Whitman-Walker Institute Inc

UNDERSTANDING VIRAL SUPPRESSION FOR NEWLY DIAGNOSED HIV+ MEN TO INFORM IMPLEMENTATION OF TASP AND U=U

EXAMINING MODIFIABLE PSYCHOSOCIAL PREDICTORS OF HIV SEROCONVERSION IN A LARGE NATIONWIDE COHORT OF HIGH RISK MEN

TESTING A BIOPSYCHOSOCIAL MODEL OF MINORITY STRESS AND HEALTH FOR HIV-POSITIVE MEN

DEVELOPING A COMMUNITY-BASED FACILITY TO SUPPORT NEXT GENERATION BIOMEDICAL HIV RESEARCH - PROJECT SUMMARY/ABSTRACT WARDS 7 AND 8 IN WASHINGTON, DC ARE HOME TO SOME OF THE NATION’S MOST STARK RACIAL INEQUITIES IN HEALTH AND SOCIOECONOMIC INDICATORS, WITH RESIDENTS OF THESE WARDS BEING UNDERSERVED IN HEALTHCARE AND UNDERREPRESENTED PUBLIC HEALTH RESEARCH. AMONG THESE HEALTH INEQUITIES IS A SIGNIFICANTLY HIGHER BURDEN OF HIV, YET NONE OF THE MAJOR HIV-RELATED RESEARCH FACILITIES IN DC ARE LOCATED WITHIN THESE WARDS. TWO CENTRAL HUBS FOR HIV RESEARCH WITHIN DC—THE DC CENTER FOR AIDS RESEARCH AND THE DC CLINICAL TRIALS UNIT—BOTH OPERATE PRIMARILY OUT OF FACILITIES IN WARD 2, AND THE EFFICACY OF THIS RESEARCH WOULD BE ENHANCED BY STRONGER REPRESENTATION OF MARGINALIZED COMMUNITIES IN PROTOCOLS TO OPTIMIZE THE IMPACT OF THIS WORK ON THE NEIGHBORHOODS IN DC THAT ARE THE HARDEST HIT BY HIV, ITS CO-MORBIDITIES/CO-INFECTIONS, AND OTHER CO-OCCURRING HEALTH INEQUITIES. THUS, THE GOAL OF THE PROPOSED HIV RESEARCH FACILITIES AWARD IS TO FUND THE BUILD-OUT OF A NEW STATE-OF-THE-ART, COMMUNITY-CENTERED CLINICAL AND TRANSLATIONAL HIV RESEARCH FACILITY LOCATED WITHIN THE NEW FLAGSHIP WHITMAN-WALKER BUILDING CURRENTLY BEING CONSTRUCTED IN DC’S WARD 8, TO BE USED JOINTLY BY HIV INVESTIGATORS AT BOTH WHITMAN-WALKER AND GEORGE WASHINGTON UNIVERSITY (GWU). THE PROPOSED FACILITY WOULD ADD 10,300 SQUARE FEET OF DEDICATED RESEARCH SPACE, INCLUDING A STATE-OF-THE-ART RESEARCH LAB AND A RESEARCH PHARMACY WITH CAPACITY FOR STERILE COMPOUNDING OF INVESTIGATIONAL PRODUCTS, MORE THAN DOUBLING THE AVAILABLE SPACE FOR RESEARCH IN THIS BUILDING AND SERVING AS THE PRIMARY COLLABORATIVE HUB FOR HIV-FOCUSED RESEARCH IN SOUTHEAST DC. DOING SO WILL SIGNIFICANTLY: (1) INCREASE THE OVERALL VOLUME OF RESEARCH ABLE TO BE CONDUCTED; (2) ENHANCE THE COLLABORATION OF WHITMAN-WALKER AND GWU INVESTIGATORS, BOLSTERING THE STRATEGIC INTEGRATION OF BOTH RESEARCH PROGRAMS; (3) EXPAND THE SCOPE AND TECHNICAL CAPABILITIES OF THE WORK THAT IS POSSIBLE NOT ONLY FOR BOTH INSTITUTIONS BUT ALSO WITHIN THESE SPECIFIC NEIGHBORHOODS OF DC; (4) INDIRECTLY EXPAND THE AVAILABLE SPACE FOR SOCIAL/BEHAVIORAL AND PUBLIC HEALTH RESEARCH AS WELL BY RELOCATING ALL CLINICAL AND TRANSLATIONAL RESEARCH TO THE NEW FACILITY; (5) PROVIDE LOCAL COMMUNITIES WITH GREATER ACCESS TO AND REPRESENTATION IN CUTTING- EDGE HIV SCIENCE AND NEW OPPORTUNITIES TO HELP INFORM THESE COLLABORATIVE RESEARCH AGENDAS; (6) FACILITATE GREATER TRANSLATION AND DISSEMINATION OF BREAKTHROUGHS IN HIV SCIENCE WITHIN LOCAL AND NATIONAL POLICY CONTEXTS THAT WILL BENEFIT BOTH LOCAL DC COMMUNITIES AND COMMUNITIES ACROSS THE COUNTRY; AND (7) PROMOTE NEW OPPORTUNITIES FOR TRAINING AND MENTORSHIP. IN SUM, THE PROPOSED PROJECT WILL HAVE A MULTIPLICATIVE IMPACT ON BOTH LOCAL AND NATIONAL HIV RESEARCH THROUGH THIS UNIQUE PLAN TO INCREASE THE SIZE AND SCOPE OF FACILITIES AVAILABLE AND CO-LOCATE TWO OF DC’S TOP HIV RESEARCH INSTITUTIONS TO LEVERAGE EXISTING PARTNERSHIPS AND FORGE NEW, COMMUNITY-CENTERED COLLABORATIVE RESEARCH AGENDAS. IN DOING SO, THE AWARD WILL BRING CUTTING-EDGE BREAKTHROUGHS IN HIV TREATMENT AND PREVENTION SCIENCE DIRECTLY TO UNDERSERVED COMMUNITIES MOST IMPACTED BY THE HIV EPIDEMIC IN DC AND HAS SIGNIFICANT POTENTIAL FOR PUBLIC HEALTH IMPACT FOR DECADES TO COME.

INTERSECTIONAL DISCRIMINATION AND LINKAGE TO HIV PREVENTION AND CARE IN TRANSGENDER WOMEN IN ECUADOR - 7. PROJECT SUMMARY-ABSTRACT LATIN AMERICA DID NOT ACHIEVE ANY REDUCTIONS IN NEW HIV CASES IN THE LAST DECADE. IN ECUADOR, TRANSGENDER WOMEN—THOSE WHO IDENTIFY AS WOMEN OR ON THE TRANSFEMININE SPECTRUM AND WHO WERE ASSIGNED A MALE SEX AT BIRTH—WHO HAVE SEX WITH CISGENDER MEN ARE A KEY POPULATION IN THE HIV EPIDEMIC. HIV PREVALENCE IN ECUADOR IS BETWEEN 20.7%-34.8% AMONG TRANSGENDER WOMEN—THE HIGHEST IN LATIN AMERICA. STUDIES ARE URGENTLY NEEDED TO GUIDE HIV PREVENTION AND CARE EFFORTS TO CURB HIV INFECTION RATES. PEOPLE WITH MULTIPLE MARGINALIZED IDENTITIES, SUCH AS TRANSGENDER WOMEN OF AFRICAN DESCENT LIVING IN POVERTY, ARE AT HIGHER RISK OF EXPOSURE TO INTERSECTIONAL DISCRIMINATION THAN THE GENERAL U.S. POPULATION AND HAVE HIGH RATES OF HIV. YET THE EXTENT TO WHICH ECUADORIAN TRANSGENDER WOMEN ARE BURDENED BY INTERSECTIONAL DISCRIMINATION AND ITS EFFECT ON THE LINKAGE TO HIV PREVENTION AND CARE OUTCOMES REMAINS UNKNOWN. THIS K01 AWARD WILL PROVIDE THE CANDIDATE WITH TRAINING IN INTERSECTIONAL QUALITATIVE, QUANTITATIVE, INTERVENTION DEVELOPMENT, AND GRANT WRITING TO ADDRESS THE CHALLENGE OF INTERSECTIONAL DISCRIMINATION AND HIV BURDEN IN TRANSGENDER WOMEN IN ECUADOR. THE PROPOSED RESEARCH WILL ASSESS THE MECHANISMS THROUGH WHICH INTERSECTIONAL DISCRIMINATION EXERTS ITS IMPACT ON LINKAGE TO HIV PREVENTION AND CARE FOR TRANSGENDER WOMEN IN ECUADOR WHILE EXTENDING AND DEEPENING CANDIDATE’S RESEARCH SKILLS. IN RESEARCH AIM 1, THE CANDIDATE WILL ASSESS EXPERIENCES OF INTERSECTIONAL DISCRIMINATION (E.G., HIV STIGMA, RACISM, CLASSISM) IN RELATION TO HIV PREVENTION AND CARE THROUGH IN-DEPTH QUALITATIVE INTERVIEWS WITH TRANSGENDER WOMEN (TRAINING AIM 1: APPLICATION OF INTERSECTIONALITY TO QUALITATIVE METHODS). IN RESEARCH AIM 2, THE CANDIDATE WILL CONDUCT A SURVEY TO CHARACTERIZE AND LONGITUDINALLY TEST THE PATHWAYS THAT LINK INTERSECTIONAL DISCRIMINATION WITH HIV PREVENTION AND CARE LINKAGE OUTCOMES OVER A 6-MONTH PERIOD (TRAINING AIM 2: EPIDEMIOLOGICAL METHODS AND LONGITUDINAL QUANTITATIVE RESEARCH DESIGN). IN RESEARCH AIM 3, THE CANDIDATE WILL IMPLEMENT THE FIRST SIX PHASES OF THE SYSTEMATIC ADAPT-ITT MODEL TO ADAPT AN HIV INTERVENTION FOR TRANSGENDER WOMEN (TRAINING AIM 3: SKILLS FOR INTERVENTION DEVELOPMENT). FINDINGS FROM THIS STUDY AND TRAINING WILL POSITION THE CANDIDATE TO DEVELOP AN R01 PROPOSAL TO IMPLEMENT REMAINING STEPS OF THE ADAPT-ITT MODEL AND CONDUCT A RANDOMIZED CONTROLLED TRIAL OF THE INTERVENTION (TRAINING AIM 4: GRANT WRITING). AS AN ECUADORIAN NON-BINARY QUEER U.S. IMMIGRANT RESEARCHER, THE CANDIDATE HAS THE CULTURAL AND RESEARCH BACKGROUND TO LEVERAGE THIS PROPOSED K01 TO TRANSITION TO CAREER INDEPENDENCE AND ADDRESS KEY KNOWLEDGE AND INTERVENTION GAPS FOR HIV PREVENTION AND CARE IN ECUADOR.