Vaginal practices in HIV positive women in Zambia a bio-behavioral intervention

应聘者：玛丽亚·L·阿尔凯德在西班牙马德里自治大学获得医学学位，并在迈阿密杰克逊纪念医院完成内科住院医师和传染病研究员资格。她是迈阿密大学米勒医学院传染病系的医学助理教授。导师：黛博拉·琼斯博士是迈阿密大学米勒医学院精神病学和行为科学系的研究副教授，在行为研究干预方面拥有丰富的经验，以降低国内外感染艾滋病毒的男性和女性的性风险。Fischl博士是迈阿密大学米勒医学院的医学教授，也是艾滋病毒临床研究领域公认的世界领导者。琼斯博士和费舍尔博士都有丰富的导师经验，他们将确保阿尔凯德博士的培训、拟议的研究和职业发展取得成功。研究：在撒哈拉以南的妇女中，阴道内实践(VP)很常见，并与细菌性阴道病(BV)和艾滋病毒传播有关。基于Alcaide博士从赞比亚获得的先导研究结果(R01HD058481S~Alcaide等人，2011)，这项研究将开发和测试旨在降低VP的生物行为干预。这项初步研究测试了生物行为干预，结果支持其在8周内同时减少VP和BV的有效性。目前的提案将评估针对赞比亚卢萨卡艾滋病毒感染妇女中VP的生物行为干预的长期影响，并评估VP和BV对生殖器炎症和艾滋病毒脱落的相对贡献。AIM 1.1将开发和评估降低VP的生物行为干预的长期影响。AIM 1.2将比较有无BV的HIV感染VP妇女的BV、生殖器炎症标志物和HIV脱落率。AIM 1.3将对参与干预或控制条件的HIV感染妇女的BV、生殖器炎症标志物和HIV生殖器脱落进行比较。这一旨在减少VP的创新生物行为干预措施有可能对赞比亚社区的公共卫生产生重大影响，并与VP和HIV感染高发的其他撒哈拉以南国家相关。K23奖励机制将使阿尔凯德博士获得临床和行为研究方面的新技能，在赞比亚进行VP研究，开发具有研究结果的R01应用程序，并成为一名独立的临床研究员。

DESCRIPTION (provided by applicant): Candidate: Maria L Alcaide received her medical degree from The Universidad Autonoma de Madrid, Spain and completed her Internal Medicine residency and Fellowship in Infectious Diseases at Jackson Memorial Hospital in Miami. She is Assistant Professor of Medicine at the Division of Infectious Diseases at the University of Miami Miller School of Medicine. Mentors: Dr. Deborah Jones is Research Associate Professor in the Department of Psychiatry & Behavioral Sciences at the University of Miami Miller School of Medicine with extensive experience in behavioral research interventions to reduce sexual risk in HIV infected men and women domestically and internationally. Dr. Fischl is Professor of Medicine at the University of Miami Miller School of Medicine and an acknowledged world leader in the field of HIV clinical research. Drs. Jones and Fischl both have extensive mentorship experience and will ensure the success of Dr. Alcaide's training, proposed studies and career development. Research: Intravaginal practices (VP) are common among women in sub-Saharan and implicated in the development of bacterial vaginosis (BV) and HIV transmission. Building on pilot study results from Zambia obtained by Dr. Alcaide (R01HD058481S~ Alcaide et al., 2011), this study will develop and test a bio-behavioral intervention designed to decrease VP. The pilot study tested a bio-behavioral intervention and results support its effectiveness in reducing both VP and BV over 8 weeks. The current proposal will evaluate the long term impact of a bio-behavioral intervention targeting VP among HIV infected women in Lusaka, Zambia, and assess the relative contribution of VP and BV to genital inflammation and HIV shedding. Aim 1.1 will develop and evaluate the long term impact of a bio-behavioral intervention to decrease VP. Aim 1.2 will compare rates of BV, genital inflammatory markers and HIV shedding in HIV infected women engaging in VP with and without BV. Aim 1.3 will compare BV, genital inflammatory markers and HIV genital shedding in HIV infected women participating in the intervention or control conditions. This innovative bio-behavioral interventio designed to reduce VP has the potential to have a significant public health impact in the Zambian community and relevance for other sub-Saharan countries with high prevalence of both VP and HIV infection. The K23 award mechanism will allow Dr. Alcaide to obtain new skills in clinical and behavioral research, conduct a study of VP in Zambia, develop an R01 application with study results, and become established as an independent clinical investigator.