R01HD109117
Project Grant
Overview
Grant Description
Systems Analysis and Improvement Approach to Improve Integration of HIV Prevention and Treatment Services
East and Southern Africa is home to 6.2% of the world's population but includes 54% of all people living with HIV (PLWH). In this region, three out of five PLWH are women, and there is a particularly high burden of HIV amongst adolescent girls and young women (AGYW). Over half of African women use family planning (FP) services.
Integration of HIV prevention and treatment with FP services holds promise for supporting progress toward the UNAIDS 95-95-95 targets for testing, treatment, and prevention. Nevertheless, integration of even basic HIV prevention and treatment services into FP clinics remains low, and how best to integrate these services is still unknown.
In a previous trial, the Systems Analysis and Improvement Approach (SAIA) was an effective implementation strategy for improving HIV counseling and testing in a small selection of FP clinics in Mombasa County, Kenya when delivered by research staff. SAIA incorporates a cascade analysis tool, sequential process flow mapping, and cycles of micro-intervention development, implementation, and assessment to improve a care cascade.
More data is needed to understand if SAIA is effective for also improving linkage to HIV care and screening and linkage to pre-exposure prophylaxis (PrEP) in FP clinics when SAIA is delivered at scale by Kenyan public health workforce.
The first objective of this study is to conduct a cluster-randomized trial evaluating the effectiveness of SAIA versus control (usual procedures with no specific intervention) for increasing HIV counseling, testing, linkage to HIV care, and screening and linkage to PrEP in new FP clients and new and returning AGYW clients. There will be a particular focus on the HIV prevention and treatment of AGYW in this study, and any AGYW presenting for FP care will be prioritized.
Quantitative and qualitative data will be analyzed using the RE-AIM framework to evaluate the program's reach, effectiveness, adoption, implementation, and maintenance. To understand how SAIA could be integrated into national Ministry of Health policies and programs, activity-based costing will be conducted to estimate the budget and program impacts of SAIA, scaled to a county level, from a Ministry of Health perspective.
It is hypothesized that compared to control, SAIA will be effective at increasing HIV counseling, HIV testing, linkage to HIV care, and screening and linkage to PrEP for new FP clients and all new and returning AGYW FP clients when delivered at scale by Kenyan public health staff.
The implementation evaluation, costing, and budget impact analysis will establish a roadmap for national-level implementation, positioning Kenya as a global leader in integrating FP/HIV services.
East and Southern Africa is home to 6.2% of the world's population but includes 54% of all people living with HIV (PLWH). In this region, three out of five PLWH are women, and there is a particularly high burden of HIV amongst adolescent girls and young women (AGYW). Over half of African women use family planning (FP) services.
Integration of HIV prevention and treatment with FP services holds promise for supporting progress toward the UNAIDS 95-95-95 targets for testing, treatment, and prevention. Nevertheless, integration of even basic HIV prevention and treatment services into FP clinics remains low, and how best to integrate these services is still unknown.
In a previous trial, the Systems Analysis and Improvement Approach (SAIA) was an effective implementation strategy for improving HIV counseling and testing in a small selection of FP clinics in Mombasa County, Kenya when delivered by research staff. SAIA incorporates a cascade analysis tool, sequential process flow mapping, and cycles of micro-intervention development, implementation, and assessment to improve a care cascade.
More data is needed to understand if SAIA is effective for also improving linkage to HIV care and screening and linkage to pre-exposure prophylaxis (PrEP) in FP clinics when SAIA is delivered at scale by Kenyan public health workforce.
The first objective of this study is to conduct a cluster-randomized trial evaluating the effectiveness of SAIA versus control (usual procedures with no specific intervention) for increasing HIV counseling, testing, linkage to HIV care, and screening and linkage to PrEP in new FP clients and new and returning AGYW clients. There will be a particular focus on the HIV prevention and treatment of AGYW in this study, and any AGYW presenting for FP care will be prioritized.
Quantitative and qualitative data will be analyzed using the RE-AIM framework to evaluate the program's reach, effectiveness, adoption, implementation, and maintenance. To understand how SAIA could be integrated into national Ministry of Health policies and programs, activity-based costing will be conducted to estimate the budget and program impacts of SAIA, scaled to a county level, from a Ministry of Health perspective.
It is hypothesized that compared to control, SAIA will be effective at increasing HIV counseling, HIV testing, linkage to HIV care, and screening and linkage to PrEP for new FP clients and all new and returning AGYW FP clients when delivered at scale by Kenyan public health staff.
The implementation evaluation, costing, and budget impact analysis will establish a roadmap for national-level implementation, positioning Kenya as a global leader in integrating FP/HIV services.
Awardee
Funding Goals
THE EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENTS MISSION IS TO LEAD RESEARCH AND TRAINING TO UNDERSTAND HUMAN DEVELOPMENT, IMPROVE REPRODUCTIVE HEALTH, ENHANCE THE LIVES OF CHILDREN AND ADOLESCENTS, AND OPTIMIZE ABILITIES FOR ALL.
Grant Program (CFDA)
Awarding / Funding Agency
Place of Performance
Seattle,
Washington
981951016
United States
Geographic Scope
Single Zip Code
Related Opportunity
Analysis Notes
Amendment Since initial award the total obligations have increased 401% from $715,033 to $3,583,525.
University Of Washington was awarded
SAIA for Improved HIV-FP Integration in East Africa
Project Grant R01HD109117
worth $3,583,525
from the National Institute of Child Health and Human Development in April 2022 with work to be completed primarily in Seattle Washington United States.
The grant
has a duration of 5 years and
was awarded through assistance program 93.865 Child Health and Human Development Extramural Research.
The Project Grant was awarded through grant opportunity Dissemination and Implementation Research in Health (R01 Clinical Trial Optional).
Status
(Ongoing)
Last Modified 4/6/26
Period of Performance
4/1/22
Start Date
3/31/27
End Date
Funding Split
$3.6M
Federal Obligation
$0.0
Non-Federal Obligation
$3.6M
Total Obligated
Activity Timeline
Transaction History
Modifications to R01HD109117
Additional Detail
Award ID FAIN
R01HD109117
SAI Number
R01HD109117-366045563
Award ID URI
SAI UNAVAILABLE
Awardee Classifications
Public/State Controlled Institution Of Higher Education
Awarding Office
75NT00 NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development
Funding Office
75NT00 NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development
Awardee UEI
HD1WMN6945W6
Awardee CAGE
1HEX5
Performance District
WA-07
Senators
Maria Cantwell
Patty Murray
Patty Murray
Budget Funding
| Federal Account | Budget Subfunction | Object Class | Total | Percentage |
|---|---|---|---|---|
| National Institute of Child Health and Human Development, National Institutes of Health, Health and Human Services (075-0844) | Health research and training | Grants, subsidies, and contributions (41.0) | $1,429,212 | 100% |
Modified: 4/6/26