Georgian Implementation Science Fogarty Training Program (GIFT)

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Despite many available evidence-based interventions (EBIs) to prevent HIV, new infections and mortality in Georgia have increased by 30% and 335%, respectively. Georgia is a LMIC with HIV prevalence of 0.4% and concentrated in key at-risk populations (KAPs) like MSM and PWID, where the epidemic is growing fastest. Though all the elements of the HIV prevention toolkit are present in Georgia (voluntary counseling/testing [VCT], pre-exposure prophylaxis [PrEP], opioid agonist therapies [OAT], syringe services programs [SSPs] and treatment as prevention [TasP]), they are markedly under-scaled in terms of coverage and, importantly, are not adequately implemented in KAPs. In addition to suboptimal implementation of HIV prevention, Georgia’s ability to control its epidemic has been hampered by its lack of expertise in biostatistics. This expertise is need not only to analyze a rich array of databases that could guide more effective implementation in real-time, but in its ability to rigorously design, implement and analyze data from implementation trials, which are urgently needed in the Georgian context where the epidemic is concentrated in KAPs and where stigma and discrimination abounds. To meet this need, we propose to develop and institutionalize the Georgian Implementation Science Fogarty Training (GIFT) program at Ilia State University (ISU), the leading research institution in Georgia, in collaboration with Yale University. GIFT will leverage the combined resources of Yale University (Medicine and Public Health) with ISU, through provision of long-, mid-, and short-term training. GIFT will focus on HIV prevention through advanced training in biostatistics and implementation research methods. Specifically, GIFT adheres to three core aims, including to: 1) train 4 GIFT faculty in Year 1, followed by 6 doctoral students recruited in Years 2 and 3, who will focus their training on HIV prevention and who will receive advanced training in biostatistics and implementation research methods through a hybrid learning program; 2) transfer knowledge and build capacity within ISU, the Caucasus and Eastern Europe and Central Asia through short-term training at a Summer Bootcamp; and 3) develop the HIV Implementation Science and Biostatistical Methods Resource Hub to consolidate resources and build partnerships for better population outcomes. All doctoral students will be paired with ISU and Yale mentors and gain real-world experience analyzing data from HIV implementation trials now underway or completed at Yale. Training resources will be contextualized for the HIV epidemic in Georgia. Building on prior experience with Fogarty training programs and existing successful collaborations and partnerships between Yale and ISU, we are poised to train the next generation of public health researchers more effectively, recognizing the need for better implementation with HIV prevention in KAPs. GIFT will provide advanced training to produce a phased transfer of knowledge, skills and expertise from Yale to ISU over the course of five years, resulting in a model curriculum for training at Georgia’s top research university, with strong support by regional and local faculty and commitment by community, government and international partnerships.