Mentoring and Patient Oriented Research at the Nexus of Unhealthy Alcohol Use and HIV

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Unhealthy alcohol use among persons with HIV (PWH) has deleterious effects on retention in the HIV Care Continuum, increases HIV transmission risk behaviors, complicates the management of age-related comorbidities and increases mortality. I am a general internist and clinical HIV specialist. My research career over the past 14 years has focused at the nexus of HIV and alcohol use. My research and scholarship have contributed to the understanding of the epidemiology and clinical consequences of alcohol use among PWH, and to the adaptation and testing of interventions for unhealthy alcohol use among PWH, particularly women. I seek this K24 Mid-Career Investigator Award to 1) Expand my patient oriented research skills and experience in implementation research, in order to rigorously implement evidence based alcohol interventions for PWH in clinical and community settings, allowing me to expand my patient oriented intervention research from trials of efficacy to effectiveness and implementation; and 2) increase mentoring time, enhance my mentoring and leadership skills, and thereby expand the cadre of junior faculty and trainees pursuing research careers focused on alcohol and HIV. I will accomplish these goals through didactics, training, direct experience and mentorship from experts in implementation research, mentoring and leadership development. Throughout this award period I will work closely with mentees to develop individual development plans tailored to their values and goals which will serve as a blue print for their training activities. The new research proposed in this award will capitalize on the existing resources and infrastructure of the NIAAA funded Alcohol Research Consortium in HIV (ARCH), nested in the CFAR Network of Integrated Clinical Systems (CNICS), a multi-site clinical cohort of PWH receiving care across 8 HV clinics in the United States. ARCH is testing the effectiveness of an alcohol treatment algorithm integrated into three HIV clinics. With implementation research collaborators and trainees, and skills gained from proposed K24 career development activities, I will use mixed methods to explore and evaluate multi-level factors that influence adoption, implementation and maintenance of this approach to alcohol treatment in HIV clinical settings. This mixed methods research, which includes in-depth interviews and quantitative surveys, will provide a number of opportunities for trainees interested in implementation research focused on alcohol and HIV. I have a strong record of research funding, and am a long-standing investigator with the Johns Hopkins HIV Clinical Cohort, ARCH, and a behavioral clinical trials program for women with and at risk of HIV. These resources, combined with the strong scientific environment at Johns Hopkins, serve as an outstanding platform to train the next generation of investigators in the areas of alcohol use and HIV.