The candidate is an instructor in infectious diseases at Columbia University Medical Center (CUMC), and her long-term goal is to become an independent investigator studying the interaction between social and structural factors and HIV treatment outcomes in international and domestic Latino communities. Her short-term goals are to expand her experience in international research, refine her skills in biostatistical methods, and further the understanding of the interaction between mobility and HIV care outcomes in mobile communities. She has an extensive track record of basic science and clinical research, and has been building the framework for this project in the Dominican Republic (DR) for the past four years. CUMC sits at one end of the New York-Dominican Republic air-bridge, a pattern of circular migration between the two countries. Our goal is to understand the interactions between mobility and HIV treatment amongst Dominicans in our own HIV treatment center in Washington Heights, New York (WH), and in Santo Domingo (SD), DR. Our primary hypothesis is that individual mobility leads to interruptions in antiretroviral therapy, and, in turn, to antiretroviral treatment failure. We will undertake a qualitative assessment of mobility using comparative ethnography in the Dominican pafient population at both sites (WH and SD), and use that knowledge to develop a community-appropriate and evidence based measure of mobility. We will then conduct case-control studies to assess mobility as a predictor of treatment failure at both sites. We will also examine differences in those failing with and without antiretroviral drug resistance. This research will take place at CUMC and collaborafing institutions in the DR with the mentorship of Dr. Scott Hammer, an internationally recognized HIV investigator. Dr. Jennifer Hirsch, a specialist in HIV and migration, and Dr. Louise Kuhn, an expert in HIV treatment outcomes in resource-limited settings. CUMC serves the largest community of Dominicans outside of the DR, and the collaborating institutions in the DR have long histories of successful clinical research and existing research initiatives with CUMC.

Public Health Relevance

By using multidisciplinary techniques to examine the interaction between mobility and HIV treatment outcomes on both sides of the New York-Dominican Republic airbridge, the researchers will generate novel findings of significance to both countries and to other regions where circular migration is common. The research may also be relevant to the impact of mobility on treatment outcomes of other chronic illnesses.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Mentored Patient-Oriented Research Career Development Award (K23)
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Acquired Immunodeficiency Syndrome Research Review Committee (AIDS)
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Bacon, Melanie C
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University of Texas Health Science Center San Antonio
Internal Medicine/Medicine
Schools of Medicine
San Antonio
United States
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Taylor, Barbara S; So-Armah, Kaku; Tate, Janet P et al. (2017) HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer. J Acquir Immune Defic Syndr 75:500-508
Taylor, Barbara S; Liang, Yuanyuan; Garduño, L Sergio et al. (2014) High risk of obesity and weight gain for HIV-infected uninsured minorities. J Acquir Immune Defic Syndr 65:e33-40
Taylor, Barbara S; Reyes, Emily; Levine, Elizabeth A et al. (2014) Patterns of geographic mobility predict barriers to engagement in HIV care and antiretroviral treatment adherence. AIDS Patient Care STDS 28:284-95
Lanham, Holly Jordan; Leykum, Luci K; Taylor, Barbara S et al. (2013) How complexity science can inform scale-up and spread in health care: understanding the role of self-organization in variation across local contexts. Soc Sci Med 93:194-202
Taylor, Barbara S; Chiasson, Mary Ann; Scheinmann, Roberta et al. (2012) Results from two online surveys comparing sexual risk behaviors in Hispanic, black, and white men who have sex with men. AIDS Behav 16:644-52
Myers, Julie E; Taylor, Barbara S; Rojas Fermín, Rita A et al. (2012) Transmitted drug resistance among antiretroviral-naive patients with established HIV type 1 infection in Santo Domingo, Dominican Republic and review of the Latin American and Caribbean literature. AIDS Res Hum Retroviruses 28:667-74
Taylor, Barbara S; Garduno, L Sergio; Reyes, Emily V et al. (2011) HIV care for geographically mobile populations. Mt Sinai J Med 78:342-51
Taylor, Barbara S; Hunt, Gillian; Abrams, Elaine J et al. (2011) Rapid development of antiretroviral drug resistance mutations in HIV-infected children less than two years of age initiating protease inhibitor-based therapy in South Africa. AIDS Res Hum Retroviruses 27:945-56