In this U54 application, we propose an inter-disciplinary research consortium between the University of Botswana (UB) and The University of Pennsylvania (UPenn). The consortium will focus on multiple areas of study related to one cancer type, HPV-associated cervical cancer in HIV seropositive patients as well as building research capacity in Botswana through a strong emphasis on mentoring and education. The Consortium will bring together experienced investigators from UB and UPenn with expertise in mentoring, research methodology, viral oncology, cancer therapeutics, and behavioral studies. The central research theme of the Consortium is to determine the epidemiology, pathogenesis, behavioral, clinical, and immunological risk factors, and optimal therapeutic approaches of HPV-associated cervical cancer in HIV-seropositive women in Botswana which can be translated into effective prevention and treatment strategies that will lower the burden and associated morbidity and mortality of HIV-associated cervical cancer. An accompanying major focus will be on developing sustained research infrastructure in Botswana through mentoring and education. This will be an opportunity to build independent research capacity at UB related to cancer in HIV-positive individuals. This Consortium will lay the groundwork for additional future equal research partnerships between UB and UPenn. The Consortium will achieve its central goal of developing effective prevention and treatment strategies for HIV-associated cervical cancer through the study of three unique prospective cohorts. Research is organized around three projects and four supporting cores.
The global burden of infectious disease and cancer continues to increase in low- and middle-income countries particularly in Africa. Botswana is a middle-income country with the second highest prevalence of HIV in the world. In the setting of improved survival of HIV seropositive Botswana citizens, increasing rates of HPV-associated cervical cancer have been observed. There is an urgent need to better understand the epidemiology, pathogenesis, risk factors, and optimal therapeutic approaches of HPV-associated cervical cancer in the setting of HIV which underscores the significance of our overall research aims. Likewise, there is an urgent need to increase research capacity in the developing world.