Life Projects and Antiretroviral Therapy: The Social Impacts of Scale-up

We propose here a one-year planning grant to support the development of a competitive proposal to conduct comparative social scientific research on the experiences of individuals living with HIV. The proposed planning grant will intensify the start-up phase for the work proposed in grant application HD057792-01A2, accelerating the progress of the science proposed in that study. That comparative work would (1) examine and understand how the experience of ART affects family and peer relations, sexual behaviors, marital intentions and trajectories, and reproductive goals and practices;(2) investigate and evaluate how the intersection between ART and life projects shapes sexual and reproductive practices, adherence to treatment and care, and disclosure to social and sexual contacts;and (3) develop program strategies to enhance the clinical and population-level impacts. In this one year our specific aims would be: 1) To further develop the project's conceptual framework;2) To use that conceptual framework as a guide for the development of ethnographic instruments and sampling matrices;3) To design and develop the necessary collaborations and community advisory panels ensuring both that the research contributes to the building of local research capacity and that it is framed by the buy-in of key stakeholders in order to maximize the translational impact of the research;4) To build the capacity to apply for and receive IRB approval for the subsequent long term study, a complex process which requires the review of 10 separate institutional review boards, and 5) to prepare an application to NIH for funding as a competitive continuation to conduct comparative ethnographic study on the social impacts of the provision of anti-retroviral therapy.