7. PROJECT ABSTRACT This Mentored Research Scientist Development Award (K01) will provide Dr. Chukwuemeka N. Okafor with training and expertise needed to facilitate his transition toward research independence in HIV and drug use prevention research. Dr. Okafor?s proposed training plan is designed to build upon his previous work in HIV and drug use epidemiology to increase his knowledge and expertise in: (1) the design, implementation and analysis of clinical trials and behavioral interventions for drug use prevention in the context of HIV (2) addiction research and research that integrates behavioral science and biological markers in the context of drug use and HIV (3) training in the ethical conduct of research and (4) career skills necessary for academic research. Dr. Okafor will achieve these training goals via didactic coursework, directed readings, workshops, scientific conferences, fieldwork and mentoring from an expert multidisciplinary panel of mentors led by Dr. Steve Shoptaw (primary mentor). The proposed research activities addresses an important public health issue regarding the impact of cannabis on health outcomes among persons living with HIV (PLWH). Majority of the few studies of the consequences of cannabis use in PLWH have produced mixed findings. Potential explanations for lack of clear evidence of the health consequences of cannabis might be due to the different active constituents (cannabinoids) in the cannabis products used. Tetrahydrocannabidiol (THC) and cannabidiol (CBD) are the most frequently studied cannabinoids and growing evidence suggest that they have opposing effects on symptoms of distress (e.g. depression and anxiety) and HIV relevant health outcomes (inflammation and HIV viral load). Specifically, THC is associated with mood altering and negative health effects, while CBD does not alter mood and may have therapeutic properties. Therefore, whether quantifiable biomarkers of THC and CBD in PLWH who use cannabis can provide clarification on the consequences of cannabinoids in PLWH has not being determined. The proposed project will employ two approaches to address this question including a secondary analysis of existing data from a cohort study and a pilot feasibility study involving PLWH who use cannabis. Specifically, the proposed project aims to: 1) determine relationships between measured concentrations of THC and CBD in urine with biomarkers of inflammation and HIV viral load in PLWH, (2) investigate associations between measured concentrations of THC and CBD in urine with symptoms of distress among PLWH and 3) To determine feasibility of and impact of a 28-day cannabis abstinence based contingency management (CM) program on changes in symptoms of distress, inflammation and HIV viral load. Completing the proposed project will provide an excellent pedestal for Dr. Okafor to transition into an independent research career.
With the evolving state laws governing cannabis use in the United States, there is a need for sound scientific evidence on the impact of the different active constituents in cannabis on the health outcomes of vulnerable populations particularly persons living with HIV (PLWH). Through this K01 award, I will develop skills and knowledge in clinical trials, behavioral interventions for drug use, addiction research and research integrating biological markers in HIV and drug use research. Findings from this study will provide timely data on the impact of THC and CBD on symptoms of distress, inflammation and HIV viral load in PLWH.