# The science for the last mile: Enhanced epidemiologic surveillance to accelerate HIV elimination

> **NIH NIH K01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $135,824

## Abstract

PROJECT SUMMARY/ABSTRACT
Cities account for a large proportion of the global population of people living with HIV. As a result, Cities have
become the focus of UNAIDS's “Fast Track” approach to ending the AIDS epidemic through targeted scale-up
of prevention and testing services. In the United States, HIV surveillance data indicates a shifting composition
of the population of people newly infected with HIV, with females and minority populations accounting for
disproportionate rates of infection. These emerging health disparities in HIV incidence suggest that the largely
successful “Getting to Zero” public health initiatives (e.g. rapid expansion of pre-exposure prophylaxis [PrEP],
needle exchange and safe injecting sites, etc.) are not reaching the most vulnerable populations.
Leveraging routinely collected surveillance data paired with primary data collection, the major goal of this
research is to identify the residual drivers of HIV infection in Fast Track cities, using San Francisco as a test
case. This proposal seeks to provide multidisciplinary methodological and theoretical training to investigate the
scientific knowledge gap of ongoing HIV transmission in the era of “Getting to Zero.” The proposed training
areas are: (1) semi-parametric statistical modeling and machine learning in order to improve the accuracy and
precision of population size estimation methods; (2) molecular epidemiology and phylogenetic techniques to
assess the relatedness of HIV viral sequences between individuals, inferring a shared source of infection; and
(3) minority stress theory to measure the (socio-structural) characteristics of the environment and relate these
structural exposures to disparities in HIV infection. Aligned with the training components, the research goals of
this study are to: (a) estimate how many people are living with HIV in San Francisco and quantify the
magnitude of disparities in infection rates and access to health care services; (b) identify the sociodemographic
correlates of membership to a transmission cluster; and (c) identify the socio-structural facilitators of recent HIV
infections, particularly among minority populations, using a case-control study design. The evidence generated
from this work could have a direct impact on San Francisco's Getting to Zero campaign and inform novel
intervention targets for other Fast Track cities. Additionally, the exceptional methodological and practical
experience gained from this project will position the candidate for an impactful career as an independent
researcher.

## Key facts

- **NIH application ID:** 10348162
- **Project number:** 5K01AI145572-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Paul Douglas Wesson
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $135,824
- **Award type:** 5
- **Project period:** 2020-03-01 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10348162

## Citation

> US National Institutes of Health, RePORTER application 10348162, The science for the last mile: Enhanced epidemiologic surveillance to accelerate HIV elimination (5K01AI145572-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10348162. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*