The applicant's long-term goal is to build a career as an independent investigator in multidisciplinary international health research focusing on HIV/AIDS research in resource-limited settings to help reduce the global HIV epidemic. In this award the candidate will build on her behavioral science background by developing knowledge and skills in public health, epidemiology, and infectious diseases with direct applications to international HIV/AIDS prevention research. The goals of this mentored award are to obtain training in these disciplines, gain expertise in methods and analysis for using biological outcomes in intervention trials, and experience conducting international HIV prevention research. The proposed research program will adapt an effective theory-based brief client-centered prevention for positives intervention designed to decrease risky sexual behavior (the OPTIONS Project), to the primary prevention setting of outpatient routine/opt-out HIV testing and counseling (RTC) in Uganda. Uganda is one of the countries most affected by the HIV epidemic and approximately 80% of those who are HIV-positive are unaware of their status. In an effort to address this situation, Uganda is expanding RTC programs. The structure and content of counseling during RTC differs dramatically from that offered during opt-in HIV-testing. Recommendations for counseling during RTC call for abandoning the client-centered counseling approach advocated in opt-in testing, in place of providing brief information and referrals for support and care services. Furthermore, unlike other HIV-counseling and testing programs, RTC places little emphasis on reducing sexual risk behavior, which is a missed opportunity for prevention.
The aims of the research are: 1) conduct formative research to understand the dynamics of sexual risk behavior and elicit recommendations for adapting the intervention, 2) adapt, pilot-test, and refine the brief client-centered RTC intervention, and 3) investigate behavior change processes following RTC to identify psychosocial, social-cognitive and behavioral factors that explain short and long term sexual risk behavior change. The research will also explore the concordance between self- report and biological markers of unprotected sexual behavior and estimate the potential effect size of the brief client-centered RTC intervention on preventing new sexually transmitted infections (STIs). The proposed research will prepare the candidate to test the effects of the resultant intervention on reducing STI incidence and risky sexual behavior in a future large randomized controlled trial. This research is especially timely in Uganda and elsewhere as RTC is being scaled up. If a future trial of the proposed intervention shows it to be an effective HIV-prevention approach it is well situated to be adopted as the standard-of-care for RTC in Uganda and hopefully throughout the world as well.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01MH083536-02
Application #
7616416
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Pequegnat, Willo
Project Start
2008-05-01
Project End
2013-04-30
Budget Start
2009-05-01
Budget End
2010-04-30
Support Year
2
Fiscal Year
2009
Total Cost
$155,385
Indirect Cost
Name
Rhode Island Hospital
Department
Type
DUNS #
075710996
City
Providence
State
RI
Country
United States
Zip Code
02903
Kiene, Susan M; Dove, Meredith; Wanyenze, Rhoda K (2018) Depressive Symptoms, Disclosure, HIV-Related Stigma, and Coping Following HIV Testing Among Outpatients in Uganda: A Daily Process Analysis. AIDS Behav 22:1639-1651
Sileo, Katelyn M; Kintu, Michael; Kiene, Susan M (2018) The intersection of intimate partner violence and HIV risk among women engaging in transactional sex in Ugandan fishing villages. AIDS Care 30:444-452
Kiene, Susan M; Sileo, Katelyn M; Dove, Meredith et al. (2018) Hazardous alcohol consumption and alcohol-related problems are associated with unknown and HIV-positive status in fishing communities in Uganda. AIDS Care :1-9
Kiene, Susan M; Lule, Haruna; Sileo, Katelyn M et al. (2017) Depression, alcohol use, and intimate partner violence among outpatients in rural Uganda: vulnerabilities for HIV, STIs and high risk sexual behavior. BMC Infect Dis 17:88
Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna et al. (2017) ""That would be good but most men are afraid of coming to the clinic"": Men and women's perspectives on strategies to increase male involvement in women's reproductive health services in rural Uganda. J Health Psychol 22:1552-1562
Kiene, Susan M; Gbenro, Olumide; Sileo, Katelyn M et al. (2017) How Do We Get Partners to Test for HIV?: Predictors of Uptake of Partner HIV Testing Following Individual Outpatient Provider Initiated HIV Testing in Rural Uganda. AIDS Behav 21:2497-2508
Kiene, Susan M; Lule, Haruna; Hughes, Peter et al. (2017) Concordance Between Laboratory Diagnosed Sexually Transmitted Infections and Self-Reported Measures of Risky Sex by Partner Type Among Rural Ugandan Outpatients. AIDS Behav 21:2167-2172
Bateganya, M H; Sileo, K M; Wanyenze, R K et al. (2016) Strategies for delivery of HIV test results in population-based HIV seroprevalence surveys: a review of the evidence. Public Health 135:3-13
Sileo, Katelyn M; Kintu, Michael; Chanes-Mora, Paola et al. (2016) ""Such Behaviors Are Not in My Home Village, I Got Them Here"": A Qualitative Study of the Influence of Contextual Factors on Alcohol and HIV Risk Behaviors in a Fishing Community on Lake Victoria, Uganda. AIDS Behav 20:537-47
Kiene, Susan M; Bateganya, Moses H; Lule, Haruna et al. (2016) The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda. AIDS Behav 20:1928-36

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