Molecular Epidemiology of HIV Transmission Networks

描述（由申请人提供）：这个职业发展奖的目标是博士。独立临床研究者所需的培训及经验。该提案的职业目标是获得艾滋病毒导向的分子流行病学领域的专业知识，包括熟悉生物统计学和研究设计，熟练使用分子遗传学研究艾滋病毒传播模式和人口动态，获得艾滋病毒行为和预防科学的经验，并接受适当的培训，包括道德实践的负责任的研究行为。在美国，人类免疫缺陷病毒（HIV）感染者的人数继续增加，通过社交网络在高危群体中传播。查明发生艾滋病毒传播的网络，可导致有针对性的筛查和有效的预防干预。目前由公共卫生部门实施的艾滋病毒流行病学接触者追踪计划往往受到报告和回忆偏差的限制，这些偏差是继发于感染和诊断之间的滞后时间以及艾滋病毒感染者不愿意报告伴侣。这项研究计划整合了分子流行病学和公共卫生计划，以确定传播网络，并开发行为评估和干预工具。与罗得岛的其他主要学术中心和卫生部合作，分子流行病学将用于加强接触者追踪计划和制定未来有针对性的预防策略。这项研究的目的是：1）利用分子系统发育方法确定艾滋病毒感染者之间的传播网络; 2）确定可能作为干预目标的与传播网络有关的危险因素和特征;和3）确定形成传播网络的个人的接触者，以诊断艾滋病毒感染但不知情的病例，确定危险行为的特征，并评估新的预防干预措施的可接受性。这项研究将有助于对艾滋病毒流行病学进行全面调查，并制定一个可在其他地方实施的有效公共卫生模式。在此期间，陈博士将由布朗大学分子遗传学和艾滋病毒流行病学领域的专家指导，包括Rami Kantor博士（主要导师）和Kenneth Mayer博士。

DESCRIPTION (provided by applicant): The goal of this career development award is for Dr. Philip A. Chan to acquire the training and experience necessary to become an independent clinical investigator. The career goals of this proposal are to gain expertise in the field of HIV-oriented molecular epidemiology including familiarity with biostatistics and study design, to become skilled using molecular phylogenetics to study HIV transmission patterns and population dynamics, to acquire experience in HIV behavior and prevention sciences, and to receive proper training in the Responsible Conduct of Research including ethical practices. The number of Human Immunodeficiency Virus (HIV) infected individuals continues to increase in the United States, propagated by transmission in social networks among high-risk groups. Identification of networks within which HIV transmission occurs can lead to targeted screening and effective prevention interventions. Current HIV epidemiologic contact tracing programs implemented by public health departments are often limited by reporting and recall bias secondary to the lag time between infection and diagnosis as well as the reluctance of HIV-infected individuals to report partners. This research proposal integrates molecular epidemiology and public health programs to identify transmission networks and develop behavior assessment and intervention tools. In collaboration with other major academic centers in Rhode Island and the Department of Health, molecular epidemiology will be used to enhance contact tracing programs and develop future targeted prevention strategies. The objectives of the research are to: 1) Identify transmission networks among HIV- infected individuals using molecular phylogenetic approaches; 2) Determine risk factors and characteristics associated with transmission networks that may be targeted for interventions; and 3) Identify contacts of individuals forming transmission networks to diagnose HIV-infected yet unaware cases, characterize risk behaviors, and assess acceptability of novel prevention interventions. This research will allow a comprehensive investigation of HIV epidemiology and development of an effective public health model that can be implemented elsewhere. During the course of this award, Dr. Chan will be mentored by experts from Brown University in the field of molecular genetics and HIV epidemiology including Dr. Rami Kantor (primary mentor) and Dr. Kenneth Mayer.