女中U=U的两个方面。这个K43的科学目标是告知 制定一项基于证据的干预措施，解决年轻人所面临的复杂关系“集群”， 感染艾滋病毒的妇女是该组织的一部分，以减少艾滋病毒向其伴侣和子女的传播。培训 该K43的目标是获得必要的基础技能的强化指导和正式培训， 制定循证干预措施，以阻止感染艾滋病毒的年轻妇女继续感染艾滋病毒。的 该奖项的具体研究目标是：1）调查艾滋病毒传播的预测因素，2）开发 并验证性健康和生殖健康复原力的量化措施，以及3）绘制因果路径 年轻人的性健康和生殖健康韧性、意外怀孕和病毒抑制之间的关系 感染艾滋病毒的妇女。该奖项利用了两个现有的知识和研究基础设施， 在南非东开普省的Mzantsi Wakho和HEY BABY两个大队。这项研究推动了NIH 通过推进关于艾滋病毒在高度脆弱人群中传播的科学， 为这一人群制定预防艾滋病毒的循证干预措施，并建设 一位LMIC新兴研究人员和她将与之合作的早期职业研究人员。

PROJECT SUMMARY Candidate: Dr. Toska is steadfast in her commitment to support young women living with HIV in lower- and middle-income countries (LMICs) to survive and thrive, which includes developing interventions that enable them to adhere to ART, engage in healthy sexual relationships, and plan safe pregnancies. Her career development plan focuses on: 1) cultivating scientific expertise to investigate sexual and reproductive health resilience, a concept developed for this award, 2) gaining knowledge on developing socio-behavioral interventions for young women living with HIV, and 3) expanding leadership and mentorship skills. These objectives will be realized through the support of highly-experienced mentors, who are global scientists in research on HIV, adolescents and young people, and sexual and reproductive health in LMICs. Through this award, Dr. Toska will consolidate her career goal of becoming a global leader in socio-behavioral interventions to reduce onward HIV transmission among young people living with HIV in LMICs. Research: Reducing onward HIV transmission among young women living with HIV in LMICs is central to breaking the cycle of transmission, by addressing both vertical (mother-to-child) and horizontal (sexual) transmission to partners. Global HIV prevention efforts to date focus on supporting all people living with HIV to stop onward HIV transmission through viral suppression (Undetectable=Untransmittable). Growing evidence has documented how young women living with HIV experience poorer HIV treatment outcomes, higher rates of unintended pregnancies and greater risk of passing on HIV to their children. No intervention addresses these two aspects of U=U among young women living with HIV. The scientific goal of this K43 is to inform the development of an evidence-based intervention that addresses the complex relationship ‘clusters’ that young women living with HIV are part of, to reduce onward HIV transmission to their partners and children. The training objective of this K43 is to obtain intensive mentoring and formal training on the foundational skills necessary to develop an evidence-based intervention to stem onward HIV infection among young women living with HIV. The specific research aims of this award are to 1) investigate predictors of onward HIV transmission, 2) develop and validate a quantitative measure for sexual and reproductive health resilience, and 3) map causal pathways between sexual and reproductive health resilience, unintended pregnancies, and viral suppression among young women living with HIV. This award capitalizes on the intellectual and research infrastructure of two existing cohorts, Mzantsi Wakho and HEY BABY, based in the Eastern Cape, South Africa. The study advances NIH priorities by advancing science on HIV transmission in a highly vulnerable population, promoting the development of an evidence-based interventions for HIV prevention for this population, and building capacity for an LMIC emerging researcher and the early career researchers she will collaborate with.