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

每年，全世界有27.5万人死于宫颈癌，其中约88%死于宫颈癌 发生在低收入和中等收入国家，在这些国家艾滋病毒感染最严重， 熟练的护理是最穷的。2017年肯尼亚成人艾滋病毒发病率为1.21/1000。确实有 1,500,000名肯尼亚艾滋病毒携带者：860,000名女性，而男性为52,000名。宫颈 癌症是这个国家最常见的妇科癌症。粗略的发病率 肯尼亚宫颈癌发病率为22.4/100,000，年龄标化率(15-44岁)是 40.1/10万。宫颈肿瘤/癌症在感染艾滋病毒的妇女中更为常见 (WLHIV)。随着越来越多的人获得联合抗逆转录病毒药物，WLHIV的寿命越来越长 如果我们要最大限度地改善他们的健康和生活，仅提供艾滋病毒是不够的 通过包括PEPFAR计划在内的许多计划进行治疗，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 WLHIV中宫颈癌的发病机制及优化筛查、预防和治疗 艾滋病毒相关宫颈癌的治疗。一个由肯尼亚研究人员组成的多学科小组将 接受培训，进行艾滋病毒、人乳头瘤病毒、宫颈癌相关研究，最终目标是减少 WLHIV中与宫颈癌相关的死亡。培训范围将与优先事项有关 肯尼亚卫生部确定的领域：1)关于艾滋病毒之间相互作用的翻译研究 和HPV；2)改进宫颈癌筛查计划，包括低成本 技术；3)评估宫颈癌前病变/癌症的最佳治疗方案 WLHIV；4)HPV疫苗接种业务研究；5)行为、社会和 与HPV感染、宫颈癌前期/癌症和HPV疫苗接种有关的伦理问题。我们 建议培训6名长期受训研究生(2名博士和4名硕士)；8名中等 医生、护士、细胞技术员、数据经理、药剂师、 社会工作者、研究助理、实验室技术员；并进行短期 在这些优先领域举办专题讨论会/讲习班。最终目标是培养一支 肯尼亚西部的多学科研究谁将支持NIH优先领域的研究 并提高肯尼亚关于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.