The HIV epidemic has seen multiple shifts in affected populations over its course, with the current-day epidemic largely affecting racial and ethnic minorities. In addition, low- and middle-income countries (LMICs) continue to shoulder a disproportionate share of disease burden. These populations may have different manifestations of disease, variable disease epidemiology, and diverse treatment needs. To promote training in HIV research in minority and international populations, Scholars in both tracks will be able to select an elective focus in Inner-city HIV or in International HIV if relevant to their research and training.
For the Inner-city HIV focus, we partner with the University of Maryland (UMD) and the NIH to provide training experience with the District of Columbia Partnership for AIDS Progress (DC PFAP). The District of Columbia has an extraordinarily high rate of HIV infection, particularly in minorities. In 2008, Dr. Henry Masur and Dr. Shyam Kottilil initiated the DC PFAP, a unique collaboration between NIH and the DC Department of Health that provides 95% of HIV care in the city. The program includes the nation’s largest urban HIV cohort study, the DC Cohort (10,000 individuals), an HIV prevention program, and focuses on HIV co-morbidities. This program has been a global leader in conducting studies in disadvantaged populations and includes basic and translational science, implementation research, and first-in-human trials. It has been highly successful in partnering with the minority community and local providers, and Dr. Kottilil has demonstrated that these populations, despite multiple social challenges, can be successful partners in research. The program also has a city-wide database that serves research and public health purposes. The DC PFAP works collaboratively with Dr. Kottilil’s site at the Institute of Human Virology (IHV), as well as with NIH, and patient transportation between sites for research studies is well-accepted. This Baltimore-Washington partnership creates a powerful network of patient populations and academic expertise. Scholars will be able to receive training and establish research projects within this program.
The Inner-city focus will provide unique opportunities such as
1. Access to underserved, marginalized, predominantly minority HIV patient populations
2. Innovative clinical and translational research in HIV comorbidities including hepatitis viruses and cardiovascular morbidities
3. HIV and HBV functional cure early phase clinical trials.
Scholars will spend mentored time conducting research that allows high-impact clinical research training. They will select a Mentor at Pitt, as well as one at the University of Maryland/NIH. Scholars will have direct access to a large patient population at various stages of HIV disease for studying HLBS Comorbidities or Cure. In addition, Scholars can work with early phase clinical trials that evaluate cardiovascular dysfunction associated with HIV by imaging conducted at the IHV and the NIH clinical center. As part of this training, trainees will have the opportunity to rotate at the NIH Clinical Center HIV clinic and inner-city clinics in DC. Scholars will also have opportunities to participate in data collection, management, and analysis of HBV functional cure initiatives and HIV cure gene therapy studies being conducted exclusively at IHV/UMD/NIH. Other potential studies that Scholars could develop include implementing pulmonary function testing in this marginalized, minority population. Finally, Scholars will have opportunities to participate in ongoing clinical trials that target lipid abnormalities using novel host target pathways (CD24 molecule).
For our International HIV focus, we utilize several sites in Africa. Dr. Jean Nachega runs the Pittsburgh-Stellenbosch University AIDS-Comorbidities Training Research Program, a Fogarty Center-supported program. This program conducts research in HIV-associated co-morbidities and provides engagement with policymakers and stakeholders to translate research into clinical practice and influence public health policy. In addition, Dr. Alison Morris is a member of the International Council for the African Microbiota Institute at Stellenbosch University, and research experiences will also be offered there.
Opportunities also exist at the University of Ghana, where Dr. Solomon Ofori-Acquah has a joint appointment and leads a U54-funded Center focused on genomics of hemolysis in the out-patient sickle cell disease clinics in the Korle Bu Teaching Hospital, a 2,000-bed facility with scheduled weekly HIV clinics for children and adults. He has established a successful research training program there that will be accessible to Scholars.
Additional international opportunities exist through the University of Maryland. Over the past 12 years, the Institute of Human Virology at the University of Maryland has developed an extensive global health program with a particular focus on infectious diseases in sub-Saharan Africa, which will be facilitated by Dr. Man Charurat. During the last decade-plus, this program has been awarded >$300 million in grants and has reached over 500,000 people with health care and education. Programs focus on high-level technical assistance, advanced clinical education, and operational research to improve in-country best practices. The Division has strong, dedicated programs in East Africa (Kenya, Rwanda, and Tanzania), Southern Africa (Botswana and Zambia), and West Africa (Nigeria) with more than 13 active grants.
Scholars will have the opportunity to select from among these multiple institutions to receive training and to perform research projects.
Additional Rotation Opportunities
Center for the Analysis and Management of the Multicenter AIDS Cohort Study (CAMACS)
CAMACS, located in Baltimore at the Johns Hopkins MACS site, is the central data center for MACS and will provide hands-on experience in the conduct of a multi-center, long-term cohort study including protocol development, regulatory compliance, data monitoring and study monitoring. The CAMACS datacenter oversees requesting MACS samples from the biorepository, compiling datasets for investigators, and provides required analytic support. CAMACS has agreed to host our scholars for a 2-week rotation.
During this rotation, the Scholar will be immersed in the activities of the data coordinating center and learn about how a large, multi-center study is run. Activities will include attendance at scientific and working meetings to learn about issues in initiating sub-studies as part of an ongoing cohort study, issues in longitudinal data collection, analytical topics in longitudinal cohort studies, and tracking of data and biospecimens. This in-person experience with a well-established, successful data coordinating center provides a unique experience for our Scholars pursuing clinical research. This rotation will also facilitate interactions with MACS and development of research utilizing data and/or biological specimens.
Rotation with the Center for Medicine and the Microbiome
The growing field of microbiome research touches many aspects of HLBS Co-morbidities and HIV Cure. Scholars with an interest in the microbiome may decide to join the Center for their primary research project or may elect to perform a month-long rotation at the Center run by Dr. Alison Morris. Scholars will learn about techniques for bacterial and fungal sequencing, sample collection, and analyses. Other educational experiences are also available from the Center including a monthly seminar and a yearly boot camp.