Human immunodeficiency virus (HIV) affects human’s immune system and causes Acquired immunodeficiency syndrome (AIDS). HIV infection remains one of the largest global epidemics; it is estimated that about 38 million people currently live with HIV worldwide. HIV is not curable right now but highly treatable with effective antiretroviral therapies (ARTs). Research on HIV/AIDS is led by Profs Hogan, Liu, Chrysanthopoulou, and Steingrimsson. They collaborate with investigators locally at the Boston-Providence Center for HIV Research (Boson/Providence CFAR), Brown Alcohol Research Center on HIV, Brown Data Science Initiative (DSI), and globally with researchers at various national and international research centers (e.g., AmPATH programs). Their collaborative research includes (1) behavioral health research of HIV/AIDS (e.g. to reduce drug/substance use and other behaviors known to interfere the ART effectiveness); (2) HIV prevention (e.g. to identify barriers/facilitators on HIV testing and prophylaxis); (3) optimizing HIV treatment continuum/cascades; (4) research on HIV among high risk/vulnerable populations such as men-who-have-sex-with-men (MSM), minority populations; people in the judicial system, women, and adolescents/children; (5) HIV related neural science research. Their collaborative and methodological research has secured rich research funds from NIAID, NIAAA, NIAID, NHLBI, NICHD, USAID, etc.
Alcohol and HIV: Biobehavioral Interactions and Intervention
By increasing understanding of how excessive alcohol consumption and interventions to reduce excessive drinking can impact HIV-related health outcomes and sexual behavior that transmits HIV, this program project can contribute greatly to efforts to reduce alcohol use and improve the health of those living with HIV and to reduce the spread of HIV. Collaborative research in this domain has strong connections with Boston/Providence Center for AIDS Research where Prof Hogan serves as a co-Director of the Biostatistics Core and Brown Alcohol Research Center on HIV where Prof Liu serves as a co-Director of the Research Methods Core.
Development and Pilot Testing of a Persuasive Health Communication Intervention for Emergency Department Patients Who Decline Rapid HIV/HCV Screening
Emergency departments (EDs) are an ideal venue to conduct screening for both HIV and HCV, given the high prevalence of HIV and HCV risk-taking behaviors among ED patients (e.g., sexual risk and drug use, particularly injection-drug use during the current opioid epidemic in the US); the known feasibility and acceptability of HIV and HCV screening in this setting; the proven yield of identifying those with undiagnosed infections in the ED; and the ability to link those with infections to subsequent care after the ED visit. Screening for both infections in EDs is preferable due to: (1) the shared overlap of some risk behaviors for HIV and HCV acquisition (e.g., drug use), (2) the relatively high co-occurrence of these infections in some populations, (3) the more complex medical needs and worse sequelae for those co-infected, and (4) efficiency. Despite the strong rationale for ED HIV/HCV screening, best practices on how to conduct screening so to maximize patient screening uptake have yet to be identified. This collaborative research project aims to gain invaluable preliminary data for a subsequent R01 randomized, controlled trial that ultimately aims to determine if: (1) a persuasive health communication intervention can convince those who initially decline screening to be tested; (2) emergency department (ED) medical staff or HIV/HCV counselors should conduct opt-out, rapid HIV/HCV screening; and (3) if ED medical staff or HIV/HCV counselors using the intervention are better at convincing patients to be tested for HIV and HCV. The overall research purpose is to help identify evidence-based practices to improve ED HIV/HCV screening.
Fogarty HIV Research Training Program for Low-and Middle-Income Country Institutions
The overall goal of the Fogarty HIV Research Training (HIVRT) Program is to strengthen the scientific capacity of institutions in low- and middle-income countries (LMICs) to conduct HIV research on the evolving HIV epidemic in their countries. Trainees will be jointly trained by the biostatistics program at Brown and by experts in a broad domain of HIV research. Trainees are expected to contribute their knowledge and assist with the buildup of scientific programs to reduce HIV pandemic in LMICs.
HIV Treatment and Failure and Drug Resistance in Western Kenyan Children (RESPECT)
This collaborative research will generate new information on the development of treatment failure and drug resistance among a large, well-characterized cohort of HIV-infected children in western Kenya who receive common medications, using detailed, longitudinal, clinical, adherence, and drug concentration data. The proposed research is relevant to public health since such information is limited in the scientific literature, and withot it we cannot accurately assess treatment failure and drug resistance in HIV-infected children, which can lead to sickness and death. The long-term goal of this research is to provide evidence to improve clinical guidelines and chronic disease management for HIV-infected children in resource-limited settings.
HPV and Cervical Cancer in Kenyan Women with HIV/AIDS (HPV)
The interaction of human papillomavirus (HPV) with human immunodeficiency virus (HIV) represents one of the most "dangerous liaisons" for women in Sub-Saharan Africa. Almost all cervial cancers are caused by persistent high-risk HPV. Persistent HR-HPV infection is more common among women with HIV comnpared to HIV-negative women. Understanding the prevalence and persistence of HPV infection and addressing the modifiable co-factors could have profound implications on strategies to treat the infection and reduce cervical cancer. Research in this domain also will provide critical knowlege to optimize the screen strategies for HPV and HIV coinfections, and to improve the treatment of the infections for patients in low to middle income countries beyond implementation of HPV 16/18-based vaccines.
Optimizing HIV Treatment Monitoring under Resource Constraints
Effective use of antiretroviral therapy is critical for managing and preventing the spread of HIV in the developing world. Research in this domain includes developing methods that make optimal use of diagnostic tests having limited availability to monitor the effectiveness of therapy and to prompt a change in regimen when it is warranted. Machine learning methods can be used to derive the best strategies to treat HIV along the HIV treatment cascade. Successful implementation is expected to improve patient outcomes and help to prevent the spread of treatment-resistant strains of HIV.
Real Time Phylogeny and Contact Tracing to Disrupt HIV Transmission
The collaborative research study “Real Time Phylogeny and Contact Tracing to Disrupt HIV Transmission” is conducted to evaluate the benefits of integrating different methods - contact tracing used to obtain social information from HIV-infected persons, and phylogenetics used to compare HIV between infected persons - to disrupt HIV transmission in the state of Rhode Island. The strong partnership between the state’s Department of Health and its academic institutions significantly enhances the public health impact of this research and help bring small Rhode Island closer to its goal of being the first state to get to zero new HIV infections.