Characterizing Extragenital Gonorrhea and Chlamydia: Natural History & HIV Impact

生殖器外淋病和衣原体的特征:自然史

基本信息

  • 批准号:
    8900941
  • 负责人:
  • 金额:
    $ 17.55万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2014
  • 资助国家:
    美国
  • 起止时间:
    2014-08-01 至 2019-07-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Gonorrhea (GC) and chlamydia (CT) at the pharynx and the rectum comprise the majority of GC and CT infections in men who have sex with men (MSM). However, as primarily asymptomatic infections, they often go undiagnosed and untreated. As such, GC/CT infections at these extra-genital sites may constitute an important reservoir of sustained transmission in the MSM population. Gonococcal infections at the pharynx may also play an important role in fostering the development of antimicrobial resistance due to the unique constellation of Neisseria gonorrhoeae's ability to scavenge DNA and the oropharynx as important environment for commensal Neisseria species. Rectal GC/CT infections have been shown to increase the risk for HIV acquisition. However, little is known about the natural history of extra-genital GC and CT, nor the extent to which rectal GC/CT increase the risk of HIV acquisition through a biologically-mediated process or sexual behavior. This K23 proposal aims to 1) determine the natural history extra-genital gonorrhea and chlamydia infection among MSM & associated sociobehavioral determinants, and 2) quantify variations in HIV shedding at the rectum during rectal GC/CT infection by conducting a prospective cohort study of MSM, half of which are HIV-infected, who will self-collect pharyngeal and rectal swabs and document sexual activity on a weekly basis for one year. We will document incidence, duration of infection, and associated sociobehavioral factors with extra-genital GC/CT; and we will evaluate differences in HIV RNA log copies between baseline and incident rectal infections as well as describe temporal variations in HIV RNA shedding over the course of rectal GC/CT infections. We will also 3) test whether the risk of HIV acquisition is associated with rectal GC or CT infection controlling for seroadaptive behaviors using more than 10 years of clinical data collected at an urban STD Clinic; and 4) estimate the potential impact of enhanced extra-genital testing and treating on the incidence of GC, CT and HIV using deterministic mathematical modeling. Not only will these studies answer key clinical and epidemiologic question about extra-genital GC, CT and HIV, but these studies will provide experiential learning to complement a structured career development plan for the PI to develop skills in longitudinal data analysis, sociobehavioral research and mathematical modeling. The ultimate goal of this K23 award is to provide the time, experience, training and mentorship necessary to allow the PI to become an independent investigator dedicated to the prevention and control of STD and HIV in vulnerable populations.
描述(由申请人提供): 男男性行为者 (MSM) 的 GC 和 CT 感染主要由咽部和直肠的淋病 (GC) 和衣原体 (CT) 构成。然而,由于主要是无症状感染,它们常常得不到诊断和治疗。因此,这些生殖器外部位的 GC/CT 感染可能构成 MSM 人群中持续传播的重要储存库。由于淋病奈瑟菌具有独特的清除 DNA 的能力,并且口咽部是共生奈瑟菌物种的重要环境,因此咽部的淋球菌感染也可能在促进抗菌药物耐药性的发展中发挥重要作用。直肠 GC/CT 感染已被证明会增加感染 HIV 的风险。然而,人们对生殖器外 GC 和 CT 的自然史以及直肠 GC/CT 通过生物介导的过程或性行为增加 HIV 感染风险的程度也知之甚少。该 K23 提案旨在 1) 确定 MSM 和相关社会行为决定因素中生殖器外淋病和衣原体感染的自然史,以及 2) 通过对 MSM 进行前瞻性队列研究,量化直肠 GC/CT 感染期间直肠 HIV 排出的变化,其中一半是 HIV 感染者,他们将自行收集咽部和直肠样本 一年内每周进行拭子检测并记录性活动。我们将通过生殖器外 GC/CT 记录发病率、感染持续时间以及相关的社会行为因素;我们将评估基线和事件直肠感染之间 HIV RNA 日志拷贝的差异,并描述直肠 GC/CT 感染过程中 HIV RNA 脱落的时间变化。我们还将 3) 使用在城市 STD 诊所收集的超过 10 年的临床数据来测试 HIV 感染风险是否与控制血清适应行为的直肠 GC 或 CT 感染相关; 4) 估计潜在影响 使用确定性数学模型加强对 GC、CT 和 HIV 发病率的生殖器外检测和治疗。这些研究不仅将回答有关生殖器外GC、CT和HIV的关键临床和流行病学问题,而且这些研究还将提供体验式学习,以补充PI的结构化职业发展计划,以培养纵向数据分析、社会行为研究和数学建模方面的技能。 K23 奖项的最终目标是提供必要的时间、经验、培训和指导,使 PI 成为一名致力于预防和控制弱势群体性病和艾滋病毒的独立调查员。

项目成果

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Lindley Barbee其他文献

Lindley Barbee的其他文献

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{{ truncateString('Lindley Barbee', 18)}}的其他基金

Quantifying the Use of Epidemiologic Treatment and its Role in the Development of Antimicrobial-Resistant N. gonorrhoeae among Men who have Sex with Men (MSM)
量化流行病学治疗的使用及其在男男性行为者 (MSM) 耐药性淋病奈瑟菌发展中的作用
  • 批准号:
    10312821
  • 财政年份:
    2020
  • 资助金额:
    $ 17.55万
  • 项目类别:
A Prospective Cohort Study to Determine Optimal Timing of Test of Cure for Pharyngeal Gonorrhea with NAAT
确定 NAAT 治疗咽部淋病最佳时机的前瞻性队列研究
  • 批准号:
    9583290
  • 财政年份:
    2018
  • 资助金额:
    $ 17.55万
  • 项目类别:
Characterizing Extragenital Gonorrhea and Chlamydia: Natural History & HIV Impact
生殖器外淋病和衣原体的特征:自然史
  • 批准号:
    9312730
  • 财政年份:
    2014
  • 资助金额:
    $ 17.55万
  • 项目类别:
Characterizing Extragenital Gonorrhea and Chlamydia: Natural History & HIV Impact
生殖器外淋病和衣原体的特征:自然史
  • 批准号:
    8765338
  • 财政年份:
    2014
  • 资助金额:
    $ 17.55万
  • 项目类别:

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