PROJECT SUMMARY/ABSTRACT
The overall goal of the proposed K43 Emerging Global Leader Award is to support Dr. Stephen Okoboi’s
research training to develop as an independent global health HIV researcher. Dr. Okoboi is currently a
postdoctoral fellow and Deputy Head of Research at Makerere University Infectious Disease Institute in
Uganda. Conducting the proposed studies in this application will facilitate his training goals to: 1) gain
expertise in behavioural science methods to better understand the processes and preventive behaviours
underlying peer delivery of HIV and syphilis self-tests combined with assisted partner notification (APN)
services, 2) gain expertise in the design and conduct of randomized trials in real world settings, and 3) acquire
advanced skills in health economic evaluation. This proposal builds on the unique skills he already has in
epidemiology and nursing while leveraging a multidisciplinary team of mentors to ultimately become a
productive and influential independent investigator in HIV prevention research. The research goal of this
proposal is to conduct a rigorous proof-of-concept evaluation to assess the feasibility, acceptability,
preliminary effectiveness, and cost effectiveness of peer delivered HIV and syphilis self-testing coupled with
assisted partner notification services. Men who engage in sexual relations with other men (MSM) are
disproportionately affected by HIV and syphilis. In Uganda, MSM HIV prevalence is 13.2% versus 4.7% in
similarly aged males, while syphilis prevalence is 8.3% versus 5.8% in males aged 15-64 years. Syphilis and
HIV transmission share common transmission routes and syphilis increases risk of HIV acquisition,
transmission, and disease progression. The World Health Organization recommends dual HIV/syphilis testing
for MSM, but uptake of facility-based testing is low because of stigma and discrimination in healthcare
settings. Differentiated service delivery models, such as peer delivered HIV/syphilis self-tests and linkage to
care for those who test positive, could circumvent health facility stigma and other structural barriers to
accessing care. However, no studies to our knowledge have evaluated the effectiveness of peer delivered
HIV/syphilis self-testing linked to partner services for MSM. To address this research gap, Dr. Okoboi will
conduct formative research to inform the implementation of peer-delivered HIV/syphilis self-tests combined
with APN for Ugandan MSM (Aim 1), conduct a randomized trial to pilot test the preliminary effectiveness of
peer delivered HIV/syphilis self-tests and APN relative to standard of care (Aim 2), and estimate the cost
implications of peer-delivered HIV/syphilis self-testing and APN compared to facility-based testing (Aim 3).
Dr. Okoboi’ s research goals correspond with his training goals, and at the completion of this award, he will
be in an excellent position to submit an R01 application to further advance HIV prevention research for MSM
in sub-Saharan Africa.
