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Psychosocial distress, inflammatory reactivity and central sensitization in the pathway to HIV-related pain: characterizing the associations and developing a pragmatic, coping-focused intervention.

Award Number: K43TW011442
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/27/2019
PERIOD OF PERFORMANCE END DATE: 11/30/2025

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Psychosocial distress, inflammatory reactivity and central sensitization in the pathway to HIV-related pain: characterizing the associations and developing a pragmatic, coping-focused intervention. - Project Summary Candidate Dr Madden is a senior lecturer at the University of Cape Town who is committed to a research career in South Africa, with the career vision of leading interdisciplinary research to understand pain mecha- nisms and develop scale-able, focused treatments that safely and effectively relieve pain in resource-limited settings. With 5 years of dedicated research time, she will be able to implement her systematic career devel- opment plan to (1) deepen her understanding of advanced methodology and expertise in research program management, (2) expand her knowledge of HIV, immunology and psychosocial influences on pain, and (3) gain valuable first-hand experience in conducting community-based research in South Africa. This will de- velop her as the first South African cross-disciplinary expert in the interactions between psychology, immu- nology and pain in HIV. The career development plan is built around coordinated, cross-disciplinary training at the University of Cape Town, Harvard University and University of Michigan; hands-on research in South Africa, and close mentorship from a carefully selected team of highly experienced research scientists. Research Living with HIV is frequently accompanied by persistent pain and psychosocial distress (PSD). Most HIV-related pain is not explained by peripheral neuropathy, but resembles complex chronic pain condi- tions in which the immune system has been found to have an exaggerated response to provocation (inflam- matory reactivity). PSD is known to contribute to immune dysregulation and to pain. One pathway by which PSD may influence HIV-related pain is via inflammatory reactivity (IR) – but this has not been established. In this Research Project, Phase 1 (Specific Aim 1) aims to characterize the relationships between PSD, IR, central sensitization and persistent pain in HIV. It will use a cohort study with baseline measures from HIV+ people with/without persistent pain (2 groups), and longitudinal follow-up of a subsample of participants from each group over a 6-month period. Mediation analysis will clarify whether IR represents a pathway for the influence of PSD on HIV-related pain; group comparisons will contrast IR and central sensitization between those with and without persistent pain; generalized mixed effect models will examine fluctuations in PSD, IR and pain over time in each group. This will be the first characterization of the associations between psycho- social distress, inflammatory reactivity, central sensitization and HIV-related pain. Phase 2 (Specific Aim 2) aims to develop and determine the feasibility and acceptability of a pragmatic, scale-able, coping-focused intervention to decrease distress and pain in people with HIV in South Africa. The intervention will be devel- oped, for non-specialist delivery, during a culturally secure, stepwise formative process including community and receiver engagement. A small open pilot trial (n = 10) that incorporates iterative revision of intervention content and delivery will be used to test intervention feasibility and acceptability and to troubleshoot imple- mentation and assessment procedures to inform future, fully powered clinical testing.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2023	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	International Research and Research Training	000	5	5/14/2026	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	International Research and Research Training	000	5	2/17/2025	NON-COMPETING CONTINUATION	$0
2025	2023	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	International Research and Research Training	001	5	9/16/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $98,612 )
2023	2023	UNIVERSITY OF CAPE TOWN	LOVERS WALK	CAPE TOWN				ZAF	International Research and Research Training	000	5	4/10/2023	NON-COMPETING CONTINUATION	$98,612
														Subtotal = $98,612

Issue Date FY: 2022 ( Subtotal = $113,289 )
2022	2022	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH				ZAF	International Research and Research Training	000	4	4/15/2022	NON-COMPETING CONTINUATION	$113,289
														Subtotal = $113,289

Issue Date FY: 2021 ( Subtotal = $185,545 )
2021	2021	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH				ZAF	International Research and Research Training	000	3	4/13/2021	NON-COMPETING CONTINUATION	$104,545
2021	2021	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH				ZAF	International Research and Research Training	001	3	7/21/2021	SUPPLEMENT FOR EXPANSION	$81,000
														Subtotal = $185,545

Issue Date FY: 2020 ( Subtotal = $167,112 )
2020	2020	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	International Research and Research Training	002	2	5/1/2020	NON-COMPETING CONTINUATION	$113,115
2020	2020	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	International Research and Research Training	003	2	9/4/2020	SUPPLEMENT FOR EXPANSION	$53,997
2020	2019	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	International Research and Research Training	000	1	4/28/2020	NEW	$0
2020	2019	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	International Research and Research Training	001	1	5/1/2020	NEW	$0
														Subtotal = $167,112

Issue Date FY: 2019 ( Subtotal = $109,633 )
2019	2019	UNIVERSITY OF CAPE TOWN	LOVERS WALK	RONDEBOSCH		007700		ZAF	International Research and Research Training	000	1	7/24/2019	NEW	$109,633
														Subtotal = $109,633

Grand Total All Awards = $674,191

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Psychosocial distress, inflammatory reactivity and central sensitization in the pathway to HIV-related pain: characterizing the associations and developing a pragmatic, coping-focused intervention.

Award Number: K43TW011442

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/27/2019

PERIOD OF PERFORMANCE END DATE: 11/30/2025

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