Yale has received a $10.8 million grant from the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA) to support a Center for Interdisciplinary Research on AIDS. The mission of the center will be to conduct research aimed at preventing HIV infection and reducing the harmful consequences of AIDS in vulnerable and underserved populations. The center also will examine AIDS-related legal policy as well as ethical issues related to its research findings.
"Yale is extremely pleased that its ongoing efforts involving AIDS will be augmented appreciably by the interdisciplinary work of this new center supported by NIMH and NIDA," said President Richard C. Levin. "We believe that this research effort -- which will draw upon Yale's expertise in public health, the social sciences, policy analysis and legal and ethical issues -- will be of great and timely benefit to the people of our state, as well as nationally and internationally."
The Center for Interdisciplinary Research on AIDS (CIRA) initially will conduct four research projects over several years involving adolescents, women and drug users -- populations in which HIV infections are still increasing at an alarming rate. Three of those four projects will be carried out exclusively in Connecticut, which ranks 16th among states in the number of reported AIDS cases despite being 38th in population.
Building on Yale's AIDS research. Dr. David A. Kessler, dean of the School of Medicine, said: "AIDS research at Yale has been devoted primarily to providing the best possible treatment. CIRA's research will build upon that strength by focusing on the social and behavioral aspects of prevention, and on providing psychosocial support for HIV-infected individuals and their families. A center of excellence such as CIRA can reach out beyond individual departments and schools and bring faculty together around a common purpose -- in this case to deal more effectively and efficiently with one of the most serious public health problems to affect this country and the world in this century."
Focus on at-risk populations. Dr. Michael H. Merson, dean of public health and professor and chair of the department of epidemiology and public health (EPH), will direct CIRA. "This center will be unique in a number of ways. It will focus on the populations that have recently emerged to be at greatest risk of HIV infection, bring together scientists from a wide range of disciplines, and provide a comprehensive and frank analysis of the legal policy and ethical issues confronting policy makers in this country," said Dr. Merson. "The center's success will be measured by the impact of its research findings on the actions of those working to prevent AIDS and to provide support for those affected by the disease."
Dr. Merson, who was executive director of the World Health Organization's worldwide efforts to control the AIDS epidemic 1990-95, said Yale is uniquely qualified to establish such a center. He cited Yale's location in a state with a relatively high HIV-infection rate; the University's experience in research with infected women, children and injection drug users; and its close-knit relationships with primary-care providers and community-based AIDS organizations in New Haven as well as in other Connecticut communities.
Yale also has the necessary academic breadth to make an interdisciplinary program successful, Dr. Merson said. CIRA faculty will be drawn not only from EPH, which is an accredited school of public health located in the School of Medicine, but also from a number of Yale's Graduate School of Arts and Sciences departments (psychology, biology, political science), Yale's Institution for Social and Policy Studies, and its Schools of Law, Management, Medicine, and Nursing.
"We are focusing our initial research on the epidemic in Connecticut because of the urgency of the situation here and our desire to establish close partnerships with community groups," Dr. Merson said. "We will ensure that the center's research is based on needs they identify, and that the findings are effectively disseminated. In fact, the only project that will look beyond Connecticut among the initial four is the project to evaluate needle-exchange programs, which will involve collaborators in Chicago and Oakland."
The three projects that will focus solely on Connecticut include research on how to best frame HIV prevention messages for low-income women; a study of adolescent pregnancy and the risk of contracting HIV and other sexually transmitted diseases; and research to better understand the social networks of injection drug users and ways to prevent HIV infection using these networks.
Once these projects are well underway, CIRA plans to extend its research to children and other vulnerable populations, and will begin collaborating with colleagues beyond Connecticut in the United States and abroad who are undertaking similar research, Dr. Merson said.
Yale already has a number of AIDS programs in place, including an inpatient and outpatient adult AIDS treatment program; a pediatric AIDS program that provides medical, social and counseling services for infected children and their families; the first needle-exchange based health services program in the country; and an "HIV in Prisons" program providing services to 11 correctional facilities statewide.
Psychosocial research at Yale has included studies of the effects of HIV disease in families, particularly on uninfected surviving children, and the development and evaluation of mental health programs for children whose parents are HIV-infected.
To underscore community involvement, scientists from two Hartford-based organizations -- the Institute for Community Research, and the Hispanic Health Council -- will be included in CIRA. The scientists have expertise in ethnographic research not found at Yale, Dr. Merson said.