Development and assessment of an HIV disclosure intervention for men in Uganda

点击翻译按钮获取中文摘要

PROJECT SUMMARY Background: In sub-Saharan Africa, men consistently lag behind women along each step of the HIV care cascade and contribute to HIV transmission among women. Disclosure of HIV is a key step in prevention, however, few evidence-based resources exist to support HIV disclosure among men with HIV (MWH) in sub- Saharan Africa. Candidate: My long-term goal is to become an independent, NIH-funded clinical researcher dedicated to interventions to support HIV and sexually transmitted infection (STI) prevention and treatment in resource limited settings. Mentoring: Drs. Jessica Haberer (clinical trial implementation) and Lynn Matthews (methods for intervention development; co-primary mentors) are both successful NIH-funded investigators who have both mentored multiple NIH career development awardees. Drs. Winnie Muyindike (HIV clinical care engagement and outcomes), Andrew Mujugira (male engagement in HIV and STI care and research), Christina Psaros (behavioral science theory), Seth Kalichman (HIV disclosure and assisted partner notification), and Bethany Hedt-Gauthier (advanced clinical trial analysis and biostatistics) will provide additional focused mentorship to ensure success. Research: The goal of this proposal is to develop and test an HIV disclosure intervention focused on MWH meeting the following eligibility criteria: with STI symptoms who are either not accessing antiretroviral therapy or are accessing antiretroviral therapy but without viral suppression. In Aim 1, I will identify the unique HIV disclosure needs and preferences to support HIV disclosure through in-depth qualitative interviews with up to 30 MWH meeting eligibility criteria. In Aim 2, I will utilize the findings from Aim 1 to adapt interventions with HIV disclosure components in order to develop a novel HIV disclosure intervention focused on MWH. The intervention will be iteratively refined through focus group discussions with up to 20 participants, their sexual partners, and a community advisory board. In Aim 3, I will recruit 70 MWH meeting eligibility criteria for participation in a randomized controlled trial to pilot test the intervention against an attention-matched control group. Participants will be encouraged to bring their sexual partners for study enrollment and HIV testing and counseling. Up to 15 MWH and their sexual partners will be invited for qualitative interviews. I will measure the primary outcomes of acceptability and feasibility by mixed methods. Training: To achieve my aims and gain research independence, I require additional training in: 1) behavioral science theory for behavioral intervention development and assessment 2) methods for behavioral intervention development, and 3) advanced behavioral clinical trial analysis. Based on my previous research experience and success, support from an exceptional mentoring team, strong institutional commitment, and an innovative research plan, I am well-positioned to become an independent clinical investigator focused on HIV and STI prevention and treatment in resource limited settings.