Social Determinants of HIV

Social determinants of health (SDH) comprise overlapping social structures and economic systems that account for most health inequities. Examining SDH may be useful in identifying and monitoring HIV-related inequities, such as racial and gender disparities in HIV testing, engagement in care, and treatment. This proposal requests funding for a pre-doctoral research training program to address SDH including structural racism and gender inequality, intersectional stigma, residential segregation, aging, and marginalizing structures influencing HIV. Combatting the ongoing syndemic of SDH, HIV, affiliated co-morbidities, and other potentially overlapping infectious diseases such as Coronavirus, requires cutting edge public health research conducted by scientists of the highest caliber. This pre-doctoral program will be located in the department of Sociomedical Sciences within Columbia University, Mailman School of Public Health (MSPH). The training program will take advantage of the interdisciplinary expertise across MSPH in mentoring experience and expertise in SDH among people at risk and living with HIV. We also propose to collaborate with faculty at the HIV Center on Clinical and Behavioral Studies at Columbia University Irving Medical Center (CUIMC), the International Center for AIDS Care and Treatment Program, at MSPH, and the Social Interventions Group at the Columbia University School of Social Work. This wealth of faculty have outstanding records in publishing, funding, and successfully mentoring trainees. We propose to fund ten MSPH pre-doctoral fellows. Recruitment will be focused such that at least 50% of fellows enrolled will be under-represented trainees. Eligible trainees are pre-doctoral students admitted to Columbia University's MSPH departments of Sociomedical Sciences, Biostatistics, Epidemiology, and Population and Family Health, and committed to understanding social determinants of HIV. Trainees are required to complete in their primary department, specific theoretical, methodological, and biostatistical pre-doctoral department requirements. All fellows will receive mentoring and co-mentoring and will be required to complete the following training components: (1) a Faculty-Fellow seminar that alternates hosting guest speakers discussing professional development, structural interventions, social policies, community-engaged research, and social determinants of HIV, with a student-led journal club, (2) coursework on social and economic determinants of health, (3) coursework on social epidemiology, (4) coursework on HIV, (5) coursework on multilevel modeling, (6) attendance in HIV Grand Rounds at CUIMC, (7) a course in the responsible conduct of research, (8) grantsmanship, (9) experiential training to hone publication, and presentation skills, and (10) doctoral research on the social determinants of HIV. This pre-doctoral program aims to prepare MSPH students for research and teaching careers that examine SHD, and marginalizing structural factors that influence HIV, nationally and globally.