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.

Public Health Relevance

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..

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Newcomer, Susan
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University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
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Evon, Donna M; Stewart, Paul W; Amador, Jipcy et al. (2018) A comprehensive assessment of patient reported symptom burden, medical comorbidities, and functional well being in patients initiating direct acting antiviral therapy for chronic hepatitis C: Results from a large US multi-center observational study. PLoS One 13:e0196908
Evon, D M; Amador, J; Stewart, P et al. (2018) Psychometric properties of the PROMIS short form measures in a U.S. cohort of 961 patients with chronic hepatitis C prescribed direct acting antiviral therapy. Aliment Pharmacol Ther 47:1001-1011
Rosen, David L; Grodensky, Catherine A; Miller, Anna R et al. (2018) Implementing a Prison Medicaid Enrollment Program for Inmates with a Community Inpatient Hospitalization. J Urban Health 95:149-158
Grodensky, Catherine A; Golin, Carol E; Pack, Allison P et al. (2018) Adaptation and delivery of a motivational interviewing-based counseling program for persons acutely infected with HIV in Malawi: Implementation and lessons learned. Patient Educ Couns 101:1103-1109
Widman, Laura; Golin, Carol E; Kamke, Kristyn et al. (2018) Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program. Am J Public Health 108:96-102
Evon, Donna M; Golin, Carol E; Ruffin, Rachel et al. (2017) Development and Pilot-Testing of a Cognitive Behavioral Coping Skills Group Intervention for Patients with Chronic Hepatitis C. Contemp Clin Trials Commun 6:85-96
Evon, Donna M; Golin, Carol E; Stewart, Paul et al. (2017) Patient engagement and study design of PROP UP: A multi-site patient-centered prospective observational study of patients undergoing hepatitis C treatment. Contemp Clin Trials 57:58-68
Wohl, David A; Golin, Carol E; Knight, Kevin et al. (2017) Randomized Controlled Trial of an Intervention to Maintain Suppression of HIV Viremia After Prison Release: The imPACT Trial. J Acquir Immune Defic Syndr 75:81-90
Widman, L; Golin, C E; Kamke, K et al. (2017) Feasibility and acceptability of a web-based HIV/STD prevention program for adolescent girls targeting sexual communication skills. Health Educ Res 32:343-352
Evon, Donna M; Golin, Carol E; Stoica, Teodora et al. (2017) What's Important to the Patient? Informational Needs of Patients Making Decisions About Hepatitis C Treatment. Patient 10:335-344

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