Health Consequences of Food & Nutrition Insecurity for HIV+ Women & Their Infants

食物对健康的影响

• 批准号: 8663963
• 负责人: Sera Lewise Young
• 金额: $ 17.01万
• 依托单位: CORNELL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-17 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8663963
• 关键词: 1 year old; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Africa South of the Sahara; Agriculture; Anthropology; Anti-Retroviral Agents; Applications Grants; Area; Behavior; Biological Preservation; Breast Feeding; Caring; Child; Childhood; Cohort Studies; Communities; Complement; Complex; Counseling; Data; Data Analyses; Data Set; Development; Disease; Disease Progression; Duct (organ) structure; Education; Epidemic; Evaluation; Exclusive Breastfeeding; Face; Family; Focus Groups; Food; Goals; Growth; HIV; HIV Infections; Health; Household; Individual; Infant; Infant Health; International; Intervention; Interview; Kenya; Knowledge; Lead; Light; Link; Maternal Health; Maternal and Child Health; Medical; Mental Health; Mentors; Mentorship; Mission; Morbidity - disease rate; Mothers; Nutritional; Outcome; Participant; Pathway interactions; Personal Satisfaction; Population; Pregnant Women; Prevalence; Province; Psyche structure; Psychosocial Assessment and Care; Public Health; Qualitative Research; Randomized; Relative (related person); Research; Research Activity; Research Personnel; Research Subjects; Research Training; Resources; Risk; Services; Site; Techniques; Testing; Training; Training Activity; Training Programs; Vertical Disease Transmission; Vulnerable Populations; Weight Gain; Woman; Women' s Health; base; career; cohort; design; effective intervention; experience; high risk; improved; infant outcome; innovation; member; mortality; mother nutrition; novel; nutrition; physical conditioning; pregnant; prevent; psychosocial; treatment program

DESCRIPTION (provided by applicant): Food and nutrition insecurity (F&NI) are inextricably linked to the HIV epidemic, and their relationship is bidirec-tional. Although we have some understanding of the mechanisms by which HIV acquisition and disease pro-gression lead to F&NI, the mechanisms by which F&NI increase the likelihood of HIV acquisition and disease progression have only recently begun to be investigated. Strikingly, the mechanisms by which F&NI affect the health of HIV+ pregnant women and their infants have not been investigated to date. However, preliminary data suggest that F&NI reduce antiretroviral adherence, gestational weight gain, and the duration of exclusive breastfeeding, all of which have consequences for the health of the mother and child, including vertical trans-mission. Therefore, the scientific objectie of this K01 application is to elucidate the mechanisms by which F&NI have deleterious effects on the health of HIV+ mothers and their infants. My central hypothesis is that F&NI are detrimental to the health of HIV+ pregnant women and their infants via nutritional, disease, and psy-chosocial pathways. This hypothesis will be tested with 3 specific aims: (1) to describe and assess F&NI and associated modifiable determinants among HIV+ pregnant and lactating women in Kenya, (2) to characterize the magnitude and pathways by which F&NI impact maternal and infant health among a cohort of HIV+ preg-nant women in Kenya, (3) develop a plan for a multi-level intervention to reduce F&NI to improve health of HIV+ mothers and their children. The qualitative research (for Aims 1 and 3) and cohort study (for Aim 2) will leverage resources at Family AIDS Care and Education Services, an HIV care and treatment program in Nyanza province, Kenya, the primary study site for several of my K01 mentors. My training in medical anthro- pology and international nutrition will serve me well, but I need additional mentorship and training in 1) as- sessment of F&NI among mothers and infants, 2) statistical analysis of complex longitudinal data sets 3) the management of HIV and HIV-associated diseases in low-resource settings, 4) assessment of psychosocial well-being and childhood development, and 5) the design, implementation, and evaluation of multi-level inter- ventions. This training will further my long-term career goal of becoming an independent investigator with qualitative and quantitative expertise in the design and implementation of efficacious, culturally acceptable in- terventions that reduce morbidity and mortality of mothers and young children. The training and research are significant because F&NI is highly prevalent in sub-Saharan Africa, HIV+ pregnant women are disproportion- ately affected by it, and there are a number of potentially serious health consequences for women and their infants. A better understanding of how F&NI is deleterious will provide knowledge to design more effective in- terventions to improve the health of HIV+ mothers and their HIV-exposed infants. This innovative research will generate novel data to test theoretically driven hypotheses about the pathways by which F&NI may impact the health of HIV-infected mothers and their infants.

描述（由申请人提供）：食物和营养不安全（F＆NI）与HIV流行无关，它们的关系是bidirect的。尽管我们对艾滋病毒获取和疾病疾病导致F＆NI的机制有所了解，但F＆NI增加了HIV获取和疾病进展的可能性，直到最近才开始研究。令人惊讶的是，迄今为止，尚未对F＆NI影响HIV+孕妇及其婴儿的健康的机制进行调查。但是，初步数据表明，F＆NI降低了抗逆转录病毒的依从性，妊娠体重增加以及独家母乳喂养的持续时间，所有这些都会对母亲和儿童的健康产生影响，包括垂直trans-mission。因此，该K01应用的科学对象是阐明F＆NI对HIV+母亲及其婴儿的健康产生有害影响的机制。我的中心假设是，F＆NI通过营养，疾病和PSY选择性途径不利于HIV+孕妇及其婴儿的健康。该假设将以3个特定目的进行检验：（1）描述和评估肯尼亚的HIV+孕妇和哺乳期妇女之间的F＆NI以及相关的可修改决定因素（2），以表征F＆ni在肯尼亚的同伴中影响HIV+ Pregg-Nant女性（3）kenya seke+ Sepition（3）的妇女健康的大小和途径（3），（3），（3）母亲及其子女。定性研究（针对目标1和3）和队列研究（针对目标2）将利用家庭艾滋病护理和教育服务的资源，这是肯尼亚Nyanza Province的HIV护理和治疗计划，这是我的K01几位导师的主要研究网站。 My training in medical anthro- pology and international nutrition will serve me well, but I need additional mentorship and training in 1) as- sessment of F&NI among mothers and infants, 2) statistical analysis of complex longitudinal data sets 3) the management of HIV and HIV-associated diseases in low-resource settings, 4) assessment of psychosocial well-being and childhood development, and 5) the design, implementation, and evaluation多级交流。这项培训将进一步成为我的长期职业目标，即在设计和实施有效的，文化上可接受的内科服务方面成为独立研究者，以降低母亲和幼儿的发病率和死亡率。培训和研究之所以重要，是因为F＆NI在撒哈拉以南非洲高度普遍，HIV+孕妇受到IT的影响不佳，并且对妇女及其婴儿有许多潜在的严重健康后果。更好地了解F＆NI如何有害，将提供知识，以设计更有效的信息，以改善HIV+母亲及其艾滋病毒暴露的婴儿的健康。这项创新的研究将生成新的数据，以测试有关F＆NI可能影响HIV感染的母亲及其婴儿健康的途径的理论驱动的假设。