Preclinical Cardiovascular Disease among Adolescents and Young Adults in Haiti

项目总结 林赛·赖夫博士是一位全球健康流行病学家，他的职业目标是利用流行病学研究 对感染艾滋病毒的青少年和青壮年实施高影响力的卫生干预措施。完毕 在过去的十年里，她发表了10篇第一作者的论文，重点是评估健康结果和 在海地AYALH之间的干预。AYALH在数十年的艾滋病毒感染中幸存下来，现在面临与艾滋病毒相关的 合并症，特别是心血管疾病(CVD)，随着年龄的增长进入成年期。她的K01目标是 扩大她的培训和研究，将重点放在艾滋病毒相关的临床前心血管疾病-无症状心脏代谢方面 提示AYALH中CVD-发病的异常。她将调整基于证据的干预措施，以 预防早发性CVD，对整个生命周期的AYALH有影响。 她的培训目标是培养以下方面的专业知识：1)AYALH中的心血管疾病流行病学；2)混合方法； 和3)实施科学，以设计和实施干预措施，以预防心血管疾病发病率和 死亡率。她的职业发展计划包括来自一个团队的多学科指导， 在AYALH、HIV和CVD流行病学以及实施科学研究方面拥有数十年经验 在全球健康环境中。该团队在全球卫生领域有着无可挑剔的指导记录 研究。赖夫博士还将参加补充的高级课程，以支持她的培训目标。她 K01得到了强大的研究和培训环境的支持，该环境利用了40年的合作 在威尔·康奈尔(纽约)和GHESKIO(海地)之间。 Reif博士的研究计划建立了AYALH中临床前心血管疾病的流行病学，并使 循证干预预防临床前心血管疾病的发病及其进展。她将进行一次 对500名18-30岁的艾滋病病毒感染者和500名艾滋病病毒感染者进行了为期3年的前瞻性队列研究 海地。在目标1中，她将评估临床前心血管疾病(前期)的患病率、发病年龄和进展 高血压、微量白蛋白尿和血脂异常)由艾滋病毒血清状态引起。她将在3年内评估风险因素 领域：生活方式、艾滋病毒相关和心理社会。她假设了由艾滋病毒驱动的一系列风险因素- 相关因素和心理社会因素与AYALH的临床前CVD相关。在《目标2》中，她将适应 以循证为基础的WHO心脏技术包用于LICS中AYALH的混合方法和 实施科学。K01解决了以下人群对临床前心血管疾病流行病学的认识差距 AYALH并告知适应循证心血管疾病干预措施，以预防过早残疾和 在这些人进入成年期时死亡。莱夫博士的培训和职业发展计划 补充和扩展她现有的技能，并最终提交NIH R01，帮助她 过渡到独立调查员。

PROJECT SUMMARY Dr. Lindsey Reif is a global health epidemiologist with a career goal to leverage epidemiologic research to implement high-impact health interventions for adolescents and young adults living with HIV (AYALH). Over the past decade, she has published 10 first-author papers focused on evaluating health outcomes and interventions among AYALH in Haiti. AYALH, who have survived decades of HIV, now face HIV-related comorbidities, specifically cardiovascular disease (CVD), as they age into adulthood. Her K01 objective is to expand her training and research to focus on HIV-related preclinical CVD— asymptomatic cardiometabolic abnormalities indicating the onset of CVD—among AYALH. She will adapt evidence-based interventions to prevent early onset CVD with impact for AYALH across the lifecourse. Her training objectives are to build expertise in: 1) CVD epidemiology among AYALH, 2) mixed-methods, and 3) implementation science in order to design and implement interventions to prevent CVD morbidity and mortality. Her career development plan includes multidisciplinary mentorship from a team that brings decades of experience in research among AYALH, HIV and CVD epidemiology, and implementation science across global health settings. The team has an impeccable track record of mentorship in global health research. Dr. Reif will also take complementary advanced coursework to support her training objectives. Her K01 is supported by a robust research and training environment that leverages a 40-year collaboration between Weill Cornell (New York) and GHESKIO (Haiti). Dr. Reif’s research plan establishes the epidemiology of preclinical CVD among AYALH and adapts an evidence-based intervention to prevent the onset of preclinical CVD and its progression. She will conduct a prospective cohort study among 500 HIV+ and 500 HIV- participants ages 18-30 years, followed for 3 years in Haiti. In Aim 1, she will evaluate the prevalence, age of onset and progression of preclinical CVD (pre- hypertension, microalbuminuria, and dyslipidemia) by HIV serostatus. She will evaluate risk factors in 3 domains: lifestyle, HIV-related, and psychosocial. She hypothesizes clusters of risk factors, driven by HIV- related and psychosocial factors, are associated with preclinical CVD among AYALH. In Aim 2, she will adapt the evidence-based WHO HEARTS technical package for AYALH in LICs using mixed methods and implementation science. This K01 addresses the knowledge gap of the epidemiology of preclinical CVD among AYALH and informs the adaptation of evidence-based CVD interventions to prevent premature disability and death among this population as they emerge into adulthood. Dr. Reif’s training and career development plan complement and expand her existing skillset and culminate in the submission of an NIH R01 facilitating her transition to independent investigator.