Preventing Weight Gain and Diabetes in People with HIV in South Africa

预防南非艾滋病毒感染者体重增加和糖尿病

• 批准号: 10668540
• 负责人: Jennifer Manne-Goehler
• 金额: $ 19.61万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-14 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10668540
• 关键词: Acceleration; Acquired Immunodeficiency Syndrome; Address; Adopted; Africa; Africa South of the Sahara; Anthropometry; Area; Behavioral; Behavioral Model; Body Weight Changes; Cardiovascular system; Caring; Chronic; Chronic Disease; Clinical; Clinical Trials; Collaborations; Communicable Diseases; Conduct Clinical Trials; Data; Data Analyses; Demographic and Health Surveys; Diabetes Mellitus; Diabetes prevention; Dietary Practices; Disease; Educational Status; Epidemic; Epidemiologic Methods; Epidemiology; Feasibility Studies; Feedback; Foundations; Funding; General Hospitals; Glucose Intolerance; Glycosylated hemoglobin A; Goals; HIV; Health; Health system; Home; Intake; International; Intervention; Intervention Studies; Intervention Trial; Interview; Lead; Massachusetts; Measures; Medicine; Mentors; Mentorship; Metabolic; Metabolic Diseases; Morbidity - disease rate; Obesity; Obesity Epidemic; Observational Study; Overweight; Paper; Persons; Pharmaceutical Preparations; Physical activity; Physicians; Pilot Projects; Population; Positioning Attribute; Preventive; Public Health; Publications; Publishing; Randomized; Regimen; Reporting; Research; Research Institute; Research Priority; Risk Factors; Scientist; South Africa; Testing; Time; Training; Treatment Efficacy; Trust; United States National Institutes of Health; Weight; Weight Gain; Woman; acceptability and feasibility; antiretroviral therapy; arm; care systems; career; clinical trial analysis; cohort; data integration; design; diabetes risk; efficacy testing; excessive weight gain; experience; fast food; feasibility testing; global health; glucose tolerance; glycosylated serum albumin; improved; increased appetite; low and middle-income countries; men; mortality; multidisciplinary; nutrition; obesity prevention; observational cohort study; pharmacologic; prevent; prospective; prototype; public health relevance; skill acquisition; skills; standard of care; sugar; sweetened beverage; therapy design; therapy development; treatment as usual; treatment program

PROJECT SUMMARY Background: Obesity and diabetes are important risk factors for morbidity and mortality in people with HIV (PWH), especially in sub-Saharan Africa where health systems are already grappling with a rapid rise in metabolic disease. Dolutegravir (DTG)-based antiretroviral therapy (ART) has recently been adopted as the first-line regimen in most of the region, despite evidence that it is associated with excess weight gain. While the HIV care system offers a capable health systems platform, obesity and diabetes prevention is not a current focus of care paradigms. Candidate: I am a Clinical Fellow in Infectious Diseases at Massachusetts General Hospital and a physician-scientist with doctoral-level training in global health epidemiology and a strong track record of published observational research. However, my recent experiences caring for PWH have led to a desire to gain new skills in the design and execution of interventional trials to prevent metabolic disease in this population. My overarching career goal is to become an independent, NIH-funded physician-scientist with expertise in the metabolic complications of treated HIV, and in developing and testing clinical interventions to prevent these complications. Training: To achieve research independence, I will require additional training in 1) obesity medicine and diabetes prevention, 2) behavioral model-based intervention design, and 3) the conduct and analysis of clinical trials to prevent metabolic complications of HIV. Mentors: My training and research plans will be overseen by my primary mentor Dr. Mark Siedner, who has extensive mentoring experience and conducts both observational cohort studies and clinical trials in South Africa. Drs. Janet Lo (obesity medicine and diabetes prevention), Christina Psaros (behavioral model-based intervention design), and Deborah Wexler (the conduct and analysis of clinical trials) will serve as co-mentors to provide additional focused expertise. I will also receive annual feedback from my Scientific Advisory Board, which includes Drs. Rochelle Walensky, Naomi Levitt, Robert Parker, and Till Bärnighausen. Research: With guidance from my team of mentors, I will explore the metabolic effects of DTG among PWH in South Africa and develop and pilot an intervention to mitigate these complications through three specific aims: 1) To determine the behavioral correlates of weight change and glucose intolerance for PWH transitioning to DTG-based ART in South Africa; 2) To develop an acceptable and contextually appropriate intervention to prevent weight gain and diabetes in PWH on DTG-based ART in South Africa; and 3) To conduct a factorial-randomized feasibility study of interventions to prevent weight gain and diabetes among PWH on DTG-based ART versus usual care. We will carry out this research through existing collaborations with the Wellcome Trust-funded Africa Health Research Institute (AHRI). Through this period of training and research, I will be well positioned to achieve research independence and plan to submit an NIH R01 application in the fourth year of this project to test the efficacy of an intervention to prevent weight gain and diabetes in PWH in South Africa.

项目总结

项目成果

Impact of diabetes on longevity and disability-free life expectancy among older South African adults: A prospective longitudinal analysis.

• DOI: 10.1016/j.diabres.2023.110577
• 发表时间: 2023-03
• 期刊: DIABETES RESEARCH AND CLINICAL PRACTICE
• 影响因子: 5.1
• 作者: Payne, Collin F.;Liwin, Lilipramawanty K.;Wade, Alisha N.;Houle, Brian;Du Toit, Jacques D.;Flood, David;Manne-Goehler, Jennifer
• 通讯作者: Manne-Goehler, Jennifer

Diabetes risk and provision of diabetes prevention activities in 44 low-income and middle-income countries: a cross-sectional analysis of nationally representative, individual-level survey data.

• DOI: 10.1016/s2214-109x(23)00348-0
• 发表时间: 2023-10
• 期刊: LANCET GLOBAL HEALTH
• 影响因子: 34.3
• 作者: Rahim, Nicholas Errol;Flood, David;Marcus, Maja E.;Theilmann, Michaela;Aung, Taing N.;Agoudavi, Kokou;Kumararyal, Krishna;Bahendeka, Silver;Bicaba, Brice;Bovet, Pascal;Diallo, Alpha Oumar;Farzadfar, Farshad;Guwatudde, David;Houehanou, Corine;Houinato, Dismand;Hwalla, Nahla;Jorgensen, Jutta;Kagaruki, Gibson Bernard;Mayige, Mary;Wong-McClure, Roy;Larijani, Bagher;Moghaddam, Sahar Saeedi;Mwalim, Omar;Mwangi, Kibachio Joseph;Sarkar, Sudipa;Sibai, Abla M.;Sturua, Lela;Wesseh, Chea;Geldsetzer, Pascal;Atun, Rifat;Vollmer, Sebastian;Baernighausen, Till;Davies, Justine;Ali, Mohammed K.;Seiglie, Jacqueline A.;Manne-Goehler, Jennifer
• 通讯作者: Manne-Goehler, Jennifer

Improving health outcomes of people with diabetes: target setting for the WHO Global Diabetes Compact.

• DOI: 10.1016/s0140-6736(23)00001-6
• 发表时间: 2023-04-15
• 期刊: Lancet (London, England)

Characteristics and efficacy of physical activity interventions to improve cardiometabolic and psychosocial outcomes in people living with HIV in sub-Saharan Africa: a protocol for a systematic review.

• DOI: 10.1186/s13643-023-02186-5
• 发表时间: 2023-02-23
• 期刊: Systematic reviews
• 影响因子: 3.7

The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative, individual-level data in 680 102 adults.

• DOI: 10.1016/s2666-7568(21)00089-1
• 发表时间: 2021-06
• 期刊: The lancet. Healthy longevity
• 作者: Flood D;Seiglie JA;Dunn M;Tschida S;Theilmann M;Marcus ME;Brian G;Norov B;Mayige MT;Singh Gurung M;Aryal KK;Labadarios D;Dorobantu M;Silver BK;Bovet P;Adelin Jorgensen JM;Guwatudde D;Houehanou C;Andall-Brereton G;Quesnel-Crooks S;Sturua L;Farzadfar F;Saeedi Moghaddam S;Atun R;Vollmer S;Bärnighausen TW;Davies JI;Wexler DJ;Geldsetzer P;Rohloff P;Ramírez-Zea M;Heisler M;Manne-Goehler J
• 通讯作者: Manne-Goehler J