Dr. Robert Choi is currently a Senior Fellow in the University of Washington's (UW) Division of Allergy and Infectious Disease. He has extensive international experience, including one year with Medicines Sans Frontieres in Darfur as a Medical Team Leader, and recently completed an MPH degree in epidemiology. Dr. Choi's primary goal is to build a career in global HIV/AIDS research. Through the IRSDA he will develop into an independent clinical investigator with expertise in molecular epidemiology and HIV mucosal immunity. His secondary goal is to teach and train future Kenyan investigators and in this way strengthen the collaborative research environment in Nairobi. Dr. Choi is committed to an academic career based in a developing nation, and plans to spend approximately 80% of his time in this setting. Although heterosexual contact is the primary mode of HIV transmission, the transmission rate per contact is low, suggesting that immune factors may mediate transmission risk. This proposal will be nested in an ongoing NIH-funded HIV-discordant couples study and will investigate the role of HIV-1 neutralizing mucosal IgA and IgG on genital shedding of HIV-1 (Aim 1) and HIV-1 transmission to uninfected partners (Aim 2).
The final aim will determine the correlates of IgA and IgG responses in HIV-1-infected individuals, including sexually transmitted diseases, bacterial vaginosis, innate factors, and CD4 count (Aim 3). During the award period, Dr. Choi will take formal didactic courses at the UW in epidemiology, biostatistics and immunology and have clinical activities at the Hope Center HIV Clinic in Nairobi one half-day per week. Dr. Carey Farquhar (Primary Mentor) and James Kiarie (On-site Mentor) are experts in conducting HIV-1 prevention research in Kenya and will oversee Dr. Choi's research project and career development. Theii- expertise in epidemiology and clinical HIV research methods will be complemented by input from Dr. Choi's Scientific Advisory Committee, comprised of Dr. Kristina Broliden, basic scientist, and Dr. Barbra Richardson, biostatistician. These 4 individuals will formally evaluate Dr. Choi's progress twice annually based on pre- determined milestones.

Public Health Relevance

This proposal will help us understand the complex interaction between humoral mucosal immunity, HIV-1 shedding in mucosal compartments, and altered HIV infectivity. Understanding this may contribute to development of novel HIV prevention strategies targeting both HIV-uninfected and HIV-infected individuals, such as vaccines and microbicides. Be referenced at this time;include a statement that one from the Registry will be used. Training in the Responsible Conduct of Research:

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZRG1-ICP2-B (51))
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Jessup, Christine
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University of Washington
Internal Medicine/Medicine
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Guthrie, Brandon L; Introini, Andrea; Roxby, Alison C et al. (2015) Depot Medroxyprogesterone Acetate Use Is Associated With Elevated Innate Immune Effector Molecules in Cervicovaginal Secretions of HIV-1-Uninfected Women. J Acquir Immune Defic Syndr 69:1-10
Soh, Jason; Rositch, Anne F; Koutsky, Laura et al. (2014) Individual and partner risk factors associated with abnormal cervical cytology among women in HIV-discordant relationships. Int J STD AIDS 25:315-24
Mackelprang, Romel D; Bosire, Rose; Guthrie, Brandon L et al. (2014) High rates of relationship dissolution among heterosexual HIV-serodiscordant couples in Kenya. AIDS Behav 18:189-93
Muiru, Anthony N; Guthrie, Brandon L; Bosire, Rose et al. (2013) Incident HSV-2 infections are common among HIV-1-discordant couples. J Infect Dis 208:1093-101
Choi, Robert Y; Levinson, Pauline; Guthrie, Brandon L et al. (2012) Cervicovaginal HIV-1-neutralizing immunoglobulin A detected among HIV-1-exposed seronegative female partners in HIV-1-discordant couples. AIDS 26:2155-63
Conley, N Jeanne; Pavlinac, Patricia B; Guthrie, Brandon L et al. (2012) Distance from home to study clinic and risk of follow-up interruption in a cohort of HIV-1-discordant couples in Nairobi, Kenya. PLoS One 7:e43138
Levinson, Pauline; Choi, Robert Y; Cole, Amy L et al. (2012) HIV-neutralizing activity of cationic polypeptides in cervicovaginal secretions of women in HIV-serodiscordant relationships. PLoS One 7:e31996
Choi, Robert Y; Fowke, Keith R; Juno, Jennifer et al. (2012) C868T single nucleotide polymorphism and HIV type 1 disease progression among postpartum women in Kenya. AIDS Res Hum Retroviruses 28:566-70
Guthrie, Brandon L; Choi, Robert Y; Liu, Amy Y et al. (2011) Barriers to antiretroviral initiation in HIV-1-discordant couples. J Acquir Immune Defic Syndr 58:e87-93
Guthrie, Brandon L; Choi, Robert Y; Bosire, Rose et al. (2010) Predicting pregnancy in HIV-1-discordant couples. AIDS Behav 14:1066-71