Candidate: I am an infectious diseases epidemiologist committed to reducing HIV incidence in resource- limited settings through combination HIV prevention. My career goal is to be an epidemiology professor with a robust combination HIV prevention research portfolio. As an epidemiologist with behavioral science exposure, I am well positioned to achieve this goal. However, to compete successfully for R01 funding, I would benefit from a brief period of mentored training and research. I have extensive experience in the design and analysis of behavioral research, but limited experience in the design and delivery of theory-driven behavioral interventions. In a two-year mentored phase, both my training and research activities will focus on cultivating skills for designing and delivering theory-driven behavioral intervention. I have assembled an exceptional team of mentors to support this goal: Dr. William C. Miller (primary mentor), Dr. Mina Hosseinipour (primary co- mentor), and Drs. Nuala McGrath, Carol Golin, and Suzanne Maman (co-mentors). All members of the team have prolific scientific accomplishments and extensive experience in the design, implementation and evaluation of combination HIV prevention approaches in sub-Saharan Africa. They are committed to supporting me and collaborating with each other. Mentored Phase Research (K99, years 1-2): In sub-Saharan Africa, strategies to increase HIV testing among men and engage them in HIV prevention, care, and treatment are urgently needed. Such engagement can have treatment benefits for HIV-infected men, prevention benefits for HIV-uninfected men, and treatment benefits for their HIV-infected female partners. Option B+, Malawi s program for providing immediate, lifelong combination antiretroviral therapy (cART) to all HIV-infected pregnant women at the time of diagnosis, is a promising setting for engaging male partners in care. Within Option B+, I will develop an intervention that uses contract partner notification to recruit male partners and then engage them in a couple-based intervention with their HIV-infected female partner (Aim 1). The intervention will be guided by formative research and the dyad-level Interdependence Theory and aimed at improving linkage to care for HIV-infected male partners, preventing HIV acquisition for HIV-uninfected male partners, and promoting cART retention for HIV-infected female partners. Independent Phase Research (R00, Years 3-5): I will conduct a randomized controlled trial (N=500 couples) to assess intervention effectiveness at one year. I will assess whether the intervention increases HIV testing and linkage to care among HIV-infected male sex partners (Aim 2); identifies HIV-discordant couples, and decreases the likelihood of HIV exposure for HIV- uninfected male sex partners (Aim 3); and improves cART retention and viral suppression for all female partners (Aim 4). Future Directions: The R00 results will inform an R01 with longer-term viral suppression and HIV-incidence outcomes. I will transition from a mentored postdoctoral research associate to an independent investigator capable of designing behavioral interventions and leading combination HIV prevention trials.
Asking HIV-infected women in antenatal care to recruit their male partners to the clinic can have treatment benefits for HIV-infected male partners, prevention benefits for HIV-uninfected male partners, and treatment benefits for female partners. This is an application to develop an intervention to recruit male partners to the clinic and engage them in the care of their HIV-infected female partners and address their own HIV needs. This intervention will be evaluated for male and female HIV prevention, care, and treatment outcomes at one year.
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