This K24 proposal builds upon a decade of clinical and epidemiologic research in Zambia, where the candidate - Benjamin Chi, MD, MSc - has lived since 2003. The application is timed to correspond with an important midcareer transition, as Dr. Chi returns to the U.S. in July 2015 to coordinate his ongoing global research and training activities from the University of North Carolina at Chapel Hill (UNC). Dr. Chi's career to date has focused on clinical research and effectiveness studies. Through this K24 award, he seeks formal training in the burgeoning field of implementation research. This work will greatly augment his current portfolio in patient- oriented research, allowing him to further explore facilitators and barriers to the successful implementation of proven interventions. He has recruited a multidisciplinary faculty to collaborate and support him in this endeavor, one that reflects the breadth and depth of UNC's resources in implementation research. Candidate: Dr. Chi is a recognized thought leader in the prevention of mother-to-child HIV transmission (PMTCT). He has led high-impact clinical trials and effectiveness studies, and seeks to complement these skills by developing capacity in implementation research. Despite growing investment from NIH and others, there is currently a paucity of such expertise in the field of PMTCT. The rigorous methods developed in domestic implementation research have not yet translated widely in international work, a gap this application aims to address. Mentoring Plan/Environment: Dr. Chi has an established track record in research training, including leadership of two NIH-funded fellowship programs. Because of competing administrative responsibilities, however, his available time for mentorship has become limited in recent years. With K24 support, he will rededicate his efforts in the mentoring of advanced trainees (e.g., postdoctoral fellows, junior faculty) as they look to become independently funded investigators. He will leverage UNC's extensive resources to accomplish this goal, including NIH-funded centers and training programs, networks and collaborations, and global health institutes and departments. Research Plan: Dr. Chi proposes to study the implementation of new point-of-care (POC) technologies for early infant diagnosis of HIV (EID). POC assays hold great promise, but many factors regarding their implementation - including their integration into existing services - are yet unknown. Built upon the framework of a soon-to-begin randomized NIH-funded study, Dr. Chi will identify barriers to EID uptake and measure the fidelity of diagnostic service implementation (i.e., the extent to which the intervention is delivered as designed), comparing POC-based services to the current standard of HIV DNA PCR testing. Using data obtained from this trial, he will model the population impact of POC EID and other, related interventions to determine optimal strategies for rolling-out EID services across different settings. This plan offers a framework for Dr. Chi's training in implementation research while also providing a platform for mentoring future investigators committed to patient-oriented research.

Public Health Relevance

After a decade of living and working in Zambia, the candidate for this midcareer development award will return to the U.S. in July 2015. In this application, he proposes a plan to develop new skills in the burgeoning field of implementation research that will expand his work in the prevention of mother-to-child transmission of HIV. This award will also provide protected time for the mentorship of junior investigators, allowing the candidate to guide and advise the next generation of researchers committed to global health.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AI120796-03
Application #
9433620
Study Section
Acquired Immunodeficiency Syndrome Research Review Committee (AIDS)
Program Officer
Miller, Judith A
Project Start
2016-02-03
Project End
2021-01-31
Budget Start
2018-02-01
Budget End
2019-01-31
Support Year
3
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Kopp, D M; Tang, J H; Bengtson, A M et al. (2018) Continence, quality of life, and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study. BJOG :
Chi, Benjamin H; Mutale, Wilbroad; Winston, Jennifer et al. (2018) Infant Human Immunodeficiency Virus-free Survival in the Era of Universal Antiretroviral Therapy for Pregnant and Breastfeeding Women: A Community-based Cohort Study From Rural Zambia. Pediatr Infect Dis J 37:1137-1141
Chi, Benjamin H; Rosenberg, Nora E; Mweemba, Oliver et al. (2018) Involving both parents in HIV prevention during pregnancy and breastfeeding. Bull World Health Organ 96:69-71
Ford, Catherine; Chibwesha, Carla J; Winston, Jennifer et al. (2018) Women's decision-making and uptake of services to prevent mother-to-child HIV transmission in Zambia. AIDS Care 30:426-434
Castillo, Marcela C; Vwalika, Bellington; Stoner, Marie C D et al. (2018) Risk of stillbirth among Zambian women with a prior cesarean delivery. Int J Gynaecol Obstet 143:360-366
Vinikoor, Michael J; Zyambo, Zude; Muyoyeta, Monde et al. (2018) Point-of-Care Urine Ethyl Glucuronide Testing to Detect Alcohol Use Among HIV-Hepatitis B Virus Coinfected Adults in Zambia. AIDS Behav 22:2334-2339
Vinikoor, Michael J; Sinkala, Edford; Chilengi, Roma et al. (2017) Impact of Antiretroviral Therapy on Liver Fibrosis Among Human Immunodeficiency Virus-Infected Adults With and Without HBV Coinfection in Zambia. Clin Infect Dis 64:1343-1349
Vwalika, Bellington; Stoner, Marie C D; Mwanahamuntu, Mulindi et al. (2017) Maternal and newborn outcomes at a tertiary care hospital in Lusaka, Zambia, 2008-2012. Int J Gynaecol Obstet 136:180-187
Barlow-Mosha, Linda; Angelidou, Konstantia; Lindsey, Jane et al. (2016) Nevirapine- Versus Lopinavir/Ritonavir-Based Antiretroviral Therapy in HIV-Infected Infants and Young Children: Long-term Follow-up of the IMPAACT P1060 Randomized Trial. Clin Infect Dis 63:1113-1121
Vinikoor, Michael J; Mulenga, Lloyd; Siyunda, Alice et al. (2016) Association between hepatitis B co-infection and elevated liver stiffness among HIV-infected adults in Lusaka, Zambia. Trop Med Int Health 21:1435-1441

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