Candidate: Maria L Alcaide received her medical degree from The Universidad Autonoma de Madrid, Spain and completed her Internal Medicine residency and Fellowship in Infectious Diseases at Jackson Memorial Hospital in Miami. She is Assistant Professor of Medicine at the Division of Infectious Diseases at the University of Miami Miller School of Medicine. Mentors: Dr. Deborah Jones is Research Associate Professor in the Department of Psychiatry &Behavioral Sciences at the University of Miami Miller School of Medicine with extensive experience in behavioral research interventions to reduce sexual risk in HIV infected men and women domestically and internationally. Dr. Fischl is Professor of Medicine at the University of Miami Miller School of Medicine and an acknowledged world leader in the field of HIV clinical research. Drs. Jones and Fischl both have extensive mentorship experience and will ensure the success of Dr. Alcaide's training, proposed studies and career development. Research: Intravaginal practices (VP) are common among women in sub-Saharan and implicated in the development of bacterial vaginosis (BV) and HIV transmission. Building on pilot study results from Zambia obtained by Dr. Alcaide (R01HD058481S~ Alcaide et al., 2011), this study will develop and test a bio-behavioral intervention designed to decrease VP. The pilot study tested a bio-behavioral intervention and results support its effectiveness in reducing both VP and BV over 8 weeks. The current proposal will evaluate the long term impact of a bio-behavioral intervention targeting VP among HIV infected women in Lusaka, Zambia, and assess the relative contribution of VP and BV to genital inflammation and HIV shedding.
Aim 1. 1 will develop and evaluate the long term impact of a bio-behavioral intervention to decrease VP.
Aim 1. 2 will compare rates of BV, genital inflammatory markers and HIV shedding in HIV infected women engaging in VP with and without BV.
Aim 1. 3 will compare BV, genital inflammatory markers and HIV genital shedding in HIV infected women participating in the intervention or control conditions. This innovative bio-behavioral interventio designed to reduce VP has the potential to have a significant public health impact in the Zambian community and relevance for other sub-Saharan countries with high prevalence of both VP and HIV infection. The K23 award mechanism will allow Dr. Alcaide to obtain new skills in clinical and behavioral research, conduct a study of VP in Zambia, develop an R01 application with study results, and become established as an independent clinical investigator.

Public Health Relevance

The long term goal of this proposal is to decrease transmission rates of HIV by decreasing the harmful behavior of intravaginal practices and the associated consequences such as bacterial vaginosis, genital inflammation and HIV shedding. Our results will clarify the pathway underlying the relationship between VP and HIV transmission and propose a bio-behavioral intervention to decrease VP.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
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Mofenson, Lynne M
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University of Miami School of Medicine
Internal Medicine/Medicine
Schools of Medicine
Coral Gables
United States
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Alcaide, Maria L; Rodriguez, Violeta J; Fischl, Margaret A et al. (2017) Addressing intravaginal practices in women with HIV and at-risk for HIV infection, a mixed methods pilot study. Int J Womens Health 9:123-132
Alcaide, Maria L; Ramlagan, Shandir; Rodriguez, Violeta J et al. (2017) Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa. AIDS Behav 21:2135-2140
Peltzer, Karl; Weiss, Stephen M; Soni, Manasi et al. (2017) A cluster randomized controlled trial of lay health worker support for prevention of mother to child transmission of HIV (PMTCT) in South Africa. AIDS Res Ther 14:61
Alcaide, Maria L; Chisembele, Maureen; Malupande, Emeria et al. (2017) A bio-behavioral intervention to decrease intravaginal practices and bacterial vaginosis among HIV infected Zambian women, a randomized pilot study. BMC Infect Dis 17:338
Strbo, Natasa; Alcaide, Maria L; Romero, Laura et al. (2016) Loss of Intra-Epithelial Endocervical Gamma Delta (GD) 1 T Cells in HIV-Infected Women. Am J Reprod Immunol 75:134-45
Alcaide, Maria L; Feaster, Daniel J; Duan, Rui et al. (2016) The incidence of Trichomonas vaginalis infection in women attending nine sexually transmitted diseases clinics in the USA. Sex Transm Infect 92:58-62
Alcaide, Maria L; Strbo, Natasa; Romero, Laura et al. (2016) Bacterial Vaginosis Is Associated with Loss of Gamma Delta T Cells in the Female Reproductive Tract in Women in the Miami Women Interagency HIV Study (WIHS): A Cross Sectional Study. PLoS One 11:e0153045
Alcaide, Maria L; Cook, Ryan; Chisembele, Maureen et al. (2016) Determinants of intravaginal practices among HIV-infected women in Zambia using conjoint analysis. Int J STD AIDS 27:453-61
Alcaide, Maria L; Chisembele, Maureen; Malupande, Emeria et al. (2015) A cross-sectional study of bacterial vaginosis, intravaginal practices and HIV genital shedding; implications for HIV transmission and women's health. BMJ Open 5:e009036
Alcaide, Maria L; Chisembele, Maureen; Mumbi, Miriam et al. (2014) Examining targets for HIV prevention: intravaginal practices in Urban Lusaka, Zambia. AIDS Patient Care STDS 28:121-7

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