These 12-month projects cover a range of topics and will build capacity for additional HIV research at Third Coast CFAR institutions. Their selection also speaks to the impressive reputation Northwestern University and University of Chicago have for innovative cross-institutional and interdisciplinary work.

Pre-Release Linkage to HCV, HIV, and Addiction Services (PRELINK)

Mai Pho, MD

Outbreaks of HIV and HCV have been associated with syringe sharing among partners injecting prescription opioids in the US Midwest, and HCV prevalence is disproportionately growing among young people who inject drugs. Evidence-based interventions including antiviral treatment for HCV and HIV, access to harm reduction services, and medication assisted treatment are effective, however lack of coordinated efforts leave substantial gaps throughout the care continuum for both opioid use disorder and HCV, particularly in criminal justice involved populations.

This project seeks to implement a coordinated management model of pre-release assessment, screening, and linkage to care in a rural jail setting. We will leverage the academic/public health partnerships and analytical cores of the Third Coast CFAR in an implementation study of pre-release assessment, disease testing, and re-entry linkage to care in a rural county jail/state and local health department collaboration. Knowledge gained will inform broader statewide implementation of the model as well as inform the analysis of long-term impacts such as recidivism, related-hospitalizations, and deaths for this vulnerable population.

Understanding Barriers to PrEP among African American Women in Chicago

Lisa Hirschhorn, MD, MPH

Jessica Ridgway, MD, MS

While Chicago is a leader in implementing pre-exposure prophylaxis (PrEP), the number of women prescribed this important prevention intervention is extremely low. We propose an exploratory, mixed methods implementation science project to inform approaches to improve women’s access to and uptake of PrEP. The work will apply an implementation science framework (Exploration, Preparation, Implementation, Sustainment, EPIS) to guide the exploratory and preparation work in this proposal and plan for next steps for future funding.

The work will be supported by an interdisciplinary Scientific Advisory Group (SAG) including PrEP researchers / implementers, community-based representatives, and experts in sociology and implementation science. The project will conclude with a design meeting convening investigators, providers (medical and community-based), other experts in work to understand and improve disparities in access for AA women, the SAG and the Chicago Department of Public Health (CDPH) to identify candidate evidence based interventions (EBIs) to bridge the PrEP gap for AA women for adaptation and testing through an NIH grant proposal.

Catalyzing the field of HIV Implementation Science: Getting systems to deliver the right intervention, to the right people, at the right time, in the right dose

Brian Mustanski, PhD

Nanette Benbow, MAS

Stefan Baral, MD, MPH

Led by Brian Mustanski and Nanette Benbow at Northwestern University and Stefan Baral at Johns Hopkins University, this conference will offer a unique opportunity to gather implementation science experts, HIV implementation researchers, and their community partners to increase knowledge and practice in the field and increase public health and community knowledge of the benefits that implementation science can offer. This conference grows out of the successful, academic-public health partnership established by the DC-CFAR’s established Inter-CFAR HIV Continuum Working Group.

The Third Coast CFAR and Johns Hopkins CFAR, in collaboration with the DC, Emory and University of Washington CFARs and the NIDA- funded Center for Prevention Implementation Methodology for Drug Abuse and HIV (Ce-PIM), are uniquely positioned to organize and host the conference because of their strong partnership with US health departments and global implementation partners, the successful history of the ECHHP/Continuum of Care Working Group, and their strengths in scientifically rigorous implementation research (e.g., simulation modeling of intervention impact, hybrid and implementation trial methodologies).

Instrumentation to Expand HIV/AIDS-relevant Biomarker Discovery

Thomas Hope, PhD

The Viral Pathogenesis Core received additional funding to purchase a MESO QuickPlex SQ 120 imager. This instrument expands the core’s scope of services to include the efficient and more affordable analysis of specimens to measure biomarkers of stress, inflammation, and immune activation. Increasingly, observing changes in cytokines and biomarkers such as C-reactive protein and IL-6 are important outcomes in social and behavioral HIV research. The principal investigators of four NIDA and NIMH-funded studies have already requested a consultation to develop assays for their projects.

This instrument is also a vital tool for translational and biomedical researchers. An additional five NIH-sponsored studies associated with the Third Coast CFAR plan to use the equipment for a broad range of tests. These studies’ aims include examining HIV’s penetration of epithelial barriers during sexual transmission and more closely examining molecular mechanisms of action during immune activation in order to develop therapies that will deliver a functional cure for HIV. Services using the MESO QuickPlex sequencer will be available in early 2018.