Sunday, May 18, 2025
5/18/2025
Preclinical Cardiovascular Disease among Adolescents and Young Adults in Haiti - PROJECT SUMMARY Dr. Lindsey Reif is a global health epidemiologist with a career goal to leverage epidemiologic research to implement high-impact health interventions for adolescents and young adults living with HIV (AYALH). Over the past decade, she has published 10 first-author papers focused on evaluating health outcomes and interventions among AYALH in Haiti. AYALH, who have survived decades of HIV, now face HIV-related comorbidities, specifically cardiovascular disease (CVD), as they age into adulthood. Her K01 objective is to expand her training and research to focus on HIV-related preclinical CVD— asymptomatic cardiometabolic abnormalities indicating the onset of CVD—among AYALH. She will adapt evidence-based interventions to prevent early onset CVD with impact for AYALH across the lifecourse. Her training objectives are to build expertise in: 1) CVD epidemiology among AYALH, 2) mixed-methods, and 3) implementation science in order to design and implement interventions to prevent CVD morbidity and mortality. Her career development plan includes multidisciplinary mentorship from a team that brings decades of experience in research among AYALH, HIV and CVD epidemiology, and implementation science across global health settings. The team has an impeccable track record of mentorship in global health research. Dr. Reif will also take complementary advanced coursework to support her training objectives. Her K01 is supported by a robust research and training environment that leverages a 40-year collaboration between Weill Cornell (New York) and GHESKIO (Haiti). Dr. Reif’s research plan establishes the epidemiology of preclinical CVD among AYALH and adapts an evidence-based intervention to prevent the onset of preclinical CVD and its progression. She will conduct a prospective cohort study among 500 HIV+ and 500 HIV- participants ages 18-30 years, followed for 3 years in Haiti. In Aim 1, she will evaluate the prevalence, age of onset and progression of preclinical CVD (pre- hypertension, microalbuminuria, and dyslipidemia) by HIV serostatus. She will evaluate risk factors in 3 domains: lifestyle, HIV-related, and psychosocial. She hypothesizes clusters of risk factors, driven by HIV- related and psychosocial factors, are associated with preclinical CVD among AYALH. In Aim 2, she will adapt the evidence-based WHO HEARTS technical package for AYALH in LICs using mixed methods and implementation science. This K01 addresses the knowledge gap of the epidemiology of preclinical CVD among AYALH and informs the adaptation of evidence-based CVD interventions to prevent premature disability and death among this population as they emerge into adulthood. Dr. Reif’s training and career development plan complement and expand her existing skillset and culminate in the submission of an NIH R01 facilitating her transition to independent investigator.
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