Expansion of research and mentoring opportunities to reduce the burden of maternal and pediatric HIV in Botswana

摘要/摘要 我正在申请K24续签，目的是扩大我的NIH资助研究的范围，并扩大 博茨瓦纳-哈佛艾滋病研究所在博茨瓦纳的伙伴关系中的导师机会。在过去的23年里， 我在博茨瓦纳建立了一个成功的研究项目，最近的重点是不良生育结果 对感染艾滋病毒儿童的监测和新的治疗战略。我曾成功地指导或共同指导过 在我的职业生涯中，近50名年轻的研究人员，以及我目前的K24，对我最近的指导至关重要 活动。尽管面临新冠肺炎的挑战，我的K24研究和指导目标还是实现了--还有 经常扩大--在过去的5年里。有了重新资助，我的K24资助的研究将有以下几个方面 有指导的研究目标，涵盖我资助的所有研究活动：(1)评估6周艾滋病毒的吸收情况 DNA聚合酶链式反应检测、缺乏检测的风险因素和博茨瓦纳艾滋病毒垂直传播的风险因素 国民治疗计划；(2)评估卡替格列韦-LA暴露前预防(PrEP)的摄取 通过博茨瓦纳国家方案在怀孕期间提供服务；(3)确定孕产妇死亡率 玛丽娜夫人医院剖腹产的发病率和死亡率(按艾滋病毒状况分列)，以及 制定干预措施，以标准化剖腹产的医学指征，同时培训我目前的受训者 成为一名导师；以及(4)进行专门的诊断和定性访谈，以优化战略 对于未来对高度精选的艾滋病毒携带者儿童和青少年进行的分析治疗中断(ATI)， 同时在博茨瓦纳的实验室导师中培养研究独立性。我的培训计划将具体地 扩展我在母婴医学和艾滋病毒治疗策略方面的专业知识，我的指导计划将包括 与波士顿和博茨瓦纳的联合导师一起以团队方式高效地利用新计划中的机会 奖项、正在进行的临床试验以及现有的数据集和标本。我更新K24的最终目标是 应用是扩大能力，到下一年在博茨瓦纳进行以患者为导向的高影响力研究 来自非洲和美国的一代全球卫生领导者。

Summary / Abstract I am applying for a K24 renewal with the goal of expanding the scope of my NIH-funded research and expanding mentorship opportunities at the Botswana-Harvard AIDS Institute Partnership in Botswana. In the past 23 years, I have built a successful research program in Botswana with a recent focus on adverse birth outcomes surveillance and novel treatment strategies for children with HIV. I have successfully mentored or co-mentored nearly 50 young investigators in my career, and my current K24 has been essential for my recent mentoring activities. Despite the challenges of COVID-19, my K24 research and mentoring aims have been achieved – and often expanded – over the past 5 years. With re-funding, my K24-supported research will have the following mentored research aims, which span all of my funded research activities: (1) to evaluate uptake of 6-week HIV DNA PCR testing, risk factors for lack of testing, and risk factors for HIV vertical transmission in the Botswana national treatment program; (2) to evaluate the uptake of cabotegravir-LA pre-exposure prophylaxis (PrEP) offered in pregnancy through the Botswana national program; (3) to determine the incidence of maternal morbidity and mortality associated with cesarean section at Princess Marina Hospital (by HIV status), and develop interventions to standardize medical indications for caesarean section, while training my current mentee to become a mentor; and (4) to perform specialized diagnostics and qualitative interviews to optimize a strategy for a future analytic treatment interruption (ATI) among highly selected children and adolescents living with HIV, while fostering research independence in a Botswana-based laboratory mentee. My training plan will specifically expand my expertise in maternal-fetal medicine and HIV cure strategies, and my mentoring plan will involve a team approach with co-mentors in Boston and Botswana to efficiently utilize opportunities within a new Program Award, ongoing clinical trials, and existing datasets and specimens. The ultimate goal of my K24 renewal application is to expand capacity to conduct high-impact patient-oriented research in Botswana by the next generation of global health leaders from Africa and the United States.