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.

摘要 人的流动性在推动艾滋病毒的感染和传播方面发挥着重要作用 造成糟糕的艾滋病毒护理级联结果。来自大型临床试验的新证据表明，移动性 对成功执行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，因为它可以将在地理上传播的流行病联系起来，导致引入 将艾滋病毒带入社区，减少接触干预措施，并扰乱艾滋病毒护理参与。有一件急事 需要更好地了解导致艾滋病毒差异的流动的地理空间和时间维度 为改善流动人口中艾滋病毒感染的结果，提出了可行和可推广的干预措施。然而， 这些领域的研究才刚刚起步。非常需要一支经过培训的科学队伍。 人类流动性和艾滋病毒，以应对这些挑战，特别是对于在医学上代表性不足的科学家。 卡罗尔·卡姆林博士，产科、妇科和生殖学系副教授 加州大学旧金山分校的科学和行为科学家，受过社交方面的培训 人口学。她的跨学科研究计划侧重于人类流动性和艾滋病毒的研究 预防和护理成果。在这份以病人为本的职业生涯中期研究人员奖的申请书中 研究(K24)，卡姆林博士提出了一个全面的指导、研究和职业发展计划 这将推进减少因人类流动而导致的艾滋病毒结果的全球差异的目标。 这项提案的总体目标是：1)扩大卡姆林博士的POR在人类流动性方面的范围 通过追求地理空间和社会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的级联结果 在SSA的流动PLHIV中；以及2)让研究员和初级教员参与开发新的 在非洲流动人口中推进艾滋病毒预防和治疗目标的多学科POR。 虽然K24为新研究提供了有限的资源，但有支持和保护时间 由K24提供，卡姆林博士将能够利用她目前研究的现有基础设施：1) 查明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)量化高流动性人群来源地和目的地诊所之间的“距离衰减” 在环境中使用艾滋病毒(艾滋病毒)，并评估其对艾滋病毒护理参与的影响(目标2)；合成 利用实施科学框架在该领域取得的累积成果和新发展，以及 召集一个多学科专家小组，审查有希望的干预措施并确定其优先次序； 评估改善艾滋病毒的两种原型策略的潜在可行性、可接受性和适当性 流动艾滋病毒感染者之间的护理参与度(目标3)在K24的支持下，该项目为 持续开展影响较大的研究，以应对流动性对根除艾滋病毒工作构成的挑战。