Posts classified under: Education

South American Program in HIV Prevention Research (SAPHIR)

Abstract: Effective HIV prevention interventions require the integrated analysis of behavioral, biological, and social transmission patterns within specific cultural contexts. The South American Program in HIV Prevention Research (SAPHIR) program offers developing investigators from the U.S. an intensive, structured program of education and practical research training on comprehensive HIV prevention in an international environment. Specific Aim 1. To provide researchers from the U.S. with a structured program of education and training based on a focused research topic within the field of HIV prevention in Latin America. SAPHIR program trainees are paired with research mentors from the U.S. and Latin America to develop an independent research program incorporating both secondary analysis of existing data and design of an original research study protocol. Potential research topics include behavioral, epidemiological, clinical and laboratory issues related to HIV prevention within specific Latin American contexts. Specific Aim 2. To provide a program of didactic instruction and interactive seminars addressing integrated approaches to HIV prevention in international settings. The training program includes a weekly series of lectures and seminars on key areas of global HIV prevention, including lectures, journal clubs, research presentations, and ethics case conferences. The conceptual framework for the educational program is based on the intersection of scientific disciplines through the lens of comprehensive HIV prevention. Specific Aim 3. To build the capacity of a collaborative network of international investigators and research centers with individual areas of scientific expertise to produce integrated approaches to HIV prevention research in Latin America. In addition to practical training for young investigators, a secondary aim of the program is to promote inter-institutional collaboration and capacity-building for participating research centers. Graduates of the program accomplish the following goals: 1) Acquire a foundation of knowledge in the four core areas of comprehensive HIV prevention (epidemiology, diagnosis, treatment, and prevention); 2) Complete a secondary data analysis and prepare a corresponding abstract for submission to an international scientific conference; 3) Design an independent research sub-study; 4) Prepare a study protocol that meets requirements for the ethical conduct of research with human subjects as defined by the UCLA Office for Human Research Participant Protection; 5) Submit a funding proposal for peer review and receive a written summary statement; and 6) Present results of their research in a local community venue and at an annual conference of program trainees and mentors. All SAPHIR graduates acquire the exposure, skills, and practical experience necessary to gain admission to competitive post-doctoral training programs and to build an academic career in international HIV prevention research.

Project Number: 2R25MH087222-11

https://reporter.nih.gov/search/UTGlOQLsKEmZHEyMDXv20w/project-details/10012883

 

Contact PI/ Project Leader

CLARK, JESSE LAWTON , ASSISTANT PROFESSOR-IN-RESIDENCE (jlclark@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: The newest generation of physician scholars recognizes the need for global approaches to HIV prevention but lacks structured opportunities for research training in international sites. Our dedicated program of education and practical training in international HIV prevention studies fills an important deficit in current AIDS research.

 

 

Project Start Date: 01-August-2011

Project End Date:31-March-2026

Budget Start Date: 03-June-2021

Budget End Date: 31-March-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF MENTAL HEALTH / FY Total Cost by IC: $255,193

Evaluating the PrEP cascade in HIV-negative pregnant and breastfeeding women in South Africa (PrEP-PP)

Abstract: HIV-negative pregnant and breastfeeding women in South Africa are at extremely high risk of HIV acquisition despite increased access to and initiation of antiretroviral therapy (ART) in South Africa. We urgently need effective interventions to reduce HIV incidence in pregnant and breastfeeding women. Currently PrEP is one of the only female controlled methods that is effective for preventing HIV acquisition. PrEP-PP is a study of pre-exposure prophylaxis (PrEP) among HIV-1 seronegative Pregnant and Postpartum women in two South African urban primary health care facilities. Effective use of PrEP could contribute to eliminating maternal HIV acquisition, and hence eliminating mother to child HIV transmission (MTCT). However, PrEP efficacy requires adherence during periods of sexual activity and adherence requires PrEP access, awareness and counseling. Currently, a major obstacle in the field is the lack of knowledge of women’s initiation, retention and adherence to PrEP during pregnancy and breastfeeding periods in Africa. Now is the time to evaluate how best to provide PrEP to vulnerable pregnant and breastfeeding women as WHO recently developed guidelines for providing PrEP in pregnancy and breastfeeding women but there are limited data on acceptability, initiation and adherence in pregnant and breastfeeding women in Africa where the burden of HIV is greatest. Our study will focus on the following specific aims: 1. Determine the distribution of women across the PrEP cascade (initiation, retention, and adherence) and outcomes (HIV acquisition, transmission, and adverse events) in a cohort of pregnant and breastfeeding women in Cape Town, South Africa 2. Evaluate patient and provider-level factors associated with the PrEP cascade (initiation, retention and adherence) using quantitative and qualitative approaches 3. Apply an established mathematical model to simulate the impact of improvement in the PrEP cascade on HIV infections averted (maternal and perinatal) Our PrEP-PP study is urgent and essential to understand the PrEP cascade in pregnant and breastfeeding women in South Africa and to identify factors associated with PrEP initiation and adherence to develop interventions to ensure that everyone in this at-risk population can benefit from PrEP. The results from the PrEP-PP study will provide a model for the South African Government, and other Governments in the region, to scale up PrEP delivery among pregnant and breastfeeding women at risk of HIV acquisition and perinatal transmission and contribute to the elimination of perinatal HIV transmission.

Project Number: 1R01MH116771-01A1

https://reporter.nih.gov/search/dkK25PIoW0KfsaDd4N5FHw/project-details/9623865

 

Contact PI/ Project Leader

COATES, THOMAS J., PROFESSOR IN RESIDENCE (tcoates@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV-negative pregnant and breastfeeding women in South Africa (SA) are populations at very high risk of HIV acquisition. Pre-exposure prophylaxis (PrEP) is one of the only female controlled methods that can prevent HIV acquisition. Our study, PrEP-PP, will evaluate the PrEP cascade ( PrEP initiation, retention, adherence) and patient and provider-level factors associated with the PrEP cascade to inform future PrEP programs.

 

 

Project Start Date: 15-September-2018

Project End Date: 30-June-2023

Budget Start Date: 15-September-2018

Budget End Date: 30-June-2019

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF MENTAL HEALTH / FY Total Cost by IC: $579,553

Developing Capacity for Opioid Use Disorder Treatment in Mental Health

Abstract: Untreated opioid use disorders (OUDs) can have devastating consequences for people with serious mental illness (SMI). While the size of the population with unmet need is unknown, studies indicate that 87% of US adults with co-occurring disorders do not receive SUD treatment, and large numbers of individuals with mental illness are on chronic prescription opioids, a risk factor for heroin use and the development of an OUD. Untreated OUDs in the SMI are important because OUDs increase morbidity and mortality and are associated with higher healthcare and social costs, homelessness, and incarceration. Increasing access to OUD treatment and improving patient outcomes in the SMI will require addressing both the supply of and the demand for treatment. At the system and provider level, the availability of treatment needs to be increased. At the patient level, patient demand for treatment needs to increase, by identifying and addressing patient perceptions of need, desire and preferences for treatment. In this developmental R34, we propose to evaluate system, provider and patient-level facilitators and barriers, and then to use this information to develop an implementation strategy and toolkit to promote the use of medication assisted treatment (MAT)–the use of FDA-approved medications for OUDs in combination with behavioral therapies–for people with COD receiving public mental health treatment. The results of the R34 will prepare us for a future R01 study of the effectiveness of the implementation strategy and toolkit on MAT adoption, implementation and sustainability. We focus on MAT because of its demonstrated effectiveness and cost-savings, and specialty mental health because of the large role the mental health system plays in treating individuals with COD. Aims 1-3 seek to assess organizational capacity (at the system and provider level); organizational readiness (at the provider level); and perceived needs, attitudes and preferences (at the patient level). In Aim 4, we will use findings from Aims 1-3 to guide development of the implementation strategy and toolkit, using stakeholder input and a systematic process for strategy development. By implementation strategy we mean a group of implementation interventions that will address barriers at multiple levels. By toolkit, we mean the resources providers and clinics will need to execute implementation. To conduct the research, we will collaborate with the Los Angeles County Department of Mental Health, the largest mental health department in the United States. Despite serving nearly 20,000 individuals with COD, in 2016 only 37 prescriptions for MAT were written. Using a mixed methods approach, we will conduct interviews, focus groups, and surveys with patients and providers from 8 clinics serving an ethnically and geographically diverse population. Our study is a first step towards increasing access to OUD treatment for a vulnerable, costly and underserved population. Our approach is innovative because we consider barriers from the system, provider, and patient perspectives, and address both organizational supply and patient demand.

 

Project Number:5R34DA046950-03

https://reporter.nih.gov/search/lgY4Yg_KkkiENbzm6wpebg/project-details/9989081

 

 

Contact PI/ Project Leader

OBER, ALLISON, ASSOCIATE BEHAVIORAL SCIENTIST (ober@rand.org)

 

 

Organization

RAND CORPORATION

 

 

PUBLIC HEALTH RELEVANCE: Opioid use disorders (OUDs) can have devastating consequences for people with serious mental illness. We propose to evaluate system, provider and patient-level facilitators and barriers, and then to use this information to select and tailor an implementation strategy to promote the use of medication assisted treatment (MAT)–the use of FDA-approved medications for OUDs in combination with behavioral therapies–for people with co- occurring disorders receiving public mental health treatment. Our study is a first step towards increasing access to OUD treatment for a vulnerable, costly and underserved population.

 

 

Project Start Date: 15-September-2018

Project End Date:28-February-2023

Budget Start Date: 01-September-2020

Budget End Date: 28-February-2023

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE ON DRUG ABUSE / FY Total Cost by IC: $133,361

Mopati: A Pilot HIV Treatment Partner Intervention in Botswana

Abstract:Botswana has the second-highest HIV prevalence in the world. Low-cost, scalable interventions are essential to support people living with HIV to adhere to antiretroviral treatment (ART) and remain in care. One such intervention is the use of treatment partners, which are recommended by HIV treatment guidelines in at least 20 countries worldwide. Specifically, national HIV policies of several countries, including Botswana, recommend that healthcare providers encourage patients initiating ART to identify an individual who can provide support, accompany patients to appointments, and provide medication reminders. Although a large body of work indicates the key role of social support in promoting adherence, research on treatment partners’ effectiveness has shown mixed results. Thus, research is needed to determine how support from treatment partners can be better harnessed. Our R21 study examined optimal characteristics of treatment partners. Results indicated that effective treatment partners not only help with adherence, but also provide essential non-medical support (e.g., transport, food preparation), and that effective treatment partners are more likely to be spouses or other intimate partners than other types of network members. Treatment partners, especially of unsuppressed patients, requested counseling skills training. Using our R21 as a basis, we propose to pilot test the effects of the Mopati program (“partner” in Setswana, the official language of Botswana), a multi-level intervention that guides healthcare providers and patients about treatment partner selection, and trains treatment partners on provision of effective support. The Specific Aims are: (1) To develop a multi-level treatment partner intervention with input from community and healthcare provider stakeholders in Botswana; and (2) To conduct a pilot test of the feasibility, acceptability, and preliminary effects on viral suppression of a multi-level treatment partner intervention. We will recruit 80 people living with HIV who are not virally suppressed and their 80 treatment partners in 2 matched clinic pairs (4 clinics total; 20 dyads/clinic) in Gaborone, Botswana. Clinics will be randomly assigned to standard of care or a healthcare provider guidance and treatment partner training intervention (i.e., all clinic providers receive training on advising patients about treatment partner selection, and all treatment partners receive HIV treatment education and training on counseling patients using a non-confrontational, non-judgmental style). We will survey patients and treatment partners at baseline and 6-months post-baseline and collect viral load from clinic records. Intervention feasibility and acceptability will be assessed via mixed methods (e.g., semi-structured interviews with patients, treatment partners, and clinic staff; refusal rates). We will present results to the committee that develops the Botswana National HIV and AIDS Treatment Guidelines. This research presents a unique opportunity to examine ways to improve ART use in practice across countries and has relevance for both HIV- care as well as healthcare for other conditions (e.g., diabetes, tuberculosis) that require strict adherence.

 

Project Number:5R34MH121229-03

https://reporter.nih.gov/search/_VOqXMKqJUm7lziiCBdL8A/project-details/10175050

 

Contact PI/ Project Leader

BOGART, LAURA M, SENIOR BEHAVIORAL SCIENTIST (LBOGART@RAND.ORG)

MOSEPELE, MOSEPELE

 

Organization

RAND CORPORATION

 

PUBLIC HEALTH RELEVANCE: Treatment adherence partners are recommended by HIV treatment guidelines in at least 20 countries worldwide to reduce treatment nonadherence and discontinuation by accompanying patients to appointments and providing medication reminders. The proposed research will develop and pilot test a multi-level clinic- based intervention to guide people living with HIV on treatment partner selection, educate treatment partners about HIV treatment, and train treatment partners on counseling skills, in order to increase the number of patients who are virally suppressed. This research has public health relevance not only for the treatment of HIV globally, but for the treatment of other health conditions that require strict adherence (e.g., diabetes, tuberculosis).

 

 

Project Start Date: 16-July-2019

Project End Date:31-May-2023

Budget Start Date: 01-June-2021

Budget End Date: 31-May-2023

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES / FY Total Cost by IC:$241,074

A Randomized Controlled Trial of an Antiretroviral Treatment Adherence Intervention for HIV+ African Americans

Abstract: Compared to Whites, Black people living with HIV are less likely to adhere to antiretroviral treatment (ART) and be virally suppressed. Our research has identified culturally relevant factors contributing to disparities among HIV-positive Black Americans, including stigma and medical mistrust (e.g., “conspiracy beliefs,” that ART is poison), in addition to structural and psychosocial factors related to poverty, healthcare access, and mental health. However, ART adherence interventions have rarely been culturally congruent, which may explain why relatively few interventions have shown robust effects on adherence or viral suppression. We propose to conduct a randomized controlled trial (RCT) of Rise, a culturally congruent adherence counseling intervention for HIV-positive Black men and women. Rise counselors possess specialized HIV treatment knowledge and are trained in motivational interviewing (MI) skills to overcome culturally relevant barriers to adherence and retention in care; they also assist with linkage to social services. Rise is ideally implemented in community organizations, enabling clients to seek services in non-medical settings, which helps to overcome mistrust of healthcare, and increase readiness for adherence. In a pilot RCT, Rise led to increased adherence (measured by electronic monitoring) relative to a wait-list control group over time, showing a large effect size (Cohen’s d=.87). However, the pilot did not evaluate effects on viral suppression or include long-term follow-up. Thus, we propose to conduct an RCT of Rise that follows best practices for evidence-based HIV treatment adherence intervention design and testing. The Specific Aims are: (1) To conduct a randomized controlled trial to examine the effects of a culturally congruent adherence intervention on antiretroviral treatment adherence, retention in care, and viral suppression among Black men and women living with HIV; (2) To examine culturally relevant mediators (e.g., medical mistrust, stigma) that may help to explain the effects of the intervention on antiretroviral treatment adherence, retention in care, and viral suppression among Black men and women living with HIV; and (3) To conduct a cost effectiveness analysis of the intervention. A total of 350 Black men and women will be randomly assigned to the intervention or usual care control group (175 per group). Adherence will be electronically monitored daily (and downloaded bi-monthly) from baseline to 12- months post-baseline. Viral load will be assessed through venipuncture at baseline and 6- and 12-months post-baseline. If Rise is found to be effective, the next step would be to conduct research to determine effective and feasible methods for intervention implementation and dissemination to community settings.

 

Project Number:5R01NR017334-05

https://reporter.nih.gov/search/fBC_i3mW8Um9oV5TwXdA_A/project-details/10111573

 

 

Contact PI/ Project Leader

BOGART, LAURA M, SENIOR BEHAVIORAL SCIENTIST (LBOGART@RAND.ORG)

 

Organization

RAND CORPORATION

 

 

PUBLIC HEALTH RELEVANCE: Black people living with HIV show lower levels of antiretroviral treatment adherence than do Whites. However, few culturally congruent interventions have been developed and tested. We propose to conduct a randomized controlled trial (RCT) of Rise, an innovative, culturally congruent adherence intervention for HIV-positive Black men and women that targets cultural and structural issues contributing to health disparities. Rise facilitates improved adherence and retention in care through client-centered counseling and assistance with linkage to social services.

 

 

Project Start Date: 01-May-2017

Project End Date:28-February-2023

Budget Start Date: 01-March-2021

Budget End Date: 28-February-2023

 

 

NIH Categorical Spending

Funding IC: NATIONAL INSTITUTE OF NURSING RESEARCH/ FY Total Cost by IC:$678,640

The UCLA HIV/AIDS Substance Abuse, and Trauma Training Program

Abstract: The NIH Working Group on Diversity in the Biomedical Research Workforce recently released a set of recommendations to improve the diversity of the research workforce, including establishing a “system of mentorship “networks” for underrepresented minority students that will provide career guidance throughout their career development.” To that end, this R25 application responds to PAR-10-173 (NIDA Research Education Program for Clinical Researchers and Clinicians) and seeks five years of funding for the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (hereafter, “Program”). The Program mission is to provide training and mentorship to early career clinician researchers or post-doctoral scholars who are ethnically and culturally diverse and whose focus is reducing substance abuse and HIV transmission in underserved populations at high risk for traumatic stress and health disparities. The goal is for Scholars to establish career independence, including NIH funding for their research. This program represents an evolution of our multidisciplinary, multiethnic team’s NIMH ARRA-funded HIV/AIDS Translational Training Program, which successfully provided two years of training and mentorship to five postdoctoral scholars, several of whom have received or are seeking NIDA funding. Our pilot program highlighted the need to make substance abuse and traumatic stress more central to the Program’s conceptual orientation because this link has not been the focus of training grants that target underserved populations at risk for HIV and health disparities. Our Program will provide a two-year course of training and mentorship to a total of 20 (five per year for 4 years) early career clinical researchers and post-doctoral scholars who hold funded fellowships or other academic positions but need specific training in HIV/AIDS, substance abuse, traumatic stress and health disparities. Underserved populations, particularly those racial/ethnic minority populations, are disproportionately affected by substance abuse and HIV/AIDS and typically experience a high degree of traumatic stress. To learn about the confluence of these phenomena, Scholars will attend two week-long Institutes per year for two years and will receive continual, personalized career mentoring, training, and research supervision. Each cohort of Scholars will be followed for the duration of the training grant and each cohort will present their research in Year 2, form a network of collaborative mentoring, and come together in Year 5 to share their experiences and progress in achieving Program goals. Scholars will be mentored by a core faculty mentor as well as a “home” mentor, i.e., someone regularly accessible to the Scholar who has the relevant expertise and commitment to mentoring the Scholar for the duration of the Program. Each Scholar will be expected to use pilot funding from the Program to conduct research (e.g., qualitative study, secondary analyses, etc.) that will serve as preliminary studies in their NIDA application during their two year tenure.

Project Number: 5R25DA035692-025

Implementation Science for Intervention Delivery in Healthcare Settings

Abstract:  Implementation science examines the efficiency of intervention implementation and to translate the existing efficacious intervention models to real world services. It could potentially enhance the effectiveness and sustainability of the behavioral intervention projects. I received my PhD in epidemiology from the University of California, Los Angeles (UCLA) in 2009. Through my involvement in several large-scale HIV behavioral intervention projects and my doctoral dissertation study, I realized the importance of implementation science in intervention delivery and determined long-term career goal to become an implementation science researcher to bridge the gap between existing knowledge and service delivery. To fill in the gap between my current skill set and the career goal, I will receive training in areas related to implementation science, including health policy, intervention adaptation, and healthcare management. The health policy training will familiarize me with the process of policy development and its influence on the intervention adaptation and implementation; the intervention adaptation courses will inform me with the general concept and framework to design the study ensuring all aspects of intervention implementation are addressed; and the health management training will provide me with analytical tools to model leadership decision making and to evaluate the implementation flow in healthcare settings. The mentor team members, Drs. Li Li, Mary-Jane Rotheram-Borus, Thomas J. Coates and Zunyou Wu, are all internationally reorganized experts in behavioral intervention implementation and adaptation. My institute, the UCLA Semel Center for Community Health (CCH) and the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), UCLA, provide me with support from a multidisciplinary team of top researchers. Collaborating with the National Center for AIDS/STD Control and Prevention (NCAIDS), China CDC, I will conduct a mentored research using an intervention trial with significant yet heterogeneous outcome to investigate multilevel factors influencing the intervention implementation and outcome, and to find the optimal approach to incorporate the intervention model into the current healthcare settings. The study will be conducted in three phases. Phase 1 will be review of related policies and in-depth interviews with healthcare administrators and hospital directors, with the aim to explore the policy barriers and facilitators in adaptation of the intervention model. Phase 2 will be conjoint analysis with hospital directors to model the decision-making in intervention adaptation and routinization in the healthcare facilities. Phase 3 will be bottleneck analysis to locate structure bottlenecks in compliance with the intervention component. The finding will provide implications for future intervention delivery in healthcare settings. Application of some analytical tools in other fields, including conjoint analysis and bottleneck analysis, will potentially contribute to the development of implementation science methodology. Based on the data achieved from the study, I will prepare for a R01 application in implementation science in Year 4 of the K award period.

Project Number: 5K01MH1021447-05

MMT CARE for HIV Prevention: A Randomized Controlled Trial

Abstract: This project uses a combination prevention approach to respond to the urgent need for improved quality of services at methadone maintenance therapy clinics, provider-client interactions, and client outcomes.

We conduct the 5-year randomized controlled trial that targets methadone maintenance treatment (MMT) programs in China. Applying the principles of combination prevention, the intervention (MMT CARE) integrates psychosocial and behavioral components into a pharmacological framework for methadone maintenance. A total of 68 MMT clinics are randomly selected from five provinces. From each clinic, 6 service providers and 36 clients are recruited, totaling 408 providers and 2,448 clients in the study. The 68 clinics are randomized to 1) an MMT CARE intervention group or 2) a control group (34 clinics each). Service providers who complete the training conduct three individual motivational enhancement sessions with clients. Efficacy of the intervention is evaluated at baseline and at 6, 12, 18, and 24-month follow-ups.

Project Number: 4r01da033160-05

Natural History of AIDS in Homosexual Men

Abstract: The UCLA Center of the Multicenter AIDS Cohort Study proposes to continue to document clinical, immunologic, physiologic, behavioral, virologic, genetic and psychosocial changes in HIV-infected and -uninfected men-who-have-sex-with-men (MSM). This includes proposed studies to document these changes in MSM recruited 1983-4 and 2001-2, as well as plans to recruit new untreated and recently treated HIV-infected MSM (primarily African- and Hispanic- Americans), to maintain the cohort. The UCLA MACS will provide leadership and participation in the working groups, MACS-wide and local studies and research publications, and collaborative multi-cohort studies, as it has since the inception of the MACS 30 years ago. The UCLA MACS has recruited a large team of young and established co-investigators from a wide range of disciplines. These investigators have developed, and are continuing to develop, innovative proposals to advance our understanding of the pathophysiology, immunology, genetics and biobehavioral characteristics of treated and untreated HIV infection. The breadth, youth, experience and innovation of the UCLA MACS investigators, combined with the experience and commitment of the long-term staff, and our leadership of quality control procedures for immunologic and virologic measures and specimen processing, will continue to play an invaluable role in the success of the MACS over the next five years.

Project Number: 5U01SI035040-25

An mHealth Platform for Health Care Workers to Link South Africans to HIV Care

Abstract:  The South African National Development Plan recognizes the value of health care delivery models such as home based counselling and testing (HBCT) by aiming to train between 700,000 and 1.3 million community health workers (CHW) to implement community-based health care by 2030. The CHW role include working with households to facilitate access and linkage to primary health care facilities, provide outreach and community organization support, health education and coaching on health system navigation. Key barriers to sustainability and scale-up of community health worker programs include: i) a lack of integration between CHW and the health system; ii) poor tracking of how many people receive health services in their home; and iii) once referrals are successful, inadequate communication about the referral to and from the referral site. The South African health information system is currently ill equipped to handle these challenges and needs to be strengthened. We propose a 2-year study to develop and test a mHealth platform aimed at addressing these challenges for persons living with HIV (PLH). We focus on HIV due to the high prevalence rates in South Africa and impact that mobile technologies can make on HIV care. A mHealth platform will be developed that can be used by CHW to enroll household members and track their movement into and between health facilities. It will provide a standard interface by which current and future systems can query the stored data, thereby increasing interoperability and long term sustainability. The platform will unobtrusively support communication between clinic-based health providers and CHW supervisors. In summary, we aim to:1) Assess the perceived barriers and benefits to implementing an mHealth platform to link PLH to care through key informant interviews and foucs groups with health officials, clinic staff, CHW, and PLH; 2) Develop an mHealth platform that is inexpensive, scalable, open to integration, and can monitor patients from HBCT into facility based health care; and 3) Pilot test the mHealth platform and compare linkage to care between PLH from two communities that deploy our mHealth platform (mHealth communities) and PLH from two control communities where HBCT is currently being conducted without our mHealth platform. In the mHealth communities, we will also evaluate process measures to identify bottle necks between HBCT and visitation to an mHealth clinic.

Project Number: 5R21MH16351-02

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