The focus for this proposal is research training for people from Botswana in relation to the various uses of ART for prevention and treatment in the modern era of the HIV epidemic. Recent advancements in coverage strategies and antiretroviral combinations within the Botswana national ART program offer a unique environment for use of modern HIV treatment, safety, and prevention research for the developing world, with a host of research opportunities for training researchers in Botswana, to match current research activities of the faculty mentors and key partners at the Botswana site. The in-country institution for this proposal is the Harvard T.H. Chan School of Public Health, and our LMIC partner for training is the Botswana Harvard AIDS Institute Partnership (BHP), a limited liability nonprofit corporation (LLC) with the Ministry of Health (MOH) in Botswana. BHP is the largest HIV/AIDS research organization in Botswana, and one of the largest in Africa. The long-term goals and objectives of this training program are to train research leaders for BHP, the University of Botswana, and the MOH. Botswana currently has one of the highest prevalence rates of HIV in the world (22%), but has also had the highest rate of antiretroviral drug treatment (ART) for patients with HIV (about 90%) in Africa. The government of Botswana currently operates the most advanced HIV treatment program in Africa, using a universal test-and-treat strategy. The training faculty at Harvard and BHP will focus on how ?modern? ART impacts treatment outcomes, safety, and prevention research. HIV-related courses, seminars, and workshops are available for trainees. We have requested funds for 2 predoctoral and 3 postdoctoral positions each year. We estimate that we will train about 18 trainees over 5 years, allowing for multiple years for each PhD candidate and some postdoctoral fellows, and assuming several short-term trainees could fill a single annual training slot. Stipends will be based on current degrees and research experience; thus an MD on an MS or PhD program would be eligible for a postdoctoral-level stipend. Each trainee will have a principal advisor and a faculty advisory committee. Selection of trainees is based on previous academic performance, references, experience, and assurance that the candidates will return to participate in HIV research in Botswana. The quality of the program will be monitored by a Training Advisory Committee composed of experts from the US and from developing countries. The success of the training program will be judged by the relative increase in senior research positions at BHP, UB, and MOH that are individuals who were trained by this program after the second and fourth years. Success will also be judged by the implementation of successful prevention research programs that involve trainees, numbers of trainee publications in high-impact journals, and number of staff positions filled by former trainees at the BHP and the Ministry of Health.

Public Health Relevance

Partnering with the Botswana Harvard AIDS Institute Partnership (BHP), a limited liability nonprofit corporation (LLC) with the Ministry of Health (MOH) in Botswana, we propose to create a training program focused on research for prevention and treatment of HIV/AIDS, especially emphasizing the several modern uses of ART, in Botswana, a country in southern Africa where HIV is of very high prevalence. Treatment for AIDS disease in Botswana has been effective, and a cost-effective prevention program is now the greatest need.

Agency
National Institute of Health (NIH)
Institute
Fogarty International Center (FIC)
Type
International Research Training Grants (D43)
Project #
2D43TW009610-06
Application #
9548812
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Bansal, Geetha Parthasarathy
Project Start
2013-08-01
Project End
2023-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
6
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Harvard University
Department
Microbiology/Immun/Virology
Type
Schools of Public Health
DUNS #
149617367
City
Boston
State
MA
Country
United States
Zip Code
Anderson, Motswedi; Choga, Wonderful T; Moyo, Sikhulile et al. (2018) In Silico Analysis of Hepatitis B Virus Occult Associated Mutations in Botswana Using a Novel Algorithm. Genes (Basel) 9:
Anderson, Motswedi; Choga, Wonderful Tatenda; Moyo, Sikhulile et al. (2018) Molecular Characterization of Near Full-Length Genomes of Hepatitis B Virus Isolated from Predominantly HIV Infected Individuals in Botswana. Genes (Basel) 9:
N'Guessan, Kombo F; Anderson, Motswedi; Phinius, Bonolo et al. (2017) The Impact of Human Pegivirus on CD4 Cell Count in HIV-Positive Persons in Botswana. Open Forum Infect Dis 4:ofx222
Ogwu, Anthony; Moyo, Sikhulile; Powis, Kathleen et al. (2016) Predictors of early breastfeeding cessation among HIV-infected women in Botswana. Trop Med Int Health 21:1013-1018
Lin, Nina; Gonzalez, Oscar A; Registre, Ludy et al. (2016) Humoral Immune Pressure Selects for HIV-1 CXC-chemokine Receptor 4-using Variants. EBioMedicine 8:237-247
Anderson, Motswedi; Gaseitsiwe, Simani; Moyo, Sikhulile et al. (2016) Slow CD4+ T-Cell Recovery in Human Immunodeficiency Virus/Hepatitis B Virus-Coinfected Patients Initiating Truvada-Based Combination Antiretroviral Therapy in Botswana. Open Forum Infect Dis 3:ofw140
Zash, Rebecca; Souda, Sajini; Leidner, Jean et al. (2016) HIV-exposed children account for more than half of 24-month mortality in Botswana. BMC Pediatr 16:103
Moyo, Sikhulile; Vandormael, Alain; Wilkinson, Eduan et al. (2016) Analysis of Viral Diversity in Relation to the Recency of HIV-1C Infection in Botswana. PLoS One 11:e0160649
Iketleng, Thato; Moyo, Sikhulile; Gaseitsiwe, Simani et al. (2016) Plasma Cytokine Levels in Chronic Asymptomatic HIV-1 Subtype C Infection as an Indicator of Disease Progression in Botswana: A Retrospective Case Control Study. AIDS Res Hum Retroviruses 32:364-9
Rossenkhan, Raabya; MacLeod, Iain J; Brumme, Zabrina L et al. (2016) Transmitted/Founder HIV-1 Subtype C Viruses Show Distinctive Signature Patterns in Vif, Vpr, and Vpu That Are Under Subsequent Immune Pressure During Early Infection. AIDS Res Hum Retroviruses 32:1031-1045

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