The proposed study is nested within Project Accept, a NIMH-sponsored Phase III Randomized Controlled Trial in Sub-Saharan Africa and Thailand. PA is an HIV prevention trial in which communities in Africa and Thailand were randomized to receive: a community-based HIV voluntary counseling and testing intervention plus standard clinic-based VCT (SVCT), or SVCT alone. The purpose of the proposed health research is to better understand beliefs, perceptions, awareness and knowledge of ART affecting: uptake of ART, uptake of HIV testing, and influence on HIV risk behaviors in Thai and Tanzanian study communities. Utilizing Project Accept data for this research study, the following long-term study objectives will be achieved: 1) determine knowledge and information gaps obstructing ART uptake, 2) understand influence of ART availability on HIV risk behaviors, and 3) expand the knowledge base of behaviors surrounding ART uptake in Thai and Tanzanian study communities. Specific study aims are to: 1) Understand ART perceptions, beliefs and awareness in Intervention vs. Comparison Communities in Thailand and Tanzania, 2) Assess the impact of the Project Accept Intervention on ART knowledge and awareness of ART availability in Thai and Tanzanian health systems, 3) Determine how ART influences HIV risk behaviors in Thailand and Tanzania. Project Accept qualitative data from ethnographic studies in Tanzania and Thailand are rich in information surrounding ART perceptions, knowledge and beliefs. In-depth interviews conducted with intervention and comparison community cohorts at the following Project Accept intervention times (baseline, 6-months, 15- months, and 30-months) will be analyzed to answer the research questions and achieve the study aims. The proposed study is highly relevant to a NIMH mission objective: strengthening the public health impact of NIMH-support research, in particular research that develops and disseminates behavioral interventions that prevent HIV/AIDS transmission. By understanding the perceptions, knowledge, awareness and beliefs of ART in Tanzania and Thailand, behavioral interventions that prevent HIV/AIDS transmission (one of the objectives of NIMH's Division of AIDS and Health and Behavior Research) can be further developed and disseminated in the respective regions.
Understanding HIV/AIDS anti-retroviral therapy (ART) awareness, perceptions, beliefs and knowledge, and determining how ART availability influences HIV risk behaviors, is crucial to understanding ART health behaviors, determining health education and information needs, and promoting ART uptake in Tanzania and Thailand. We aim to: determine knowledge and information gaps obstructing ART uptake, understand influence of ART availability on HIV risk behaviors, and expand the knowledge base of behaviors surrounding ART uptake in Thai and Tanzanian study communities. This research will help advance development of health education interventions tailored to populations in need of, but with limited knowledge of, ART in order to: facilitate and promote ART uptake as HIV prevention and treatment and increase HIV testing, thereby reducing HIV transmission.