This K24 renewal application for a Mid-Career Investigator Award in Patient-Oriented Research will continue to provide me with the protected time necessary to focus my research and mentoring at the leading edge of substance abuse and infectious diseases. During the past 4 years of the current K24, I have been the PI on seven federally-funded (NIDA, SAMHSA, HRSA, CDC) awards, totaling more than $12 million. During this same time, I have co-authored 40 peer-reviewed scientific papers, six chapters in books and have been invited to present at numerous national and international meetings. I have successfully mentored many junior investigators with whom I co-author manuscripts;three have received K23 awards, one has an R21 and an R01, two have R21s under review and others received smaller grants through foundations, the pharmaceutical industry and professional organizations. Through this K24, my goals are to continue: 1) my productivity in patient-oriented research;2) mentorship of junior investigators;and 3) to increase the awareness of the interface between substance abuse and infectious diseases. As part of this K24 application, I also intend to extend my work globally. My research to date has broadly involved epidemiological, health services outcomes and intervention studies involving drug users with or at risk for HIV. My focus has involved interventions targeting out-of-treatment drug users - primarily in community, HIV clinical care, drug treatment and correctional settings. These settings are complementary as HIV+ drug users (HIDUs) filter between these areas and each offers unique opportunities for intervention. Specifically, I am now developing NIDA-funded programs of directly administered antiretroviral therapy (DAART) in community and correctional settings and as part of prison- and jail-release programs. I am also investigating secondary HIV prevention strategies for HIDUs in these settings. I am fortunate to now be collaborating with colleagues in Eastern Europe and Southeast Asia. We are currently in the midst of developing novel treatment intervention and HIV risk-reduction research in these settings. This preliminary work will provide unique opportunities to expand evidence-based interventions and treatment globally to settings profoundly affected by drug use and infectious diseases. If allowed to continue on my current trajectory, I am likely to be able to achieve my short- and long-term career development goals.
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