# ART diversion in Rakai, Uganda

> **NIH NIH R21** · JOHNS HOPKINS UNIVERSITY · 2020 · $197,657

## Abstract

Summary
Drug sharing is commonly reported for other prescription medications, but to date, no studies have examined
antiretroviral drug diversion (buying, selling, borrowing, or lending) for therapeutic use among people living with
HIV. We previously conducted qualitative interviews with people living with HIV in high-prevalence fishing
communities (hotspots) along Lake Victoria in the Rakai region, Uganda. Participants reported frequent, short-
term sharing of antiretroviral treatment (ART) with coworkers/friends that was motivated by the desire to keep
taking drugs despite challenges to regular clinic attendance and adherence. However, we do not know how
common ART diversion is at the population-level, who is most likely to divert antiretroviral drugs, or whether ART
diversion affects HIV treatment outcomes such as HIV viral suppression. We therefore propose a mixed methods
study to better understand ART diversion and whether it can be leveraged to reach and support sub-optimally
adherent, hard-to-reach individuals living with HIV. The study will be conducted through the Rakai Community
Cohort Study, a population-based cohort study conducted among all residents aged 15-49 in 40 communities in
southcentral Uganda. Aim 1 will measure the prevalence, distribution, and factors associated with ART diversion
in this representative sample. Aim 2 will assess the association between ART diversion and HIV viral
suppression. Aim 3 will explore acceptability and feasibility of a novel intervention among ART-sharing dyads
that builds upon these existing networks of social trust to reach sub-optimally adherent, hard-to-reach HIV
patients.

## Key facts

- **NIH application ID:** 9927335
- **Project number:** 1R21AI145682-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CAITLIN E KENNEDY
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $197,657
- **Award type:** 1
- **Project period:** 2020-09-09 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9927335

## Citation

> US National Institutes of Health, RePORTER application 9927335, ART diversion in Rakai, Uganda (1R21AI145682-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9927335. Licensed CC0.

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