# RCT to reduce HIV acquisition and viral load among migrants, Rakai, Uganda

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2022 · $581,971

## Abstract

PROJECT SUMMARY (ABSTRACT)
The Rakai Health Sciences Program (RHSP), Uganda, proposes an implementation science community-
randomized controlled trial (CRCT) of a novel intervention to newly in-migrated individuals (“Welcome In-
coming Neighbor” [WIN]), to optimize their rapid linkage to combination HIV prevention (CHP) services. RHSP
data show that within the first 36 months after in-migration, compared to residents, HIV-negative in-migrants
are at increased risk of HIV acquisition and HIV+ in-migrants underutilize antiretroviral therapy (ART)
increasing the risk of onward transmission. The theory-based WIN intervention includes community
sensitization, community-based WIN scouts (WINs), and enhanced, differentiated clinic services for in-
migrants. WINs will conduct active community surveillance to rapidly identify and welcome in-migrants, provide
them with information about the availability of CHP and high rates of use by residents (to “normalize” uptake),
utilize a motivational interviewing approach to encourage CHP adoption, refer in-migrants to free services,
provide vouchers enabling them to receive priority clinic services, and follow-up in-migrants to assess and
further encourage engagement in CHP. Specific Aims: Aim 1: To randomize 40 individually matched
communities in a 1:1 ratio to the WIN intervention or control arm. In-migrants aged 15-49 in each arm will
undergo a baseline and 2 follow-up surveys at ~18-month intervals. Primary end points are HIV incidence in
initially HIV-negative in-migrants (n ~3,800 py per arm), and viral load suppression in HIV+ (n ~740 per arm).
CHP coverage rates and sexual behaviors will also be compared (secondary outcomes). Aim 2a: To use a
mixed methods approach (in-depth interviews, process & survey data) and RE-AIM (Reach, Effectiveness,
Adoption, Implementation, Maintenance) to (i) guide interim intervention adaptation as necessary; (ii) interpret
trial results; and, (iii) translate the research into future action. Aim 2b: To conduct cost studies to provide
information on affordability and sustainability. Innovation and Impact: This novel intervention will rapidly
engage a vulnerable priority population of in-migrants, to optimize CHP and HIV impact in rural Uganda.

## Key facts

- **NIH application ID:** 10408017
- **Project number:** 5R01MH115799-05
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Larry William Chang
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $581,971
- **Award type:** 5
- **Project period:** 2018-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10408017

## Citation

> US National Institutes of Health, RePORTER application 10408017, RCT to reduce HIV acquisition and viral load among migrants, Rakai, Uganda (5R01MH115799-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10408017. Licensed CC0.

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