This proposal describes a 5-year training and research program that will allow Dr. Aadia Rana to achieve her goal of becoming an independent patient-oriented investigator with expertise in HIV health services and health disparities, integrating research and public health practice. The proposed program will build on the candidate's prior experience in HIV clinical research by enhancing her skills in mixed methods, health services, and clinical trials research involving behavioral interventions. The training plan will take advantage of an exceptional mentoring team and institutional environment that involves close collaboration between Alpert Medical School of Brown University, the University of Mississippi Medical Center, and the Mississippi Department of Health. Postpartum minority HIV-infected women in the southern United States face substantial challenges in access and retention in HIV care. This novel research proposal utilizes a population-based approach in evaluating retention in care among postpartum minority women in the rural South, and integrates a mixed-methods approach to examine the socioeconomic, demographic, and structural determinants of retention in care in this vulnerable population.
The specific aims of this proposal are: 1) To comprehensively describe linkage and retention to HIV care following delivery, and the socioeconomic, demographic and structural determinants of linking and retaining in HIV care among postpartum women in Mississippi; 2)To prospectively evaluate the cascade of diagnosis, linkage, and retention in HIV medical care and the socioeconomic, psychosocial, and structural determinants of linking and retaining in HIV care among postpartum HIV-infected women in Mississippi; 3) To characterize the psychosocial facilitators and barriers to successful linkage and retention to care following delivery using qualitative methods. We will then incorporate the results of all of these studies in a future trial piloting an intervention integrating clinic and public health systems aimed at improving retention in HIV care among perinatal HIV-infected in Mississippi. This research will lay the groundwork for a larger research program on HIV care that will include rigorous evaluation of interventions aimed at improving the delivery of HIV care in disadvantaged populations with consideration for cost-effectiveness.

Public Health Relevance

The proposed research is relevant to public health because it will lead to an increased understanding of retention in care among postpartum minority women in the rural South. Improving linkage and retention to care following delivery will have significan impact on the success of the treatment as prevention strategy to decrease incidence of HIV infection and impact medical outcomes for women who experience disparities in access to care in the South. The objectives of this mixed methods research project are in line with the trans- NIH goal of reducing new HIV infections, addressing health disparities in HIV care, and improving outcomes for patients with HIV.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH100955-05
Application #
9539226
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Gordon, Christopher M
Project Start
2017-06-01
Project End
2019-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
5
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Rosen, Rochelle K; McGarrity, Larissa A; Salmoirago-Blotcher, Elena et al. (2017) Telephone-Delivered Mindfulness Training for People Living with HIV: A Qualitative 360° Inquiry. AIDS Behav 21:3194-3201
Salmoirago-Blotcher, Elena; Rich, Carla; Rosen, Rochelle K et al. (2017) Phone-delivered mindfulness training to promote medication adherence and reduce sexual risk behavior among persons living with HIV: Design and methods. Contemp Clin Trials 53:162-170
Youn, Bora; Shireman, Theresa I; Lee, Yoojin et al. (2017) Ten-year trends in antiretroviral therapy persistence among US Medicaid beneficiaries. AIDS 31:1697-1707
Youn, Bora; Shireman, Theresa I; Lee, Yoojin et al. (2017) Ten-year trends in anti-retroviral therapy persistence among US medicaid beneficiaries, 2001-2010. AIDS :
Rhodes, Corinne M; Cu-Uvin, Susan; Rana, Aadia I (2016) Pregnancy Desire, Partner Serodiscordance, and Partner HIV Disclosure among Reproductive Age HIV-Infected Women in an Urban Clinic. Infect Dis Obstet Gynecol 2016:8048457
Rana, Aadia I; van den Berg, Jacob J; Lamy, Eric et al. (2016) Using a Mobile Health Intervention to Support HIV Treatment Adherence and Retention Among Patients at Risk for Disengaging with Care. AIDS Patient Care STDS 30:178-84
Kojic, Erna Milunka; Rana, Aadia I; Cu-Uvin, Susan (2016) Human papillomavirus vaccination in HIV-infected women: need for increased coverage. Expert Rev Vaccines 15:105-17
Reece, Rebecca; Norman, Betty; Kwara, Awewura et al. (2016) Retention in Care of HIV-Positive Postpartum Females in Kumasi, Ghana. J Int Assoc Provid AIDS Care 15:406-11
Kumar, Natasha; Reece, Rebecca; Norman, Betty et al. (2015) Delayed entry to care by men with HIV infection in Kumasi, Ghana. Pan Afr Med J 22:107
Rana, Aadia I; Liu, Tao; Gillani, Fizza S et al. (2015) Multiple gaps in care common among newly diagnosed HIV patients. AIDS Care 27:679-87