Mentoring Clinical Investigators in Patient Oriented Research on Human Mobility and HIV

指导临床研究人员进行以患者为中心的人类流动性和艾滋病毒研究

• 批准号: 10257799
• 负责人: Carol Suzanne Camlin
• 金额: $ 13.42万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10257799
• 关键词: AIDS prevention; Address; Africa; Africa South of the Sahara; Area; Automobile Driving; Behavioral; Budgets; California; Caring; Clinic; Clinical Investigator; Clinical Trials; Cohort Studies; Communities; Complex; Data; Demography; Destinations; Development; Development Plans; Dimensions; Discipline of obstetrics; Eastern Africa; Elements; Epidemic; Exposure to; Faculty; Funding; Funding Mechanisms; Geographic Locations; Geography; Goals; Gynecology; HIV; HIV risk; HIV/STD; Health system; Human; Infrastructure; Intervention; Intervention Studies; Interview; Kenya; Knowledge; Lead; Link; Location; Longitudinal Studies; Measurement; Measures; Medicine; Mentors; Mentorship; Methods; Midcareer Investigator Award in Patient-Oriented Research; Modeling; Network-based; Outcome; Pathway Analysis; Patients; Persons; Pilot Projects; Play; Population; Prevalence; Provider; Public Domains; Reproductive Sciences; Research; Resources; Role; San Francisco; Scientist; Sex Behavior; Social Network; Sorting - Cell Movement; Testing; Theoretical Domains framework; Theoretical model; Time; Training; Treatment outcome; Uganda; Universities; Woman; Work; care outcomes; career; career development; cost; design; feasibility testing; geographic population; implementation framework; improved; meetings; men; mid-career faculty; multidisciplinary; network models; novel; patient oriented research; population based; preference; programs; prototype; research and development; research study; social; theories; therapy development; transmission process

ABSTRACT Human mobility plays a substantial role in driving the acquisition and transmission of HIV and contributing to poor HIV care cascade outcomes. New evidence from large clinical trials shows that mobility presents a major challenge to the successful implementation of well-recognized HIV eradication strategies such as universal testing and treatment, as it can link geographically-spread epidemics, lead to introductions of HIV into communities, reduce exposure to interventions, and disrupt HIV care engagement. There is an urgent need to better understand the geospatial and temporal dimensions of mobility that lead to disparities in HIV outcomes, and for feasible and scalable interventions to improve HIV outcomes in mobile populations. Yet, research in these areas is nascent. There is a great need for an expanded scientific workforce with training in human mobility and HIV to tackle these challenges, particularly for scientists under-represented in medicine. Dr. Carol Camlin an Associate Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at the University of California, San Francisco, and a behavioral scientist with training in social demography. Her cross-disciplinary research program has focused on the study of human mobility and HIV prevention and care outcomes. In this application for the Midcareer Investigator Award in Patient-Oriented Research (K24), Dr. Camlin proposes a comprehensive mentoring, research and career development plan which will advance the goal to reduce global disparities in HIV outcomes that result from human mobility. The overall goals of this proposal are to: 1) Expand the scope of Dr. Camlin's POR in human mobility and HIV through pursuit of training in geospatial and social network modeling methods, 2) Lay the groundwork for conducting high-quality, large-scale, theory driven interventions to improve HIV care cascade outcomes among mobile PLHIV in SSA; and 2) Engage fellows and junior faculty in the development of new multidisciplinary POR to advance HIV prevention and treatment goals among mobile populations in Africa. While the K24 provides limited resources for new research, with the support and protected time provided by the K24, Dr. Camlin will be able to leverage the existing infrastructure of her current studies to: 1) identify the geospatial networks of mobile populations and HIV “risk flows” in areas of Kenya and Uganda (Aim 1); 2) quantify the `distance decay' between clinics in origins and destinations of highly mobile persons living with HIV (PLHIV) in the settings, and assess its influence on HIV care engagement (Aim 2); synthesize cumulative findings and new developments in the field using an implementation science framework, and convene a multidisciplinary panel of experts to review and prioritize promising interventions; and develop and evaluate the potential feasibility, acceptability and appropriateness of two prototype strategies to improve HIV care engagement among mobile PLHIV (Aim 3.) With K24 support, this project lays the groundwork for sustained high impact research to address the challenges posed by mobility to efforts to eradicate HIV.

抽象的 人员流动在推动艾滋病毒和艾滋病毒的获得和传播方面发挥着重要作用 导致艾滋病毒护理级联结果不佳。大型临床试验的新证据表明，移动性 对成功实施公认的艾滋病毒根除战略提出了重大挑战 例如普遍检测和治疗，因为它可以将地理上传播的流行病联系起来，从而导致引入 HIV 进入社区，减少干预措施的接触，并扰乱 HIV 护理参与。有紧急情况 需要更好地了解导致艾滋病毒差异的流动性的地理空间和时间维度 的结果，以及可行和可扩展的干预措施，以改善流动人口的艾滋病毒结果。然而， 这些领域的研究才刚刚起步。迫切需要扩大科学劳动力队伍并接受以下方面的培训： 人类流动性和艾滋病毒来应对这些挑战，特别是对于医学领域代表性不足的科学家而言。 卡罗尔·卡姆林 (Carol Camlin) 博士，产科、妇科和生殖系副教授 加州大学旧金山分校的科学博士，一位接受过社会学培训的行为科学家 人口统计。她的跨学科研究项目重点研究人类流动性和艾滋病毒 预防和护理结果。在本申请中以患者为导向的职业中期研究者奖中 研究（K24），Camlin博士提出全面的指导、研究和职业发展计划 这将推进减少因人口流动而导致的艾滋病毒结果全球差异的目标。 该提案的总体目标是： 1) 扩大 Camlin 博士的 POR 在人员流动方面的范围 和艾滋病毒，通过地理空间和社交网络建模方法的培训，2）奠定基础 进行高质量、大规模、理论驱动的干预措施，以改善艾滋病毒护理级联结果 SSA 中的流动艾滋病病毒携带者； 2) 让研究员和初级教师参与新学科的开发 多学科 POR 旨在推进非洲流动人口的艾滋病毒预防和治疗目标。 虽然 K24 为新研究提供有限的资源，但有支持和受保护的时间 由 K24 提供，Camlin 博士将能够利用她当前研究的现有基础设施来：1) 确定肯尼亚和乌干达地区流动人口和艾滋病毒“风险流”的地理空间网络（目标 1）； 2) 量化高流动人口居住地的出发地和目的地的诊所之间的“距离衰减” 环境中感染艾滋病毒（PLHIV）的人，并评估其对艾滋病毒护理参与的影响（目标 2）；合成 使用实施科学框架在该领域积累的发现和新发展，以及 召集一个多学科专家小组来审查和优先考虑有希望的干预措施；并发展和 评估两种改善艾滋病毒原型策略的潜在可行性、可接受性和适当性 流动艾滋病病毒感染者的护理参与（目标 3） 在 K24 的支持下，该项目为以下方面奠定了基础： 持续进行高影响力的研究，以应对流动性给根除艾滋病毒工作带来的挑战。