This proposed four-year development period will be used for research and training activities that will give Dr. Bor the skills and experience necessary to become an independent investigator. Dr. Bor's long-term career goal is to apply the theory and analytical tools of economics to the study of population health, with a focus on HIV treatment and prevention. Building on a strong background in quantitative data analysis, Dr. Bor has proposed a training plan to develop skills in mixed methods study designs, content area expertise in behavioral economics, and epidemiological approaches to causal inference. The training plan will involve formal coursework, directed readings on specific topics, and a mentored research project. The research will investigate how the scale-up of HIV treatment in rural South Africa has shaped beliefs about the HIV risk environment, and how these beliefs influence behaviors related to HIV testing, sexual behavior, and human capital investment (e.g., education). Although the health benefits of ART for HIV patients are well documented, less is known about how increased availability of ART has influenced economic, health, and care-seeking behaviors at the community level. These spillover effects have implications for cost-benefit analyses of ART scale-up, and may inform interventions to increase HIV testing, care, and treatment. The proposed research will combine analysis of existing data from a health and demographic surveillance site in rural KwaZulu-Natal with collection of primary qualitative, survey, and experimental data in a mixed methods design. A brief intervention to increase take up of HIV testing will be developed and piloted in a randomized evaluation.
To maximize the effectiveness of large-scale ART programs, evidence is needed on methods to increase HIV testing and linkage to care early in the course of HIV infection. I will undertake a mixed methods study to understand how young South Africans perceive the HIV risk environment in the age of ART, and how these perceptions affect HIV testing and care seeking, sexual risk behaviors, and future-oriented investments in themselves, e.g. education. The findings of this research will inform economic evaluations of the full benefits of ART scale-up, as well as interventions to increase rates of HIV testing and early care seeking.
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