I have had the opportunity to develop a clinical research career in the overlap between addiction and infectious diseases, in particular among injection drug users, with a focus on incarcerated populations. The purpose of this application for a Midcareer Investigator Award in Patient-Oriented Research (K24) is to provide protected time that I can devote to mentor junior clinical investigators in patient-oriented research focused on critical issues related to HIV and other infectious diseases among addicted individuals. This proposal builds on the existing resources at our institution that has a robust track record of training undergraduate, graduate, post-graduate students, trainees and junior faculty to become independent investigators in multiple disciplines. My host institution is committed to research training that can prepare the next generation of physicians to bridge the gaps in our knowledge in HIV care and prevention, especially in HIV treatment and prevention in persons affected by the disease of addiction. The Division of Infectious Diseases at The Miriam Hospital, Brown Medical School, includes the NIH funded Adult AIDS Clinical Trials Unit, the Brown/Tufts/Lifespan Center for AIDS Research, the AIDS International Training and Research Program, the Center for Drug Addiction and AIDS Research, funded training grants, and the recently founded, Center for Prisoner Health and Human Rights at The Miriam Hospital. The spread of HIV through drug injection and sexual contact with injection drug users has been a leading cause of HIV since the very beginning of the epidemic in the United States, and is driving the HIV epidemic in many parts of the world. In the United States, between 20-26% of all individuals with HIV infection pass through a correctional setting each year. In the correctional setting, there exist tremendous opportunities for the diagnosis, prevention, treatment of infectious diseases, as well as linkage to medical care and substance abuse treatment. My CSAT funded, Project MOD, has demonstrated that linkage to methadone maintenance treatment at the time of release from incarceration is a very promising strategy to reduce the risks of HIV, along with recidivism and resumption of drug use. My currently funded R01 is further exploring the benefits of linkage to substance abuse treatment in this population. Both provide excellent opportunities to mentor junior colleagues in patient oriented research.
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