PROJECT SUMMARY/ABSTRACT The proposed University of California San Francisco (UCSF)/Blood Systems Research Institute (BSRI), University of Cape Town (UCT) and South Africa National Blood Service (SANBS) research training program in HIV-related transfusion medicine and hematology research will train blood bankers and hematologists to perform high-quality HIV research to address relevant research questions in South Africa. South Africa needs research on its HIV epidemic's impact on the national blood supply and HIV-related hematology complications. Since 2007, we have already accomplished a series of in-country short courses and identified a pool of 30-50 potential junior scientists for in-country HIV research in transfusion medicine and hematology among SANBS staff and UCT junior faculty and medical postgraduates but their potential remains unfulfilled. This proposal builds upon a 15-year history of HIV research collaboration between SANBS and UCSF/BSRI that yielded research evidence to support a safe and adequate blood supply in South Africa. Under the NHLBI-funded REDS-III International HIV research network, this collaboration will provide a funded research infrastructure for trainees through 2019. Our needs assessment indicates that specific deficiencies in biostatistics, manuscript preparation and research career mentoring need to be overcome to achieve our vision of a sustainable, independent HIV-related transfusion medicine and hematology research enterprise in South Africa. We propose Specific Aims of: 1) a research and development institute at SANBS; 2) an academic UCT Hematology Division; and 3) broader human capital development to raise South Africa as a regional center of excellence in this research. A three-tiered educational approach will be tailored to trainees at various levels of their research careers: in-country short courses on clinical research methodology and protocol design will reach a large number of trainees; for a smaller number lacking skills in study design, biostatistics and data analysis we propose medium-term internships in Cape Town and San Francisco including course work and research internships; finally, for a select few, Master's and PhD training in specific research disciplines will be tailored to their needs at the UCT School of Health Sciences. Throughout, trainees will be mentored as they accomplish their own research projects and compete for mini-grants funded by the program. The REDS-III HIV research network will provide research opportunities in terms of access to human subjects, databases and biological specimens. Research projects will address high-priority questions in HIV-related transfusion medicine and hematology in South Africa, including: HIV prevalence and incidence as measured by novel assays; risk factors for incident HIV infection to detect new trends in the epidemic; HIV-related anemia; appropriate transfusion therapy for HIV patients; and HIV lymphomas. The result of this program will be a substantial improvement in human capital for HIV-related transfusion medicine and hematology research within the two South African blood service organizations, UCT and neighboring southern African countries.

PROJECT NARRATIVE With the world's largest epidemic of HIV infection, South Africa needs additional research in HIV-related transfusion medicine and hematology. This training grant will form a partnership between U.S. researchers, the two South African blood service organizations and the University of Cape Town to provide three types of clinical research training to promising young scientists. The program will help to prevent HIV transmission by blood transfusion and improve the treatment of HIV-related hematologic diseases in South Africa.