My career goal is to become a global leader in multidisciplinary HIV/AIDS research in resource- limited settings with a focus on research integrating HIV clinical care and secondary HIV prevention strategies. My short term goal is to establish myself as an independent investigator as a tenure-track junior faculty member at Johns Hopkins and to develop a productive and sustainable program of research in Uganda. Research Project. My proposed research consists of two phases: Phase 1-Perform secondary behavioral outcomes analyses on a dataset of a trial conducted to assess the effect of peer health workers on AIDS care outcomes in Rakai, Uganda. Concurrently, I will perform cost-effectiveness analysis of this peer health worker intervention. Phase 2- Perform comprehensive formative research and then implement a community-based trial of a peer health worker intervention to integratively (i) improve patient retention, (ii) increase basic care package utilization, and (iii) decrease risky sexual behaviors among PLHIV not yet on antiretroviral therapy. The peer health worker intervention will center on home visits to individual patients. Subsequently, I will perform cost-effectiveness analysis of this intervention. Career Development Plan. My proposed training and mentoring activities will center on (i) behavioral intervention research and ii) cost-effectiveness analysis research of HIV prevention and care interventions. My proposed applied research, which will be closely coordinated with my training activities, will focus on the impact of peer health workers, a group of community health workers who are people living with HIV, on integrated patient retention, care, and secondary HIV prevention efforts in Rakai, Uganda. Research Environment. I will be well supported within the well funded and respected Division of Infectious Diseases at Johns Hopkins. I will also have the excellent and proven research infrastructure of the Rakai Health Sciences Program in Uganda to support the design and implementation of my research plan.

Public Health Relevance

These study findings may serve as a model for the design of large scale peer health worker-led interventions to improve the care, retention, and secondary HIV prevention of people living with HIV in low-resource settings. These studies may serve as a model for integrating prevention and care interventions, an area in which there is a critical need for innovative, inexpensive, and effective interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH086338-05
Application #
8599483
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Stirratt, Michael J
Project Start
2010-01-01
Project End
2014-12-31
Budget Start
2014-01-01
Budget End
2014-12-31
Support Year
5
Fiscal Year
2014
Total Cost
$182,790
Indirect Cost
$13,540
Name
Johns Hopkins University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Chang, Larry W; Grabowski, Mary K; Ssekubugu, Robert et al. (2016) Heterogeneity of the HIV epidemic in agrarian, trading, and fishing communities in Rakai, Uganda: an observational epidemiological study. Lancet HIV 3:e388-96
Linas, Beth S; Genz, Andrew; Westergaard, Ryan P et al. (2016) Ecological Momentary Assessment of Illicit Drug Use Compared to Biological and Self-Reported Methods. JMIR Mhealth Uhealth 4:e27
Linas, Beth S; Latkin, Carl; Genz, Andrew et al. (2015) Utilizing mHealth methods to identify patterns of high risk illicit drug use. Drug Alcohol Depend 151:250-7
Linas, Beth S; Latkin, Carl; Westergaard, Ryan P et al. (2015) Capturing illicit drug use where and when it happens: an ecological momentary assessment of the social, physical and activity environment of using versus craving illicit drugs. Addiction 110:315-25
Chang, Larry W; Nakigozi, Gertrude; Billioux, Veena G et al. (2015) Effectiveness of peer support on care engagement and preventive care intervention utilization among pre-antiretroviral therapy, HIV-infected adults in Rakai, Uganda: a randomized trial. AIDS Behav 19:1742-51
Billioux, Alexander; Nakigozi, Gertrude; Newell, Kevin et al. (2015) Durable Suppression of HIV-1 after Virologic Monitoring-Based Antiretroviral Adherence Counseling in Rakai, Uganda. PLoS One 10:e0127235
Grabowski, Mary K; Lessler, Justin; Redd, Andrew D et al. (2014) The role of viral introductions in sustaining community-based HIV epidemics in rural Uganda: evidence from spatial clustering, phylogenetics, and egocentric transmission models. PLoS Med 11:e1001610
Reynolds, Steven J; Sempa, Joseph B; Kiragga, Agnes N et al. (2014) Is CD4 monitoring needed among ugandan clients achieving a virologic and immunologic response to treatment? AIDS Patient Care STDS 28:575-8
Burkey, Matthew D; Weiser, Sheri D; Fehmie, Desiree et al. (2014) Socioeconomic determinants of mortality in HIV: evidence from a clinical cohort in Uganda. J Acquir Immune Defic Syndr 66:41-7
Kirk, Gregory D; Linas, Beth S; Westergaard, Ryan P et al. (2013) The exposure assessment in current time study: implementation, feasibility, and acceptability of real-time data collection in a community cohort of illicit drug users. AIDS Res Treat 2013:594671

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