This application is for a Mid-Career Investigator Award in Patient-Oriented Research (K24). Through this award, my goals are to increase: 1) my productivity in patient-oriented research; 2) increase mentorship of beginning investigators; and 3) awareness of the interface between substance abuse and infectious diseases. My research to date has broadly involved epidemiological, health services outcomes and intervention studies involving drug users with or at risk for HIV. My focus has involved interventions targeting out-of-treatment drug users - primarily in community and correctional settings. These settings are complementary as HIV+ drug users (HIDUs) filter between these two domains, both of which offer unique opportunities for intervention. Specifically, I am now developing NIDA-funded programs of directly observed therapy (DOT) for HIV treatment in correctional, community and the transition between these settings. This research uses a randomized controlled trial design with biological (HIV-1 RNA, CD4 count, HIV-1 genotypic resistance), behavioral (adherence, HIV quality of life, self-efficacy) and health services (entry into and retention in drug treatment, use health care services) outcomes. Similar to drug treatment and correctional systems, DOT provides a structure for adherence to antiretroviral therapy (ART). Without strict adherence, HIDUs will experience poor health outcomes, increased infectivity to others by inadequately suppressed HIV-1 RNA levels and develop resistance to HIV medications that can then be transmitted to others. Therefore, development and evaluation of such programs may impact on the organization of and health care delivery for HIDUs. The K24 mechanism is ideally suited for my career development. In addition to being committed to increase my level of mentorship, I have a long-standing history of external funding to provide a research infrastructure for beginning investigators. I work within an exceptional institution with expertise in the areas of substance abuse, infectious diseases, and HIVIAIDS, from which qualified candidates can be recruited. I have a commitment from the institution to reduce my clinical and administrative duties so that I can focus on scholarly research and mentorship. I have effectively mentored a small number of beginning investigators who have moved on to independent careers. Lastly, I have long-term goals of developing a novel institutional training program in the interface between substance abuse and infectious diseases. Therefore, if allowed the opportunity to decrease my current clinical and administrative responsibilities, I am likely to be able to achieve my short- and long-term career development goals.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24DA017072-03
Application #
6943057
Study Section
Special Emphasis Panel (ZDA1-KXA-N (02))
Program Officer
Czechowicz, Dorynne D
Project Start
2003-09-01
Project End
2008-06-30
Budget Start
2005-07-01
Budget End
2006-06-30
Support Year
3
Fiscal Year
2005
Total Cost
$130,062
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
043207562
City
New Haven
State
CT
Country
United States
Zip Code
06520
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Mbaba, Mary; Brown, Shan-Estelle; Wooditch, Alese et al. (2018) Prevalence, Diagnosis, and Treatment Rates of Mood Disorders among Opioid Users under Criminal Justice Supervision. Subst Use Misuse 53:1519-1528
Springer, Sandra A; Di Paola, Angela; Barbour, Russell et al. (2018) Extended-release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living with HIV and Alcohol use Disorders Transitioning to the Community: Results From a Double-Blind, Placebo-Controlled Trial. J Acquir Immune Defic Syndr 79:92-100
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Vijay, Aishwarya; Earnshaw, Valerie A; Tee, Ying Chew et al. (2018) Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia. LGBT Health 5:61-68
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Dubov, Alex; Galbo Jr, Phillip; Altice, Frederick L et al. (2018) Stigma and Shame Experiences by MSM Who Take PrEP for HIV Prevention: A Qualitative Study. Am J Mens Health 12:1843-1854
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Shrestha, Roman; Karki, Pramila; Altice, Frederick L et al. (2018) Measuring Acceptability and Preferences for Implementation of Pre-Exposure Prophylaxis (PrEP) Using Conjoint Analysis: An Application to Primary HIV Prevention Among High Risk Drug Users. AIDS Behav 22:1228-1238
Rich, Katherine M; Valencia HuamanĂ­, Javier; Kiani, Sara N et al. (2018) Correlates of viral suppression among HIV-infected men who have sex with men and transgender women in Lima, Peru. AIDS Care 30:1341-1350

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