Specific Aims. The goal of this proposal is to enable the Tomsk Regional Center for AIDS and other Infectious Diseases (TRCAID) to (1) plan and develop a comprehensive HIV/AIDS prevention and treatment research agenda relevant to its patient population and (2) enhance the infrastructure necessary for the Center to conduct such research. The result will be to develop a CIPRA U01 grant application in approximately two years. R03 funding will allow the TRCAID to develop additional institutional infrastructure and provide appropriate training as well as begin the process of data collection and research design necessary to achieve that goal. Background and Significance. The AIDS epidemic is spreading faster in the former Soviet bloc than anywhere else in the world. The Tomsk Oblast, in southwestern Siberia, where the epidemiological impact of HIV, TB, and STDs is much worse than for the European part of Russia. TRCAID is the best-equipped facility in the region to address the NIAID CIPRA priorities and develop independent research capability. Research Design and Methods. This planning grant will use three strategies: (1) creation of an External Advisory Committee composed of (a) faculty at Baylor College of Medicine in Houston, Texas, and local and regional healthcare leaders in Tomsk. The Baylor faculty will mentor the TRCAID personnel who will develop a functioning research infrastructure over the next two years. The Russian advisors will provide links to the local and federal ministries of health so that TRCAID can effectively implement the training and suggestions provided by the address the tasks necessary to build a research infrastructure at TRCAID; and (3) a process of learning by doing, by which TRCAID staff will be mentored as they develop plans for the CIPRA U01 application that will be submitted in two years. The project will provide professional development related to (1) prevention and treatment of HIV/AIDS according to current WHO and western standards; (2) medical ethics, protection of human subjects, and establishment of an institutional review board (IRB) for protection of human subjects; (3) biostatistics and research design; and (4) English language training for designated TRCAID staff and investigators directly involved in the current R03 and anticipated U01 projects. TRCAID staff will design a research project related to prevention of mother-to-child-transmission (MTCT), including assessment of HIV and barriers to prenatal care in Tomsk Region and development of targeted patient education materials. TRCAID will also identify appropriate and optimal HIV/AIDS drug regimens and ascertain their availability, especially in the context of HIV-associated co-morbid infections such as mycobacterium tuberculosis. Over the two years of the grant, there will be approximately 15 exchange visits between Tomsk and Houston.
