The long term objective of this proposal is to develop thought a cooperative agreement an adolescent Medicine Trial Network (ATN) that will enroll and retain adolescents ages 12 to 24 years in intervention research related to primary, secondary, and tertiary HIV/AIDS prevention studies. A research agenda will be developed by the Adolescent Medicine Leadership Group (AMLG) using behavioral, microbicidal, prophylactic, therapeutic and vaccine trails both independently and collaboration with existing networks. The majority of these studies will focus on collaboration with such networks as the HIV prevention Trails Network, HIV Vaccine Network, Pediatric and Adult AIDS Clinical Trails Groups, and the Community Programs for Clinical Research on AIDS to implement the ATN research agenda. The current application is to develop an Adolescent Medicine Treatment Unit (AMTU) that will enroll at least 75 HIV-infected and 125 HIV-uninfected youth ages 12 to 24 years into clinical trails as designated by the AMLG. The overarching goal of this proposal is to develop innovate strategies that combine behavior management and therapeutics to impact HIV disease in sexually active adolescents at multiple stages of health and care, particularly minority youth hardest hit by the HIV epidemic. Additionally, the growing population of patients perinatal transmitted HIV infection who have aged into the adolescent and young adult population require multifaceted evaluations of their behavior and biology. Regardless of their age at diagnosis, these youth with perinatal HIV infection face many of the same myriad psychosocial and developmental challenges as their sexually-infected peers but from the perspective of a long term chronic disease. As many of the perinatal infected youth become sexually active adolescents, they struggle with developmental issues that effect their medication and other health risks. The Modlin Report of the Office of AIDS Research describes the need to explore an effort at primary prevention that combines multiple strategies simultaneously focused on the goal of HIV prevention. For example, innovative behavior change combine with prophylactic microbicide and barriers in high risk HIV negative population would address the problem of HIV transmission from several approaches. With rear to therapeutic opportunity, adolescence may provide a potential for immune reconstruction unavailable in children or adults that may inform both traditional antiretroviral therapy approach as well as less traditional immune enhancement therapeutics. The etiology and implications of poor adherence, for which adolescents have great notoriety, is inadequately understood in HIV infection and requires new intervention strategies. Co- morbidities of sexually transmitted infections have been documented but the long term consequences of these infections requires further study. Finally, the communication to community organizations of prevention strategies that are successful and of strategies that fail is an essential component of that required work.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HD040505-03
Application #
6637414
Study Section
Special Emphasis Panel (ZHD1-DRG-D (02))
Program Officer
Nugent, Robert
Project Start
2001-04-16
Project End
2006-02-28
Budget Start
2003-03-01
Budget End
2004-02-29
Support Year
3
Fiscal Year
2003
Total Cost
$1,071,790
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Pediatrics
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
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Harper, Gary W; Bruce, Douglas; Hosek, Sybil G et al. (2014) Resilience processes demonstrated by young gay and bisexual men living with HIV: implications for intervention. AIDS Patient Care STDS 28:666-76
Harper, Gary W; Fernandez, Isabel M; Bruce, Douglas et al. (2013) The role of multiple identities in adherence to medical appointments among gay/bisexual male adolescents living with HIV. AIDS Behav 17:213-23
Doll, Mimi; Harper, Gary W; Robles-Schrader, Grisel M et al. (2012) Perspectives of community partners and researchers about factors impacting coalition functioning over time. J Prev Interv Community 40:87-102
Lin, Alison J; Dudek, Julia C; Francisco, Vincent T et al. (2012) Challenges and approaches to mobilizing communities for HIV prevention among young men who have sex with men of color. J Prev Interv Community 40:149-64
Reed, Sarah J; Miller, Robin Lin; Francisco, Vincent T et al. (2012) Programmatic capacity and HIV structural change interventions: influences on coalitions' success and efficiency in accomplishing intermediate outcomes. J Prev Interv Community 40:118-30
Willard, Nancy; Chutuape, Kate; Stines, Stephanie et al. (2012) Bridging the gap between individual-level risk for HIV and structural determinants: using root cause analysis in strategic planning. J Prev Interv Community 40:103-17
Robles-Schrader, Grisel M; Harper, Gary W; Purnell, Marjorie et al. (2012) Differential challenges in coalition building among HIV prevention coalitions targeting specific youth populations. J Prev Interv Community 40:131-48