The objective of this project is to establish training for clinical and behavioral research on HIV prevention and care in the Dominican Republic. Effective clinical research must begin with an understanding of appropriate data collection and management, and must be linked with an ability to provide quality clinical care.
The specific aims are to train the staff of one of the country's leading non-governmental organization health care providers, Profamilia. The importance of gender empowerment to stem the HIV epidemic in the developing world has been amply described and Profamilia has a 30- year history of providing health care to indigent women. The 3 specific aims are to train the Profamilia staff in:(1 ) qualitative behavioral research to document and explore sociocultural factors affecting HIV risk behavior, (2) good clinical practices including data collection and management, in preparation for long term clinical research which will follow women with HIV and cervical disease, and (3)the clinical assessment of patients who are HIV-infected to determine their needs for care and options for treatment. The research design entails specific training to meet each of these aims: (1)Training of university students and clinical counselors from the Profamilia clinics in ethnographic observation, the construction of qualitative interview instruments and the design and use of focus groups. The researchers will work with the patient population of the Profamilia clinics and will learn to study and develop interventions to affect HIV risk behavior. (2)Training of gynecologists, internists and nurses in the obtaining and recording of clinical and medical information and preserving patient confidentiality. Once this basic infrastructure has been established, these personnel will learn to screen for and study prospectively HIV co-factors including chlamydia and cervical disease. (3) Training a team of nurses, physicians, counselors and educators in the need for, benefits of and side effects and toxicities of antiretroviral medications with the ultimate goal of enabling participation in broader HtV research trials This will be done by a team of physicians, nurses and counselors with 12 years of experience treating hundreds of Dominican patients with AIDS in New York City. This project will establish links with other Dominican institutions involved in HIV prevention and care, develop clinical research trainees, and assist with an island wide response to the HIV epidemic as a component of the well established Cornell-Vanderbilt-GHESKIO Fogarty training program. ? ?
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