Samara Oblast is a region of Russia with a significant emerging HIV epidemic particularly in prisons and it has one of the highest rates of multiple drug resistant tuberculosis (TB) in the world. The global objective is to develop local capacity and plan collaborative research to address public health and clinical problems at the focus of the HIV and TB epidemics. Specifically we would: (1) develop the partnership to maximize the training opportunities in the field of AIDS/TB research that can be provided by each partner; (2) identify the training gaps and needs across the main clinical and nursing groups, administrative, scientific and training resources in order develop a plan to address these needs to how training of different professional groups can be integrated to ensure that the aggregate training is greater than the sum of its parts; (3) maximize the interaction and develop the most appropriate research strategies with one or more partners to address key questions relating to the application of clinical care, to benefit those already infected with HIV and/or TB and measures to prevent or reduce TB and other opportunistic infections in HIV patients; (4) plan the key studies needed to establish strong baseline data for the conventional and molecular epidemiology of HIV including clade analysis and the presence of drug resistant strains particularly in key sentinel groups;(5) develop stronger interactions between social and health-based care groups to address the underlying social problems (eg IVDU, alcoholism); (6) plan the development of an HIV and Opportunistic Infections Research Laboratory in Samara Oblast, Russia; (7) develop a long-term plan for development of local research capacity using the knowledge and resources gained from the ICOHRTA program to achieve future goals. Further research would include the development of: (a) sentinel surveillance of HIV epidemic; (b) clade and drug resistance analysis of HIV strains region-wide; (c) baseline analysis, and prevention of respiratory, gastroenterological and systemic opportunistic infections in HIV positive people; (d) assessment of the need of rapid molecular testing; (e) analysis of sexual and drug behavior and HIV-related stigma and (f) development of HIV and Opportunistic Infections laboratory in Samara. The proposal will lead to increased local capacity in the areas of HIV and TB disease control. Public information: This proposal will facilitate collaborative work with NIH and build local research capacity in AIDS and TB. ? ? ?
