1079-South Africa-Universal Test and Connect for HIV Service Delivery in South Africa

Universal test and connect for HIV service delivery is an HIV sero-neutral approach to HIV care that includes pillars for prevention and treatment. An HIV sero-neutral approach signifies a paradigm switch for clinicians, emphasizing that whether a patient tests positive or negative for HIV, they should be linked to care. Patients who test positive for HIV should be started on immediate antiretroviral treatment and those who test negative should be screened for and provided with PrEP if eligible.

PrEP is highly underutilized around the world, but particularly in South Africa with rates of only as high as 1.7% of South Africans ever haven taken it, despite having 20% of the world's population who lives with HIV. The Emergency Department is a venue where the most vulnerable patients seek healthcare and many ED patients do not interact with the healthcare system elsewhere, and have been shown to have an undiagnosed rate of HIV as high as 7%. We hope to define for the first time the prevalence of HIV in Emergency Departments in the Western Cape, identify the percentage of patients who would be eligible for PrEP, do a pilot study for patient choices of oral vs. injectable PrEP with same-day initiation from the ED, and run implementation science outcome projects of feasability and acceptability by both patients and providers in the ED. 

We would expect students to work directly with the Fogarty fellow from Johns Hopkins University Department of Emergency Medicine to participate in study activities at one of our field sites (Tygerberg Hospital or Gugulethu Community Health Centre). They would be responsible for recruitment, testing, HIV counseling, data collection, and preliminary data analysis. At the culmination of the field experience, we anticipate that the student will be able to first author an abstract of preliminary data from the project for a national or international conference.

collaborative, however the Emergency Department can be a little chaotic depending on acuity.

Has the ability to adapt to new venues and are able to have an open mind about how to contribute effectively. They should be able to bring fresh ideas and be able to take initiative.

Experience with research protocols
Foundational epi and biostats knowledge, completing one of either the required epi or biostats by the start of their field experience
Ability to create an abstract for a conference
Interpersonal and teamwork skills, including cultural competency

Name: David Rudolph, drudolp3@jhmi.edu 

I would describe my communication and mentorship styles as... 

Open and engaging, inviting ideas of participants and sharing in a collaborative learning partner where we are able to learn from each other

A complementary student would have a working style and mentorship expectations that are..

flexible and adaptable to unexpected changes throughout the research process. Global health can be challenging work especially in a field placement, where things out of our control happen and I would expect the student to have an open mind and have a problem-solving attitude. 

Estimated Costs:

Housing: $1250/month
Food: $250/month
Internet/phone costs: $50/month for SIM card (25 GB)
Local transportation: $50/month for Ubers around city, transportation to project site can be covered by project

Total: $1600/month

Additional support for PI:

We would be able to provide a weekly food stipend