Pilot Award

Methods to improve accuracy in self-reported sexual behavior are critical in reducing errors that impede accurate assessment of intervention outcomes and prevalence estimates of HIV-related risk. Research findings to date provide abundant empirical evidence that reliability and validity of self-reported sexual behavior is a major problem. Scientific models of the survey question-answer process specify question comprehension as a necessary precursor to enhancing data quality.

Methods to improve accuracy in self-reported sexual behavior are critical in reducing errors that impede accurate assessment of intervention outcomes and prevalence estimates of HIV-related risk. Research findings to date provide abundant empirical evidence that reliability and validity of self-reported sexual behavior is a major problem. Scientific models of the survey question-answer process specify question comprehension as a necessary precursor to enhancing data quality.

The Women's Interagency HIV Study (WIHS) is a longitudinal cohort study of women with HIV, and a risk-set match control group; the women enrolled are primarily African American and Latina, with a small number of Asian and Caucasian non-Hispanic women. In Fall of 2011, the WIHS National Community Advisory Board (NCAB) requested to receive their individual estimates of ancestry admixture that are being used as covariates in genomic studies.

The increasing call for community-level evaluation of "combination HIV prevention" (packages of our best evidence-based HIV prevention interventions) has brought to the forefront the need to develop novel methods of both evaluating these combinations of interventions in aggregate and estimating the relative contributions of individual components of the combined intervention. However, such comprehensive methods do not exist.

The Women's Interagency HIV Study (WIHS) is a longitudinal cohort study of women with HIV, and a risk-set match control group; the women enrolled are primarily African American and Latina, with a small number of Asian and Caucasian non-Hispanic women. In Fall of 2011, the WIHS National Community Advisory Board (NCAB) requested to receive their individual estimates of ancestry admixture that are being used as covariates in genomic studies.

The increasing call for community-level evaluation of "combination HIV prevention" (packages of our best evidence-based HIV prevention interventions) has brought to the forefront the need to develop novel methods of both evaluating these combinations of interventions in aggregate and estimating the relative contributions of individual components of the combined intervention. However, such comprehensive methods do not exist.

Chronic immune activation is a significant determinant of HIV-mediated CD4+ T cell loss and disease progression. Despite effective viral suppression, chronic inflammation persists at levels higher than in uninfected people, yet the inflammatory stimuli and the mechanisms by which inflammation persists and promotes disease pathology are not completely understood. Many mechanisms likely contribute to chronic immune activation including persistent antigenemia, depletion of T regulatory cells (Tregs), and stimulation of toll-like receptors.

My research has consistently focused on the effects of poverty and of social/cultural context on the health of our most disadvantaged youth, particularly homeless youth in San Francisco and street children in Kisumu, Kenya. Through my work in San Francisco since 2001, I demonstrated the feasibility of longitudinal epidemiological work with street youth, demonstrated the role of street culture, social networks and race in HIV risk of street youth, and developed a community collaborative project for street-based STI testing of street youth.

Chronic immune activation is a significant determinant of HIV-mediated CD4+ T cell loss and disease progression. Despite effective viral suppression, chronic inflammation persists at levels higher than in uninfected people, yet the inflammatory stimuli and the mechanisms by which inflammation persists and promotes disease pathology are not completely understood. Many mechanisms likely contribute to chronic immune activation including persistent antigenemia, depletion of T regulatory cells (Tregs), and stimulation of toll-like receptors.

My research has consistently focused on the effects of poverty and of social/cultural context on the health of our most disadvantaged youth, particularly homeless youth in San Francisco and street children in Kisumu, Kenya. Through my work in San Francisco since 2001, I demonstrated the feasibility of longitudinal epidemiological work with street youth, demonstrated the role of street culture, social networks and race in HIV risk of street youth, and developed a community collaborative project for street-based STI testing of street youth.