The current challenges facing Uganda with regard to the need for effective and sustainable programs for delivering HIV care and integrating prevention into ART scale-up, reveal the need for multidisciplinary expertise in social and behavioral research. Most of the HIV research conducted in Uganda and by investigators at Makerere University has been biomedical in focus, and much of the social and behavioral HIV research experience of the University faculty has been with quantitative analysis of large structured surveys, and less with addressing formative, process, and outcome evaluations of HIV-related behavioral interventions. The proposed project will begin to fill this void through a partnership between Makerere University in Uganda, RAND in the United States, and care provider organizations in Uganda that will develop the capacity of Makerere investigators to conduct social and behavioral research that will address these challenges. The project will implement three pilot studies that will provide a training ground for building this research capacity and pragmatic, innovative solutions to prevention and treatment challenges facing the local community: (1) Develop and pilot a program to activate HIV clients as agents of prevention;(2) Examine quality of care, operational efficiency and cost across various models of ART scale-up;(3) Evaluate the impact of ART on social, economic and risk behavior outcomes. The goal of the project is to provide the training, research experience, and structural support to position the targeted Makerere investigators to compete successfully for independent HIV research funding and become recognized in the region as key contributors to HIV behavioral and social science. This focus on social, behavioral and health systems research also enables Makerere to capitalize on its partnership with RAND, which is known for its expertise in the development and evaluation of health care systems, and multidisciplinary approach to social and behavioral science. Furthermore, RAND's multidisciplinary roster of health scientists offers additional advantages with regard to building capacity for a wide array of research skills and tackling the complex and multi-faceted challenges of HIV care in Uganda. The public health benefits include the improved ability of Ugandan scientists to conduct innovative, multi-disciplinary social and behavioral research to address the HIV/AIDS challenges facing Ugandans.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Resource-Related Research Projects (R24)
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Special Emphasis Panel (ZHD1-DSR-W (07))
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Newcomer, Susan
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Infectious Diseases Institute
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Wagner, Glenn J; Slaughter, Mary; Ghosh-Dastidar, Bonnie (2017) Depression at Treatment Initiation Predicts HIV Antiretroviral Adherence in Uganda. J Int Assoc Provid AIDS Care 16:91-97
Wagner, Glenn J; Ghosh-Dastidar, Bonnie; Slaughter, Mary Ellen (2015) Engagement in HIV Prevention Advocacy Associated with Increased Consistent Condom Use Among HIV Clients in Uganda. AIDS Behav 19:1150-6
Wanyenze, Rhoda K; Matovu, Joseph K B; Kamya, Moses R et al. (2015) Fertility desires and unmet need for family planning among HIV infected individuals in two HIV clinics with differing models of family planning service delivery. BMC Womens Health 15:5
Wagner, Glenn J; Ghosh-Dastidar, Bonnie; Slaughter, Mary Ellen et al. (2014) Changes in condom use during the first year of HIV treatment in Uganda and the relationship to depression. Ann Behav Med 48:175-83
Atuyambe, Lynn Muhimbuura; Ssegujja, Eric; Ssali, Sarah et al. (2014) HIV/AIDS status disclosure increases support, behavioural change and, HIV prevention in the long term: a case for an Urban Clinic, Kampala, Uganda. BMC Health Serv Res 14:276
Wanyenze, Rhoda K; Wagner, Glenn J; Tumwesigye, Nazarius M et al. (2013) Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda. BMC Public Health 13:98
Okeke, Edward N; Wagner, Glenn J (2013) AIDS treatment and mental health: evidence from Uganda. Soc Sci Med 92:27-34
Nannungi, Annet; Wagner, Glenn; Ghosh-Dastidar, Bonnie (2013) The Impact of ART on the Economic Outcomes of People Living with HIV/AIDS. AIDS Res Treat 2013:362972
Alamo, Stella T; Wagner, Glenn J; Ouma, Joseph et al. (2013) Strategies for optimizing clinic efficiency in a community-based antiretroviral treatment programme in Uganda. AIDS Behav 17:274-83
Alamo, Stella T; Colebunders, Robert; Ouma, Joseph et al. (2012) Return to normal life after AIDS as a reason for lost to follow-up in a community-based antiretroviral treatment program. J Acquir Immune Defic Syndr 60:e36-45

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