Battling Stigma for Service Engagement among Women with HIV in Vietnam

Abstract:Women living with HIV/AIDS (WLHA) bear a higher level of stigma because of their socio-cultural vulnerabilities. Women are more likely to internalize social stigma and produce a sense of shame and loss of self-worth, which results in a delay in health service seeking and compromised health outcomes. In Vietnam, stigma towards WLHA is exacerbated by the deeply rooted female inferiority culture. However, research targeting WLHA is generally lacking. We propose this study to address stigma among WLHA and explore the use of virtual support system in WLHA’s service engagement in Vietnam. The 2-year study will proceed in two phases in Hanoi, Vietnam. Phase 1 will be formative studies, including in-depth interviews with 30 WLHA and focus groups with 20 service providers and community stakeholders. This phase aims to investigate the cultural and contextual background of HIV and gender roles in Vietnam and to identify effective strategies to support and engage WLHA in healthcare. These formative findings will inform the development of an intervention to be pilot tested in the next phase. Phase 2 will be a 6-month intervention pilot with 90 WLHA using an online/offline hybrid approach. During Month 1 of the pilot, WLHA will participate in an in-person section to form mutual support groups and prepare for the following online components. During Month 2-4 of the pilot, study investigators will teach WLHA a series of empowerment strategies to cope with stigma and utilize social support to seek healthcare services. These skills will be taught via interactive online group activities. During Month 4-6, WLHA will self-administer the online groups without the intervention of study investigators. WLHA’s multidimensional stigma measures, mental health burdens, and service use self- efficacy will be assessed at baseline, month 4, and month 6. Progress data of the intervention will be documented to inform the feasibility and sustainability of the online support approach. Acceptability data and feedback will be collected from the WLHA participants upon completion of the 6-month pilot period.

Project Number: 1R21TW012018-01

https://reporter.nih.gov/search/9c5dRBJyvkGOpSB3l9HRSw/project-details/10302007

 

Contact PI/ Project Leader

LIN, CHUNQING,  (lincq@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV stigma and discrimination have enormous negative impacts on women, and reducing internalized stigma has significant implications for the effort to engage women in HIV prevention and care. This proposed study will devise strategies to empower women living with HIV in Vietnam to combat HIV and gender intersectional stigma. This study will lead to implementable and scalable approaches to promote women living with HIV’s mental health and service seeking not only in Vietnam but also globally.

 

 

Project Start Date: 17-September-2021

Project End Date: 31-May-2023

Budget Start Date: 17-September-2021

Budget End Date: 31-May-2022

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE OF DRUG ABUSE + FOGARTY INTERNATIONAL CENTER / FY Total Cost by IC: $219,421

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

Engaging Seronegative Youth to Optimize HIV Prevention Continuum

Abstract:Young people at highest risk for HIV in the U.S. will be gay, bisexual transgender youth (GBTY) and homeless youth (HY) in communities with high HIV incidence and overwhelmingly Black and Latino. Focusing on Los Angeles and New Orleans, seronegative youth at highest risk for HIV will be screened in homeless shelters and gay-identified community-based organizations (CBO). A cohort of 1500 seronegative youth will be recruited that is 82% male (79% GBTY), 66% Black, 16% Latino, and 18% white, non-Hispanic. About 27% will be 12-17 and 73% between 18-24 years old. All youth will be followed longitudinally over 24 months at four month intervals and tested for HIV, STI, serious substance abuse, health care utilization, and comorbid conditions – a Prototypical Retention/Prevention (R/P) Strategy. Over 24 months, acutely HIV infected youth will be triaged to Study 1. This Prototypical R/P Strategy operationalizes the CDC’s recommendations for the engagement of GBTY in repeat HIV testing, linkage to care, and options for combination prevention (PrEP, PEP – with behavioral interventions). Building on this team’s extensive experience with behavioral and mobile/social media interventions, a randomized controlled trial (RCT) will be conducted with four intervention conditions: 1) an Automated Messaging and Monitoring Intervention (AMMI), which will use texts to diffuse prevention messages daily and to monitor risk behaviors weekly (n=900); 2) a Peer Support intervention on a social media platform (i.e., Facebook) in which young people will post messages and stories about their experiences preventing HIV, plus the AMMI (n=200); 3) an eNavigator intervention in which a B.A.-level staff supports youth, primarily through texting and social media, but also in-person meetings, to provide support in crisis situations, refer to treatment, and assist in gaining access to health care and other services, plus Peer Support and AMMI (n=200); and, 4) a combined intervention of eNavigator, Peer Support, and AMMI (n=200). A single outcome will be composed of six key behaviors (access to medical care, accessing and adherence to PrEP or PEP, treatment of all STI, and 100% condom use). In addition to evaluating the added benefit of increasing levels of intervention, the brief 7- item weekly text-messaging monitoring surveys will provide approximately 100,000 weekly reports of indicators of primary and secondary outcomes that can inform our understandings about the relationships between risk and comorbid states. This study will have policy implications for the allocation of resources to HIV testing resources in local communities, the uptake and scalability of text and social media interventions, and the models for diffusing evidence-based interventions (EBI) globally (without requiring replication with fidelity to a manual).

Project Number: 5U19HD089886-05

https://reporter.nih.gov/search/4vgAl9SY20-gSBejiQexgQ/project-details/10161248

 

Contact PI/ Project Leader

SWENDEMAN, DALLAS TRAVIS, ASSOCIATE PROFESSOR, CENTER CO-DIRECTOR (dswendeman@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE:  Unavailable

 

FOA: RFA-HD-16-035Study Section: ZHD1-DSR-N

 

Project Start Date: Unavailable

Project End Date: 31-May-2022

Budget Start Date: 01-June-2020

Budget End Date: 31-May-2021

 

NIH Categorical Spending

Funding IC:  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT / FY Total Cost by IC: $200,503

Goals for Adherence with Low-cost Incentives (GOALS)

Abstract: Treatment outcomes of HIV-positive youth in Uganda and elsewhere are threatened by low medication adherence. Despite the clear need for adherence support among youth, few interventions target this particularly vulnerable group during a time of heightened risk-taking behavior and unfinished development of cognitive control processes such as planning and goal-directed behavior. Incentives informed by behavioral economics (BE) have successfully changed a range of health behaviors by countering present bias (the tendency of overly discounting the future benefits of preventive health behaviors) including our own study that improved ART adherence. However, they have rarely been tested among youth living with HIV (YLWH) who are likely to particularly benefit from such extrinsic rewards given their observed problems with self-control. Traditional incentives that require individuals to reach a uniform, high eligible threshold by design leave out those unable to meet it, often most in need of support. In a pilot study, we tested a novel incentive design that allowed even those with low initial adherence to qualify for incentives, resulting in their improved adherence. BE theory suggests that the effort exerted to reach a goal depends on how far away it is from the participant; if the goal is within close reach, the participant shows great willingness to achieve it, but if the goal is set too high, s/he becomes demotivated and may give up. Based on this insight, we restructured our incentive design to allow participants to set their own eligibility threshold. We propose to build on our pilot results using a randomized controlled trial (RCT) to establish effectiveness. Our intervention, GOALS, proposes testing externally assigned sub-goals gradually increasing towards 90% (T1, n=140) and self-chosen, participatory interim goals (T2, n=140), against a traditional, fixed goal of 90% (T3, n=140). The control group (n=140) will receive the usual standard of care. The primary outcome is electronically measured ART adherence collected throughout the study and for 12 months after incentives are withdrawn to measure the persistence of behavior change; suppressed viral load will be the secondary outcome. The Specific Aims in year 1 (Improvement Phase) is to evaluate the relative effectiveness of the three incentivization approaches for improving adherence among YLWH. In year 2 (Maintenance Phase), we test the relative effectiveness of the three ways of incentivization for maintaining adherence. In year 3 (Persistence Phase) the goal is to investigate for 12 months the relative effectiveness of the three GOALS intervention arms at creating behavioral persistence once incentives are removed. Specific Aim 4 is to perform a cost-effectiveness analysis including a comparative analysis of those GOALS intervention arms that show a positive intervention impact for improving and/or maintaining adherence.

Project Number: 1R01HD104555-01

https://reporter.nih.gov/search/4vgAl9SY20-gSBejiQexgQ/project-details/10161248

 

Contact PI/ Project Leader

LINNEMAYR, SEBASTIAN, ECONOMIST (slinnema@rand.org)

 

Organization

RAND CORPORATION

 

PUBLIC HEALTH RELEVANCE: There is a paucity of support for young people living with HIV (YLWH) who often fail to achieve viral suppression, with catastrophic consequences in particular in resource-constrained countries in which treatment options are limited. This study aims to improve ART adherence among YLWH by providing small incentives based on insights from behavioral economics, combined with text messages sent by mobile phone. The approach is particularly targeted at those with low adherence as it allows to adjust eligibility thresholds for incentives to participants’ initial adherence, thereby reducing health inequality and facilitating high, long-term ART adherence for a particularly vulnerable group of HIV clients.

 

 

Project Start Date: 17-May-2021

Project End Date:31-January-2026

Budget Start Date: 17-May-2021

Budget End Date:31-January-2022

 

NIH Categorical Spending

Funding IC:  EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT / FY Total Cost by IC:$724,445

Getting Off: A Theory-based mHealth Intervention for Methamphetamine-using MSM

Abstract: Methamphetamine (MA) use among men who have sex with men (MSM) is associated with increased rates of HIV prevalence and transmission, as well as substandard advancement along the HIV Prevention and Care Continua. MA use among MSM is deeply integrated into socio-sexual networks including the use of smartphone applications (“app”) and websites to find sexual partners. Given the growth of mobile health technology, it is no longer necessary or reasonable to limit MA treatment options to physical sites, clustered in urban areas, and administered using generic, non-tailored content. The project builds upon the established efficacy of our manualized MA-abuse treatment intervention, “Getting Off: A Behavioral Treatment Intervention for Gay and Bisexual Male Methamphetamine Users,” and the highly promising findings from our successful Stage I proof-of-concept study, to complete translation of Getting Off into a cross-platform (iOS and Android) app and assess the app’s efficacy and non-inferiority in a scientifically rigorous randomized trial. The Getting Off app, like the group-based intervention before it, will use the principles of Cognitive Behavioral Theory and Stages of Change to help MSM reduce or eliminate MA use and HIV sexual risk behaviors, and increase advancement along the HIV Prevention or Care Continuum (including uptake of HIV testing, pre-, and post- exposure prophylaxis [PEP/PrEP] and PrEP adherence and persistence for those who are HIV negative; ART uptake and adherence for those who are HIV positive). This project will 1) refine and enhance the first 8 sessions of the Getting Off MA-abuse treatment intervention developed in Stage I based on feasibility pilot test user feedback, 2) conduct formative research to develop the remaining 16 sessions of the Getting Off MA- abuse treatment intervention into a cross-platform computerized mobile app targeted to reduce MA use and HIV sexual risk behaviors, and increase advancement along the HIV Prevention or Care Continuum, and 3) conduct a RCT to evaluate reductions of MA use and HIV sexual risk behaviors, and increased advancement along the HIV Prevention or Care Continuum, using three approaches: a) Efficacy Trial – a two-arm RCT to determine intervention effects through comparison of the Immediate Delivery (ID; n=150) and Delayed Delivery (DD; n=150) arms; b) Efficacy Trial – an observed treatment effects analysis to compare pre/post data from the pooled ID and DD conditions (N=300); and, c) Non-inferiority Trial – a two-arm historical matched comparison design to evaluate the outcomes of the Getting Off app (ID + DD; N=300) relative to a matched sample of participants having previously attended the brick-and-mortar group-based Getting Off intervention (N~600; total N=900). The RCT uses repeated measures to assess participants at baseline, 1-, 2- (DD condition only), 3-, 6-, and 9-month follow-up. This study could have significant public health impact by greatly expanding access to effective, affordable, private, culturally competent and highly scalable MA treatment to this very high-risk population.

Project Number: 1R01DA045562-01A1

https://reporter.nih.gov/search/wXqheaHzyUy0u0LsyaI8ew/project-details/9628755

 

Contact PI/ Project Leader

REBACK, CATHY J, PROFESSOR (reback@friendsresearch.org)

 

Organization

FRIENDS RESEARCH INSTITUTE, INC.

 

PUBLIC HEALTH RELEVANCE: Methamphetamine (MA) use among MSM is strongly associated with HIV infection and interrupted progression along the HIV Prevention and Care Continua. This study will complete the development and evaluation of an evidence-based, theory-driven, and culturally competent treatment app for MA-using MSM, designed to reduce or eliminate MA use and HIV sexual risks, increase uptake of HIV testing and pre- and post-exposure prophylaxis (PrEP/PEP), including PrEP adherence and persistence for those who are HIV negative, and increase retention in HIV care and adherence to ART for those who are HIV positive. Given the severe personal and public health consequences of MA use, the public health significance of this app is very high as it will provide this population with a tailored treatment opportunity that is easily accessible, affordable, private, and highly scalable.

 

Project Start Date: 15-July-2018

Project End Date:30-April-2023

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

Abstract: This R25 renewal application responds to PAR-16-224 for continued funding for the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP). Our Program’s mission is to provide training and mentorship to early career postdoctoral scholars whose focus is reducing substance abuse and transmission of HIV in underserved populations at high risk for traumatic stress and health disparities. To date, our Program has been highly successful in training a diverse, productive group of 19 Scholars and seven Affiliate Scholars. Our core curriculum will maintain focus on our core topics, with the addition in this renewal of courses on social network analysis, technology-based interventions, addiction psychiatry, and implementation science. Our Program provides a two-year course of training and mentorship to a total of 20 (five/year over four years) postdoctoral and early career scholars. Our Program is unique in its incorporation of traumatic stress as a form of dysregulation, particularly as experienced by underserved populations. These populations, particularly racial/ethnic minority populations, are disproportionately affected by HIV/AIDS and typically experience a high degree of traumatic stress. Our Specific Aims are to: (1) Advance HA-TTP Scholars’ knowledge of the ways in which substance abuse, HIV/AIDS, traumatic stress, and health disparities are interconnected, particularly in underrepresented populations; (2) Provide focused, intensive mentorship to support Scholars’ research interests and career trajectories in the key areas addressed by this Program; (3) Capitalize on a local and national multidisciplinary, multiracial/ethnic network of expert faculty who are committed to fostering the intellectual and professional growth of the Scholars; and (4) Evaluate the impact of the Program on Scholars’ knowledge and productivity. 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 will be followed for the duration of the training grant, and all cohorts will come to together in the final year to share their experiences and successes. Scholars will be mentored by a UCLA-based core faculty mentor as well as a home mentor. Scholars will develop the necessary skills to pursue a productive research program in areas related to substance use, HIV/AIDS, traumatic stress, and health disparities. They will be supported in the development of competitive grant applications, including receiving a modest amount of funds to prepare preliminary studies data. The UCLA-based leadership team and core faculty include members from clinical and community psychology, medical anthropology, addiction psychiatry, public health, and social work. This Program will enhance nationwide efforts to diminish the prevalence of HIV/AIDS, substance use and traumatic stress to improve health and quality of life.

Project Number: 2R25DA035692-06

https://reporter.nih.gov/search/coWayWzr1EOmY6_GJvewwg/project-details/9561840

 

Contact PI/ Project Leader

WYATT, GAIL E.,PROFESSOR (GWYATT@MEDNET.UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: The mission of the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP) is to provide training and mentorship to early career postdoctoral scholars whose focus is reducing substance abuse and transmission of HIV in underserved populations at high risk for traumatic stress and health disparities. Our Program provides a two-year course of training and mentorship to a total of 20 scholars. By fostering the growth of Scholars committed to conducting research with underrepresented populations that are disproportionately affected by HIV/AIDS, substance abuse, and traumatic stress, this Program will enhance nationwide efforts to diminish the prevalence of these problems and thereby improve health and quality of life.

 

 

Project Start Date: 01-June-2013

Project End Date: 31-January-2024

Budget Start Date: 01-March-2018

Budget End Date:31-January-2020

 

NIH Categorical Spending

Funding IC:  NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC:$377,991

Biobehavioral Research Approaches to reduce Effects of Trauma on Mental and Physical Health and Cognitive Outcomes in South Africa

Abstract: The UCLA/South African Trauma Training Research (Phodiso) Program seeks five additional years of funding to prepare future investigators to conduct research on trauma exposure and injury prevention in the context of South Africa’s high levels of interpersonal and community violence and intentional injuries. The Phodiso Program is an international collaboration between UCLA and the South African Research Consortium (SARC), which includes the Human Sciences Research Council (HSRC), North-West University (NWU), and University of Cape Town (UCT) and is based on a number of NIH-funded projects: 1) The Eban Project, a randomized clinical trial testing a culturally congruent intervention for HIV serodiscordant African American couples (R01; 2001-2009; El Bassel, et al., 2010); 2) The Implementation of the Eban Project, (NIH RO1; 2012-2017) 3) The Aftermath of Rape among South African Women (The Fulufhelo Project), a study examining the short- and long-term psychosocial sequelae of rape among South African women (R03; 2009-2013); and 4) The HIV/AIDS Substance use and Trauma Training Program for racial and ethnic minority postdoctoral scholars and early career investigators (R25; 2013-2018) (Wyatt and Milburn, co-PIs). Guided by ecological theory, social learning theory, and the Sexual Health Model, the focus of the Phodiso Scholar’s research will be to minimize the negative health and mental health effects of trauma exposure, specifically depression and post-traumatic stress disorder (PTSD), in South Africa. An additional emphasis of the training will focus on the neurobiological and neurobehavioral manifestations of trauma, disease, substance use and intentional injury. In the past 10 years of funding, a total of eleven scholars have graduated from the Phodiso program and will join the core SARC and the TAMT, to assist with mentoring new Scholars. For this renewal, the UCLA and SARC core faculty and TAMT will conduct a countrywide application process to select one early career research candidate per year for a two-year postdoctoral fellowship. Scholars will receive research mentorship including a quarter of study (i.e., a 3-month period) at UCLA, one selection and planning meeting and one short-term trauma workshop each year in South Africa. Scholars will conduct their own research projects in South Africa as a basis for future studies in this field, and work closely with their SARC host university and TAMT mentors. The Phodiso Trauma Training program and the research careers of the scholars will be tracked over time. Specifically, the sustainability of the training program and integration into academic, private, and government-supported agencies and the Scholar’s ability to establish and sustain independent research careers will be evaluated and documented. Future goals will include encouraging the South African government to adopt the Phodiso program as a successful and replicable model of cross-cultural trauma research training.

Project Number: 2D43TW007278-11

https://reporter.nih.gov/search/3mBMfcaKOkGk9o8D_fB3Zw/project-details/9232020

 

Contact PI/ Project Leader

WYATT, GAIL E, PROFESSOR (GWYATT@MEDNET.UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Myanmar has experienced one of the most serious HIV/AIDS epidemics in Southeast Asia. Because the country has been isolated from the rest of the world for 50+ years, there are very few researchers and public health specialists trained in advanced research methodologies who can do research to guide HIV/AIDS policy and staff the Myanmar University of Public Health. This program will address that need by providing degree and postdoctoral training in advanced research methodology.

 

 

Project Start Date: 25-May-2005

Project End Date: 31-August-2021

Budget Start Date: 15-September-2016

Budget End Date: 31-August-2017

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER + OFFICE OF THE DIRECTOR, NATIONAL INSTITUTES OF HEALTH/ FY Total Cost by IC: $269,997

UCLA/Myanmar Training Program in Advanced HIV/AIDS Methodologies

Abstract: Myanmar has one of the worst epidemics of HIV/AIDS in Southeast Asia. Implementation of an effective HIV control program has been hampered by the isolation of Myanmar from the global community for more than 50 years. This isolation has prevented contemporary training in advanced research methodology for doctors and scientists in Myanmar. The UCLA Department of Epidemiology will collaborate with the Myanmar University of Public Health (UPH) to address this need. UCLA will provide training for six master’s of science trainees, as well as nine months of training in research methodology at UCLA for ten senior faculty of UPH and the AIDS Control Program. The M.S. candidates will conduct the field research for their theses in Myanmar under the supervision of UPH faculty. The short courses to be given in Myanmar include HIV biology, epidemiology, prevention of transmission, research methodology, research ethics, public health intervention strategies, and use of advanced technologies in support of epidemiologic research in developing countries. Candidates for the UCLA-based programs will be recommended by the Myanmar UPH faculty on the basis of their academic records, commitment to HIV and public health research, and intention to promote the health of the people of Myanmar.

Project Number: 5D43TW009600-05

https://reporter.nih.gov/search/-__kmzr9iE-k4ehpkEtYuA/project-details/9487770

 

Contact PI/ Project Leader

DETELS, ROGER, PROFESSOR (DETELS@UCLA.EDU)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Myanmar has experienced one of the most serious HIV/AIDS epidemics in Southeast Asia. Because the country has been isolated from the rest of the world for 50+ years, there are very few researchers and public health specialists trained in advanced research methodologies who can do research to guide HIV/AIDS policy and staff the Myanmar University of Public Health. This program will address that need by providing degree and postdoctoral training in advanced research methodology.

 

 

Project Start Date: 27-May-2014

Project End Date: 31-March-2022

Budget Start Date: 01-April-2018

Budget End Date:31-March-2022

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER + NATIONAL INSTITUTE ON DRUG ABUSE/ FY Total Cost by IC: $295,072

Evaluation of pre-exposure prophylaxis cascade in pregnant and breastfeeding women in Cape Town, South Africa

Abstract: HIV-uninfected pregnant and breastfeeding women in South Africa are at high risk of HIV acquisition despite increased uptake of antiretroviral therapy (ART) and maternal seroconversion during pregnancy and breastfeeding contributes significantly toward pediatric HIV infections. Comprehensive HIV prevention programs that include biomedical interventions, such as pre-exposure prophylaxis (PrEP), could dramatically reduce HIV incidence in pregnant and breastfeeding women in high HIV incidence areas and reduce vertical HIV transmission. The overarching goal of this proposal is to evaluate the feasibility and acceptability of integrating PrEP into antenatal and postnatal care, to describe the cascade in women initiating PrEP in this setting, and to evaluate the reasons for attrition along the PrEP cascade in a cohort of pregnant and breastfeeding women Candidate: I am an HIV epidemiologist with a background in HIV research and program development, implementation in Africa. I am applying for a five-year Fogarty IRSDA K01 award to obtain training, mentorship, and research experience to become an independent investigator capable of obtaining R01 funding. Mentoring: I have put together an exceptional multi-disciplinary mentoring team with extensive experience in HIV prevention research in South Africa that integrates clinical research, epidemiology, PrEP and qualitative methods. Drs. Thomas Coates (UCLA) and Landon Myer (University of Cape Town, South Africa) will serve as co-Primary mentors and bring complementary expertise in behavioral science and clinical trials. In addition to my two Primary mentors, my co-mentors provide expertise in specific content areas and methodologies and are based in both the U.S. and South Africa. My co-mentorship team includes: Dr. Pamina Gorbach (U.S.-based, behavioural epidemiologist with significant experience in mixed methods research, Dr. Linda-Gail Bekker (SA-based, clinical trials, PrEP and research in young women). Training: Specific training in clinical trials, advanced biostatistics, behavioural science and mixed methods analysis, will be achieved through intensive mentored training, coursework, workshops and and primary research in South Africa. Guided by my mentorship team, these training and research experiences will establish my independent investigator career as an expert in research in pregnant and breastfeeding women in low resource settings. Research: The specific aims are to: (1) Evaluate the feasibility and acceptability of integrating PrEP into antenatal and postnatal/well-baby services; (2) Describe the PrEP cascade of initiation, retention, and adherence in a cohort of HIV-uninfected pregnant and breastfeeding women, (3) Evaluate attrition and associated factors across the PrEP cascade. The results from our study will provide a model to implement WHO guidance and scale-up PrEP delivery in pregnant and breastfeeding women at risk of HIV and contribute to the elimination of vertical HIV transmission. We will use the formative research to apply for a R01 grant to evaluate interventions to improve retention in the PrEP cascade in a larger cohort of pregnant and breastfeeding women.

Project Number: 5K01TW011187-02

https://reporter.nih.gov/search/07mRB8oPokuMg0OWfAXBVA/project-details/9789716

 

Contact PI/ Project Leader

JOSEPH DAVEY, DVORA POSTDOCTORAL FELLOW (dvoradavey@ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: HIV-negative pregnant and breastfeeding women in South Africa are at high-risk of HIV. Pre-exposure prophylaxis (PrEP) is safe and effective at preventing HIV. Our study will evaluate: (1) Acceptability & feasibility of integrating PrEP into ante and postnatal care, (2) the PrEP cascade (initiation, retention, adherence) and (3) Loss to follow up and factors associated with loss in a cascade in 200 pregnant/breastfeeding women.

 

 

Project Start Date: 21-September-2018

Project End Date: 31-January-2023

Budget Start Date: 01-April-2019

Budget End Date: 31-January-2020

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER/ FY Total Cost by IC: $139,018

Innovative strategies to increase ART Initiation and viral suppression among HIV+ men in Malawi

Abstract: Men continue to be missed by HIV testing and treatment services. Index partner testing is a critical strategy for reaching men. Index HIV self-testing (HIVST), whereby ART clients take HIVST kits home to their sexual partners for testing, is a new strategy that dramatically increases index testing among men, and is being taken to scale across Malawi. However, only 25% of men identified as HIV-positive through Index HIVST initiate ART after 6- months. Innovative strategies to increase ART initiation and retention among men are urgently needed. The overarching goal of the proposed K01 is to develop and pilot a home-based ART intervention (ART initiation + 3-months ART care) to increase ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among men who test HIV-positive through Index HIVST in Malawi. Candidate: I am a social scientist with a background in HIV research in sub-Saharan Africa. My long-term goal is to transition from observational social science to clinical trials research in innovative HIV service delivery models among hard-to-reach populations, such as men. I am applying for a five-year K01 award to obtain training, mentorship, and research experience. Mentoring: I have an exceptional multi-disciplinary mentoring team with extensive experience in HIV care and management and clinical trials in the region. The team has complementary expertise in social science and clinical trials in HIV service delivery models (Dr. Thomas Coates – Primary Mentor), best practices in HIV care and management and differentiated models of care in Malawi (Drs. Judith Currier and Risa Hoffman), scalability and sustainability of interventions (Dr. Sundeep Gupta – Malawi-based), and advanced biostatistics (Dr. Ron Brookmyer). Career Development: To achieve my long-term goals, we have developed a detail plan to build skills in four additional areas: (1) best clinical practices for ART care and maintenance; (2) clinical trials in novel approaches to HIV service delivery; (3) advanced statistical methods; and (4) ethics in clinical trials research in low-resource settings. Research Activities: The specific aims accompanying the career development plan are to: (1) Develop a home-based ART intervention for male partners tested through Index HIVST, using in-depth interviews with male Index HIVST users (n=15-20) and their partners (n=15-20), and focus group discussions with key informants (n=18-30). (2) Determine the potential effectiveness of home-based ART versus standard facility-based ART (on ART initiation (primary outcome) and 6-month viral suppression (secondary outcome) among male Index HIVST users in a pilot trial with 200 HIV-positive men. Expected Outcomes: Results from this study will inform definitive trial to test home-based ART services for men identified as HIV-positive through index HIVST strategies. The project will also give me the additional skillsets needed to become an independent investigator in clinical trials.

Project Number: 1K01TW011484-01

https://reporter.nih.gov/search/lzNvPVXZdEyO9lcrU7nKLQ/project-details/9889473

 

Contact PI/ Project Leader

DOVEL, KATHRYN L, POSTDOCTORAL FELLOW (KDovel@mednet.ucla.edu)

 

Organization

UNIVERSITY OF CALIFORNIA LOS ANGELES

 

PUBLIC HEALTH RELEVANCE: Men in sub-Saharan Africa who test HIV-positive continue to have poor ART initiation and retention outcomes. By developing and piloting a home-based ART intervention for men who use index HIV self-testing (HIVST) strategies, the proposed project will provide additional knowledge on how to best reach men with HIV services across the testing and treatment continuum. The project has the potential to improve public health by engaging HIV-positive men across the cascade, a critical population to curbing the HIV epidemic.

 

 

Project Start Date: 16-September-2019

Project End Date: 30-June-2024

Budget Start Date: 16-September-2019

Budget End Date:30-June-2020

 

NIH Categorical Spending

Funding IC:  FOGARTY INTERNATIONAL CENTER/ FY Total Cost by IC: $145,233