# Omuyambi: Traditional healer support to improve HIV viral suppression in rural Uganda

> **NIH NIH R01** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $657,743

## Abstract

PROJECT SUMMARY AND ABSTRACT
People living with HIV (PLWH) in rural sub-Saharan Africa are three times less likely to achieve viral
suppression than their urban counterparts. Novel HIV service delivery models for rural PLWH are needed to
improve the HIV continuum of care and achieve viral suppression. Traditional healers (TH) are lay providers
who serve as the first line of healthcare in rural Africa, and frequently provide care to PLWH who have
disengaged from HIV care. TH are accessible, trusted members of rural communities, but have not been
integrated into HIV care programs. Our prior cluster randomized trial demonstrated that partnerships with TH
quadrupled the uptake of HIV testing in rural Uganda through facilitation of HIV counseling and self-testing.
Building on these results, we adapted an evidence-based lay provider intervention for delivery by Ugandan TH
to support subsequent steps of the HIV continuum. The TH-delivered program is called Omuyambi (“Support”
in Runyankole) and includes assisting PLWH to link to care for ART initiation, providing ongoing counseling on
ART adherence, and encouraging retention in clinical care. We conducted a pilot study of this lay provider
program among 12 TH and 20 PLWH who were disengaged from HIV care or ART naïve. Results were
overwhelmingly positive: 100% of PLWH linked to HIV care and initiated ART within 14 days, 95% reported
ART adherence and 100% were retained in care after nine months. Building upon this evidence, we
hypothesize that TH can support clinic-based care and improve viral suppression among rural PLWH. We
will conduct a hybrid type I effectiveness-implementation cluster randomized trial to evaluate the effectiveness
of the Omuyambi intervention on viral suppression among ART naïve/defaulted PLWH in Uganda.
• Aim 1: Compare the Omuyambi intervention versus routine HIV clinic-based care (control) in a cluster
randomized trial. Forty TH clusters that include ≥650 PLWH will be randomized to the Omuyambi intervention
or to a control arm, in which TH will refer PLWH to clinic-based HIV care alone. Primary clinical outcome is
viral suppression at 12 months measured via dried blood spot analysis. We hypothesize that 80% of PLWH in
the intervention arm will achieve viral suppression, compared with 60% in the control arm.
• Aim 2: Evaluate implementation of Omuyambi using a convergent mixed methods study design and the
Consolidated Framework for Implementation Research (CFIR). Qualitative and quantitative data will be
collected from participating TH, PLWH, HIV clinic staff, and Ministry of Health Officials. These data will be used
to assess Omuyambi implementation determinants and outcomes.
The proposed research is significant as it responds to the World Health Organization and Ugandan Ministry of
Health calls for community-based interventions to improve HIV viral suppression where current programs
have suboptimal impact. If effective, this approach has the potential to improve the HIV contin...

## Key facts

- **NIH application ID:** 10788439
- **Project number:** 5R01MH132440-02
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** Radhika Lu Sundararajan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $657,743
- **Award type:** 5
- **Project period:** 2023-02-15 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10788439

## Citation

> US National Institutes of Health, RePORTER application 10788439, Omuyambi: Traditional healer support to improve HIV viral suppression in rural Uganda (5R01MH132440-02). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10788439. Licensed CC0.

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