The purpose of this NIH F31- Diversity application is to obtain support for the PI, Kristina Tymes-Wilbekin, for mentored research and career development activities within her MD/PhD training that will enhance her potential to become a successful physician scientist. The project goal is to develop skills in infectious disease epidemiology and reproductive health that will allow the PI to study behavioral and socio-cultural factors that influence women?s experiences and decisions related to sexual health outcomes using mixed method study applications. The primary objective of the research proposal is to investigate potential relationships between vaginal hygiene, sexual behaviors and uptake of ring-based multipurpose prevention technologies among women at increased risk of unintended pregnancy and acquisition/transmission of sexually transmitted infections or HIV infection. Currently new vaginal rings are being developed and tested as multipurpose prevention technologies that act as a hormonal contraceptive and can prevent/treat sexually transmitted infections or HIV infection. This project is specifically focused on understanding these factors in the context of intravaginal ring delivery, due to a demonstration that a continuous contraceptive vaginal ring (CVR) regimen has potential noncontraceptive and pharmacological benefits that can increase women?s adherence. This project seeks to quantitatively characterize perception of menstrual suppression among Kenyan women pre- and post-CVR use (Aim 1), and then utilize the findings for development and application of a tool to assess similar perceptions in African-American women in the Southeastern U.S.
(Aims 2 A and 2B). The long-term objective of our research is to better understand women?s experience with CVRs in order to inform multipurpose prevention technology development and improve sexual health options among high-risk populations. The proposed training plan for the PI is sponsored by her project co-mentors, Dr. Jeanne Marrazzo and Dr. Sadeep Shrestha. Included within the training plan are objectives to help develop the PI in three major areas: (1) rigorous research in the STI/HIV, contraception, and multipurpose prevention technology fields, including familiarity with the existing literature, critically evaluating published studies, principles of scientific integrity and responsible conduct of research, and methods or rigor and reproducibility; and (2) infectious disease epidemiology, including methodology, study design, and biostatistical analysis; and (3) career and professional development, inclusive of communication through presentations, journal article review, learning skills in grant writing, and translation of research findings for clinical applications. The overall goal of this training plan is to give the PI a foundation for a successful progression as a physician scientist and furthering the PI?s ultimate career goal of working with a collaborative team that bridges the gap between epidemiological research and improvement in women?s reproductive and sexual health outcomes.
The Southeastern U.S. has the highest rates of unintended pregnancy as well as STI/HIV infection and current efforts are met with improper use of contraception and low adherence to antiretorviral pre-exposure prophylaxis (PrEP). This project is proposing to investigate behavioral and socio-cultural factors involved in contraception decisions and attitudes towards multipurpose prevention technologies by translating current knowledge from data collected in Sub-Saharan Africa to other high-risk vulnerable populations. These data will expand our understanding of women?s perceptions giving context for implementation of multipurpose prevention technologies and providing improved reproductive and sexual health options.
