Addressing the Intimate Partner Violence and HIV Syndemic in Kampala, Uganda: Implementation Science for Intervention Optimization and Adaptation

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ABSTRACT: This application outlines an interdisciplinary, implementation science project related to the integration of intimate partner violence prevention and HIV care that will support the F31 applicant to complete dissertation requirements for an Implementation Science PhD through the Department of Global Health at the University of Washington. The applicant's goals for training include building skills for advanced quantitative and qualitative research design and analysis; reinforcing multidisciplinary training approaches; deepening training in responsible conduct for international research and, developing publication record and presentation skills. To achieve these goals, the applicant has assembled a team of mentors with expertise in intimate partner violence, HIV treatment and prevention, implementation science, behavioral sciences and epidemiology. Mentorship team members have established track records of collaboration and mentoring PhD candidates. The novel proposed research will leverage the Sponsor's ongoing NIMH-funded project entitled “Integrated PrEP and ART delivered in Ugandan public health clinics to improve HIV and ART outcomes for HIV serodiscordant couples” (R01MH110296; PI:Heffron), an ongoing couples-based, integrated ART/PrEP (pre-exposure prophylaxis) delivery intervention in Kampala, Uganda. This F31 proposal outlines research involving HIV care and treatment facilities and providers engaged with this parent study to collect novel data in order to guide the development of optimized implementation strategies for concurrently targeting the co-occurring and intersecting global health challenges of HIV and intimate partner violence (IPV). This project will inform the optimization and adaptation of integrated service offerings for IPV and HIV treatment and prevention in limited-resource settings. To this end, the proposed F31 research will leverage quantitative, qualitative and implementation science research approaches to elaborate strategies for optimizing and adapting implementations that address the IPV/HIV syndemic and better characterize the complex association between IPV and HIV within the context of couples. Aim 1 will evaluate the extent to which national IPV guidelines are implemented in HIV care settings. Aim 2 will identify provider-level barriers and facilitators to implementing national IPV guidelines in HIV care settings. Aim 3 will evaluate the association between IPV and adherence to ART and PrEP among HIV-serodiscordant couples. Upon achieving the proposed aims, the F31 applicant will be well-suited to pursue a career in academic research and prepare proposals to further the development and testing of couples-based interventions that integrate IPV prevention and treatment into existing HIV prevention and treatment programs.