Determinants of HIV Transmission

描述（由申请人提供）： 迫切需要有效的艾滋病毒预防战略，有效的艾滋病毒疫苗是大幅降低艾滋病毒新感染率的最佳长期希望。为了实现这一目标，我们目前对艾滋病毒传播的生物学和流行病学的了解仍然有限。该计划项目将侧重于识别和系统评估最近感染艾滋病毒的个人和将艾滋病毒传播给他们的性伴侣（传播对），以阐明和量化有助于传播的流行病学，行为，生物学，病毒学和宿主因素。 圣地亚哥原发性感染研究小组在招募急性和最近感染艾滋病毒的个体及其传播伙伴方面有着悠久而成功的历史。通过新的方法来扩大我们对这些研究参与者的识别，如临床和标本核心中所述，我们将在项目1中解决（传输概率）：（目标1）每次接触的传播概率（J），（目标2）伴侣更换率（c），（目标3）传染期持续时间（D），从而确定该人群中HIV的生殖数（R0）。这些调查将与项目2（传播相关因素）相辅相成，项目2将确定和量化艾滋病毒性传播的重要生物（目标1）、病毒（目标2）和宿主（目标3）相关因素的贡献。最重要的是，这项研究将允许准确估计潜在的预防策略或候选疫苗的预期功效，这是基于对目标人群正在进行的风险行为的估计以及对有助于艾滋病毒传播的病毒和宿主因素的全面了解。行政核心（核心A）将在协调本项目的行政、财政、数据和统计支持方面发挥核心作用，并提供科学支持，促进研究者和合作者之间的协同互动，这对互动项目的成功至关重要。临床和标本核心（核心B）将识别、招募和入组研究受试者，并采集、处理、储存和管理满足两个拟定研究项目目标所需的临床标本。

DESCRIPTION (provided by applicant): Effective prevention strategies for HIV are critically needed, and an effective HIV vaccine is the best long-range hope to dramatically reduce the rate of new HIV infections. To this goal, our current understanding of the biology and epidemiology of HIV transmission remains limited. This Program Project will focus on the identification and systematic evaluation of individuals who have been recently infected with HIV and the sexual partners who transmitted HIV to them (Transmission Pairs) to elucidate and quantify epidemiologic, behavioral, biologic, virologic, and host factors that contribute to transmission. The San Diego Primary Infection research group has a long and successful history of recruiting acutely and very recently HIV-infected individuals and their transmitting partners. With new approaches to expand our identification of such study participants, as described in the Clinical and Specimen Core, we will address in Project 1 (Transmission Probability): (Aim 1) the transmission probability per contact ((J), (Aim 2) the rate of partner change (c), (Aim 3) the duration of infectious stages (D), and thus determine the reproductive number (R0) of HIV in this population. These investigations will be complemented with Project 2 (Transmission Correlates) that will identify and quantify the contributions of important biologic (Aim 1), viral (Aim 2), and host (Aim 3) correlates of HIV sexual transmission. Most importantly, this research will allow for the accurate estimation of a potential prevention strategy or candidate vaccine's anticipated efficacy based on both an estimation of the target populations' ongoing risk behavior and a thorough understanding of viral and host factors that contribute to HIV transmission. The Administrative Core (Core A) will play a central role in coordinating the administrative, fiscal, data, and statistical support for this Project as well as providing scientific support and facilitating synergistic interaction among investigators and collaborators critical to the success of the interactive projects. The Clinical and Specimen Core (Core B) will identify, recruit and enroll study subjects and collect, process, store, and manage the clinical specimens needed to meet the objectives of the two proposed research projects.