: Lower and middle income countries (LMIC) in Africa have the highest burden of HIV disease globally, as well as high rates of alcohol abuse. Alcohol consumption is linked to the HIV cascade at every point, from increasing the risk of acquiring and transmitting HIV, to its dangerous interaction with antiretroviral therapies (ARVs), which may cause premature death. If the spread of HIV is to be stopped in countries facing the highest incidence, alcohol abuse must also be addressed. The concurrent distressed of alcohol and HIV are a particular burden to women and families in LMIC. Families face increased unemployment, injuries and violence, and the increasing alcohol use in women leads to more children born with Fetal Alcohol Spectrum Disorders (FASD). While there are a number of biomedical interventions to prevent HIV and improve HIV linkage to care, the success of these strategies is tied to alcohol use and related social factors. New tools, such as SMS-based adherence reminders and counseling, mobile rapid diagnostic testing and other innovative social media and technological interventions, hold great promise to help lower the rates of alcohol use, HIV transmission risk, and the HIV treatment cascade. These technologies also improve data informed management of health providers, including community based workers. These potentially game changing resources are largely unavailable in LMIC, especially in Africa. There are a number of challenges LMIC must overcome in the adoption of these new alcohol abuse reduction and HIV prevention strategies: implementation of these interventions requires the support of technological, health sector, and policy level infrastructure that is often missing, or slow to react in LMIC, and the technological expertise to utilize these tools must be paired with deep cultural understanding in order to successfully incorporate them to LMIC communities. Our proposal addresses these interwoven concerns through a three-year conference series in which alcohol and HIV researchers, innovative health technologists, and LMIC implementation experts (identified in collaboration with NIAAA staff) will come together to develop and diffuse new alcohol and HIV reduction strategies for broad implementation in African LMIC. Given the lifelong consequences on both infants and their families, the conference series will focus on women and children globally. This interdisciplinary, collaborative series will build relationships among researchers who share common challenges, stimulate a research agenda and establish a process to advance the science of cost-effective, scalable alcohol abuse and HIV interventions, and build capacity within LMIC to incorporate new health technologies and innovations into alcohol and HIV research. This series addresses the Office of AIDS Research highest priority: improving implementation of treatments for HIV and a key comorbidity - alcohol use.

Public Health Relevance

Women and children bear the greatest burden of both alcohol abuse and HIV in lower and middle income countries (LMIC): maternal and partner alcohol abuse have lifelong consequences for children and families including Fetal Alcohol Spectrum Disorders, higher HIV transmission risk, and compromised long-term health of people living with HIV. Together, alcohol abuse and HIV place a great strain on already under resourced LMIC health care systems, but new health intervention technologies offer promise of alleviating LMIC health challenges. We propose to address these interwoven concerns by conducting a three-year conference series pairing alcohol and HIV researchers; innovative health technologists; and LMIC implementation experts to advance the science of cost-effective, scalable alcohol abuse and HIV interventions and build capacity within LMIC to incorporate and broadly diffuse new health technologies and innovations into alcohol and HIV research.

National Institute of Health (NIH)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Conference--Cooperative Agreements (U13)
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Special Emphasis Panel (ZAA1)
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Freeman, Robert
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University of California Los Angeles
Schools of Medicine
Los Angeles
United States
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van Heerden, Alastair; Tomlinson, Mark; Skeen, Sarah et al. (2017) Innovation at the Intersection of Alcohol and HIV Research. AIDS Behav 21:274-278
Gordon, Sara; Rotheram-Borus, Mary Jane; Skeen, Sarah et al. (2017) Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise. AIDS Behav 21:262-273
Davis, Emily C; Rotheram-Borus, Mary Jane; Weichle, Thomas W et al. (2017) Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years. AIDS Behav 21:174-182
Parry, Charles D H; Tomlinson, Mark; Bryant, Kendall et al. (2017) Fresh Perspectives on the Alcohol and HIV Nexus: A Call for Action in an Era of Increased Opportunities and Challenges. AIDS Behav 21:121-125