Improving Antiretroviral Management for HIV

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DESCRIPTION (provided by applicant): The goal of this K24 renewal application is to allow the applicant to continue to mentor trainees pursuing a career in clinical HIV investigation. This application would provide continued opportunities to utilize ongoing and planned clinical studies to mentor Infectious Disease fellows, junior faculty and graduate students in HIV related clinical research projects through the UCSD AVRC, the California Collaborative Treatment Group (CCTG) and the CFAR Network of Integrated Clinical Systems (CNICS) and to continue to expand the applicant's participation in the UCSD training programs for clinical research. The studies outlined in the aims provide opportunities for in-depth mentoring as well as investigation of timely and important scientific questions in HIV management and pathogenesis. For each of the aims and sub-aims, a mentee is the primary leader of the study: trainees have worked with the applicant to develop the studies from the inception and will participate in every aspect of protocol development, study execution, statistical analyses, results interpretation, presentation and publication of the results. All of the main studies are funded (mentees participated in the grant writing process) and for laboratory sub-aims, trainees have participated in recently submitted grant applications. The goal of mentoring will be achieved through the conduct of 2 scientific aims which incorporate several clinical studies. SPECIFIC AIM 1: To analyze CNICS cohort data to evaluate trends in antiretroviral (ARV) exposure and resultant virologic and resistance outcomes including disparities in outcome among women and African Americans. Clinical Studies: CNICS 002, CNICS 019 plus new CNICS concept proposal in development. SPECIFIC AIM 2: To investigate technologic and behavioral methodologies which improve adherence to ARV and reduce high-risk behavior in order to potentially reduce transmission from HIV- infected subjects. Clinical studies: CCTG 592 and new CCTG studies in development. The goal of this project is to allow the Principal Investigator to continue to mentor trainees pursuing a career in clinical HIV investigation. This application would provide continued opportunities to utilize ongoing and planned clinical studies to mentor Infectious Disease fellows, junior faculty and graduate students in HIV related clinical research projects through the UCSD AVRC, the California Collaborative Treatment Group (CCTG) and the CFAR Network of Integrated Clinical Systems (CNICS). Ultimately, the project would help to ensure that the next generation of scientists is available to meet the challenges of improving science and treatment of HIV infected patients.