Candidate: Maria L Alcaide received her medical degree from The Universidad Autonoma de Madrid, Spain and completed her Internal Medicine residency and Fellowship in Infectious Diseases at Jackson Memorial Hospital in Miami. She is Assistant Professor of Medicine at the Division of Infectious Diseases at the University of Miami Miller School of Medicine. Mentors: Dr. Deborah Jones is Research Associate Professor in the Department of Psychiatry &Behavioral Sciences at the University of Miami Miller School of Medicine with extensive experience in behavioral research interventions to reduce sexual risk in HIV infected men and women domestically and internationally. Dr. Fischl is Professor of Medicine at the University of Miami Miller School of Medicine and an acknowledged world leader in the field of HIV clinical research. Drs. Jones and Fischl both have extensive mentorship experience and will ensure the success of Dr. Alcaide's training, proposed studies and career development. Research: Intravaginal practices (VP) are common among women in sub-Saharan and implicated in the development of bacterial vaginosis (BV) and HIV transmission. Building on pilot study results from Zambia obtained by Dr. Alcaide (R01HD058481S~ Alcaide et al., 2011), this study will develop and test a bio-behavioral intervention designed to decrease VP. The pilot study tested a bio-behavioral intervention and results support its effectiveness in reducing both VP and BV over 8 weeks. The current proposal will evaluate the long term impact of a bio-behavioral intervention targeting VP among HIV infected women in Lusaka, Zambia, and assess the relative contribution of VP and BV to genital inflammation and HIV shedding.
Aim 1. 1 will develop and evaluate the long term impact of a bio-behavioral intervention to decrease VP.
Aim 1. 2 will compare rates of BV, genital inflammatory markers and HIV shedding in HIV infected women engaging in VP with and without BV.
Aim 1. 3 will compare BV, genital inflammatory markers and HIV genital shedding in HIV infected women participating in the intervention or control conditions. This innovative bio-behavioral interventio designed to reduce VP has the potential to have a significant public health impact in the Zambian community and relevance for other sub-Saharan countries with high prevalence of both VP and HIV infection. The K23 award mechanism will allow Dr. Alcaide to obtain new skills in clinical and behavioral research, conduct a study of VP in Zambia, develop an R01 application with study results, and become established as an independent clinical investigator.

Public Health Relevance

The long term goal of this proposal is to decrease transmission rates of HIV by decreasing the harmful behavior of intravaginal practices and the associated consequences such as bacterial vaginosis, genital inflammation and HIV shedding. Our results will clarify the pathway underlying the relationship between VP and HIV transmission and propose a bio-behavioral intervention to decrease VP.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23HD074489-03
Application #
8676851
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Russo, Denise
Project Start
2012-09-01
Project End
2017-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Miami School of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
Peltzer, Karl; Babayigit, Suat; Rodriguez, Violeta J et al. (2018) Effect of a multicomponent behavioural PMTCT cluster randomised controlled trial on HIV stigma reduction among perinatal HIV positive women in Mpumalanga province, South Africa. SAHARA J 15:80-88
Lakshmi, Seetha; Beekmann, Susan E; Polgreen, Philip M et al. (2018) HIV primary care by the infectious disease physician in the United States - extending the continuum of care. AIDS Care 30:569-577
Rodriguez, Violeta J; Chisembele, Maureen; Jones, Deborah L et al. (2018) Influencing the importance of health, partners, and hygiene among Zambian women. Int J STD AIDS 29:259-265
Peltzer, Karl; Rodriguez, Violeta J; Lee, Tae Kyoung et al. (2018) Prevalence of prenatal and postpartum depression and associated factors among HIV-infected women in public primary care in rural South Africa: a longitudinal study. AIDS Care 30:1372-1379
Cook, R R; Peltzer, K; Weiss, S M et al. (2018) A Bayesian Analysis of Prenatal Maternal Factors Predicting Nonadherence to Infant HIV Medication in South Africa. AIDS Behav 22:2947-2955
Chisembele, Maureen; Rodriguez, Violeta J; Brown, Megan R et al. (2018) Intravaginal practices among young HIV-infected women in Lusaka, Zambia. Int J STD AIDS 29:164-171
Strbo, Natasa; Romero, Laura; Alcaide, Maria et al. (2017) Isolation and Flow Cytometric Analysis of Human Endocervical Gamma Delta T Cells. J Vis Exp :
Peltzer, Karl; Weiss, Stephen M; Soni, Manasi et al. (2017) A cluster randomized controlled trial of lay health worker support for prevention of mother to child transmission of HIV (PMTCT) in South Africa. AIDS Res Ther 14:61
Alcaide, Maria L; Rodriguez, Violeta J; Brown, Megan R et al. (2017) High Levels of Inflammatory Cytokines in the Reproductive Tract of Women with BV and Engaging in Intravaginal Douching: A Cross-Sectional Study of Participants in the Women Interagency HIV Study. AIDS Res Hum Retroviruses 33:309-317
Alcaide, Maria L; Ramlagan, Shandir; Rodriguez, Violeta J et al. (2017) Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa. AIDS Behav 21:2135-2140

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