PARTNERSHIPS FOR HIV/AIDS RESEARCH IN AFRICAN POPULATIONS
RFA-HD-02-003

SAMPLE RESEARCH QUESTIONS AND CONTACT INFORMATION

CONTACT INFORMATION

SAMPLE RESEARCH QUESTIONS

Illustrative examples of research questions or issues that may be addressed in the research project component of applications responding to this RFA include, but are not limited to, the following:

1. Behavioral, Cultural, Social, and Psychosocial Factors that Influence HIV/AIDS Prevention, Care, and Management
   
   
   • How do social, economic, behavioral, cultural, and psychosocial factors influence how African families manage HIV/AIDS-related illness, including seeking and accessing diagnosis, treatment, and care? What are the knowledge, attitudes, and practices of effective caregivers and other health care providers in the community? What types of care do individuals and families seek and from whom? How are these decisions made and by whom?
     
     
   • What is the role of the family in promoting the adoption of behaviors to reduce risk of HIV acquisition and transmission? How is this affected by changes in the family brought about by HIV infection and AIDS deaths?
     
     
   • What sex education messages, materials, and programs are being used, in which settings (e.g., community-based organizations, schools, churches, neighborhoods, families), and delivered by whom? Which elements are most promising in reaching intended audiences? Are psychologically and culturally appropriate media messages, regarding the route of HIV transmission, and its prevention, reaching target populations and having an effect on sexual behavior?
     
     
   • What behavioral, social, and contextual factors influence prevention program design and effectiveness with women and young people in Africa?
     
     
   • What is the impact of community leaders (elected and selected), faith communities, non-governmental organizations, governmental organizations, traditional healers, and other community groups on prevention efforts and provision of care for HIV-infected individuals?
     
     
   • How do family structure and inheritance patterns, both legal and informal, influence both health-seeking and care-giving for HIV-infected and HIV-affected individuals?
     
     
   • How do gender-based norms, values, and expectations affect the ability of women, children, and families to avoid behaviors that expose them to HIV risk and how do they affect prevention efforts? What are effective interventions to integrate men into HIV prevention and care?
     
     
2. The Role and Impact of Traditional Health Practitioners and Related Practices
   
   
• How do traditional health practitioners address HIV/AIDS-related prevention and treatment practices? How safe and effective are such practices? What is the impact of such practices on HIV viral load, on opportunistic infections, and on patients' quality of life?
  
  
• What is the impact of the knowledge, expectations, and quality of training of both traditional and Western-trained health care providers on the care-seeking, care-accepting, and preventive behaviors of their patients?
  
  
• How can traditional healers and practices be linked to and/or integrated with Western-trained physicians and biomedical approaches to provide optimal HIV/AIDS prevention and care services? Can such involvement help increase the acceptance of voluntary counseling and testing, compliance with treatment regimens or patient well being?
  
  
• What are the attitudes and beliefs of traditional healthcare providers about the importance and availability of a balanced diet in the care and treatment of HIV-infected patients in Africa?
  
  
• What are effective HIV/AIDS-related training programs for traditional healthcare and education providers and religious leaders? How does the selection and training of traditional healers influence their beliefs and practices related to HIV/AIDS prevention and care?
  
  
• How does the accessibility and affordability of the care provided by traditional healers compare, in the minds of users, to that provided by Western-trained medical providers?
  
  
3. The Impact of HIV/AIDS on Child Health and Development in Africa
   
   
• What is the impact of HIV/AIDS, in any family member, on family interactions, child development (physical, social, emotional, and cognitive or biopsychosocial), and family socioeconomic status? How does parental HIV-infection affect the degree to which children are subject to child labor? What are the consequences of such labor for the child and other family members? What other roles do children take on within the family? Within the community? What are the consequences for the social, emotional, and cognitive development of children and adolescents when they assume these roles?
  
  
• What is the effect of parental HIV-infection on children's (both HIV-positive and HIV-negative) access to formal and informal education and training during the parent(s)' illness and following the parent(s)' death?
  
  
• What is the effect of HIV-positive parent(s) on children's nutritional status (quantity and quality) and access to health care? How does this vary with the age of the child and with family and caregiver structure?
  
  
• What happens to children after the death of one or both parents? Under what conditions are they likely to lose all sources of support? Be cared for by extended family? Cared for by the community? Does the parents' cause of death (e.g., AIDS) influence subsequent life of the child?
  
  
• What happens to orphan children who are placed within foster families? Does the parents' cause of death (e.g., AIDS) affect placement and outcome of the placement, both formal and informal? What conditions are most likely to lead to an appropriate placement providing care and protection from exploitation?
  
  
• Do long-term developmental outcomes (e.g., into adulthood) for AIDS orphans differ from those for children orphaned by other causes? Are the incidences of mental illness (e.g., depression, anxiety, or obsessive-compulsive disorder) higher for AIDS orphans?
  
  
4. Understanding Stigma and its Influence on HIV/AIDS Prevention, Care, and Management
   
   
• What are the determinants of HIV-related stigma in African families and communities? How are these determinants influenced? Do these determinants differ and, if so, how do they differ, from stigma associated with other diseases? Do they differ by gender, ethnicity, class or age of the individuals stigmatized?
  
  
• What strategies and interventions are effective in reducing stigma?
  
  
• What is the impact of stigma on HIV-infected children and adolescents?
  
  
• What is the link between provision of effective care and stigma reduction?
  
  
• What is the role of traditional healers in relation to stigma and HIV/AIDS?
  
  
• What is the effect of increased knowledge and understanding of HIV transmission on stigma in both perpetrators and stigmatized? What impact does perceived or potential stigma have on the willingness of individuals to engage in preventive approaches and on the success of prevention efforts?
  
  
• What is the influence on stigma reduction programs of integrating people living with AIDS in the design and implementation of prevention and care approaches?
  
  
5. Factors Affecting the Availability and Acquisition of a Healthy Diet for HIV-Affected People
   
   
• What cultural, social, economic, nutritional, and dietary behaviors and beliefs affect decisions about infant feeding by mothers in Africa? How are these changing with the HIV epidemic? How does dietary intake or nutritional behavior change in individuals, families, and communities severely affected by HIV/AIDS?
  
  
• What factors influence the acquisition of a nutritionally well-balanced, safe diet to meet the requirements of HIV-infected infants and children for optimal growth, development, and maintenance of health? What factors influence the nutritional status of expectant mothers in Africa and how do these differ for HIV-infected mothers? What impact do those factors have on birth outcomes and the health of newborn infants?
  
  
• What is the impact of dietary customs and practices in Africa on the health of HIV-infected and HIV-uninfected women of reproductive age?
  
  
• What social and cultural factors influence the availability, access, and acceptability of safe and nutritionally adequate alternatives to mother's milk, complementary foods, and infant foods for infants and toddlers born of HIV-infected mothers?
  
  
• What maternal dietary practices are related to needs during lactation and are there special considerations in HIV positive women?
  
  
• What social and cultural factors have an impact on duration of exclusive breastfeeding and extended mixed feeding (human milk plus complementary foods) in Africa?
  
  
• What are the social practices, cultural values, and characteristics of mother-infant pairs that can have an impact on the care and management of mother and infants affected by HIV in Africa?
  
  
• What surrogate systems are available to provide adequate nutrition to children of HIV-infected mothers? What is the role of the father, the extended family, and the community? Does the adequacy of diet and care received differ depending on the guardian?
  
  
• What is the role of indigenous foods in providing an adequate diet for HIV-infected and HIV-affected people in Africa?
  
  
• What are the knowledge, attitudes, and beliefs of caregivers, e.g., medical personnel, traditional healers, etc., about the role of diet in the care and management of HIV-infected people?
  
  
6. The Role of Reproductive Health in the Acquisition, Prevention, Progression, and Treatment of HIV
   
   
• What, if any, strategies are used by women to reduce the impact of sexually transmitted infections on HIV acquisition? How do women's strategies to protect their fertility and preserve the ability to conceive and bear healthy children influence their exposure to HIV? What strategies help maintain child-bearing capabilities of HIV-infected women?
  
  
• How can family planning methods that are both appropriate and acceptable for women of childbearing age best be delivered?
  
  
• What is the effect of pregnancy and breastfeeding on disease progression in HIV-infected African women?
  
  
• In cases where treatment is available, what is the effect of HIV treatment on subsequent gynecological health, e.g., reduction in cervical cancer?
  
  

CONTACT INFORMATION

Direct inquiries regarding programmatic issues related to behavioral and social science research relevant to NICHD:

Susan Newcomer, Ph.D.
Demographic and Behavioral Sciences Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8B07, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6981
Fax: (301) 496-0962
E-mail: newcomes@exchange.nih.gov

Direct inquiries regarding programmatic issues related to behavioral research relevant to NIMH:

Willo Pequegnat, Ph.D.
Center for Mental Health Research on AIDS
Division of Mental Disorders, Behavioral Research and AIDS
National Institute of Mental Health
6001 Executive Boulevard, Room 6205, MSC 9619
Bethesda, MD 20892-9619
Telephone: (301) 443-1187
Fax: (301) 443-9719
E-mail: wpequegn@nih.gov

Direct inquiries regarding programmatic issues related to child development and well-being:

Lynne Haverkos, M.D.
Child Development and Behavior Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 4B05, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6881
Fax: (301) 480-7773
E-mail: haverkol@mail.nih.gov

Direct inquiries regarding programmatic issues related to reproductive health:

Patricia Reichelderfer, Ph.D.
Contraception and Reproductive Health Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8B13, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6991
Fax: (301) 480-1972
E-mail: reichelp@exchange.nih.gov

Direct inquiries regarding programmatic issues related to nutrition and HIV:

Daniel Raiten, Ph.D.
Office of Prevention Research and International Programs
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 2A01, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-7568
Fax: (301) 435-0009
E-mail: raitend@mail.nih.gov

Direct inquiries regarding programmatic issues related to traditional medicine:

Joana Rosario, M.D., MPH
Office of International Health Research
National Center for Complementary and Alternative Medicine
6707 Democracy Boulevard, Room 106
Bethesda, MD 20892-5475
Telephone: (301) 594-9986
Fax: (301) 480-3621
E-mail: jr69z@nih.gov

Direct inquiries regarding programmatic issues related to FIC training and capacity building initiatives:

Jeanne McDermott, Ph.D.
Division of International Training and Research
Fogarty International Center
31 Center Drive, Room B2C39, MSC 2220
Bethesda, MD 20892-2220
Telephone: (301) 496-1492
Fax: (301) 402-0779
E-mail: mcdermoj@mail.nih.gov

Direct inquiries regarding other issues related to infrastructure development and capacity-strengthening:

F. Gray Handley
Office of Prevention Research and International Programs
6100 Executive Boulevard, Room 2A01, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-7567
Fax: (301) 435-0009
E-mail: handleyg@exchange.nih.gov

Direct inquiries regarding review issues:

Robert Stretch, Ph.D.
Division of Scientific Review
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 5E03, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 496-1485
Fax: (301) 402-4104
E-mail: stretchr@mail.nih.gov

Direct inquiries regarding fiscal matters to:

Christopher Myers
Grants Management Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8A01, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6996
Fax: (301) 402-0915
E-mail: cm143g@nih.gov