Building independent research leaders in HIV-associated malignancies in Uganda

点击翻译按钮获取中文摘要

PROJECT SUMMARY / ABSTRACT The incidence of cancer among persons with HIV infection has increased annually since the widespread availability of antiretroviral therapy. Cancer is now a leading cause of death among HIV-positive persons, as survival after a diagnosis of an HIV-associated malignancy (HIVAM) is poorer compared with HIV-negative cancers across the world. In regions with a high prevalence of both HIV and viral oncogens, AIDS-defining malignancies such as Kaposi Sarcoma, non-Hodgkin lymphoma and cervical cancer present some of the largest threats to the health of HIV-infected individuals; non-AIDS defining cancers such at hepatocellular carcinoma, lung cancer and anal cancer now comprise >50% of HIVAM. New strategies are needed for cancer prevention and treatment among persons living with HIV in resource-limited settings. Since 2004, the Fred Hutchinson Cancer Research Center (FHCRC) has collaborated with the Uganda Cancer Institute (UCI) in Kampala, Uganda, to conduct research in HIVAM and develop new strategies for cancer treatment and prevention. Through several well-established training grants and strong relationships with our academic partners, the University of Washington (UW) and Makerere University (MU), we have trained >300 individuals in HIVAM research and care at all levels. Key informant interviews with academic, governmental and clinical leaders in Uganda find that gaps in the capacity to conduct HIVAM research persist, particularly related to junior investigators' abilities to conduct independent research. We propose to support the development of research leaders in HIVAM in Uganda through three Specific Aims: 1) Expand the cadre of trained research leaders in the field of HIVAM by conferring doctoral degrees with an emphasis on clinical trials research through our established program with the Makerere University College of Health Sciences (MakCHS); 2) Provide targeted training to facilitate the maturation of previous advanced degree trainees to independence as investigators in HIVAM in Uganda; 3) Strengthen the research skills and expand the community of Uganda investigators in HIVAM through an established Peer Mentoring Career Development program. The proposed training activities build on experiences with our current training programs and will be overseen by an experienced and outstanding committee representing leaders in HIV and oncology research from the US and Uganda.