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You are not limited to those listed below; you can expand your search for specific research expertise at UCSF Profiles and email the UCSF faculty directly. Additional international projects listed on the UCSF Global Research Projects Interactive Map.
HIV and Malaria Research in Uganda
UCSF has long standing research collaborations in Uganda. UCSF and Ugandan collaborators have established NIH funded research programs in the capital city of Kampala (Makerere University) and in the western Ugandan community of Mbarara (Mbarara University of Science and Technology). Funded projects are evaluating antiretroviral treatment in adults and children and HIV co-infections (KSHV, malaria, TB). Selected active projects including clinical investigators and funding mechanisms are described below.
Supporting the implementation of malaria prevention and control strategies and relevant ancillary activities in the Republic of Uganda as part of the President's Malaria Initiative. 1) In collaboration with the National Drug Administration (NDA), develop and maintain a viable pharmacovigilance system for anti-malarial drugs in Uganda. 2) Improve case management of febrile illness in Uganda. 3) In collaboration with the National Malaria Control Program, strengthen malaria surveillance activities in Uganda. 4) Evaluate the efficacy and effectiveness of anti-malarial drugs to provide timely, relevant, reliable, and understandable information to help guide Ugandan Government policy concerning those drugs. Contact: Grant Dorsey, MD
Anti-Retrovirals for Kaposi's Sarcoma. In sub-Saharan Africa, the intersection between the HIV epidemic and the endemic nature of Kaposi's sarcoma-associated herpesvirus (KSHV) infection has caused Kaposi’s sarcoma (KS) to become the most common malignancy in the region. In places where highly active antiretroviral therapy (HAART) is readily available (e.g., in the U.S.), use of HAART often causes regression of KS even in the absence of conventional chemotherapy. While little is known about which specific antiretroviral drugs are critical to convey HAART's effect on KS, recent data from in vitro systems and animal models suggest that protease inhibitors (PIs), originally developed to block the active site of HIV aspartyl protease, also have direct anti-KS effects above and beyond their effect on HIV.
To address the hypothesis that PI-containing HAART is superior to PI-sparing HAART in promoting KS regression, investigators at the Infectious Diseases Institute and Uganda Cancer Institute in the Mulago Hospital Complex in Kampala, Uganda, in collaboration with the University of California, San Francisco, are conducting an NIH-sponsored randomized clinical trial. This study is comparing a PI-based HAART regimen (lopinavir/ritonavir plus emtricitabine/tenofovir) to a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimen (efavirenz plus emtricitabine/tenofovir) for the ability to promote the regression of KS in persons with AIDS-related KS. Subjects are followed at four-week intervals for 48 weeks, and the primary outcome is change in KS tumor burden as assessed using the established metric from the NCI-sponsored AIDS Malignancy Consortium.
In addition to the primary aim of the randomized aspect of the study, the project has several fruitful observational objectives. The foremost aim is to determine just what percentage of patients with HIV-related KS will have a durable response to HAART alone and to identify which pre-treatment parameters are predictive of KS regression on HAART alone. Another clinical objective is to investigate the incidence and determinant s of KS-associated immune reconstitution inflammatory syndrome (IRIS). Finally, from the translational perspective, another objective is to examine the effect of HAART on KSHV-related virologic activity and host immune response to KSHV, including whether HAART reduces levels of KSHV shedding and infectiousness.
The project encompasses the investigation of three entities – KS, KSHV, and HIV – about any of which the scholar can focus his/her research project. In addition to the research components, the trial has the primary clinical responsibility for over 200 participants with HIV and KS, and thus the scholar has the opportunity to observe clinically how antiretroviral drugs can have a powerful impact on individual patients and their families. A scholar is sought to have a high level of responsibility in study implementation, working side-by-side with Ugandan physicians and managing the day-to-day field work. Contact: Jeff Martin, MD, MPH
HIV and TB: The Punctuated Antiretroviral Treatment (PART) trial is a randomized study of immediate versus delayed antiretroviral therapy in HIV infected TB patients. This is a joint MU/CWRU/ UCSF collaboration led by Drs. Roy Mugerwa (Makerere), Chris Whalen (CWRU) and Diane Havlir (UCSF). The primary aim of this study is to test the hypothesis that a short course of antiretroviral therapy in HIV + persons with a high CD4 cell count and TB will delay accelerated HIV disease progression. The secondary aims are to evaluate rates of TB clearance, immune reconstitution syndrome and tolerance of TB medications. This study provides an excellent opportunity to address questions of HIV disease in persons with high CD4 cell counts. Contact: Diane Havlir, MD
HIV Testing in TB Clinic: Family Based Home vs Clinic Testing. This is a recently funded R01 study led by UCSF epidemiologist Dr. Edwin Charlebois and Dr. Mugerwa from MU. The study is aimed at identifying optimal strategies for HIV testing. Specific aims of the study are 1) to determine the uptake of and barriers to voluntary counseling and testing (VCT) among a cross-sectional sample of 2,000 patients offered same-day results HIV VCT at the TB clinic, 2) to conduct a randomized trial among 600 households, comparing VCT uptake between home- and clinic-based VCT for family and household members of TB evaluation patients, and 3) to investigate the effectiveness of home-and clinic-based VCT in linking HIV infected persons among the 600 randomized households to HIV medical care and social support. This study provides opportunities to study HIV discordant couples and families as well as co-infections such as TB, KSHV, and malaria. Contact: Edwin Charlebois, PhD
Uganda AIDS Rural Treatment Outcomes (UARTO) Cohort. With the prevalence of HIV infection among adults varying between 10 and 40% in individual countries, sub-Saharan Africa is the site of the most compelling public health crisis of our time. Because definitive solutions to this problem – potent preventive and curative interventions – are not in hand nor on the foreseeable horizon, investment is needed to understand the natural history of HIV infection in this region and optimize the response to currently available antiretroviral therapy (ART). Optimization of response to therapy is particularly relevant given that the availability of antiretroviral therapy is fortunately rapidly expanding. For example, in just over 5 years in Uganda, treatment has expanded from less than 1% to over 50% of the HIV-infected individuals in whom it is indicated. Unfortunately, this rapid expansion in treatment access has occurred in advance of an understanding of the unique biologic, behavioral and structural determinants of therapeutic outcomes that are present in resource-limited settings like Africa.
To address the need to understand the response to ART in Africa, the Uganda AIDS Rural Treatment Outcomes (UARTO) cohort was founded as a collaboration between UCSF, Harvard, and Mbarara University of Science and Technology in Uganda. UARTO is a 500 subject prospective cohort study of HIV-infected adults who are enrolled just prior to initiation ART. The objective is to evaluate the biologic and behavioral determinants of the virologic, immunologic, and clinical course after starting therapy. Participants are examined at 3 month standard intervals at which time a variety of standardized interviewer-administered instruments are completed detailing household socioeconomic profile, food insecurity, social capital, stigma, alcohol use, mental health, functional health status, HIV transmission risk behavior and objective antiretroviral therapy adherence measures (e.g., electronic pill monitoring and random home pill counts). Blood is also collected at each visit for real-time plasma HIV RNA, CD4+ T cell count, and overall T cell activation levels; plasma, buffy coat, and saliva are processed and stored for future translational research. Motivated student-scholars are sought to take a leading role in the analysis of one or more of the many components of UARTO as well as to participate in the day-to-day management of the cohort. Contact: Jeff Martin, MD, MPH
DDCF Support for Studies in Uganda. A Distinguished Clinical Scientist award to Philip Rosenthal, entitled "Translational studies of antimalarial drug resistance" has funded studies in Kampala since late 2004. Specific aims of the project are 1) assessment of associations between the complexity and diversity of malaria infections and treatment outcomes, 2) characterization of the selection of drug resistant malaria parasites, and 3) determination of molecular mechanisms of antimalarial drug resistance. A Clinical Scientist Development Award, entitled "Interactions between HIV and Malaria in African Children," was recently awarded to Grant Dorsey. Specific aims are 1) to compare the incidence of malaria in HIV infected and uninfected children, 2) to compare the safety, tolerability, and efficacy of ACT for uncomplicated malaria in HIV infected and uninfected children, and 3) to assess the effect of ARV use on malaria incidence among HIV infected children. Contact: Phil Rosenthal, MD
Mulago Inpatient Noninvasive Diagnosis of Opportunistic Pneumonia Study (MIND) and International HIV-associated Opportunistic Pneumonias (IHOP) Study. Led by Laurence Huang, MD (UCSF Principal Investigator) and William Worodria, MBChB, MMed (Makerere University Principal Investigator), these longitudinal studies of hospitalized HIV-infected patients with pneumonia provide a platform for clinical, scientific, and operations training and research on the diagnosis and prognosis of acute respiratory illness in a resource-limited setting with a high burden of HIV and tuberculosis. With funding from the National Heart, Lung, and Blood Institute at the NIH, we are building a rolling cohort of 600 patients to compare the performance of traditional diagnostic methods to that of novel immunologic and nucleic-acid-based technologies for diagnosis of pulmonary tuberculosis (TB), Pneumocystis pneumonia (PCP), and other HIV-associated respiratory conditions. We are also investigating how establishing a diagnosis and prognosis for opportunistic conditions in HIV-infected patients affects patient outcomes, such as the likelihood of immune reconstitution disorders or of pathogen resistance to antimicrobial drugs, and how it affects systems outcomes, such as costs and health policies. Opportunities exist for medical students to conduct defined 1-year research studies that would be incorporated within the framework of the ongoing studies. Contact: Laurence Huang, MD
Mechanisms of Antimalarial Drug Resistance (funding from NIH/NIAID, NIH/NICHD, and Doris Duke Charitable Foundation). We are pursing translational studies of antimalarial drug resistance. Aims include characterization of molecular mechanisms of drug resistance and elaboration of the selection of resistance by drugs used for the treatment of malaria, the prevention of malaria, or the treatment of HIV infection. Studies include molecular characterization of malaria parasites, in vitro evaluation of responsiveness to antimalarial drugs, and molecular studies to characterize the impacts of key parasite polymorphisms on antimalarial drug efficacy and parasite fitness. These studies are conducted both at UCSF and in Uganda. Contact: Philip Rosenthal, MD
Prevention of Malaria in Tororo. This project entails 3 large clinical trials comparing 1) the antimalarial protective efficacy of different HIV therapies in children, 2) protection against placental malaria by different HIV therapies in pregnant women, and 3) protection against malaria by different intermittent or continuous antimalarial therapies in children. All of these studies will be conducted in Tororo, Uganda. Molecular studies of drug resistance will be linked to the clinical trials. Contact: Diane Havlir, MD; Grant Dorsey, MD; Philip Rosenthal, MD; Edwin Charlebois, PhD
Malaria Immunology. Several large scale studies of the development of anti-malarial immunity during childhood have recently been initiated, and will take advantage of our newly renovated state-of-the-art immunology laboratory in Tororo, which is co-located with the study clinic. These studies aim to define correlates of immune protection from malaria, in order to guide vaccine design. All of these projects are collaborative in nature and leverage blood samples obtained from clinical trial participants and epidemiologic cohort members, enabling correlation of immunologic assay results with clinical exposure and outcomes data from individual children. Projects currently underway or planned include an analysis of the impact of chemoprevention on the development of malaria-specific immune responses, and a study of the impact of fetal exposure to malaria antigens during pregnancy on immune tolerance in the infant. Contact: Margaret Feeney, MD
HIV Research in Kenya
The UCSF-Kenya Medical Research Institute (KEMRI) Program focuses on HIV and STI prevention research and the evaluation and provision of HIV/AIDS care, including antiretroviral treatment in adults and children. The UCSF PI is Craig Cohen, MD, MPH, and the KEMRI PI is Elizabeth Bukusi, MBChB, M.Med, MPH, PhD. If you are interested in participating in any of the following studies, please contact Craig Cohen, MD, MPH or Kimberly Bale, Program Manager, or the contact listed after each study.
Family AIDS Care and Education Services (FACES) is an innovative program in Nairobi and western Kenya (Nyanza Province) which operates a family-oriented model of HIV care and treatment funded through the US President's Emergency Plan for AIDS Relief (PEPFAR). The FACES family model of care focuses on identifying and enrolling all HIV-infected family members and retaining and supporting them in care. The model includes: encouraging HIV testing of partners and children; assisting with disclosure to both adults and children; providing joint family clinic appointments; support groups for pregnant women with HIV and their husbands; and a "kids club" for HIV-infected and affected children.
A growing part of the FACES model is the Student Training Education Program (STEP). Medical students and residents from UCSF, University of Nairobi, University of British Columbia, and other universities are selected four times a year for a clinical or research elective. Each spends a minimum of six weeks at a FACES site; projects can be up to a year. Students are closely mentored by clinic staff. First- and second-year medical students conducting research electives work on tailored studies; third and fourth year medical students and residents work directly with patients to gain clinical experience.
FACES serves as an important platform for conducting clinical and operational research related to HIV care and treatment. Many of the FACES-related studies are described below. Contact: Craig Cohen, MD, MPH
Shamba Maisha: Pilot agricultural intervention for food security and HIV health outcomes in Kenya. Food insecurity contributes to increased HIV transmission risk and higher HIV-related morbidity and mortality. This pilot study is testing the hypothesis that a multi-sectoral agricultural intervention will prevent HAART treatment failure, reduce co-morbidities, and decrease secondary HIV transmission risk. One hundred and twenty HIV-infected farmers on HAART in Western Kenya (60 at an intervention clinic and 60 at a control clinic) will be enrolled and followed for 1 year. This intervention will include: a) human-powered water pumps and other required farm commodities, b) microfinance loans (~$125) to purchase the pump and agricultural implements, and c) education in sustainable farming practices. The impacts of the intervention on mediating factors (food security and economic indicators) will be examined, and pathways for how improvements in these mediating factors impact health outcomes will be explored. The ultimate goal of this work is to contribute to sustainable solutions to tackle the intersecting challenges of food insecurity, poverty, and HIV/AIDS in sub-Saharan Africa. As part of Shamba Maisha, we are also studying the impact of this intervention on the health and nutritional outcomes among 0-5 year old children (aka Peds-Shamba Maisha). This study is funded by a National Institutes of Health/National Institute of Mental Health. Contact Sheri Weiser, MD, MS or Craig Cohen, MD, MPH, or Lisa Butler, PhD for the Peds-Shamba Maisha.
Identifying Opportunities for HIV Prevention among Female Migrants in Kenya. This study aims to assess the degree to which women’s participation in migration in Southern and East Africa contributes to HIV/AIDS in the regions. It also seeks to characterize features of the contexts of African women’s migration experiences- and the behavioral and mental health consequences of migration- that place female migrants at particularly high risk of HIV infection and transmission. This study is comprised of two distinct phases: a secondary data analysis using population-based survey and HIV serological data from Southern and East Africa, and an in-depth qualitative study in Kenya. The ultimate goal of this research is to reduce HIV transmission risks via a multi-level HIV prevention intervention with female migrants in western Kenya This study is funded by an National Institutes of Health. Contact: Carol Camlin, PhD
The Effects of Integrating Family Planning Services into HIV Care and Treatment in Nyanza Province, Kenya. This study seeks to help determine how to best meet the family planning needs of HIV-infected women and to provide information for policy makers and program planners that will help them implement high quality services for this population. This study is a cluster-randomized trial comparing the effects of integrating family planning services into HIV care and treatment programs on contraceptive uptake, contraceptive continuation, and unintended pregnancy rates. It compares the integration of family planning services into HIV care and treatment versus the standard referral for family planning services outside of HIV care and treatment programs. It is being conducted in FACES-affiliated clinics in Nyanza Province, Kenya. Contact: Dan Grossman, MD, or Sara Newmann, MD, MPH
Cervical Cancer Screening and Prevention (CCSP). HIV-infected women are at higher risk for developing cervical pre-cancer and cancer. That risk increases with decreasing immune function; however the effect of Anti-Retroviral Therapy (ART) on cervical cancer development and progression remains unclear. Prior to the availability of ART, HIV-related death was a much greater threat to people living in resource-limited countries, such as Kenya. With greater access to HIV care including ART, through the implementation of programs such as FACES, more people are living longer with HIV, yet remain susceptible to HIV-related illnesses.
The CCSP program at FACES aims to use resource-appropriate, safe and effective methods to screen and treat for cervical cancer and pre-cancer in this high risk population. In addition to evaluating clinical data to answer operational questions, a prospective cohort trial is being conducted to look at recurrence rates of cervical dysplasia after surgical excision to answer the question of the effect of ART on cervical cancer. Contact: Megan Huchko, MD
(Discordant Couples) Risk Reduction in HIV Serodiscordant Couples Attempting Conception. HIV negative partners in discordant heterosexual relationships are recognized as a high risk group for sexual transmission of HIV in sub-Saharan Africa. Efforts to reduce HIV transmission in this group do not address the concerns of couples who desire children. The goal of this study is to develop a preliminary understanding of the social and cultural context in which these couples are making the decision to conceive, and to explore the hypothetical acceptability of risk reduction strategies for discordant couples attempting conception. Discordant couples of reproductive age who express a general desire to have children in the future are recruited to participate in structured questionnaire followed by an in-depth interview. Findings will be used to design an investigation to determine the uptake and acceptability of interventions to reduce HIV transmission for HIV discordant couples attempting conception. Contact: Craig Cohen, MD, MPH
Application of Weighted Time-Series to Address Bias in Evaluation of Clinic- and Community-Level Research. This study uses simulation to develop, test, and apply new analytic methods (weighted time-series) for evaluation the effectiveness of community- and clinic-level interventions. It compares results using weighted time-series and conventional methods within the context of a clinic-level intervention, namely at FACES-supported clinics in Kenya. The results of this study will be used to seek funding to test the broader application of these methods in both community- and clinic-level interventions. Application of these methods has the potential to improve evaluation of many community-level interventions, particularly in settings where it is difficult to obtain individual-level information or to follow individuals in the community over time (e.g. rural or other hard to reach populations). Contact: Starley Shade, PhD, MPH
Prevention of Tuberculosis in HIV-Infected Children in Kenya. This study is evaluating the effectiveness of Isoniazid Preventive Therapy (IPT) in HIV-infected children to reduce TB incidence, morbidity and mortality. The hypothesis is that IPT will effectively reduce TB and overall morbidity and mortality in the study population. If this should occur, the Kenya National Leprosy and Tuberculosis Program can consider national guidelines for IPT in children. Contact: Craig Cohen, MD, MPH
The HIV Neurology in Kenya (THINK) Dementia Study. This study will validate a diagnostic tool for use by non-physician health care providers to diagnose HIV associated dementia. This is a cross sectional study which will involve the validating the diagnostic tools against a structured history, neurological exam, neuropsychological testing and imaging with computed tomography. Subjects will be recruited from a random sample of sites throughout Nyanza province. Contact: Ana-Claire Meyer, MD
Fertility Desires and Family Planning among HIV-Infected Couples in Nyanza Province, Kenya. This study will explore decision-making and relationship power around fertility and family planning among HIV-affected couples and community leaders in Nyanza Province, Kenya. This is a qualitative, hypothesis-generating research project which will involve in-depth, open-ended interviews with couples who present to HIV clinics for care, couples from high prevalence HIV communities, and with individual community leaders. Contact: Sara Newmann, MD, MPH
Tuberculosis Research in Zimbabwe
Transmission and Pathogenesis of MDR-TB Project (TraP MDR-TB). An estimated 10 million people worldwide have tuberculosis, of whom about 500,000 have multidrug-resistant (MDR) disease. In the past two decades, the incidence of MDR tuberculosis has tripled in HIV prevalent regions of Southern Africa. Nearly half of all MDR-TB/HIV co-infected patients succumb to their disease within 30-60 days, before a diagnosis can be made using conventional methods.
Zimbabwe is distinguished by HIV hyperendemicity, an emerging MDR-TB epidemic, and intense sociopolitical transition. In Harare, Zimbabwe, the TraP MDR-TB (Transmission and Pathogenesis of MDR-TB) Project collaborates with local health authorities to reduce the burden of drug resistant TB through early identification of patients with MDR-TB using rapid diagnostics, clinical prediction, and community and household contact investigation. Through our work we are generating the first accurate population-based estimate of MDR-TB incidence in the country since 1995, as well as undertaking the first prospective study of the contribution of microbial and human genomic factors on drug resistant TB transmission in a high HIV prevalence setting. Contact: John Metcalfe, MD, MPH
Other Research in Africa
Outcomes of femoral shaft fractures in Tanzania. This study is a prospective observational study evaluating the outcomes of operatively treated femoral shaft fractures at Muhimbili Orthopaedic Institute (MOI), the main tertiary referral center for trauma in Dar es Salaam, Tanzania. The goal is to identify the optimal treatment for femur fractures, which are an important component of the growing epidemic of trauma in Sub-Saharan Africa. We are using web and mobile-based data collection systems in collaboration with local investigators to improve data quality. Students involved in the project would have the opportunity to participate in hospital-based research activities as well as in-field data collection for patients lost to follow up. Preference for students who can commit 9 months. Contact Angelique Slade Shantz with the Orthopaedic Trauma Institute's Institute for Global Orthopaedics and Traumatology (IGOT).
Alcohol consumption in the first year of HIV care in Uganda (The BREATH Study). Alcohol is the most commonly used recreational drug in sub-Saharan Africa, where the majority of HIV cases are located. Uganda has one of the highest rates of per capita alcohol consumption in the world. Alcohol has a substantial impact on the sub-Saharan African HIV epidemic via increased risk for sexual transmission of HIV and decreased adherence to antiretroviral therapy (ART), which may lead to treatment failure. We have observed a high rate of self-reported natural recovery from hazardous drinking in the absence of alcohol treatment in a cohort of HIV positives initiating ART in Mbarara, Uganda. The Biomarker Research of Ethanol Among Those with HIV (BREATH) Study (R01 AA018631) is a mixed methods prospective cohort of 212 HIV positive alcohol consumers to (1) quantify changes in alcohol consumption during the first year of HIV care in Mbarara Uganda, and (2) examine correlates of changes in alcohol consumption. Self-reported alcohol consumption or abstinence is corroborated using phosphatidylethanol, a biomarker of heavy alcohol consumption that may be detected for extended periods of time after alcohol itself has left the body. The long-term goal of this study is to quantify changes in alcohol consumption during HIV care and to determine factors predictive of such change to inform future interventions to decrease alcohol consumption. Contact: Judy Hahn, PhD
Alcohol consumption and pre-ART HIV disease progression (The ADEPT Study). Whether heavy alcohol consumption accelerates HIV disease progression is a fundamental unanswered question with far-reaching public health implications worldwide. Alcohol is one of the most commonly used drugs in the world, and heavy alcohol consumption is very prevalent among those infected with HIV both in the USA and worldwide. While animal studies to address this question suggest that alcohol consumption early in infection may cause immune system damage and accelerate HIV disease progression, the results of human observational studies of this issue have been less clear, due to several limitations. If heavy alcohol consumption prior to ART initiation accelerates HIV disease progression, then interventions to reduce alcohol consumption should occur as early as possible. The primary goal of the Alcohol Drinking Effects on Progression prior to Treatment (ADEPT) Study (U01AA020776) is to examine this central issue of HIV-alcohol research in a longitudinal cohort study of 650 ART-naive HIV-infected individuals in Mbarara, Uganda. The aims of the ADEPT Study are to (1) determine the impact of heavy alcohol consumption on pre-ART HIV disease progression, as measured by CD4 cell count decline, and (2) examine likely biological mechanisms of alcohol induced disease progression such as microbial translocation, liver disease, and depression. This study utilizes a direct metabolite of heavy alcohol consumption, phosphatidylethanol (PEth), to increase our ability to detect unreported heavy alcohol consumption. Contact: Judy Hahn, PhD
Research in Asia
Screening for CMV retinitis in Thailand The Francis I. Proctor Foundation for Research in Ophthalmology continue to work on the use of telemedicine as a low cost means of screening for CMV retinitis in HIV/AIDS patients in Thailand. They now have a very low cost device that attaches to a cell phone that can be used to visualize the retina and plan to study its sensitivity and specificity and reliability in screening for both CMV retinitis and diabetic retinopathy in Thailand. Contact: Dr. Todd Margolis
Research in Latin America
INORMUS (International Orthopaedic Multicenter Study in Fracture Care). As a joint initiative with McMaster University, IGOT will be part of the INORMUS Project Group conducting 4-week fracture audits at multiple partnering sites to serve as a proxy to better quantify the global burden of orthopaedic trauma. This global registry will serve as a database to develop capacity building initiatives and individual research projects. IGOT has piloted this project in Ghana and Nicaragua, and will use the pilot experience to roll out the study throughout partner sites in Latin America. Preference for students who can commit 9 months. Contact Angelique Slade Shantz with the Orthopaedic Trauma Institute's Institute for Global Orthopaedics and Traumatology (IGOT).
Research in Cambodia
Cambodia Integrated HIV and Drug Prevention Implementation Program. This Cambodia Integrated HIV and Drug Prevention Implementation Program project will implement and evaluate an integrated combination HIV prevention intervention: SMARTgirl Plus for Cambodian female entertainment and sex workers, where non-injection use of amphetamine type stimulant (ATS) is high and significantly contributing to HIV risk. SMARTgirl Plus will add demonstrated approaches to ATS and HIV prevention (conditional cash transfer (CCT) and microfinance (MF) opportunities) into an existing widely disseminated program (SMARTgirl), using a stepped wedge randomized cluster design, and assess impacts on HIV related risk behavior. Adding CCT and MF to existing HIV prevention programs will broaden the scope of the current prevention model which focuses principally on reducing sexual risk through condom use and STI care, and uptake of reproductive health services. The project will also expand knowledge build capacity implementation science by promoting multisectoral collaborative activities including training and education with U.S. and Australian academic groups for Cambodian partners. Contact: Kim Page, PhD, MPH
Research with a Global Focus
Surgical Disease Research Accelerator. The global burden of surgical disease is projected to surpass that of all infectious diseases by 2030. Despite this, relatively little research on surgical conditions exists to help guide policy, interventions and allocation of resources in LMICs. We propose to help support LMIC-driven surgical disease research capacity by creating a multidisciplinary, international academic surgical consortium to act as a “research accelerator” via:
- One-year research fellowships for post-graduate trainees at home and host institutions for research in surgical conditions that impact LMICs.
- Research curriculum (in development), delivered via webcast, webinars, and research symposia (two completed).
- Suite of research tools, including question building app (in development), data collection tool, online template library, web-based mentorship portal, project database, literature review repository (in development), grant opportunity database (in development). (We are currently applying for an NIH Fogarty D43 Training Grant for this project.) Preference for students who can commit 9 months. Contact Angelique Slade Shantz with the Orthopaedic Trauma Institute's Institute for Global Orthopaedics and Traumatology (IGOT).