The Impact of Mobility on HIV Care in New York City and the Dominican Republic

应聘者是哥伦比亚大学医学中心(CUMC)的传染病讲师，她 长期目标是成为研究社会和社会之间相互作用的独立调查者 国际和国内拉丁裔社区的结构性因素和艾滋病毒治疗结果。她的短期 目标是扩大她在国际研究方面的经验，完善她在生物统计方法方面的技能， 并进一步了解移动性和移动中艾滋病毒护理结果之间的相互作用 社区。她在基础科学和临床研究方面有着广泛的记录，并一直 过去四年在多米尼加共和国(DR)为这一项目建立框架。 CUMC位于纽约-多米尼加共和国空中大桥的一端，这是一种循环迁移的模式 在这两个国家之间。我们的目标是了解机动性和艾滋病毒治疗之间的相互作用 在我们位于华盛顿高地、纽约(WH)和圣托的艾滋病毒治疗中心的多米尼加人中 多明戈(SD)博士，我们的主要假设是个体的流动性会导致抗逆转录病毒药物的中断 治疗，进而导致抗逆转录病毒治疗失败。我们将对机动性进行定性评估 在两个地点(WH和SD)的多米尼加穆斯林人口中使用比较人种学，并使用 开发适合社区的、以证据为基础的流动性衡量标准的知识。到时候我们会的 进行病例对照研究，以评估活动能力作为两个部位治疗失败的预测因子。我们还将 研究那些抗逆转录病毒耐药失败和不耐药的患者的差异。 这项研究将在中央医学中心和DR的合作机构进行，并由Dr。 斯科特·哈默，一位国际公认的艾滋病毒调查员。詹妮弗·赫希博士，艾滋病毒和艾滋病专家 移民问题，以及在资源有限的情况下研究艾滋病毒治疗结果的专家路易丝·库恩博士。CUMC 服务于DR以外最大的多米尼加人社区，以及DR中的合作机构 拥有悠久的成功临床研究的历史和与CUMC现有的研究计划。

The candidate is an instructor in infectious diseases at Columbia University Medical Center (CUMC), and her long-term goal is to become an independent investigator studying the interaction between social and structural factors and HIV treatment outcomes in international and domestic Latino communities. Her short-term goals are to expand her experience in international research, refine her skills in biostatistical methods, and further the understanding of the interaction between mobility and HIV care outcomes in mobile communities. She has an extensive track record of basic science and clinical research, and has been building the framework for this project in the Dominican Republic (DR) for the past four years. CUMC sits at one end of the New York-Dominican Republic air-bridge, a pattern of circular migration between the two countries. Our goal is to understand the interactions between mobility and HIV treatment amongst Dominicans in our own HIV treatment center in Washington Heights, New York (WH), and in Santo Domingo (SD), DR. Our primary hypothesis is that individual mobility leads to interruptions in antiretroviral therapy, and, in turn, to antiretroviral treatment failure. We will undertake a qualitative assessment of mobility using comparative ethnography in the Dominican pafient population at both sites (WH and SD), and use that knowledge to develop a community-appropriate and evidence based measure of mobility. We will then conduct case-control studies to assess mobility as a predictor of treatment failure at both sites. We will also examine differences in those failing with and without antiretroviral drug resistance. This research will take place at CUMC and collaborafing institutions in the DR with the mentorship of Dr. Scott Hammer, an internationally recognized HIV investigator. Dr. Jennifer Hirsch, a specialist in HIV and migration, and Dr. Louise Kuhn, an expert in HIV treatment outcomes in resource-limited settings. CUMC serves the largest community of Dominicans outside of the DR, and the collaborating institutions in the DR have long histories of successful clinical research and existing research initiatives with CUMC.