Intimate partner violence and cardiovascular risk among adolescent girls living with HIV in Tanzania

项目概述：这项补充方案的家长拨款的目标是加强患者- 在姆万扎为内科科学家和其他杰出的临床医生提供面向艾滋病毒临床研究的培训， 在坦桑尼亚西北部。该计划建立在二十年的合作和能力建设的基础上， 伙伴机构：姆万扎干预试验股(MITU)，这是坦桑尼亚国家研究所的一个单位 伦敦卫生和热带医学院医学研究(NIMR)，威尔 布甘多医学院，也位于姆万扎，以及威尔·康奈尔医学院。 在拟议的研究培训补编中，Fogarty D43硕士的实习生Flora Madaha女士将 开展一个有指导的研究项目，探索亲密伴侣暴力(IPV)和 青春期女孩和年轻妇女中的过早心血管疾病(CVD)危险因素(AGYW) 坦桑尼亚农村地区的艾滋病毒携带者。Madaha女士是一名社会和行为科学家，在 坦桑尼亚的医学社会学。她的职业目标是进行研究，以了解健康状况不佳的驱动因素 在坦桑尼亚艾滋病毒携带者中开展AGYW，并制定卫生干预措施，以改善长期结果。 她在这项研究培训计划中的目标是扩大她在暴力研究方面的培训，以便将其应用于 青壮年HIV携带者人群及探讨IPV对早产儿心脑血管疾病等慢性疾病的影响 整个生命过程中的合并症。 Madaha女士的培训计划包括在3个关键领域培养专门知识：1)青少年艾滋病毒流行病学； 2)定性研究；3)研究设计。除了来自她的导师团队的密集指导外， 奥凯洛、唐斯和卡皮加博士，她将在坦桑尼亚圣奥古斯丁大学完成硕士课程 在Mwanza的高管课程中，并在LSHTM完成两个名为性别和 暴力：方法和意义与艾滋病毒流行病学。她的职业发展计划包括参与 并定期在Mitu-Weill Cornell Fogarty研究研讨会上介绍正在进行的研究。她会的 还在相关的国内和国际会议上提交她的研究项目的成果。 Madaha女士的研究计划是测量与体验相关的流行率和风险因素 在300名15-24岁的艾滋病病毒携带者中，任何类型的IPV(身体、性或情感)。她会的 衡量参与者过去一年和一生感染IPV的经历和相关因素，包括：1)与艾滋病毒相关 结果(例如，抗逆转录病毒疗法(ART)方案和依从性、艾滋病毒病毒载量)，2)精神健康(例如： 抑郁、焦虑、创伤后应激)，以及3)使用《生活的本质》捕捉到的慢性共病 8分，制定与健康行为和临床参数相关的综合得分 心血管健康。她还将进行深入访谈，以评估参与者的态度、信念和 与性别赋权和预防暴力有关的知识，为今后的干预措施提供信息。

Project Summary: The goal of the parent grant of this supplement proposal is to strengthen patient- oriented HIV clinical investigation training for physician-scientists and other exceptional clinicians in Mwanza, in northwestern Tanzania. The program builds upon two decades of collaboration and capacity building by the partner institutions: Mwanza Intervention Trials Unit (MITU), which is a unit of Tanzania's National Institute for Medical Research (NIMR), the London School of Hygiene and Tropical Medicine (LSHTM), Weill Bugando School of Medicine, which is also located in Mwanza, and Weill Cornell Medical College. In the proposed research training supplement, Ms. Flora Madaha, the Fogarty D43 Master's trainee, will conduct a mentored research project exploring the association of intimate partner violence (IPV) and premature cardiovascular disease (CVD) risk factors among adolescent girls and young women (AGYW) living with HIV in rural Tanzania. Ms. Madaha is a social and behavioral scientist completing her Masters in Medical Sociology in Tanzania. Her career goal is to conduct research to understand the drivers of poor health among AGYW living with HIV in Tanzania and develop health interventions to improve long-term outcomes. Her objective in this research training proposal is to expand her training in violence research to apply this to a population of AGYW living with HIV and explore the impact of IPV on premature CVD and other chronic comorbidities across the life-course. Ms. Madaha's training plan includes building expertise in 3 key areas: 1) adolescent HIV epidemiology; 2) qualitative research, and 3) study design. In addition to intensive mentorship from her mentorship team, Drs. Okello, Downs, and Kapiga, she will complete Masters coursework at St. Augustine University of Tanzania in the executive program in Mwanza, and complete two intensive short-courses at LSHTM titled Gender and Violence: Methods and Meaning and HIV Epidemiology. Her career development plan includes participation and regular research-in-progress presentations in the MITU-Weill Cornell Fogarty Research Seminar. She will also submit the results of her research project at relevant national and international conferences. Ms. Madaha's research plan is to measure the prevalence and risk factors associated with experiencing any type of IPV (physical, sexual, or emotional) among 300 AGYW living with HIV ages 15-24 years. She will measure participants' past year and lifetime experience of IPV and factors associated including: 1) HIV-related outcomes (e.g. anti-retroviral therapy (ART) regimen and adherence, HIV viral load), 2) mental health (e.g. depression, anxiety, post-traumatic stress), and 3) chronic co-morbidities captured using the Life's Essential 8 score to formulate a composite score of health behaviors and clinical parameters associated with cardiovascular health. She will also conduct in-depth interviews to assess participants' attitudes, beliefs, and knowledge related to gender empowerment and violence prevention to inform future interventions.