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

描述（由申请人提供）：候选人：玛丽亚L Alcaide获得了她的医学学位，从大学自治德马德里，西班牙，并完成了她的内科住院医师和奖学金在迈阿密的杰克逊纪念医院传染病。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：Deborah Jones博士是迈阿密大学米勒医学院精神病学与行为科学系的研究副教授，在行为研究方面拥有丰富的经验 * 在国内和国际采取干预措施，减少艾滋病毒感染男女的性风险。Fischl博士是迈阿密大学米勒医学院的医学教授，也是HIV临床研究领域公认的世界领先者。Jones博士和Fischl博士都拥有丰富的指导经验，将确保Alcaide博士的培训、拟议学习和职业发展取得成功。 调研：阴道内实践（VP）在撒哈拉以南地区的妇女中很常见，并与细菌性阴道病（BV）和艾滋病毒传播的发展有关。基于Alcaide博士从赞比亚获得的试点研究结果（R 01 HD 058481 S ~ Alcaide等人，2011年），这项研究将开发和测试旨在降低VP的生物行为干预。初步研究测试了生物行为干预，结果支持其在8周内降低VP和BV的有效性。目前的提案将评估赞比亚卢萨卡艾滋病毒感染妇女中针对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。目标1.1将开发和评估生物行为干预对降低VP的长期影响。目的1.2将比较在有和没有BV的VP中进行的HIV感染妇女的BV、生殖器炎症标志物和HIV脱落率。目的1.3将比较参与干预或对照条件的HIV感染妇女的BV、生殖器炎症标志物和HIV生殖器脱落。这种旨在减少VP的创新生物行为干预有可能对赞比亚社区产生重大的公共卫生影响，并对VP和艾滋病毒感染率高的其他撒哈拉以南国家具有相关性。K23奖励机制将使Alcaide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R 01应用程序，并成为独立的临床研究者。

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.