Yale receives $2,100,000 for AIDS research in India

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Yale receives $2,100,000 Bill & Melinda Gates Foundation grant for

HIV prevention in India

20 Jul 2004

Yale University today announced that its Center for

Interdisciplinary Research on AIDS (CIRA) has received a $2.1

million grant from the Bill & Melinda Gates Foundation to support

HIV prevention research among high-risk populations in India.

The three-year grant will be used to conduct research on

implementing structural interventions among high-risk groups in the

four southern States of India with the highest HIV prevalence:

Andhra Pradesh, Karnataka, Tamil Nadu and Maharashtra. Structural

interventions promote public health by altering the context within

which individuals engage in health behaviors or make health-related

decisions. In HIV prevention, such interventions seek to alter

social, economic, political and normative factors that make up the

risk environments for HIV infection where individuals live and work.

" We are pleased to be a partner in efforts to curtail the spread of

HIV infection in one of the largest countries in the world, " said

H. Merson, M.D., Dean and M.R. Lauder Professor of

Public Health at Yale and an investigator on the project.

The Yale team will collaborate in this project with CARE, an

international field relief and development organization, through its

India Country Office. The team will also work with other partners

receiving support as part of the Bill & Melinda Gates Foundation's

Avahan initiative to conduct structural analyses of HIV risk and

assess structural interventions for HIV prevention.

CARE, led by S. Jana, assistant country director for health, HIV and

development, is also a grantee under the Avahan initiative of the

Bill & Melinda Gates Foundation. It is one of a number of non-

governmental organizations working to implement successful models of

community-led structural preventions for addressing HIV risk among

populations hit hardest by the epidemic in the country, particularly

among sex workers and their clients, who include truckers and

injecting drug users.

The Yale team will seek to demonstrate that CARE's interventions,

aimed at enhancing empowerment and decreasing vulnerability,

increase healthier behavior among sex workers and their clients. The

goals of the interventions include increased condom use, reduced

prevalence of sexually transmitted infections, increased self-esteem

and empowerment on the part of sex workers, and improved attitudes,

practices and policies toward sex workers on the part of various

power brokers such as pimps, brothel operators, bar owners and

police.

" Using structural interventions, we can have a substantial impact on

HIV transmission among many people simultaneously and often on other

health risks at the same time, " said principal investigator Kim M.

Blankenship, CIRA associate director and associate research

scientist in the Department of Epidemiology and Public Health (EPH)

in the Yale School of Medicine.

India's National AIDS Control Organization estimates that at the end

of 2003 there were 5.1 million, 0.9 percent of the adult population,

living with HIV/AIDS in the country. It has also estimated that

there were 520,000 new HIV infections in 2003. As in many other

countries, the poor and socially marginalized in India bear the

majority of the HIV burden.

" While it is clear that some of the most vulnerable populations have

a relatively high degree of knowledge on HIV/AIDS issues, unsafe sex

practices persist, " said Blankenship. " This suggests that their

vulnerability to infection rests less in their lack of knowledge

about HIV/AIDS than in the structural barriers that restrict their

ability to act on this knowledge. It is these barriers, and other

structural factors that need to be addressed to reduce risk and

transmission. Structural interventions provide a means for doing

this. "

Other investigators on the project include: Trace Kershaw, assistant

professor of epidemiology at EPH; Niccolai, assistant

professor of epidemiology and public health at EPH; J.

Schensul, executive director of The Institute for Community Research

in Hartford, Conn.; Burris, J.D., the E. Beasley

Professor of Law at Temple University Beasley School of Law; and

Heackathorn, professor of sociology at Cornell University.

CIRA was established in 1997 and is currently funded through a core

grant from the National Institute of Mental Health. The Center

brings together scientists from 13 different disciplines with the

mission of supporting the conduct of research aimed at the

prevention of HIV infection and the reduction of negative

consequences of HIV disease in vulnerable and underserved

populations.

CIRA also supports research on legal, policy and ethics

issues in HIV/AIDS

Contact: N. Peart

karen.peart@...

203-432-1326

Yale University

http://cira.med.yale.edu/