Male Circumcision and Use of Foreskin Tissues for HIV Prevention in Uganda

乌干达男性包皮环切术和使用包皮组织预防艾滋病毒

• 批准号: 8811495
• 负责人: RONALD H GRAY
• 金额: $ 26.54万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-13 至 2016-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8811495
• 关键词: AIDS prevention; Advisory Committees; African; Award; Bachelor' s Degree; Basic Science; Biometry; Camping; Collaborations; Country; Data; Devices; Doctor of Philosophy; Ensure; Environment; Epidemiology; Evaluation; Genetic; Genital system; Gray unit of radiation dose; HIV; Health Sciences; Immunologics; Immunology; Institution; Interdisciplinary Study; Leadership; Male Circumcision; Medical; Mentors; Microbiology; Molecular Virology; Monitor; Mucous Membrane; Population; Procedures; Program Evaluation; Public Health Schools; Research; Research Methodology; Research Training; Risk; Sampling; Scientist; Services; Site; Students; Tissues; Training; Uganda; Universities; Viral; Woman; career development; doctoral student; high risk men; implementation science; international center; men; microbiome; penis foreskin; professor; programs; uptake

DESCRIPTION (provided by applicant): Medical male circumcision (MMC) reduces HIV acquisition in men, and viral STIs in men and women. However, uptake of MMC in many African countries is less than expected and has disproportionately been among younger, lower risk men. There is an urgent need for implementation science incorporating qualitative/quantitative mixed methods research to increase the demand for MMC, particularly among higher risk men; to increase the efficiency of MMC services using MC devices, task shifting/sharing and mobile MMC camps; and to conduct population-level monitoring of coverage and impact. At the basic science level, foreskins collected during MC provide unique access to genital mucosa for study of the virologic, immunologic and host genetic factors associated with vulnerability to or protection from HIV, with implications for HIV prevention. The Rakai Health Sciences Program (RHSP) and Makerere University School of Public Health (MakSPH) in Uganda have collaborated with Johns Hopkins University (JHU) for over 20 years. We conducted two trials of MMC, post-trial surveillance, evaluation of MMC services, and assessment of MMC procedures, including new MMC devices. We have also collaborated on immunologic and virologic studies of foreskin tissues and the genital microbiome. The collaboration has trained over 50 degree and non-degree students via Fogarty International Center (FIC) awards. We propose to continue these training efforts and to provide research opportunities and career development for Ugandan scientists focusing on MMC related research, both because MMC is vital to HIV prevention, and because MMC-related research provides an opportunity for a wide range of synergistic and interdisciplinary studies. Specifically, at JHU we propose to train one PhD candidate in genital immunology, virology and molecular microbiology, and 5 MPH/MHS candidates in implementation science, epidemiology and biostatistics, program evaluation and mixed methods research. We will train 2 doctoral students at MakSPH, using an established "sandwich" PhD which allows short-term trainees to come to JHU for advanced courses and mentoring. In Uganda, we will support 5 Masters and 3 Bachelors degree trainees, and 18 diploma/certificate trainees at MakSPH and other Ugandan universities. The U.S. Program Director (PD) Dr. Ronald Gray, Professor of Epidemiology at the JHU and the Ugandan Key Foreign Collaborator is Dr. David Serwadda, Professor, at MakSPH. Training will be overseen by Training Advisory Committees in Uganda and the US. RHSP/MakSPH will provide access to the Rakai research field site for experiential training, data and samples for training-related research, and a rich stable environment for career development. The program builds on prior training and research to ensure the long-term sustainability and leadership of RHSP and MakSPH as world class HIV research institutions.

描述（由申请人提供）：医疗男性包皮环切术（MMC）减少男性感染艾滋病毒，减少男性和女性感染病毒性性传播感染。然而，许多非洲国家对MMC的接受程度低于预期，而且不成比例地发生在较年轻、风险较低的男性中。迫切需要结合定性/定量混合方法研究的执行科学，以增加特别是高风险男子对MMC的需求；通过移动通信设备、任务转移/共享和移动通信营地，提高移动通信服务的效率；并对覆盖范围和影响进行人口层面的监测。在基础科学层面，在MC期间收集的包皮为研究与HIV易感性或保护性相关的病毒学、免疫学和宿主遗传因素提供了独特的途径，对HIV预防具有重要意义。乌干达的Rakai健康科学项目（RHSP）和Makerere大学公共卫生学院（MakSPH）与约翰霍普金斯大学（JHU）合作了20多年。我们进行了两次MMC试验，试验后监测、MMC服务评估和MMC程序评估，包括新的MMC设备。我们还合作进行包皮组织和生殖微生物组的免疫学和病毒学研究。该合作项目通过福格蒂国际中心（FIC）奖培训了50多名学位和非学位学生。我们建议继续这些培训工作，并为专注于MMC相关研究的乌干达科学家提供研究机会和职业发展，这既是因为MMC对艾滋病毒预防至关重要，也是因为MMC相关研究为广泛的协同和跨学科研究提供了机会。具体来说，我们计划在JHU培养1名生殖免疫学、病毒学和分子微生物学博士候选人，以及5名实施科学、流行病学和生物统计学、项目评估和混合方法研究的MPH/MHS候选人。我们将在MakSPH培养2名博士生，采用既定的“三明治”博士，允许短期学员来JHU接受高级课程和指导。在乌干达，我们将在MakSPH和其他乌干达大学支持5名硕士和3名学士学位学员，以及18名文凭/证书学员。美国项目主任Ronald Gray博士是JHU的流行病学教授，乌干达的主要外国合作者是MakSPH的David Serwadda教授。培训将由乌干达和美国的培训咨询委员会监督。RHSP/MakSPH将为Rakai研究现场提供体验式培训，为培训相关研究提供数据和样本，并为职业发展提供丰富稳定的环境。该计划建立在先前的培训和研究基础上，以确保RHSP和MakSPH作为世界一流的艾滋病毒研究机构的长期可持续性和领导地位。