India faces the largest burden of HIV-infection of any single country in the world. Women in India are disproportionately at risk for HIV infection, through heterosexual transmission from their spouses or through commercial sex work. Cervical cancer is the single most important cause of malignancy-associated death for women in India. In fact, India has the highest rates of cervical carcinoma in the world. Thus, India faces the combined problems of a rapidly increasing HIV epidemic and a long-standing chronic endemic of cervical carcinoma. Evidence demonstrating that women with HIV infection are at an increased risk of cervical carcinoma, highlights the critical challenge facing India with the intersection of these two diseases. Prevention, detection and early treatment of cervical carcinoma in India are already public health priorities. However, there are a limited number of programs directed at this problem. There is an urgent need for the latest technology and information for diagnosis, treatment and prevention of cervical carcinoma in the setting of the expanding HIV epidemic in India. This Fogarty proposal has the following three specific aims: 1. To train Indian scientists in the etiology, epidemiology, natural history, surveillance, screening, diagnosis, and secondary prevention and treatment of cervical carcinoma, 2. To train investigators from India to evaluate the effects of HIV on HPV acquisition, persistence and risk for cervical carcinoma in India 3. To upgrade programmatic approaches in India for prevention of cervical cancer, including the sensitivity, specificity and predictive value of screening methods, and options for treatment of early lesions. This administrative supplement to our existing Fogarty AITRP award seeks to continue and expand the training and in-country research efforts of this collaboration. Specifically, we propose the following training activities: Year I - One in-country workshop plus 5 short course trainees (Epidemiology, HPV laboratory diagnosis, Cytopathological diagnosis of cervical neoplasia and clinical diagnosis and management of cervical carcinoma) Year II - One in-country workshop plus 5 short course trainees (Epidemiology, HPV laboratory diagnosis, Cytopathological diagnosis of cervical neoplasia and clinical diagnosis and management of cervical carcinoma) Year III - One in-country workshop plus 3 Advanced Research Training Awards
| Sahasrabuddhe, Vikrant V; Vermund, Sten H (2007) The future of HIV prevention: control of sexually transmitted infections and circumcision interventions. Infect Dis Clin North Am 21:241-57, xi |
