Mentoring and Patient Oriented Research at the Nexus of Unhealthy Alcohol Use and HIV

艾滋病毒感染者（PWH）中不健康的酒精使用对艾滋病毒护理的保留产生有害影响 连续性，增加了艾滋病毒传播的风险行为，使年龄相关的管理复杂化， 并发症和增加死亡率。我是一名普通内科医生和临床艾滋病专家。我的研究生涯 在过去的14年里，我们一直专注于艾滋病毒和酒精使用的关系。我的研究和奖学金 有助于了解威尔斯亲王医院酗酒的流行病学和临床后果， 以及对威尔斯亲王医院，特别是妇女，不健康酒精使用的干预措施进行调整和测试。我 寻求这个K24中期职业研究者奖，以1）扩展我以患者为导向的研究技能和经验 在实施研究中，为了严格实施基于证据的酒精干预措施， 临床和社区环境，使我能够扩大我的病人为导向的干预研究，从试验 从效率到有效性和实施;以及2）增加辅导时间，加强我的辅导， 领导技能，从而扩大初级教师和学员追求研究事业的干部 专注于酒精和艾滋病我将通过教学法、培训、直接经验和 在实施研究、指导和领导力发展方面得到专家的指导。贯穿本 奖励期我将与学员密切合作，根据他们的价值观制定个人发展计划 和目标，作为他们训练活动的蓝图。该奖项中提出的新研究 将利用NIAAA资助的酒精研究联盟的现有资源和基础设施 HIV（HIV），嵌套在CFAR综合临床系统网络（CNICS）中，这是一个多中心临床队列 在美国的8个HV诊所接受治疗的PWH。他正在测试一种酒精的有效性 治疗算法整合到三个艾滋病诊所。与实施研究合作者和受训者一起， 从建议的K24职业发展活动中获得的技能，我将使用混合方法来探索和 评估影响采用、实施和维持这一方法的多层次因素， 在艾滋病临床环境中的酒精治疗。这种混合方法的研究，其中包括深入访谈， 定量调查将为对执行研究感兴趣的受训人员提供一些机会 专注于酒精和艾滋病我有一个强大的研究基金的记录，是一个长期的调查员 与约翰霍普金斯艾滋病毒临床队列，艾滋病，和行为临床试验计划的妇女与 有感染艾滋病毒的风险。这些资源，再加上约翰霍普金斯强大的科学环境， 这是一个出色的平台，可以在酒精使用和艾滋病毒领域培训下一代调查人员。

Unhealthy alcohol use among persons with HIV (PWH) has deleterious effects on retention in the HIV Care Continuum, increases HIV transmission risk behaviors, complicates the management of age-related comorbidities and increases mortality. I am a general internist and clinical HIV specialist. My research career over the past 14 years has focused at the nexus of HIV and alcohol use. My research and scholarship have contributed to the understanding of the epidemiology and clinical consequences of alcohol use among PWH, and to the adaptation and testing of interventions for unhealthy alcohol use among PWH, particularly women. I seek this K24 Mid-Career Investigator Award to 1) Expand my patient oriented research skills and experience in implementation research, in order to rigorously implement evidence based alcohol interventions for PWH in clinical and community settings, allowing me to expand my patient oriented intervention research from trials of efficacy to effectiveness and implementation; and 2) increase mentoring time, enhance my mentoring and leadership skills, and thereby expand the cadre of junior faculty and trainees pursuing research careers focused on alcohol and HIV. I will accomplish these goals through didactics, training, direct experience and mentorship from experts in implementation research, mentoring and leadership development. Throughout this award period I will work closely with mentees to develop individual development plans tailored to their values and goals which will serve as a blue print for their training activities. The new research proposed in this award will capitalize on the existing resources and infrastructure of the NIAAA funded Alcohol Research Consortium in HIV (ARCH), nested in the CFAR Network of Integrated Clinical Systems (CNICS), a multi-site clinical cohort of PWH receiving care across 8 HV clinics in the United States. ARCH is testing the effectiveness of an alcohol treatment algorithm integrated into three HIV clinics. With implementation research collaborators and trainees, and skills gained from proposed K24 career development activities, I will use mixed methods to explore and evaluate multi-level factors that influence adoption, implementation and maintenance of this approach to alcohol treatment in HIV clinical settings. This mixed methods research, which includes in-depth interviews and quantitative surveys, will provide a number of opportunities for trainees interested in implementation research focused on alcohol and HIV. I have a strong record of research funding, and am a long-standing investigator with the Johns Hopkins HIV Clinical Cohort, ARCH, and a behavioral clinical trials program for women with and at risk of HIV. These resources, combined with the strong scientific environment at Johns Hopkins, serve as an outstanding platform to train the next generation of investigators in the areas of alcohol use and HIV.