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.
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