Document text
Principal Investigator: Domonique M Reed
Organization: COLUMBIA UNIVERSITY HEALTH SCIENCES
Fiscal Year: 2024
Award: $22,331
Funding agency: National Institute of Mental Health
PROJECT SUMMARY/ABSTRACT
Adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA), the epicenter of the global HIV
epidemic, have carried the primary burden of new HIV infections in this area for at least 30 years. Research
has prioritized characterizing the individual predictors of HIV infection among AGYW by creating risk
assessment tools that identify high-risk sub-populations for targeted HIV prevention efforts. Despite substantial
efforts, there remains a disproportionate burden of disease among this vulnerable population, suggesting a
need to identify and assess targets of intervention beyond the individual. The primary goals of this R36
dissertation proposal, Moving Beyond the Individual: A Data-driven Approach to Informing the Evidence on the
Role of Community and Societal Determinants of HIV among Adolescent Girls and Young Women in Sub-
Saharan Africa, are to create a comprehensive data source that will facilitate new ways of assessing HIV risk
among AGYW, generating improved knowledge about individual, interpersonal, community, and societal risk
factors; to characterize the interplay among these variables; and to assess the impact of interventions that
target community and societal drivers of infection to inform improved prevention efforts. To achieve these
goals, we propose three aims that will leverage publicly available, population-based data from five countries in
SSA (Cameroon, Eswatini, Malawi, Rwanda, and Uganda) and apply advanced data science and
epidemiologic methodologies. Aim 1 is to integrate publicly available data from the Population-based HIV
Impact Assessment Project (individual, interpersonal, community), the Population and Housing Census
(community), and UNAIDS Law and Policy Indicators (societal) to create a large, multi-level public health
dataset. Aim 2 is to characterize and graphically depict the pathways among individual, interpersonal,
community, and societal risk factors of HIV infection among AGYW using causal discovery algorithms to
identify underlying disease pathways. Aim 3 is to estimate the impact of intervening on community and societal
drivers of HIV infection among AGYW using parametric g-computation to model proposed intervention effects.
To examine these aims, we will take a novel, intersectional approach to assess HIV behavioral science
inquiries by leveraging causal discovery algorithms and g-computation. Findings from this research will
advance the National Institute of Mental Health Division of AIDS Research’s priority to improve the knowledge
base informing interventions, thereby advancing the development of interventions that go beyond the individual
to reduce the burden of HIV among AGYW. The research and mentorship of this R36 proposal have been
carefully crafted to optimize the ongoing doctoral training and research experience of the Principal Investigator
of this study while fostering her development as an African American independent research scientist in the
future.
Terms: <AIDS><AIDS Virus><AIDS prevention><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Address><Adolescent><Adolescent HIV risk><Adolescent Youth><Advanced Development><Affect><Africa South of the Sahara><African American><Afro American><Afroamerican><Age disparity><Algorithms><Alternative Therapies><Alternative intervention><Anti-HIV Positivity><Application Context><Approaches to prevention><Area><Assessment instrument><Assessment tool><Attitude><Behavior><Behavioral Sciences><Biological><Cameroon><Censuses><Characteristics><Communities><Community Developments><Complex><Computing Methodologies><Country><Dangerousness><Data><Data Science><Data Set><Data Sources><Development><Disease Pathway><Education><Educational aspects><Effectiveness><Environment><Epidemic><Epidemiology><Feedback><Female Adolescents><Fostering><Foundations><Future><Goals><HIV><HIV Infections><HIV Positive><HIV Positivity><HIV Prevention><HIV Seroconversion><HIV Seropositivity><HIV antibody positive><HIV disparities><HIV inequalities><HIV inequities><HIV related disparities><HIV related inequities><HIV risk><HIV risk among adolescents><HIV/AIDS disparities><HIV/AIDS inequities><HIV/AIDS prevention><HIV/AIDS related disparities><HTLV-III Infections><HTLV-III Seroconversion><HTLV-III Seropositivity><HTLV-III-LAV Infections><History><Housing><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Individual><Infection><Intervention><Intervention Strategies><Investigators><Knowledge><LAV-HTLV-III><Laws><Lymphadenopathy-Associated Virus><Malawi><Measurement><Mental Depression><Mentorship><Methodology><Mission><Modeling><NIMH><National Institute of Mental Health><Nyasaland><Pathway interactions><Pattern><Policies><Population><PrEP><Preventative intervention><Prevention><Prevention Research><Prevention approach><Principal Investigator><Process><Psyche structure><Public Health><Recording of previous events><Research><Research Personnel><Research Priority><Researchers><Risk><Risk Assessment><Risk Factors><Role><Ruanda><Rwanda><Science><Scientific Inquiry><Scientist><Sexually Transmitted Diseases><Sexually Transmitted Disorder><Sexually Transmitted Infection><Social Processes><Societal Factors><Societies><Source><Structure><Sub-Saharan Africa><Subsaharan Africa><Techniques><Training><Uganda><Venereal Diseases><Venereal Disorders><Venereal Infections><Virus-HIV><Vulnerable Populations><adolescent girl><age disadvantage><age-associated disparity><age-dependent disparity><age-related disparity><aged><analytic epidemiology><analytical epidemiology><analytical tool><big-data science><biologic><burden of disease><burden of illness><career><community factor><community-level factor><computational methodology><computational methods><computer based method><computer methods><computing method><contextual factors><data integration><depression><develop therapy><developmental><disease burden><disparity across ages><disparity due to age><disparity in age><disparity in health><epidemiologic><epidemiological><experience><gender disparity><health disparity><health seeking behavior><high risk><high risk sex activity><high risk sex behavior><high risk sexual activity><high risk sexual behavior><histories><improved><innovate><innovation><innovative><interest><intervention design><intervention development><intervention effect><intervention for prevention><interventional strategy><juvenile><juvenile human><knowledge base><mental><novel><pathway><population based><pre-exposure prophylaxis><preservation><prevention intervention><preventional intervention strategy><preventive intervention><risky sexual behavior><sexually acquired infection><social role><structural determinants><structural factors><therapy design><therapy development><transactional sex><treatment design><treatment development><trend><vulnerable group><vulnerable individual><vulnerable people><young woman>