AIDS International Training and Research Program (AITRP)

Although Bangladesh is considered to be a low HIV prevalence country, it faces a concentrated epidemic among high-risk populations, including men who have sex with men (MSM), intravenous drug users (IDUs), and female sex workers (FSW). The Vanderbilt-CIDRZ-AITRP (VU-AITRP) sponsored 9 long-term trainees from Bangladesh, 8 of who have received MPH, MSPH, or D.Ph. degrees. Working in conjunction with the International Centre for Diarrheal Disease Research (ICDDRB) in Dhaka, Bangladesh, these alumni have conducted extensive research in maternal and child health, the epidemiology of human papilloma virus among women in rural and urban Bangladesh, and the prevention and surveillance of HIV among intravenous drug users.

As one of the most populous nations in the world, China has a high prevalence of HIV among intravenous drug users (IDUs), and rising HIV and syphilis rates among men who have sex with men (MSM). Vanderbilt-CIDRZ AITRP’s (VU-AITRP) longstanding work in China was centered on HIV prevention and surveillance among these high-risk populations. While China does possess considerable research capacity, few investigators are experienced in conducting this kind of interdisciplinary clinical and operational HIV research. As such, VU-AITRP partnered with two institutes in China: the National Center for AIDS/STD Control and Preventions (NCAIDS), within the Chinese Center for Disease Control and Prevention (CDC), and the Foreign Loan Office (FLO) and the Ministry of Health of China (MOH), to work together to train a cadre of experts in conducting multi-discplinary chronic disease research and build further training capacity. The VU-AITRP trained nine long-term trainees from China, of those, six received an MPH, Ph.D., or Dr.P.H. degree from Vanderbilt or the University of Alabama at Birmingham. Our alums were engaged in several innovative and influential projects, including research on multi-component HIV intervention packages for Chinese MSM and clinical trials to test the efficacy of a multi-component “test-and-link-to-care” intervention package to reduce HIV incidence among MSM.

Chinese graduate students and postdoctoral fellows worked with Dr. Han-Zhu Qian and Dr. Sten Vermund on the Multi-component HIV Intervention Packages for Chinese MSM project.

With one of the fastest growing populations in the world, India has the second highest absolute number of HIV-infected persons after South Africa. While India does possess considerable in-country research capacity, few Indian researchers are experienced in interdisciplinary clinical and operational HIV/STD/TB research and related malignancy research. Vanderbilt-CIDRZ AITRP (VU-AITRP) sponsored 4 long-term trainees from India, and they completed MPH or doctoral degrees. Working with the National AIDS Research Institute (NARI) in Pune, India, VU-AITRP’s training emphasis in India was in HIV-cancer interactions. Integrating cost effective alternatives such as visual inspection in acetic acid and HPV screening as practical methods of providing cervical cancer screening services within HIV/AIDS care and treatment settings has proven to be effective. The demonstration of these cost-effective methods of screening has important implications for development of policies to improve the clinical care and quality of life of women living with HIV/AIDS in India, as well as other developing countries.

Training Programs

VU-AITRP, in partnership with NARI, conducted site capacity building workshops and trained clinical research staff at partnering institutions of three of the four high-HIV prevalent states in peninsular India. These workshops included training to conduct high quality international collaborative studies on cervical cancer and women’s health in the context of HIV/AIDS. Such training has been instrumental not only in bringing cancer research into NARI’s research portfolio, but also helping Indian trainees secure valuable independent research funding.

With an average of 500 new infections occurring each day, Mozambique has one of the worst HIV/AIDS epidemics in the world. They have been unable to manage the epidemic with a limited pool of experienced biomedical and behavioral researchers and clinicians. To help overcome this deficit, Vanderbilt-CIDRZ-AITRP (VU-AITRP) partnered with the Universidade Eduardo Mondlande (UEM), which currently has the only Master in Public Health program in Mozambique. The MPH program struggles to survive due to severe lack of funding and research capacity. With the help of VU-AITRP’s partnership with UEM, the two organizations worked to build program capacity, enabling Mozambicans to be trained locally by high caliber faculty at a better funded and equipped UEM.

Training Programs

VU-AITRP funded in-country workshops on ethics in medical research, quality improvement research, and capacity building in HIV and mental health. The quality improvement research workshop aimed to improve the rate of enrollment of HIV positive mothers in HIV care after delivery.
Attendees developed an understanding of the following topics: 

• how to change health care systems by analysis of health care processes
• develop pilot interventions
• use data to evaluate changes
• empower individuals to be agents of improvement

Vanderbilt-CIDRZ AITRP’s (VU-AITRP) longstanding work in Pakistan was centered on HIV prevention, treatment, and surveillance among injection drug users (IDUs) and other at-risk groups. Pakistan has had an explosive growth in HIV among IDUs and is only modestly prepared to cope with the research and policy challenges. While Pakistan has considerable research capacity, only a few investigators in Pakistan are experienced in interdisciplinary clinical and operational HIV/STD/TB research. Pakistan was a partner country since 1995, with three principal institutional partners: the Aga Khan University (AKU), the Dow University of Health Sciences, and BRIDGE, a local NGO that was created by AITRP alumni for service, training, and research in Karachi and Sindh Province.

Training Programs

VU-AITRP has had both long term and short term training programs in Pakistan. There were 14 long-term trainees from Pakistan, of whom 13 received a MPH, DrPH, MSPH, or MSc degree from VU, UAB, or the LSHTM. 

With more than one in every seven adults in Zambia currently living with HIV, Zambia has one of the world’s most devastating HIV/AIDS epidemics. In collaboration with the Center for International Disease Research Zambia (CIDRZ) and the University of Zambia Schools of Medicine (UNZA), the Vanderbilt-CIDRZ AITRP (VU-AITRP) program in Zambia trained a new generation of HIV/AIDS researchers in Zambia, promoted the initiation of HIV-related research that builds long-term relationships among international scientists, helped VU-AITRP’s partners develop into national and regional research and training centers of excellence, and tracked and documented the long-term impact of capacity building and training through the VU-AITRP program.

VU-AITRP played an important role in the development and sustainability of HIV-related research in Zambia. Through VU-AITRP funding, 32 Zambian health professionals completed MPH or MSc degrees, all of whom have returned to work in Africa to serve in government, international agency, academic, or NGO positions. Enabling our Zambian fellows to stay in their home research environments while they obtain training through the master in science distance learning program has proved to be a highly effective training plan, particularly for those fellows whose contributions in their current research positions within Zambia have been deemed so substantial that their loss to a long-term training program in the U.S. (or elsewhere) would compromise important work in Zambia.

Training Programs

More than 500 Zambians have participated in intensive VU-AITRP workshops, and more than 45 Zambians have been trained in short courses at Vanderbilt University and UAB. These programs, in addition to our AITRP Fellows program, have been instrumental in strengthening the ability of Zambian investigators to take part in large-scale public health evaluation of service, engage collaborative and independent research, and take leadership position in a wide variety of global health networks.