Inflammation, Vaginal Microbiota, and STI/HIV Risk

炎症、阴道微生物群和 STI/HIV 风险

基本信息

批准号：
9910583
负责人：
Jenell S Coleman
金额：
$ 22.93万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-05 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9910583
关键词：
AIDS prevention Address Adolescent Adolescent and Young Adult Adult Anti-inflammatory Antibiotic Therapy Bacterial Vaginosis Biological Biological Assay Biological Factors Caring Cells Cellular Phone Centers for Disease Control and Prevention (U.S.)Chlamydia trachomatis Clinic Clinic Visits Clinical Services Code Complex Conflict (Psychology)Counseling Data Ectopic Pregnancy Enrollment Ethnic Origin Female Female Adolescents Gender Goals HIV HIV Infections HIV risk Health Health Personnel Healthcare Systems Home environment Hour Immune Infection Infertility Inflammation Inflammatory Institutional Review Boards Instruction Internet Intervention Knowledge Lead Link Measures Mucous Membrane Mycoplasma genitalium Office Nursing Online Systems Ownership Parents Participant Pelvic Inflammatory Disease Population Predisposition Premature Birth Prevalence Provider Public Health Race Reporting Research Research Personnel Residual state Risk Role Running STI prevention Sampling Schedule Sexual Health Sexually Transmitted Diseases Social Behavior Surface Surveys Syndrome Technology Teenagers Test Result Testing Transportation Visit Vulnerable Populations Woman aged base boys chronic pelvic pain co-infection cytokine digital ethnic minority population high risk improved innovation insight novel strategies parent grant prevention service racial and ethnic recruit reproductive reproductive health of adolescents reproductive tract screening sexually active sexually active adolescent socioeconomics synergism telehealth treatment strategy uptake vaginal microbiota web site young man young woman

项目摘要

Adolescents and young adults (AYA) aged 15-24 years acquire half of the 20 million new sexually transmitted infections (STI) annually in the U.S. Mycoplasma genitalium (MG) is emerging as a new and important STI. Untreated STIs can lead to reproductive harm like preterm delivery, pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain, and increased susceptibility to HIV. HIV susceptibility is increased because some STIs breach the protective mucosal barrier, promote inflammation, and recruit immune cells (HIV target cells) into the genital tract. However, there are conflicting data about the relationship between MG and these inflammatory reproductive tract syndromes. In addition, our parent study found that 25% of participants who tested positive for an STI or bacterial vaginosis did not have a treating provider. Despite available clinical services, some urban residents report lack of transportation, clinic hours, and difficulty navigating the healthcare system as factors associated with not accessing care. Digital technology (e.g. internet, telehealth) offers the opportunity to increase access to STI prevention services. This innovative supplement seeks to expand the parent study to better understand the role of MG in female genital tract inflammation, and to use telehealth to engage AYAs who are not accessing traditional brick-and-mortar care. We propose the following aims: Aim 1: To measure the prevalence of MG and determine its association with inflammation; Aim 2: To determine the uptake, acceptability, and feasibility of using telehealth visits to counsel and treat those who test positive for MG; and Aim 3: To measure the uptake of 3-month retesting using an online home-based STI website. This supplement addresses a significant gap in our knowledge of MG, the critical need to better understand the interaction among vaginal microbiota, STIs, and inflammation that potentially conspire to increase HIV susceptibility in AYAs, and how a telehealth approach may reach vulnerable female AYAs who might not otherwise receive care. In the absence of such knowledge and novel strategies to engage this vulnerable population, STIs will continue to rise in the U.S. and threaten the reproductive health of AYAs.

15-24岁的青少年和年轻人（AYA）获得了2000万新人口中的一半美国每年的性传播感染 (STI) 生殖支原体 (MG) 是正在成为一种新的、重要的 STI。未经治疗的性传播感染可能会导致生殖伤害，例如早产、盆腔炎、不孕症、宫外孕、慢性盆腔疼痛、以及对艾滋病毒的易感性增加。由于一些性传播感染违反了艾滋病毒的易感性保护性粘膜屏障，促进炎症，并招募免疫细胞（HIV 靶细胞）进入生殖道。然而，关于 MG 和 MG 之间的关系，存在相互矛盾的数据。这些炎症性生殖道综合征。此外，我们的家长研究发现，25% 性传播感染或细菌性阴道病检测呈阳性的参与者没有接受治疗提供者。尽管可以提供临床服务，但一些城市居民仍报告缺乏交通，诊所时间和医疗保健系统导航困难是与不相关的因素获得护理。数字技术（例如互联网、远程医疗）提供了增加的机会获得性传播感染预防服务。这种创新的补充旨在扩大家长的范围研究旨在更好地了解 MG 在女性生殖道炎症中的作用，并利用远程医疗让无法获得传统实体护理的 AYA 参与进来。我们建议目标如下：目标 1：测量 MG 的患病率并确定其与炎;目标 2：确定远程医疗的采用率、可接受性和可行性对 MG 检测呈阳性的人进行咨询和治疗；目标 3：衡量使用家庭性传播感染在线网站进行 3 个月的重新测试。本补充解决了我们对 MG 的了解存在重大差距，迫切需要更好地理解相互作用阴道微生物群、性传播感染和炎症可能会导致艾滋病毒增加 AYA 的易感性，以及远程医疗方法如何惠及弱势女性 AYA 否则可能无法得到护理。在缺乏此类知识和新颖策略的情况下如果让这些弱势群体参与进来，性传播感染将在美国继续上升并威胁到 AYA 的生殖健康。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Breastfeeding with HIV: An Evidence-Based Case for New Policy.

感染艾滋病毒的母乳喂养：新政策的循证案例。

DOI：
发表时间：
2019-03
期刊：
影响因子：
0
作者：
Gross, Marielle S;Taylor, Holly A;Tomori, Cecilia;Coleman, Jenell S
通讯作者：
Coleman, Jenell S

A Missed Opportunity for U.S. Perinatal Human Immunodeficiency Virus Elimination: Pre-exposure Prophylaxis During Pregnancy.

美国错失的消除围产期人类免疫缺陷病毒的机会：怀孕期间的暴露前预防。

DOI：
发表时间：
2017
期刊：
影响因子：
7.2
作者：
Fruhauf, Timothee;Coleman, Jenell S
通讯作者：
Coleman, Jenell S

Improving Women's Health and Combatting Sexually Transmitted Infections Through Expedited Partner Therapy.

通过快速伴侣治疗改善女性健康并对抗性传播感染。

DOI：
发表时间：
2019
期刊：
影响因子：
7.2
作者：
Jamison, Cornelius D;Coleman, Jenell S;Mmeje, Okeoma
通讯作者：
Mmeje, Okeoma

Pharmacy-level barriers to implementing expedited partner therapy in Baltimore, Maryland.

在马里兰州巴尔的摩实施快速合作伙伴治疗的药房层面的障碍。

DOI：
发表时间：
2018-05
期刊：
影响因子：
9.8
作者：
Qin, Jennifer Z;Diniz, Clarissa P;Coleman, Jenell S
通讯作者：
Coleman, Jenell S

Conceptual Design of a Universal Donor Screening Approach for Vaginal Microbiota Transplant.

阴道微生物群移植通用供体筛选方法的概念设计。

DOI：
发表时间：
2019
期刊：
影响因子：
0
作者：
DeLong, Kevin;Bensouda, Sabrine;Zulfiqar, Fareeha;Zierden, Hannah C;Hoang, Thuy M;Abraham, Alison G;Coleman, Jenell S;Cone, Richard A;Gravitt, Patti E;Hendrix, Craig W;Fuchs, Edward J;Gaydos, Charlotte A;Weld, Ethel D;Ensign, Laura M
通讯作者：
Ensign, Laura M