Promoting Diversity, Equity, and Inclusivity in Research Training to Optimize HIV Prevention and Treatment

摘要 图尔卡纳县位于肯尼亚西北部。它是47个县中的第二大县， 约100万人 .图尔卡纳人主要是半游牧民族，经常迁徙寻找水源， 食物和牧场因此，他们的教育机会有限，贫困率和食物水平很高 不安全感早婚、一夫多妻制和性别不平等等社会文化习俗进一步限制了 女孩的教育机会。肯尼亚的牧民社区是一个边缘化群体， 健康状况参差不齐，卫生知识普及程度有限，获得和提供卫生服务的机会有限。健康 图尔卡纳县的供应商继续教育和研究机会有限， 在肯尼亚，生物医学、临床、行为和社会科学研究的代表性不足。 2018年肯尼亚基于人口的艾滋病毒影响评估报告称，图尔卡纳县的艾滋病毒流行率 为6.8%，高于全国的4.9%。图尔卡纳是肯尼亚的县之一， 没有走上实现艾滋病规划署95 - 95 - 95目标的轨道。在图尔卡纳县，只有62%的艾滋病毒感染者 （PLWH）知道他们的状态，89%的人接受ART，40%的人达到病毒抑制， 2018. 2021年肯尼亚艾滋病毒进展报告显示，图尔卡纳县的女孩人数排名第二 18岁以下从事商业性工作的人和注射毒品的年轻人， 增加了他们感染艾滋病毒的风险。因此，艾滋病毒是图尔卡纳县死亡的主要原因。 这突出表明，有必要开展研究，以确定导致艾滋病毒预防干预措施接受率低的因素 和对PLWH治疗的依从性。 该补充申请旨在促进健康提供者之间的多样性，公平性和包容性， 图尔卡纳县在研究中通过培训不同群体的卫生服务提供者的研究方法和支持 他们进行指导研究项目，解决当地的健康需求和优化艾滋病毒预防， 诊断和治疗图尔卡纳县的艾滋病病毒携带者。 1.在目标1中，我们将建设图尔卡纳县6个有前途的卫生服务提供者的能力， 通过提供面对面和虚拟研究培训以及高质量的导师制，在目标2中， 将建设图尔卡纳县卫生服务提供者的能力，以传播其 研究结果。在目标3中，我们将为图尔卡纳县的60个不同的医疗服务提供者提供机会， 通过华盛顿大学的电子学习平台获得研究技能， 进行当地相关研究的能力。 这是第一个培训补助金，我们的知识是集中在图尔卡纳县，一个县，高度 受艾滋病毒影响不成比例的边缘化人口。投资于保健提供者的培训 在图尔卡纳将有利于保留和研究的相关性和获得的研究技能方面 将直接造福这一地区。留在图尔卡纳的受训人员将能够指导其他受训人员 扩大了这一培训计划的影响。此外，利用电子学习平台是 有效，不删除必要的卫生提供者从他们的实践岗位，并允许一个更大的， 不同群体的卫生服务提供者获得基本的研究技能。 这一应用将补充目前正在开展的培训和能力建设活动， D43奖"通过研究将非传染性疾病的预防和治疗与艾滋病毒护理相结合" 在肯尼亚的培训-INTEGRATE（TW009580），由John Kinuthia博士（KNH）和Carey Farquhar博士（肯尼亚大学）领导。 华盛顿）。INTEGRATE计划旨在解决实施科学和 艾滋病毒/艾滋病感染者非传染性疾病预防和护理方面的流行病学研究， 通过实施科学和流行病学的MPH/博士课程进行长期培训： 内罗毕大学（3年）和西雅图公共卫生硕士培训（1年）; 1年博士后辅导 在肯尼亚提供了研究金，并在肯尼亚提供了关于研究方法的短期面对面和在线培训。

ABSTRACT Turkana County is located in the Northwest of Kenya. It is the second largest of 47 counties and has a population of ~1 million people . The Turkana people are mainly semi-nomadic with frequent migration in search of water, food and pasture. Consequently, they have limited education opportunities, high poverty levels and food insecurity. Socio-cultural practices such as early marriages, polygamy, and gender inequities further limit education opportunities for girls. Pastoral communities in Kenya represent a marginalized population that experience health disparities and have limited health literacy, access to and availability of health services. Health providers in Turkana County have limited continuing educational and research opportunities and are underrepresented in biomedical, clinical, behavioral and social science research in Kenya. The 2018 Kenya Population-Based HIV Impact Assessment reported that HIV prevalence in Turkana County was 6.8%, which was higher than the national prevalence of 4.9%.Turkana is among the counties in Kenya that are not on track to achieve the UNAIDS 95-95-95 targets. In Turkana County, only 62% of people living with HIV (PLWH) were aware of their status, 89% of those were receiving ART, and 40% achieved viral suppression in 2018. The 2021 Kenya HIV progress report indicated that Turkana County had the 2nd highest number of girls below 18 years who were engaging in commercial sex work and young people who inject drugs, practices that puts them at increased risk of HIV infections. As a result, HIV is the leading cause of mortality in Turkana County. This underscores the need for studies to identify factors contributing to low uptake HIV prevention interventions and adherence to treatment for PLWH. This supplement application aims to promote diversity, equity, and inclusion among health providers from Turkana County in research by training a diverse group of health providers in research methods and supporting them to conduct mentored research projects that address local health needs and optimize HIV prevention, diagnosis, and treatment for PLWH in Turkana county. 1. In Aim 1, we will build the capacity of 6 promising health providers in Turkana County to conduct HIV research by providing in-person and virtual research training and high-quality mentorship. In Aim 2, we will build the capacity of health providers based in Turkana County to disseminate the results of their research findings. In Aim 3, we will provide opportunities to 60 diverse health providers in Turkana County to gain research skills through the established University of Washington e-learning platform to enhance the capacity to conduct locally relevant research. This is the first training grant to our knowledge that is focusing on Turkana County, a county with highly marginalized population that is disproportionately affected by HIV. Investing in training of health providers in Turkana will have benefits in terms of retention and relevance of research and the research skills gained will be used to benefit this region directly. Trainees who remain in Turkana will be able to mentor other trainees from the region, amplifying the impact of this training program. Additionally, utilizing an e-learning platform is efficient, does not remove necessary health providers from their practice posts and allows for a larger and diverse group of health providers to acquire basic research skills. This application will complement the training and capacity-building activities currently underway as part of the D43 award “Integrating prevention and treatment of non-communicable diseases and HIV care through research training in Kenya-INTEGRATE (TW009580) led by Drs. John Kinuthia (KNH) and Carey Farquhar (University of Washington). The INTEGRATE program seeks to address the critical gaps in implementation science and epidemiology research in the prevention and care of non-communicable diseases among PLWH by offering long-term training through an MPH/PhD program in implementation science and epidemiology: PhD training at University of Nairobi (UoN) (3 years) and MPH training in Seattle (1 year); 1-year mentored post-doctoral fellowship in Kenya and short-term in-person and online training on research methodology in Kenya.