Brown/Moi Training Program for the Prevention of HIV related Cervical Cancer

每年，宫颈癌在全球造成275，000人死亡，其中约88% 发生在艾滋病毒感染率最高的低收入和中等收入国家， 专业护理最差。2017年，肯尼亚成人艾滋病发病率为1.21/1000。有 1 500 000名肯尼亚艾滋病毒感染者：860 000名妇女，520 000名男子。宫颈 癌症是这个国家最常见的妇科癌症。的粗发生率 肯尼亚的宫颈癌为22.4/100，000名妇女，年龄标准化率（15-44岁）是 40.1/100,000.感染艾滋病毒的妇女中宫颈瘤/宫颈癌更为普遍 （WLHIV）。随着越来越多的人获得抗逆转录病毒联合治疗， 如果我们要以最佳方式改善他们的健康和生活，仅仅提供艾滋病毒治疗是不够的， 通过包括PEPFAR项目在内的许多项目进行治疗，并看着他们死于 宫颈癌这项拟议的研究培训计划的重点是了解 宫颈癌的发病机制，并优化筛查，预防和 治疗艾滋病毒相关的宫颈癌。一个由肯尼亚研究人员组成的多学科小组将在 接受过进行HIV、HPV、宫颈癌相关研究的培训，最终目标是减少 妇女艾滋病毒感染者中与宫颈癌有关的死亡人数。培训的范围将与优先事项有关 肯尼亚卫生部确定的领域：1）关于艾滋病毒 2）改善宫颈癌筛查计划，包括降低成本 3）评估宫颈癌前病变/癌症的最佳治疗方案， WLHIV ;4）HPV疫苗接种的操作研究和5）行为，社会和 与HPV感染、宫颈癌前病变/宫颈癌和HPV疫苗接种相关的伦理问题。我们 建议培训6名长期受训人员进行研究生学习（2名博士和4名硕士）; 8名中等 医生、护士、细胞学技师、数据管理员、药剂师、 社会工作者、研究助理、实验室技术员;以及 这些优先领域的专题讨论会/讲习班。最终目标是培养一批 肯尼亚西部的多学科研究，他们将锚在这个NIH优先领域的研究 并提高肯尼亚对艾滋病毒和宫颈癌的研究能力。

Every year, cervical cancer is responsible for 275,000 deaths worldwide, of which about 88% occurred in lower and middle income countries where HIV infection is greatest and access to skilled care is poorest. The adult HIV incidence rate in Kenya is 1.21/1000 in 2017. There are 1,500,000 Kenyans living with HIV: 860,000 are women compared to 520,000 men. Cervical cancer is the most common gynecological cancer in this country . The crude incidence of cervical cancer in Kenya is 22.4/100,000 women and the age standardized rate (15-44 y.o.) is 40.1/100,000. Cervical neoplasia/cancer is more prevalent among women living with HIV (WLHIV) . As WLHIV are living longer with increasing access to combination antiretroviral therapy and if we are to optimally improve their health and lives, it is not enough to provide HIV treatment through many programs including PEPFAR programs and watch them die from cervical cancer. The focus of this proposed research training program is the understanding of the pathogenesis of cervical cancer in WLHIV and to optimize the screening, prevention and treatment of HIV related cervical cancer. A multidisciplinary group of Kenyan researchers will be trained to conduct HIV, HPV, cervical cancer related studies with the end goal of decreasing cervical cancer related deaths among WLHIV. The scope of training will be related to priority areas identified by the Kenyan MOH:1) translational research on the interactions between HIV and HPV; 2) improvement of cervical cancer screening programs including low cost technologies ;3) assessment of the best treatment options for cervical precancer/cancer among WLHIV ;4) operational studies on HPV vaccination and 5) assessment of behavioral, social and ethical issues related to HPV infection, cervical precancer/cancer, and HPV vaccination. We propose to train 6 long term trainees in graduate studies (2PhD and 4 Master’s ); 8 medium term trainees (3-6 months) for doctors, nurses, cytotechnologists, data managers, pharmacist, social workers, research assistants, laboratory technicians; and conduct short term symposiums/workshops in these priority areas. The ultimate goal is to develop a cadre of multidisciplinary researches in Western Kenya who will anchor research in this NIH priority area and to increase research capacity on HIV and cervical cancer in Kenya.