Mentoring New Investigators in Criminal Justice HIV Prevention and Treatment

描述(由申请人提供)：David Alain Wohl，医学博士，北卡罗来纳大学传染病系副教授，提交K24职业中期奖的申请。K24的目的是使接受者能够：a)投入更多的时间来增强他们在以患者为导向的研究(POR)方面的能力；以及b)在POR的实施过程中为新的临床研究人员提供指导。沃尔博士是全国公认的艾滋病毒临床研究领域的思想领袖，尤其是在探索监禁和艾滋病毒之间关系的研究方面。在这份申请中，他建议培养技能，以服务于他未来在这一重要研究领域的工作，包括定性数据收集和分析方法、更高水平的分析技术，以及有效领导的战略。他将扩大已建立的指导记录，以发展更大的能力和研究机会，以促进早期研究人员的研究生涯。候选人：沃尔博士一直是一位高生产率的艾滋病毒临床研究人员，并已将北卡罗来纳大学建立为艾滋病毒相关矫正研究的主要中心。自2003年以来，他一直得到美国国立卫生研究院的资助，开展研究，旨在优化对刑事司法系统参与者的艾滋病毒检测和护理，这是一个药物滥用和精神健康障碍普遍存在的群体，并直接将R01支持的三项调查结果转化为对北卡罗来纳州监狱系统做法的修改。根据他的调查，北卡罗来纳州监狱系统采用了抗逆转录病毒自我药物治疗，而不是普遍的直接观察治疗，转向自愿选择退出艾滋病毒吸入物检测，并为感染艾滋病毒的获释人员开发了新的过渡性护理模式。此外，沃尔在教授和指导新的研究人员方面有很好的记录，支持被指导者获得奖项和第一作者的出版物，以及这些有才华的研究人员的独立性。指导计划/环境：这项申请将利用北卡罗来纳大学广泛的培训资源，包括艾滋病研究中心(CFAR)、以公共卫生学院为基础的K30培训计划、医学院医学博士/博士计划和北卡罗来纳大学传染病研究奖学金--Wohl博士深入参与了每一个项目。作为北卡罗来纳大学CFAR监狱工作组的创始人和联席主任，北卡罗来纳大学艾滋病临床试验股的现场负责人，以及北卡罗来纳大学艾滋病培训和教育中心(ATEC)的主任，Wohl博士在接触和指导北卡罗来纳大学内外的学生、研究员和初级教员方面处于有利地位。随着对导师的需求增加，沃尔博士建议接受正式和非正式的指导，以便进一步发展成为一名导师。此外，为了更好地服务于他的主管人员并提高自己的工作效率，他寻求这一奖项，以加强和提高他的数据收集和分析技能，包括定性和定量数据收集和分析。研究计划：Wohl博士和他的合作者已经建立了成熟的研究基础设施，包括建立感染艾滋病毒和未感染艾滋病毒的监狱获释人员队列，以及他与监狱系统、公共卫生实体和其他研究小组的合作关系，作为一个平台，为指导研究提供充足的机会。在整个艾滋病毒护理级联过程中，仍有一些非常重要的问题需要回答，包括：以尊重个人自主权的方式进行艾滋病毒筛查和与监狱护理挂钩的最佳方法是什么？感染艾滋病毒的囚犯在被监禁期间在多大程度上受到照顾？能否克服释放后与艾滋病毒护理和服务挂钩的顽固的个人障碍(例如，药物滥用、精神健康障碍、缺乏动力)和结构性障碍(例如，贫穷、歧视、耻辱)？如果可以，如何克服？K24的支持将允许Wohl博士有时间从事他的研究的自然延伸的工作，并为学员研究提供丰富的机会，同时节省时间支持他对导师的投入。

DESCRIPTION (provided by applicant): David Alain Wohl, MD, an Associate Professor in the Division of Infectious Diseases at the University of North Carolina (UNC), submits this application for a K24 Mid-Career award. The purpose of the K24 is to enable recipients to: a) Devote more time to augment their capabilities in Patient-Oriented Research (POR); and b) Provide mentoring to new clinical investigators in the conduct of POR. Dr. Wohl is a nationally recognized thought-leader in HIV clinical research - particularly that exploring the nexus between incarceration and HIV. In this application he proposes to develop skills that will serve his future work in this significant area of research including qualitative data collection and analysis methodology, higher-level analytical techniques, and strategies for effective leadership. He will expand an established record of mentorship to develop greater capacity and research opportunities in order to foster the research careers of early investigators. Candidate: Dr. Wohl has been a highly productive HIV clinical researcher and has established UNC as a major center for HIV-related corrections research. Since 2003, he has been continuously NIH-funded to conduct research aiming to optimize HIV detection and care for people involved in the criminal justice system, a population with prevalent substance abuse and mental health disorders, and has directly translated the findings of three R01-supported investigations into modification of practice in the NC prison system. Based on his investigations, the NC prison system has adopted antiretroviral self-medication instead of universal directly observed therapy, shifted to voluntary opt-out HIV testing on intake, and developed new transitional care models for HIV-infected releasees. Further, Dr. Wohl has a strong record of teaching and mentorship of new investigators, supporting procurement of awards and first-authored publications by mentees, as well as independence of these talented investigators. Mentoring Plan/Environment: This application will leverage the extensive training resources at UNC including the Center for AIDS Research (CFAR), the School of Public Health-based K30 training program, the School of Medicine MD/PhD program, and the UNC Infectious Diseases research fellowship - each of which Dr. Wohl is deeply involved with. As a founder and Co-Director of the UNC CFAR Prison Working Group, Site Leader of the UNC AIDS Clinical Trials Unit, and Director of the NC AIDS Training and Education Center (ATEC), Dr. Wohl is well-positioned to access and mentor students, fellows and junior faculty within and beyond UNC. As requests for mentoring have increased, Dr. Wohl proposes to receive formal and informal guidance to develop further as a mentor. Further, to better serve those he supervises and enhance his own productively, he seeks this award to strengthen and enhance his data collection and analytical skills including qualitative and quantitative data collection and analysis. Research Plan: The established research infrastructure Dr. Wohl and his collaborators have built, including the establishment of cohorts of HIV-infected and -uninfected prison releasees, and his collaborative relationships with the prison system, public health entities, and other research groups, serve as a platform to provide ample opportunities for mentee research. There remain a number of highly significant questions to be answered across the cascade of HIV care, including: What are the best methods to conduct HIV screening and linkage to care in prison in a manner respects individual autonomy? To what extent are HIV-infected prisoners engaged in care while incarcerated? Can intransigent individual (e.g., substance abuse, mental health disorders, low motivation) and structural (e.g., poverty, discrimination, stigma) obstacles to linkage to HIV care and services after release be surmounted, and if so, how? The K24 support will permit Dr. Wohl the time to pursue work that are natural extensions of his research, and provide rich opportunities for mentee research while protecting time to support his devotion to mentorship.