This is a proposal for a midcareer investigator award in patient-oriented research (K24) for Dr. Carol Golin. Despite efforts to curb HIV spread, incidence continues to increase in the southern U.S. Behavioral programs that address risky sexual behavior and ARV adherence can improve HIV transmission-related health behaviors of individuals, but are limited. Interpersonal and community-level factors, such poverty, social norms, crime and incarceration rates, interpersonal stress, and dyadic capacity often drive or constrain vulnerability to HIV, and may impede effects of behavioral programs. There is an urgent need for a pipeline of beginning investigators, especially those from underrepresented groups, with the interest and skills to collaboratively address these factors. As Director of the UNC CFAR Social and Behavioral Science Core, Dr. Golin is increasingly called upon to mentor numerous promising young investigators seeking to work with her to obtain such skills. The proposed career development award will give Dr. Golin the dedicated time to expand and build her patient- oriented research in HIV/AIDS prevention by mentoring several talented junior colleagues at UNC in HIV prevention and adherence research. Dr.
Golin aims to create a formal UNC Program on HIV Prevention in the US South by achieving four immediate goals, to: 1) enhance her capacity to evaluate structural determinants of health and cost-effectiveness of HIV prevention intervention programs through formal and informal training and collaboration;2) extend her patient-oriented investigations (exploring the interface between motivation, self- efficacy, and risky sexual behavior) by examining the role of interpersonal and community-level determinants of the HIV epidemic in influencing the effectiveness of HIV prevention programs;3) evaluate the cost- effectiveness of the "Individuals Motivated to Participate and Adhere to Care and Treatment" (imPACT) HIV prevention program;and 4) enhance her capacity to provide effective and outstanding mentoring to junior investigators. The patient-oriented research proposed in this application, which provides a vehicle for career development for Dr. Golin and her mentees, will: 1) Examine the moderating effects of interpersonal and structural factors on the SafeTalk program's effectiveness among heterosexual HIV-infected individuals;2) Explore the views of heterosexual participants in the imPACT study and their social network members to assess dyadic and community factors that helped or impeded their use of adherence or safer sex strategies.;3) Evaluate the cost-effectiveness of the imPACT program;4) Explore potential neighborhood and dyadic contexts for HIV risk among HIV-negative women and their male partners living in high poverty, high HIV prevalence census tracts in in NC. Her long-term career objective is to grow the HIV Prevention Program she is developing to a fully established Center for creating, testing, and disseminating effective, comprehensive HIV prevention interventions for vulnerable communities throughout the Southeastern U.S.
This project will develop Dr. Carol Golin's mentoring career by providing her with training and protected time for mentoring activities with junior investigators pursuing patient-oriented research, particularly related to HIV prevention. The project will also take important formative steps in informing behavioral and structural HIV prevention programs in the Southeastern US. This project is highly relevant to public health because it will allow for the provision of high-quality mentoring to a new generation of researchers and provide a first step to enhance understanding of how interpersonal structural factors may have an impact on HIV risk reduction programs while optimizing program cost-effectiveness and toward creation of a formal UNC Program on Prevention of HIV in the Southern US..
|Roman Isler, M; Golin, C; Wang, J et al. (2016) Venues for Meeting Sex Partners and Partner HIV Risk Characteristics: HIV Prevention Trials Network (HPTN064) Women's HIV Seroincidence Study (ISIS). AIDS Behav 20:1208-18|
|Rosen, David L; Wohl, David A; Golin, Carol E et al. (2016) Comparing HIV Case Detection in Prison During Opt-In vs. Opt-Out Testing Policies. J Acquir Immune Defic Syndr 71:e85-8|
|Grodensky, Catherine A; Rosen, David L; Hino, Sayaka et al. (2016) Opt-Out HIV Testing of Inmates in North Carolina Prisons: Factors Associated with not Wanting a Test and not Knowing They Were Tested. AIDS Behav 20:859-69|
|Widman, Laura; Choukas-Bradley, Sophia; Noar, Seth M et al. (2016) Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis. JAMA Pediatr 170:52-61|
|Widman, Laura; Choukas-Bradley, Sophia; Helms, Sarah W et al. (2016) Adolescent Susceptibility to Peer Influence in Sexual Situations. J Adolesc Health 58:323-9|
|Khan, M R; Golin, C E; Friedman, S R et al. (2015) STI/HIV Sexual Risk Behavior and Prevalent STI Among Incarcerated African American Men in Committed Partnerships: The Significance of Poverty, Mood Disorders, and Substance Use. AIDS Behav 19:1478-90|
|White, Becky L; Walsh, Joan; Rayasam, Swati et al. (2015) What Makes Me Screen for HIV? Perceived Barriers and Facilitators to Conducting Recommended Routine HIV Testing among Primary Care Physicians in the Southeastern United States. J Int Assoc Provid AIDS Care 14:127-35|
|Rosen, David L; Golin, Carol E; Grodensky, Catherine A et al. (2015) Opt-out HIV testing in prison: informed and voluntary? AIDS Care 27:545-54|
|Evon, Donna M; Golin, Carol E; Bonner, Jason E et al. (2015) Adherence during antiviral treatment regimens for chronic hepatitis C: a qualitative study of patient-reported facilitators and barriers. J Clin Gastroenterol 49:e41-50|
|Bonner, Jason E; Esserman, Denise A; Golin, Carol E et al. (2015) Self-efficacy and adherence to antiviral treatment for chronic hepatitis C. J Clin Gastroenterol 49:76-83|
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