Infectious Disease

people carrying body on stretcher

Faculty in the School of Public Health Division of Epidemiology & Community Health design and implement research aimed at increasing our understanding of a wide variety of infectious diseases and conduct studies to evaluate disease prevention and control efforts. A strong focus is placed on infectious disease methodology, including transmission dynamics, screening strategies, decision and cost-effectiveness modeling, technology-based public health interventions, and randomized community intervention trials.

A number of faculty have research interests and collaborations internationally, especially in sub-Saharan African countries including Ethiopia, Uganda, Mali, and Tanzania. Other collaborations exist in South America (Brazil) and Europe (France and UK).

An Infectious Disease Epidemiology Concentration is available for students enrolled in the Epidemiology MPH. In addition to coursework, faculty work with students to help identify potential infectious disease related field experience placements.

Assessment of a community support intervention for persons living with HIV in rural Ethiopia
Alan Lifson

In Ethiopia, more than a quarter of HIV patients drop out of a health provider’s care one year after starting treatment, leading to greater risk in developing severe illness or even death, and are at greater risk of spreading HIV to others.

This study, which takes place in southern Ethiopia, is a randomized community trial evaluating the efficacy of partnering community support workers with HIV patients to provide education, counseling/social support, and linkage to the HIV clinic. 2,600 HIV patients who are newly enrolled in care will be followed for at least three years, with a primary goal of improving retention in HIV care, and secondary goals of improving client knowledge, attitudes, feeling of social support, quality of life, and clinical status. Read more about this study.

 

Adolescent medicine trials network for HIV/AIDS interventions (ATN) coordinating center
Keith Horvath

The primary mission of the ATN is to conduct both independent and collaborative research that explores promising behavioral, microbicidal, prophylactic, therapeutic and vaccine modalities in HIV-infected and at-risk adolescents, ages 12 years through 24 years. ATN activities encompass the full spectrum of research needs for youth, from primary prevention—including HIV preventive vaccine, microbicide, and pre-exposure prophylaxis trials—for HIV at-risk youth in the community to secondary, and tertiary prevention with clinical management of HIV infection among youth along the entire HIV care continuum. Secondary and tertiary prevention research investigates novel treatment strategies and regimens, drug adherence, risk reduction interventions and linkage and engagement to care strategies that can lead to optimal antiretroviral therapy initiation and virologic suppression outcomes.

 

A technology-delivered peer-to-peer support Antiretroviral Therapy adherence intervention for HIV+MSM (The UNC/Emory Center for Innovation Technology across the prevention and care continuum)
Keith Horvath

The primary aims of this project are to:

  • Examine the efficacy of a theoretically-grounded, technology-delivered, peer-to-peer social support Antiretroviral Therapy (ART) adherence intervention (called “Thrive with Me” or TWM); and
  • Improve ART adherence among HIV-positive men who have sex with men (MSM) and drug-using MSM, compared to a HIV information-only control group.

This innovative proposal is the first technology-delivered, peer-to-peer social support ART adherence intervention that uses mobile and online technologies. Read more about this project.

 

Quantifying the breadth and duration of immunity induced by Meningococcal B vaccine
Nicole Basta

Invasive meningococcal disease is a significant public health threat given the sudden onset, rapid progression and high case fatality even among previously healthy young adults. Two novel meningococcal serogroup B vaccines, Bexsero and Trumenba, were recently licensed in the U.S. to protect against the disease.

This study evaluates the kinetics of immune responses induced by these vaccines against a broad panel of disease-causing meningococcal B strains with both the gold-standard correlate of protection, serum bactericidal antibody assays using extrinsic human complement (hSBA), and a new serum bactericidal antibody assay using intrinsic human complement (iSBA). We aim to:

  • Provide evidence about the breadth and duration of immunity induced by meningococcal B vaccines to inform the design of optimal preventive vaccination strategies; and
  • Advance the field of vaccinology by increasing our understanding of the protective effects of vaccines.

 

 

The subgingival microbiome and impaired glucose regulation
Ryan Demmer

This is a longitudinal cohort study of 1,100 participants exploring the association between oral microbiota and longitudinal change in glucose and insulin resistance, as well as incident prediabetes. The study also assesses the role of chronic inflammation as a mechanism linking oral microbiota to poor metabolic outcomes.

 

CisNet – Comparative modeling to inform cervical cancer control policies
Shalini Kulasingam

New technologies, including screening tests and vaccines against human papillomavirus (HPV) — a sexually-transmitted virus known to cause cervical cancer — are dramatically changing the landscape of cervical cancer prevention in the U.S. and worldwide. To address important evidence gaps in cervical cancer control, this grant has assembled five independent research teams who have been at the frontier of modeling cervical cancer prevention over the last decade. These teams aim to: engage in formal comparative modeling; evaluate the comparative and cost-effectiveness of screening and vaccination strategies; and disseminate results to inform health policies and decision. View a related video about the HPV vaccine.

 

Restore: Improving sexual outcomes of gay and bisexual men after prostate cancer treatment
Simon Rosser

Prostate cancer (PCa) is the second most common cancer in gay and bisexual men (GBM), yet it has been severely under-researched. Because there have been no treatment studies of GBM with PCa, we do not know how well treatments work in this population. Moreover, because gay sex differs from vaginal sex, physiologically; the results from 614 studies focused on heterosexual men likely do not generalize to GBM with PCa. This study tests the effects of a multi-component online treatment program tailored for GBM survivors on their sexual and urinary outcomes. If successful, the study will demonstrate a new standard of rehabilitation care for this population.

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