This proposal describes a career development plan encompassing patient-oriented research in the area of alcohol use and HIV infection, mentorship of junior clinical investigators, and skills advancement regarding the translation of research into public health policy. The applicant is an experienced clinical researcher in the fields of substance abuse and HIV who has demonstrated commitment and the ability to conduct high quality patient-oriented research and to train clinical investigators. The mentorship plan includes working primarily with fellows, junior physician faculty, and Russian faculty to develop patient-oriented research skills. The applicant's skills development plan includes studying effective methods of translating research into pragmatic public policy pertaining to enhanced care of patients who use alcohol and are infected or at risk of infection with HIV. The research planned in this proposal explores consequences of alcohol use in HIV-infected and at-risk patients. To assist mentorship efforts and the candidate's skills development, this research plan takes advantage of 3 current studies addressing HIV and alcohol use: HIV - Longitudinal Interrelationships of Viruses and Ethanol (HIV-LIVE) (NIAAA R01-AA13766);Russian Partnership to Reduce the Epidemic Via Engagement in Narcology Treatment (Russian PREVENT) (NIAAA R21-AA14821);and the Veterans Aging Cohort Study (VACS) (RO1-NIAAA,NIA,OAR). Two specific proposed projects are described in detail: investigation of cardiovascular consequences of HIV infection and alcohol use and alcohol's impact on sex and drug risk behaviors in a Russian cohort with alcohol problems. Two additional potential projects are also briefly presented concerning neurological consequences of HIV infection and alcohol use and HIV prevention in Russian HIV-infected persons with risky alcohol use. The effort committed to this career development award will enable the applicant to advance the following long-term goals: to develop clinical researchers from Boston University and Pavlov State Medical University in St Petersburg, Russia;to examine the impact of alcohol use on patients with and at risk for HIV infection;and to impact public health policy to better care for patients with or at risk for HIV infection who use alcohol.
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