Pilot Award

A key challenge of large-scale intervention trials is to adequately describe the social, cultural and operational factors that influence study findings. Qualitative research methods are particularly useful for elucidating the processes through which such trials may affect primary clinical outcomes through social and behavioral change at the community level. This pilot award would launch the qualitative evaluation of a large "test and treat" intervention, the Sustainable East Africa Research in Community Health (SEARCH) trial.

As the prevalence of metabolic syndrome and obesity rises, and as more effective HCV treatments become available, fatty liver disease will likely become a leading cause of liver disease in persons living with HIV. The purpose of this study is to determine the association of metabolic, host genetic, and viral factors with hepatic steatosis (Aim 1) and hepatic fibrosis (Aim 2) in HIV-infected adults with and without HCV coinfection.

As the prevalence of metabolic syndrome and obesity rises, and as more effective HCV treatments become available, fatty liver disease will likely become a leading cause of liver disease in persons living with HIV. The purpose of this study is to determine the association of metabolic, host genetic, and viral factors with hepatic steatosis (Aim 1) and hepatic fibrosis (Aim 2) in HIV-infected adults with and without HCV coinfection.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

This one-year study addresses a neglected topic in HIV research in Africa: the HIV prevention needs of female migrants. The study will address critical gaps in research on methods to obtain valid probability based samples of migrant women and to estimate HIV prevalence in this population at high HIV acquisition and transmission risks. It provides data needed to enhance the study "Identifying Opportunities for HIV Prevention Among Female Migrants in Western Kenya" (K01MH093205-02, Camlin), a qualitative study of factors that facilitate HIV risks among female migrants.

HIV treatment can improve health and longevity and prevent transmission to sexual and injection drug contacts of persons with HIV. However, realizing the benefits of treatment requires consistent engagement in clinical care and adherence to anti-retroviral medication. Both HIV infection and aging are associated with neurocognitive decline. There may also be synergistic effects between HIV infection and aging that accelerate declines in cognitive function. Cognitive impairment may limit individuals? ability to engage in care, particularly in populations where co-morbidities are common.

HIV treatment can improve health and longevity and prevent transmission to sexual and injection drug contacts of persons with HIV. However, realizing the benefits of treatment requires consistent engagement in clinical care and adherence to anti-retroviral medication. Both HIV infection and aging are associated with neurocognitive decline. There may also be synergistic effects between HIV infection and aging that accelerate declines in cognitive function. Cognitive impairment may limit individuals? ability to engage in care, particularly in populations where co-morbidities are common.

There is a fundamental lack of knowledge in identifying HIV infected individuals at high risk of fracture, and determining the effectiveness of treatment. Osteoporosis is usually diagnosed using DXA that provides an estimate of areal bone mineral density (BMD) computed for skeleton sites prone to fracture such as the femoral neck and the lumbar vertebrae.

There is a fundamental lack of knowledge in identifying HIV infected individuals at high risk of fracture, and determining the effectiveness of treatment. Osteoporosis is usually diagnosed using DXA that provides an estimate of areal bone mineral density (BMD) computed for skeleton sites prone to fracture such as the femoral neck and the lumbar vertebrae.

HIV infection can result in a breakdown in intestinal immunity associated with the translocation of immunostimulatory microbial products from the gut lumen to systemic circulation, which initiates and sustains the persistent inflammation that drives progression to AIDS ¹ . In particular, we and others have shown that HIV infection induces a significant loss of IL-17-producing cells, including TH17 cells, that are critical for maintaining the mucosal barrier ^2,3 .