The New Orleans Adolescent Medicine Trials Unit (ATU) is a proposed (and current) collaborating clinical site for.the activites of the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN), a national research effort. The primary mission of the ATN is to conduct research, both independently and in collaboration with other existing research networks and investigators, in pre-adolescents, adolescents and young adults who are HIV infected or are at risk for HIV infection. The public health goal of this research effort is to support limitation of the impact and spread of HIV among young people through primary, secondary, and tertiary prevention. Research results will serve to inform individuals and communities about HIV prevention strategies that are acceptable and effective for young people most affected by HIV. The New Orleans ATU plans to continue primary prevention research through the continued development of Connect to Protect: New Orleans (C2P). C2P: New Orleans is developing a community-based infrastructure to support clinical trials evaluating behavioral, vaccine and other biomedical modalities tailored for New Orleans youth most at risk for HIV infection and transmission, particularly African-American young women. Plans include evaluation of this process, of translation of effective behavioral programs in this community, of ways of educating the community about clinical trials, of acceptability, use and effect of biomedical advances such as vaccines and microbicides. Secondary prevention studies are planned to preserve the health and functioning of HIV-infected youth. Studies include: management strategies such as short-cycle ARV therapy and evaluation of HBV immunization schedules;investigations of key areas such as long-term effects of therapies during growth and maturation, adolescent-specific HIV pathogenesis, and immune recovery under the influence of vaccine and immune-based therapies;strategies to address co-morbidities such as HIV-induced malignancies;and strategies to promote adherence to medical therapies and prevention of HIV transmission to others. Tertiary prevention studies are aimed at improving the clinical management of youth who present very ill or have few remaining therapeutic options. Each study will require its own unique methods, and all will require interdisciplinary collaborations to address the complexity of HIV infected and at-risk populations.
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