The mission of the Research Core of our CCE-SPHERE is to provide the leadership, infrastructure, oversight, and support to facilitate and guide the development and execution of research projects that will have a direct impact on health disparities in the African American (AA) population of South Carolina (SC), and ultimately the United States. Furthermore, the Research Core, through its interactions with the other CCE-SPHERE Cores will promote the translation of its research findings to the community to have the greatest impact possible on health disparities. Over the past 4 years, our current COE has focused its research efforts on human papillomavirus (HPV) and cervical cancer and HIV/AIDS. In this COE renewal application we are expanding our research focus to include head and neck cancer, some of which is caused by HPV. As with cervical cancer and HIV/AIDS, there is a large disparity in head and neck cancer, especially among AA males, with their age-adjusted mortality rate for oral and pharyngeal cancer almost 3-fold greater in AA men than in European American (EA) men (1). Three research projects are proposed in our COE renewal application. These projects focus on HPV-mediated disease (cervical cancer. Project 1, and head and neck cancer. Project 2) and HIV/AIDS (Project 3). Our research team has many years of experience with cervical disease caused by HPV, using both in vitro models and studies involving human populations, the latter supported by the current COE. In this competitive renewal application we have expanded our current HPV research team to include a physician scientist. Dr. Lisa Spiryda and a recent Ph.D. graduate with training in CBPR, Dr. Jessica Bellinger. Dr. Spiryda directs a colposcopy clinic that serves a population that is about 70% AA and includes women of all ages. Dr. Spiryda has observed that AA women in her population present with high-grade lesions more often than EA women. The collaboration with Dr. Spiryda will allow us to extend the observations we made (during the current funding period) in the Carolina Women's Care Study (CWCS) of a different high risk (HR) HPV type distribution between AA and EA women to an older population where CIN2-3 lesions are much more frequent and clinically relevant. Access to this population will allow us to ascertain whether the different prevalence of individual HR-HPV types we observed in the younger women in our studies is reflected in the HSIL cases in older women, and therefore assess the full range of clinical and epidemiological significance of these observations, particulariy for the potential effectiveness of HPV vaccination in AA women, since currently available HPV vaccines only target HR HPV16 and HPV18. We have also included Dr. Marion Boyd Gillespie and his collaborators at the Medical University of South Carolina (MUSC), whose interests are on HPV-mediated head and neck cancers. Together with Dr. Gillespie and Sutkowski, we will apply our knowledge of HPV-mediated transformation in the cervix and our experience with population studies of HPV persistence and infection to studies of the pathogenesis and determinants of HPVmediated oropharyngeal cancers, with particular attention to those risk factors and genetic determinants that are at the basis of the racial disparities between AA and EA men in this type of cancer. Our research team also recognizes the implications of the social determinants of health in understanding racial and ethnic health disparities and the need to translate the science of HPV-mediated diseases to the community. Dr. Jessica Bellinger, an AA post-doc with the SC Rural Health Research Center, University of South Carolina Arnold School of Public Health (ASPH), will bring a translational piece to Project 1 that will allow the team to begin to examine issues of racial bias and discrimination as social determinants of health. Projects 1 and 2 are designed to share personnel, methodology and resources and interact with one another, one informed by the findings of the other, and both have an important need for statistical support. Therefore, in this COE Renewal application, we have also added to our team Dr. Matteo Bottai, an expert biostatistician at the ASPH, as a key member of our research team. Our HIV/AIDS research team is equally as experienced as our HPV-mediated disease team from a communitybased research perspective in rural/minority health disparities and their qualitative data analysis expertise. Dr. Donna Richter is a nationally recognized researcher on HIV prevention and women's health issues. She leads the CDC/ASPH Institute for HIV Prevention Leadership (IHPL), now in its tenth year. Dr. Richter has used qualitative methods in many of her projects and has been a trainer on NVivo. She has conducted CBPR on HIV-related knowledge, attitudes, beliefs, and behaviors among the adult population in Africa and in the US working with the National AIDS Program and local community-based organizations on HIV prevention initiatives. Dr. Saundra Glover has studied cost and access to care issues for the dually diagnosed (HIV and mental illness). She has also partnered with the Sexually Transmitted Disease (STD) Division of the SC DHEC to facilitate train the trainer sessions on partner notification for individuals testing positive for HIV/AIDS. Dr. Glover has also served as faculty with the HIV/AIDS Prevention Leadership Institute under Dr. Richter's leadership. Dr. Medha Vyavaharkar has neariy ten years of experience nationally and internationally in providing care as well as conducting research among rural, African-American women with HIV disease. Dr. Vyavaharkar also has experience designing, conducting, analyzing, interpreting, and reporting qualitative research findings. Dr. Bankole Olatosi rounds out our HIV/AIDS research team. He is a young, African American health services researcher, trained at USC under Dr. Glover. Dr. Olatosi worked as a field investigator for the HRSA-funded Care Assessment Demonstration project on HIV/AIDS in Minneapolis. His work documenting that a high proportion of PLWHA living in SC do not remain in care provided the impetus for the current research project.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Exploratory Grants (P20)
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Special Emphasis Panel (ZMD1-PA)
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University of South Carolina at Columbia
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Wigfall, Lisa T; Bynum Mph, Shalanda A; Friedman, Daniela B et al. (2017) Patient-provider communication with HIV-positive women about abnormal Pap test results. Women Health 57:19-39
Tomar, Swati; Graves, Christian A; Altomare, Diego et al. (2016) Human papillomavirus status and gene expression profiles of oropharyngeal and oral cancers from European American and African American patients. Head Neck 38 Suppl 1:E694-704
Spiryda, Lisa Beth; Whitaker, Kara M; Messersmith, Amy et al. (2016) Clinical Utility of Molecular Biomarkers in Cervical Squamous Intraepithelial Lesions in a Young Adult Population. J Low Genit Tract Dis 20:26-30
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Wilson, Sacoby; Burwell-Naney, Kristen; Jiang, Chengsheng et al. (2015) Assessment of sociodemographic and geographic disparities in cancer risk from air toxics in South Carolina. Environ Res 140:562-8

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