Patient-Oriented Substance Use/Smoking Cessation Research in HIV Treatment and Prevention

Massachusetts General Hospital, Boston MA

Investigators

Abstract

Background. This is a K24 proposal to provide mentorship to junior colleagues (pre- and post-doctoral fellows, as well as junior faculty) in clinical intervention substance use research. The proposed mentoring will include a specific emphasis on the intersection of HIV disease management and substance use treatment with an emphasis on integrated treatments for smoking cessation. People living with HIV (PLWH) are more likely to be smokers, derive less benefit from antiretroviral therapy (ART), are more likely to experience viral rebound, report significantly poorer ART adherence. I plan to provide mentorship on a) understanding the relationships between substance use and HIV disease and treatment outcomes, b) guidance around treatment development for smoking cessation programs, specifically for sub-populations of smokers living with HIV, and c) emphasizing the priorities for implementation science in substance use treatment development research. Candidate. I have 12 years of continuous NIH-funded support addressing mental health and substance use issues in the context of HIV treatment and prevention. My current projects include three R01 trials, and two R34 projects addressing substance use and mental health issues in HIV/TB treatment and prevention. I also have a strong mentoring track record, which has included 15 years of successful mentoring >25 pre/post-doctoral fellows to faculty positions and 18 to independent funded grants with more than 50 publications with mentees as first author. My current mentorship roster includes five K mentees and four pre- and post-doctoral fellows. Mentoring Plan. I have multiple mentoring roles as Co-Director of the Harvard University Center for AIDS Research, Bio-Behavioral and Community Science Core, as the Co-Director of the APA Clinical Psychology Internship in Behavioral Medicine at Massachusetts General Hospital, and as MPI of the Harvard/BMC Fellowship in Global Psychiatry. Through each of these mechanisms I have access to psychology and behavioral medicine mentees from local clinical psychology and psychiatry training programs, as well as access to local physician and public health mentees from across the Harvard institutions. I have a steady and increasing set of requests to mentor junior level clinical researchers across disciplines with an interest in substance use and mental health in the context of HIV treatment and prevention. Research Plan. In addition to my existing projects, I will leverage current and past funded projects to undertake 4 research projects with my mentees. First, we will utilize existing data from HIV primary care clinics to examine the impact of substance use on engagement in HIV care. Second, we propose an examination of the longitudinal relationships between smoking status variables and HIV clinical and treatment outcomes will be conducted in the CNICS cohort. Third we will undertake a qualitative study to identify barriers and facilitators to implementation of smoking cessation in HIV care settings. Finally, we will conduct a moderation analysis of our NIDA R01 smoking cessation trial of the treatment effects associated with virtual intervention delivery.