Omuyambi: traditional healer support to improve HIV viral suppression in rural uganda

Active Project Grant Awarded Last action

Award ID
R01MH132440
Recipient
Awarding agency
Obligated
$5,464,139

Award facts

Assistance listing
93.242 Mental Health Research Grants
Completion date 74% complete
Place of performance
New York, NY 10065, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
And abstract people living with HIV (plwh) in rural sub-saharan africa are three times less likely to achieve viral suppression than their urban counterparts. Novel HIV service delivery models for rural plwh are needed to improve the HIV continuum of care and achieve viral suppression. Traditional healers (TH) are lay providers who serve as the first line of healthcare in rural africa, and frequently provide care to plwh who have disengaged from HIV care. TH are accessible, trusted members of rural communities, but have not been integrated into HIV care programs. Our prior cluster randomized trial demonstrated that partnerships with TH quadrupled the uptake of HIV testing in rural uganda through facilitation of HIV counseling and self-testing. Building on these results, we adapted an evidence-based lay provider intervention for delivery by ugandan TH to support subsequent steps of the HIV continuum. The TH-delivered program is called omuyambi ("support" in runyankole) and includes assisting plwh to link to care for art initiation, providing ongoing counseling on art adherence, and encouraging retention in clinical care. We conducted a pilot study of this lay provider program among 12 TH and 20 plwh who were disengaged from HIV care or art naïve. Results were overwhelmingly positive: 100% of plwh linked to HIV care and initiated art within 14 days, 95% reported art adherence and 100% were retained in care after nine months. Building upon this evidence, we hypothesize that TH can support clinic-based care and improve viral suppression among rural plwh. We will conduct a hybrid type i effectiveness-implementation cluster randomized trial to evaluate the effectiveness of the omuyambi intervention on viral suppression among art naïve/defaulted plwh in uganda. - aim 1: compare the omuyambi intervention versus routine HIV clinic-based care (control) in a cluster randomized trial. Forty TH clusters that include =650 plwh will be randomized to the omuyambi intervention or to a control arm, in which TH will refer plwh to clinic-based HIV care alone. Primary clinical outcome is viral suppression at 12 months measured via dried blood spot analysis. We hypothesize that 80% of plwh in the intervention arm will achieve viral suppression, compared with 60% in the control arm. - aim 2: evaluate implementation of omuyambi using a convergent mixed methods study design and the consolidated framework for implementation research (cfir). Qualitative and quantitative data will be collected from participating TH, plwh, HIV clinic staff, and ministry of health officials. These data will be used to assess omuyambi implementation determinants and outcomes. The proposed research is significant as IT responds to the world health organization and ugandan ministry of health calls for community-based interventions to improve HIV viral suppression where current programs have suboptimal impact. If effective, this approach has the potential to improve the HIV continuum among rural plwh towards unaids 95-95-95 benchmarks necessary to end the HIV epidemic.

Transactions

Action Obligated Date
Amendment $242,311
Amendment $420,208
Amendment A hybrid effectiveness-implementation trial of lay person support to improve HIV viral load suppression in rural communities - achieving HIV viral suppression… $420,208
Amendment $0
Amendment $557,654
Amendment $557,654
Amendment $65,773
Amendment $65,773
Amendment $591,970
Amendment $591,970
Amendment $591,970
Amendment $679,324
Original award $679,324
Show all 13

Subawards

Subrecipient Amount Awarded
Mbarara University Of Science And Technology MUST will be responsible for assisting in procurement of study supplies including staff salaries, participant incentives, reimbursements for study staff… $764,655

Quick answers

Who received award R01MH132440?

R01MH132440 was awarded to Weill Medical College Of Cornell University by National Institute of Mental Health (National Institutes of Health) on February 15, 2023.

How much is award R01MH132440 worth?

$5,464,139 has been obligated on R01MH132440.

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