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

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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.