This Impacta Salud y Educacion/School of Public Health and Universidad Peruana Cayetano Heredia R03 application requests funding to plan and prepare an application for a CIPRA multi-project P01 application for Peru and the Andean region. The theme of this CIPRA will be prevention, pathogenesis and treatment of HIV/AIDS in the Andean region. The overall aims of the Peru CIPRA are: l) to further develop regional, institutional and investigative capacity for research related to HIV prevention, vaccine and treatment through administrative, laboratory, community affairs/behavioral research, biostatistics/data management and developmental/training cores; and 2) to support specific research projects of particular importance to Peru and the Andean region of Latin America. The CIPRA includes 5 cores: A) Administration. B) Laboratory. C) Biostatistics. D) Community Education and development; and E) Developmental and training. The CIPRA cores will provide training, research and administrative support, and technical expertise for HIV research conducted in Peru, and will directly support up to six major research projects and small developmental research projects in the Peru CIPRA P01 application. All cores have oversight Core Committees, and have core coordinator positions for supervision. The specific major research projects to be proposed in the P0I application build on prior NIH-funded research projects conducted in Peru over the past several years and are: a) To study biologic and epidemiologic interactions between STDs and HIV in order to develop and conduct trials of biomedical interventions to reduce STD and HIV transmission; b) To test immunologic and clinical outcomes, adherence, and antiretroviral resistance with a simple antiretroviral regimen in persons with HIV infection; c )To assess the efficacy of a behavioral intervention among MSM in reducing risk behaviors and STD/HIV incidence; d)To determine patterns of sexual mixing between the general population and core groups in Peru, particularly female sex workers and bisexual men; and evaluate a community-randomized STD/HIV prevention trial; e) To assess the epidemiology, prevention of transmission and treatment of multi-drug resistant tuberculosis in HIV-infected persons in the Andean Region; and, f)To identify rapid diagnostic strategies and effective interventions to reduce perinatal transmission of retroviruses, particularly HIV. It is not clear what experience is present in the treatment of HIV infection, or what provision is made to provide training for Peruvian physicians in the administration of antiretroviral therapies.
