Mentored Scientist Award

Populations in sub-Saharan Africa are the most mobile in the world: up to 80% of households have at least one migrant member. Mobility is a risk factor for HIV transmission, but its impact on medication adherence for persons living with HIV (PLHIV) remains poorly understood. We will leverage the ongoing study Understanding Mobility and Risk in SEARCH Communities (RO1MH104132), which has followed over 1100 PLHIV from 12 East African communities since 2016, to study this association.

Populations in sub-Saharan Africa are the most mobile in the world: up to 80% of households have at least one migrant member. Mobility is a risk factor for HIV transmission, but its impact on medication adherence for persons living with HIV (PLHIV) remains poorly understood. We will leverage the ongoing study Understanding Mobility and Risk in SEARCH Communities (RO1MH104132), which has followed over 1100 PLHIV from 12 East African communities since 2016, to study this association.

The poor cytotoxicity of CD8+ T cells against cells harboring reactivated HIV which have a low expression of viral antigens presents a profound barrier to the success of HIV cure strategies. Discovering new pathways that safely enhance the function of cytotoxic T-lymphocytes (CTLs) has immense potential for harnessing CTLs for the ‘shock and kill’ approach. While in a quiescent state, HIV-infected resting CD4+ T cells do not express sufficient HIV antigens and, thus, are not targeted by CTLs.

The poor cytotoxicity of CD8+ T cells against cells harboring reactivated HIV which have a low expression of viral antigens presents a profound barrier to the success of HIV cure strategies. Discovering new pathways that safely enhance the function of cytotoxic T-lymphocytes (CTLs) has immense potential for harnessing CTLs for the ‘shock and kill’ approach. While in a quiescent state, HIV-infected resting CD4+ T cells do not express sufficient HIV antigens and, thus, are not targeted by CTLs.

Considerable progress in the recognition, diagnosis, and treatment of HIV has led to a significant increase in the life expectancy of this population. With this change, however, HIV+ individuals are at higher risk of developing certain co-morbidities including cardiovascular disease (CVD). HIV infection has emerged as an independent risk factor for left ventricular diastolic dysfunction (DD), predisposing these individuals to chronic illnesses including atrial fibrillation, pulmonary hypertension, and heart failure with preserved ejection fraction (HFpEF).

Considerable progress in the recognition, diagnosis, and treatment of HIV has led to a significant increase in the life expectancy of this population. With this change, however, HIV+ individuals are at higher risk of developing certain co-morbidities including cardiovascular disease (CVD). HIV infection has emerged as an independent risk factor for left ventricular diastolic dysfunction (DD), predisposing these individuals to chronic illnesses including atrial fibrillation, pulmonary hypertension, and heart failure with preserved ejection fraction (HFpEF).

In many countries with high HIV prevalence, there exists extensive stigma and discrimination against sexual minorities. In South Africa, national HIV prevention programs have largely failed to tailor HIV testing services to these marginalized, key populations, including Men who have Sex with Men (MSM). As a result, MSM have some of the highest HIV prevalence estimates in the country (33.9%) and are not testing at rates commensurate with their risk.

In many countries with high HIV prevalence, there exists extensive stigma and discrimination against sexual minorities. In South Africa, national HIV prevention programs have largely failed to tailor HIV testing services to these marginalized, key populations, including Men who have Sex with Men (MSM). As a result, MSM have some of the highest HIV prevalence estimates in the country (33.9%) and are not testing at rates commensurate with their risk.

Pneumonia is the leading cause of death amongst HIV positive persons in Uganda and other resource limited countries. Antimicrobial resistance is rising at an alarming rate throughout the world and complicating the treatment of both pneumonia and tuberculosis. Understanding region-specific microbial causes of pneumonia and their drug resistance attributes is critical for developing successful empiric therapeutic algorithms.

Pneumonia is the leading cause of death amongst HIV positive persons in Uganda and other resource limited countries. Antimicrobial resistance is rising at an alarming rate throughout the world and complicating the treatment of both pneumonia and tuberculosis. Understanding region-specific microbial causes of pneumonia and their drug resistance attributes is critical for developing successful empiric therapeutic algorithms.