It is increasingly being recognized that the risk of cancer among persons with HIV is exponentially elevated, and a secondary epidemic of cancer is now being realized among adults and children with HIV. Uganda is a country with among the highest rates of HIV-associated malignancies worldwide, where the 5- year mortality rates for HIV-associated cancers in Uganda are in excess of 90%. The University of Washington (UW), in collaboration with the Fred Hutchinson Cancer Research Center (FHCRC), has long been a leader in educating the next generation of physician-scientists in the research and clinical care of persons with both HIV and cancer. We have developed a strong partnership with the Uganda Cancer Institute (UCI) to conduct collaborative clinical research and provide training to promising Ugandan physician-scientists. Over the last year, we have trained two Ugandan physician-scientists in HIV-associated malignancies with funding from the Fogarty International Center / National Cancer Institute in conjunction with the UW International AIDS Research and Training Program (IARTP). We propose to expand on this highly successful program by training a total of 5 additional Ugandans in HIV-associated malignancies over the next 3 years. The goals of the fellowship program are: 1) To provide didactic training in the pathophysiology of HIV-associated malignancies through intensive coursework at UW focusing on public health, molecular biology, oncogenesis, epidemiologic and translational clinical research; 2) To expose Ugandan physician-scientists to the current needs in diagnosis, prevention and treatment of HIV-associated malignancies through integration into an existing tailored postgraduate Oncology training program at FHCRC; 3) To foster the development of the next generation of African investigators in HIV-associated malignancy translational clinical research by providing training in the conduct of oncologic clinical trials and establishment of collaborative research projects to be conducted in Uganda. The proposed training program leverages the established resources UW IARTP and Center for AIDS Research, Seattle participants in the AIDS Malignancy Consortium, and a leading federally-designated National Cancer Center (FHCRC) to increase the capacity of local African physician-scientists to conduct novel and collaborative research in HIV-associated malignancies. It is anticipated that this program will result in significants gains in the survival of persons afflicted with HIV-associated malignancies, programs to prevent these cancers, and important information about the biological factors predisposing to cancer in the immunocompromised which may yield new therapies. ? ? ?
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