Mentoring and Patient Oriented Research at the Nexus of Unhealthy Alcohol Use and HIV

University Of Washington, Seattle WA

Investigators

Linked publications & trials

Abstract

PROJECT SUMMARY/ABSTRACT Despite simpler, durable antiretroviral therapy and effective evidenced-based alcohol reduction interventions (EBI), unhealthy alcohol use continues to limit our ability to meet United States targets for ending the HIV epidemic through direct effects on the HIV Care Continuum (HIV-CC) and HIV Treatment as Prevention. As such, optimizing uptake of alcohol EBI among PWH is an essential aspect of HIV care. Geetanjali Chander, MD, MPH, a Professor of Medicine at the University of Washington, is a clinical HIV specialist with research and clinical expertise in interventions for alcohol use disorders among PWH. She submits this application to renew her NIAAA K24 mid-career investigator award focused at the nexus of HIV, unhealthy alcohol use, and health equity. During the initial K24 funding period, Dr. Chander greatly expanded her mentoring (7 trainees with K- level career development awards), assumed program leadership with the NIAAA P01 Alcohol Research Consortium in HIV (ARCH) as multiple PI (MPI) (funded in 2021), received a new R01 in 2020, and became MPI of a new T32 (2023) and a U34 (2023). She seeks this K24 renewal to 1) sustain her mentoring time, allowing for the continued mentoring of current trainees as they move to independence and for the addition of new trainees interested in pursuing work at the intersection of HIV and unhealthy alcohol use; 2) to enhance her mentoring and leadership skills through equity focused training, and thereby expand the cadre of diverse junior faculty and trainees pursuing research careers focused on alcohol and HIV; and 3) expand her epidemiological, clinical trial, and implementation research program by applying a health equity framework to her research questions and methods—achieved through A) formal coursework in social and structural drivers of health and health equity theory, frameworks and methods and B) applied research. The new research proposed in this award leverages ARCH and the infrastructure of the CFAR Network of Integrated Clinical Systems (CNICS), a multi-site clinical cohort representing ten university-based HIV clinics across the US, in which ARCH is embedded. With research collaborators and trainees, she proposes to design, pilot, and conduct a discrete choice experiment (DCE) across ARCH/CNICS to determine patient preferences for alcohol treatment interventions. Prior to DCE implementation, the team will use mixed methods to develop attributes, paying particular attention to structural, contextual and social drivers influencing alcohol treatment preferences. This research will lay the foundation for future equity- focused alcohol implementation research studies among PWH that account for patient preferences based on their lived experiences, lead to further expansion of her research and mentoring program, and most importantly, provide new knowledge as we seek to end the HIV epidemic and improve outcomes and quality of life among PWH with unhealthy alcohol use.