Candidate: I am an infectious diseases epidemiologist committed to reducing HIV incidence in resource- limited settings through combination HIV prevention. My career goal is to be an epidemiology professor with a robust combination HIV prevention research portfolio. As an epidemiologist with behavioral science exposure, I am well positioned to achieve this goal. However, to compete successfully for R01 funding, I would benefit from a brief period of mentored training and research. I have extensive experience in the design and analysis of behavioral research, but limited experience in the design and delivery of theory-driven behavioral interventions. In a two-year mentored phase, both my training and research activities will focus on cultivating skills for designing and delivering theory-driven behavioral intervention. I have assembled an exceptional team of mentors to support this goal: Dr. William C. Miller (primary mentor), Dr. Mina Hosseinipour (primary co- mentor), and Drs. Nuala McGrath, Carol Golin, and Suzanne Maman (co-mentors). All members of the team have prolific scientific accomplishments and extensive experience in the design, implementation and evaluation of combination HIV prevention approaches in sub-Saharan Africa. They are committed to supporting me and collaborating with each other. Mentored Phase Research (K99, years 1-2): In sub-Saharan Africa, strategies to increase HIV testing among men and engage them in HIV prevention, care, and treatment are urgently needed. Such engagement can have treatment benefits for HIV-infected men, prevention benefits for HIV-uninfected men, and treatment benefits for their HIV-infected female partners. Option B+, Malawi s program for providing immediate, lifelong combination antiretroviral therapy (cART) to all HIV-infected pregnant women at the time of diagnosis, is a promising setting for engaging male partners in care. Within Option B+, I will develop an intervention that uses contract partner notification to recruit male partners and then engage them in a couple-based intervention with their HIV-infected female partner (Aim 1). The intervention will be guided by formative research and the dyad-level Interdependence Theory and aimed at improving linkage to care for HIV-infected male partners, preventing HIV acquisition for HIV-uninfected male partners, and promoting cART retention for HIV-infected female partners. Independent Phase Research (R00, Years 3-5): I will conduct a randomized controlled trial (N=500 couples) to assess intervention effectiveness at one year. I will assess whether the intervention increases HIV testing and linkage to care among HIV-infected male sex partners (Aim 2); identifies HIV-discordant couples, and decreases the likelihood of HIV exposure for HIV- uninfected male sex partners (Aim 3); and improves cART retention and viral suppression for all female partners (Aim 4). Future Directions: The R00 results will inform an R01 with longer-term viral suppression and HIV-incidence outcomes. I will transition from a mentored postdoctoral research associate to an independent investigator capable of designing behavioral interventions and leading combination HIV prevention trials.

Public Health Relevance

Asking HIV-infected women in antenatal care to recruit their male partners to the clinic can have treatment benefits for HIV-infected male partners, prevention benefits for HIV-uninfected male partners, and treatment benefits for female partners. This is an application to develop an intervention to recruit male partners to the clinic and engage them in the care of their HIV-infected female partners and address their own HIV needs. This intervention will be evaluated for male and female HIV prevention, care, and treatment outcomes at one year.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Career Transition Award (K99)
Project #
1K99MH104154-01A1
Application #
8846733
Study Section
Special Emphasis Panel (ZMH1-ERB-K (07))
Program Officer
Allison, Susannah
Project Start
2015-03-01
Project End
2016-12-31
Budget Start
2015-03-01
Budget End
2015-12-31
Support Year
1
Fiscal Year
2015
Total Cost
$83,991
Indirect Cost
$6,222
Name
University of North Carolina Chapel Hill
Department
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Price, Joan T; Rosenberg, Nora E; Vansia, Dhrutika et al. (2018) Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi. J Acquir Immune Defic Syndr 77:53-63
Rosenberg, Nora E; Bhushan, Nivedita L; Vansia, Dhrutika et al. (2018) Comparing Youth-Friendly Health Services to the Standard of Care Through ""Girl Power-Malawi"": A Quasi-Experimental Cohort Study. J Acquir Immune Defic Syndr 79:458-466
Rosenberg, Nora E; Graybill, Lauren A; Wesevich, Austin et al. (2018) Individual, Partner, and Couple Predictors of HIV Infection among Pregnant Women in Malawi: A Case-Control Study. AIDS Behav 22:1775-1786
Hauser, Blake M; Miller, William C; Tweya, Hannock et al. (2018) Assessing Option B+ retention and infant follow-up in Lilongwe, Malawi. Int J STD AIDS 29:185-194
Chawla, Kashmira Satish; Rosenberg, Nora E; Stanley, Christopher et al. (2018) HIV and early hospital readmission: evaluation of a tertiary medical facility in Lilongwe, Malawi. BMC Health Serv Res 18:225
Kumwenda, Wiza; Kunyenje, Gregory; Gama, Jimmie et al. (2017) Information management in Malawi's prevention of Mother-to-Child Transmission (PMTCT) Program: Health workers' perspectives. Malawi Med J 29:306-310
Wesevich, Austin; Mtande, Tiwonge; Saidi, Friday et al. (2017) Role of male partner involvement in ART retention and adherence in Malawi's Option B+ program. AIDS Care 29:1417-1425
Phiri, Sam; Tweya, Hannock; van Lettow, Monique et al. (2017) Impact of Facility- and Community-Based Peer Support Models on Maternal Uptake and Retention in Malawi's Option B+ HIV Prevention of Mother-to-Child Transmission Program: A 3-Arm Cluster Randomized Controlled Trial (PURE Malawi). J Acquir Immune Defic Syndr 75 Suppl 2:S140-S148
Kopp, Dawn M; Tang, Jennifer H; Stuart, Gretchen S et al. (2017) Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study. Infect Dis Obstet Gynecol 2017:1475813
Rosenberg, Nora E; Graybill, Lauren A; Wesevich, Austin et al. (2017) The Impact of Couple HIV Testing and Counseling on Consistent Condom Use Among Pregnant Women and Their Male Partners: An Observational Study. J Acquir Immune Defic Syndr 75:417-425

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