Mentoring Junior Investigators: Comprehensive HIV Prevention

描述（由申请人提供）：这是一份为Carol Golin博士申请患者导向研究（K24）中期研究者奖的提案。尽管努力遏制艾滋病毒的传播，发病率继续增加在美国南部的行为方案，解决危险的性行为和抗逆转录病毒药物的坚持可以改善个人的艾滋病毒传播相关的健康行为，但是有限的。人际和社区层面的因素，如贫困、社会规范、犯罪率和监禁率、人际压力和双重能力，往往会推动或限制艾滋病毒易感，并可能阻碍行为规划的效果。迫切需要一批初级研究人员，特别是那些来自代表性不足的群体的人，他们有兴趣和技能来合作解决这些因素。作为UNC CFAR社会和行为科学核心的主任，Golin博士越来越多地被要求指导许多有前途的年轻研究人员，他们寻求与她一起获得这些技能。拟议的职业发展奖将给予Golin博士专门的时间，通过指导UNC的几位有才华的年轻同事进行艾滋病毒预防和依从性研究，扩大和建立她在艾滋病毒/艾滋病预防方面的以患者为导向的研究。Golin博士旨在通过实现四个直接目标，在美国南部建立一个正式的UNC艾滋病毒预防计划：1)通过正式和非正式的培训和合作，提高她评估健康结构决定因素和艾滋病毒预防干预计划成本效益的能力；2)通过研究人际和社区层面的艾滋病流行决定因素在影响艾滋病预防计划有效性方面的作用，扩展她的以患者为导向的研究（探索动机、自我效能和危险性行为之间的界面）；3)评估“积极参与和坚持护理和治疗的个人”（imPACT）艾滋病预防计划的成本效益；4)提高她为初级研究者提供有效和优秀指导的能力。本申请中提出的以患者为导向的研究，为Golin博士和她的学员提供了职业发展的载体，将：1)检验人际和结构因素对安全谈话项目在异性恋艾滋病毒感染者中的有效性的调节作用；2)探讨imPACT研究中异性恋参与者及其社会网络成员的观点，评估有助于或阻碍他们使用依从性或安全性行为策略的二元和社区因素；3)评估imPACT项目的成本效益；4)探讨生活在北卡罗莱纳州高贫困、高艾滋病毒流行人口普查区的艾滋病毒阴性妇女及其男性伴侣的艾滋病毒风险的潜在社区和双元环境。她的长期职业目标是将她正在开发的艾滋病毒预防项目发展成为一个成熟的中心，为美国东南部的弱势社区创建、测试和传播有效、全面的艾滋病毒预防干预措施

DESCRIPTION (provided by applicant): This is a proposal for a midcareer investigator award in patient-oriented research (K24) for Dr. Carol Golin. Despite efforts to curb HIV spread, incidence continues to increase in the southern U.S. Behavioral programs that address risky sexual behavior and ARV adherence can improve HIV transmission-related health behaviors of individuals, but are limited. Interpersonal and community-level factors, such poverty, social norms, crime and incarceration rates, interpersonal stress, and dyadic capacity often drive or constrain vulnerability to HIV, and may impede effects of behavioral programs. There is an urgent need for a pipeline of beginning investigators, especially those from underrepresented groups, with the interest and skills to collaboratively address these factors. As Director of the UNC CFAR Social and Behavioral Science Core, Dr. Golin is increasingly called upon to mentor numerous promising young investigators seeking to work with her to obtain such skills. The proposed career development award will give Dr. Golin the dedicated time to expand and build her patient- oriented research in HIV/AIDS prevention by mentoring several talented junior colleagues at UNC in HIV prevention and adherence research. Dr. Golin aims to create a formal UNC Program on HIV Prevention in the US South by achieving four immediate goals, to: 1) enhance her capacity to evaluate structural determinants of health and cost-effectiveness of HIV prevention intervention programs through formal and informal training and collaboration; 2) extend her patient-oriented investigations (exploring the interface between motivation, self- efficacy, and risky sexual behavior) by examining the role of interpersonal and community-level determinants of the HIV epidemic in influencing the effectiveness of HIV prevention programs; 3) evaluate the cost- effectiveness of the "Individuals Motivated to Participate and Adhere to Care and Treatment" (imPACT) HIV prevention program; and 4) enhance her capacity to provide effective and outstanding mentoring to junior investigators. The patient-oriented research proposed in this application, which provides a vehicle for career development for Dr. Golin and her mentees, will: 1) Examine the moderating effects of interpersonal and structural factors on the SafeTalk program's effectiveness among heterosexual HIV-infected individuals; 2) Explore the views of heterosexual participants in the imPACT study and their social network members to assess dyadic and community factors that helped or impeded their use of adherence or safer sex strategies.; 3) Evaluate the cost-effectiveness of the imPACT program; 4) Explore potential neighborhood and dyadic contexts for HIV risk among HIV-negative women and their male partners living in high poverty, high HIV prevalence census tracts in in NC. Her long-term career objective is to grow the HIV Prevention Program she is developing to a fully established Center for creating, testing, and disseminating effective, comprehensive HIV prevention interventions for vulnerable communities throughout the Southeastern U.S.