The proposed 4-year career development award will combine mentorship, training and research activities to enable me to develop the skills necessary to become an independent investigator in the field of HIV implementation science. In the latter years of this K award, I will submit a competitive R01 application to design and conduct an intervention to retain HIV-positive, postpartum women in care. My prior work found that pregnant HIV-positive women in South Africa are at particularly high risk of dropping out of care soon after delivery, but additional research is needed in order to develop targeted, effective interventions to improve continuity of care. Key unresolved questions that my research seeks to address are the lack of information about the characteristics of mobility within this population and the impact of population mobility on retention in postpartum HIV care. The K-related training program is a critical component of my career development plan, and includes mentorship meetings, didactic coursework, directed readings and discussions, seminars, and professional society meetings. As an epidemiologist, I am highly competent in quantitative analysis, but I require additional training in social and behavioral theory, selected qualitative research methods and geographic information systems (GIS) in order to address existing research questions that will inform future interventions. My K-supported research proposal has 3 AIMS: 1) to determine the frequency of clinic shopping and identify factors associated with clinic switching using existing databases; 2) to characterize mobility and health care utilization among pregnant and postpartum HIV-positive women; and 3) to determine the effect of mobility on retention in HIV care and adherence to ART. Project activities will take place in Johannesburg, South Africa, using existing HIV clinic data for Aim 1 and primary data collection at Witkoppen Health and Welfare Centre, a primary care clinic, for Aims 2 and 3.
My work addresses a substantial knowledge gap related to population mobility and retention in HIV care among a specific population (peripartum women) at highest risk of dropping out of HIV care. Addressing these gaps will accelerate the creation of novel interventions to improve continuity of care for women in Africa. My project aims and training objectives align to enable me to develop the skills and experience to become an independent investigator with the guidance of my highly experienced mentorship committee.
