# Minimizing losses from HIV care under universal treatment in Rwanda

> **NIH NIH K23** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2021 · $199,260

## Abstract

ABSTRACT
In this K23 proposal, Dr. Jonathan Ross describes a mentored research project and a rigorous career
development plan that will help to establish him as an independent and productive clinical investigator with
expertise in assessing and improving outcomes along the HIV care continuum in international, resource-limited
settings. The 2015 World Health Organization guidelines recommend antiretroviral therapy (ART) for all
people living with HIV (PLWH) regardless of CD4 count (universal ART). However, despite the tremendous
scale-up of ART in sub-Saharan Africa over the past two decades, many PLWH do not initiate ART or remain
in care. To ensure the success of treatment expansion to all PLWH, it is critical to understand factors
associated with not initiating or remaining on ART under universal treatment and then develop targeted
approaches to improve uptake of and retention on ART. The overall goal of this project is thus to identify
determinants of ART uptake and retention under universal ART, and design a targeted and informed
intervention to minimize loss to care. The proposed study will be conducted in Rwanda, one of the first
countries in sub-Saharan Africa to implement universal ART, and will leverage the existing infrastructure of
the Central Africa International Epidemiologic Databases to Evaluate AIDS, an established cohort of over
65,000 PLWH. Using mixed methods and the Andersen Behavioral Model of Health Services Utilization as a
framework, Dr. Ross will: (1) identify the rates and predictors of ART uptake and retention among patients
initiating HIV care under universal ART; (2) identify barriers to and facilitators of ART uptake and retention
under universal ART; and (3) develop an intervention to improve ART uptake and retention of patients at high
risk of loss to care, and pilot test its feasibility and preliminary efficacy. To accomplish these aims, he will
pursue additional training in: (1) statistical analysis of longitudinal and clustered data, (2) advanced qualitative
methods, (3) development of health services delivery interventions in resource-limited settings, and (4) conduct
of clinical and health services research in international, resource-limited settings. With completion of these
activities, along with guidance from a multi-disciplinary team of expert mentors, Dr. Ross will obtain the skills
necessary to achieve his career goal of becoming an independent investigator.

## Key facts

- **NIH application ID:** 10221464
- **Project number:** 5K23MH114752-06
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Jonathan Ross
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $199,260
- **Award type:** 5
- **Project period:** 2017-08-04 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10221464

## Citation

> US National Institutes of Health, RePORTER application 10221464, Minimizing losses from HIV care under universal treatment in Rwanda (5K23MH114752-06). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10221464. Licensed CC0.

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