PROJECT SUMMARY
Sub-Saharan Africa (SSA) has made tremendous strides in the provision and uptake of antiretroviral therapy (ART)
among HIV-infected persons. Despite these advancements, the region continues to experience low rates of adherence
and retention along the cascade of HIV care. Initiating effective ART adherence dialogue with patients while
incorporating patient-specific interventions along the continuum of care is key to improving patient engagement in HIV
care. Unfortunately, system-level factors such as long waiting times, staff shortages, lack of continuity in provider-
patient relationship, poor provider communication skills, and inconvenient clinic hours create barriers to ART
adherence. Addressing these system-level barriers is fundamental to provide a conducive patient-centered care system
that help patients adhere to ART and overcome other interpersonal and individual barriers to care. My long-term goal is
to become an independent implementation science researcher who successfully develops, implements and evaluates
multilevel interventions to address system-level barriers to patient engagement in HIV care. This K43 will provide me
with the additional training and preliminary data necessary to achieve these research goals. My training will focus on: 1.
Implementation science, 2. Advanced quantitative research methods, and 3. Economic evaluation of health
interventions. To accomplish this, I will draw from the expertise of my mentorship team lead by primary mentors Drs. Ira
Wilson (Brown University, USA) and Abraham Siika (Moi University, Kenya), both of whom have a wealth of experience
mentoring junior investigators. My mentorship team is comprised of health professionals who have expertise in clinical
research, implementation science, patient-centered care, epidemiology, biostatistics, and economic evaluation of
interventions in HIV care settings. The award and completion of this K43 grant will provide me with a strong foundation
to compete for an R01 in collaboration with other experienced investigators to extend my research to focus on multi-
level approaches to promote patient engagement in care within a patient-centered framework that incorporates other
chronic diseases. My prior training, research experience, and mentorship team, places me in a strategic position to
achieve my research goals.
