Project Summary/Abstract The goals of this K24 application are for Dr. Jennifer Downs to train physician-scientists in the conduct of patient-oriented research on schistosomiasis and women's reproductive health in Tanzania and Lebanon, and to conduct a new study on human papillomavirus (HPV) persistence in women with schistosome infections. The candidate has spent the past 16 years conducting research in Tanzania on: (1) the female genital tract and gut mucosal effects of schistosome infections and how these affect host immune response to viral infections and vaccines, and (2) implementation science to improve women's reproductive health in resource limited settings. She has also established longstanding partnerships with a leading research organization (MITU) and medical school (Weill Bugando School of Medicine) in Tanzania. These partnerships, and her ongoing research studies, provide an outstanding research environment to study schistosomiasis and women's reproductive health while providing mentorship to the next generation of patient-oriented investigators. The training that Dr. Downs offers leverages ongoing funded research in Tanzania in Aims 2-4 (2 NIH R01s and foundation awards) and a newly funded women's reproductive health research project among Syrian refugees in Lebanon (Aim 5). United States (US) trainees from Weill Cornell will be supported by NIH research training grants and spend >50% of their time at their international sites in Tanzania or Lebanon. The projects include: 1. HPV persistence and cervicovaginal dysbiosis in women with schistosome infections 2. Genital mucosal, immune, and viral effects of female genital schistosomiasis 3. Effects of Schistosoma mansoni on the gut mucosal response to oral poliovirus vaccine and gut immune cell populations 4. Implementation science to promote women's reproductive health through religious institutions 5. Implementation science to develop a mobile reproductive health intervention for Syrian refugee women Research training will focus on a diverse pool of clinical trainees ranging from medical students to junior faculty. Dr. Downs has a strong track record of mentoring patient-oriented researchers. She founded and leads the Weill Cornell Women in Global Health Research Initiative. Her trainees will participate in this longitudinal mentorship initiative and work in US-international partnerships on research projects in Tanzania (Aims 1-4) and Lebanon (Aim 5). These 5 projects offer robust clinical, translational, and implementation science training. The K24 award will enable Dr. Downs to decrease her administrative responsibilities and commit 50% effort to research and mentorship. She will seek formal training in mentorship and strengthen her skills in HPV research, working towards her long-term goal of building a world-class research and training program to improve care for schistosomiasis and women's reproductive health among the world's poorest populations.