PROJECT SUMMARY The Northwestern/Nigeria Research Training Program in HIV and Malignancies (NN-HAM) addresses a high priority NIH research area and significant problem in sub-Saharan Africa because of the widespread HIV epidemic made worse by the high burden of oncogenic viral co-infections. Antiretroviral therapy programs put into place by PEPFAR, the Global Fund and others, have resulted in a remarkable decrease in HIV-related morbidity and mortality; however, the rate of certain malignancies are rising while the population is aging. Most African medical and research institutions are ill-prepared to confront these emerging challenges. Since 2014, Northwestern University and University of Jos in Nigeria successfully collaborated in a research training program for HIV and malignancies (Northwestern and Jos University Research Training Program in HIV and Malignancies, D43 TW009575). Program highlights include: 2 master's degree-level Clinical Investigation scientists and 2 PhDs in Health Services & Outcomes Research trained; senior faculty enrichment; and 6 mentored trainee pilot awards. We further formed a network with Northwestern, University of Lagos, and University of Jos to successfully compete for an NCI-funded U54 (Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria, 1U54CA221205). This renewal Fogarty HIV Research Training Program for LMICs proposal will further enhance Nigerian scientists' capacity for large population-based HIV-malignancy research by training scientists focused on cancer molecular epidemiology. Our primary hypothesis is that building capacity in molecular cancer epidemiology, biostatistics, and bioinformatics on HIV-associated malignancies will significantly enhance our understanding of cancer epidemiology and promote mechanistic biomarker-based research that will inform preventive and therapeutic strategies, ultimately leading to a reduction in cancer incidence and mortality. This renewal application's specific aims are to: 1. train cancer molecular epidemiologists capable of: i) designing and conducting population-based molecular epidemiology studies, ii) developing protocols for biospecimen collection, processing, and storage, and iii) developing biomarkers that can be used for prevention and improved treatment of HIV-associated malignancies; 2. train several master's degree-level biostatisticians and scientists in medical informatics and bioinformatics who can manage and handle data from clinical, laboratory, and population settings, and perform comprehensive biostatistical and bioinformatic analyses generated from large population studies; and 3. create a multidisciplinary research team capable of performing advanced in-country molecular epidemiology research, including high throughput “omic” research, on HIV-associated malignancies at our network sites, University of Jos and University of Lagos. We will achieve our goals through strong mentorship and research training including: 1 PhD degree and 4 master's degrees (long-term), 3 medium-term research-project-driven training programs, several short-term in-country workshops, and innovative distance learning.

Narrative Antiretroviral therapy programs put into place by PEPFAR, the Global Fund and others have resulted in a remarkable decrease in HIV-related morbidity and mortality; however, the rate of certain malignancies are rising significantly. Most sub-Saharan African medical institutions are ill prepared to deal with this emerging health challenge. This Nigerian-based research-training program will build capacity in molecular cancer epidemiology, biostatistics, and bioinformatics to train researchers to conduct population-based molecular epidemiology cancer research, leading to the development of preventative and therapeutic strategies to reduce incidence and decrease mortality of HIV-associated malignancies in Nigeria.