Promoting diverse perspectives in research to optimize integration of NCDs and HIV care in Kenya

Abstract Turkana County located in Northwest Kenya is a semi-arid region that has traditionally been underserved and marginalized because of nomadic lifestyle of its people. The 2018 Kenya Population Based HIV Impact Assessment survey reported that the HIV prevalence in Turkana County was 6.8% which is higher than the national HIV prevalence of 4.9%. Only 62% of people

living with HIV (PLWH) were aware of their status, 89% of those were receiving ART, and 40% achieved viral suppression which is lower than the national average. Non-communicable diseases (NCDs), especially mental health problems but also co-morbid conditions such as diabetes and hypertension negatively impact the quality of life of PLWH as well as uptake and

adherence to ART. Nearly 1 in 4 PLWH experience depression and the prevalence of non- communicable diseases such as diabetes and hypertension among PLWH increase with age. Therefore, PLWH, particularly the nomadic community in Turkana who are also a hard-to-reach populations are at risk of mortality from common NCDs if these conditions are not identified and

treatment initiated. Therefore, programs providing HIV care need to integrate NCD screening, prevention and management. There are limited opportunities for advanced education and scientific research for health providers in Turkana County. Therefore, building research capacity among a diverse group of trainees serving the under-resourced Turkana County can promote

locally relevant research and bring in different perspectives to aid identification of innovative strategies to optimize NCD prevention, diagnosis and treatment for PLWH in Kenya. Our application will leverage the training and capacity building activities currently underway as part of the D43 award “Integrating prevention and treatment of non-communicable diseases and HIV

care through research training in Kenya-INTEGRATE(TW009580)” led by Drs. John Kinuthia and Carey Farquhar. The D43 provides for advanced training and mentorship in research to promote HIV and NCD integration to Kenyatta National Hospital and Ministry of Health staff. Last year, we were awarded a supplement grant “Promoting Diversity, Equity, and Inclusivity in Research

Training to Optimize HIV Prevention and Treatment-DIVERSITY” that aims to promote diversity, equity, and inclusion of health-providers and community from Turkana County in HIV research by providing foundational training in research methodologies. In this administrative supplement we plan to build on our current efforts by providing advanced research training and high-quality

mentorship to Dr. Kristina Lokuruka, a medical doctor from Turkana and a trainee in our diversity supplement. She will undertake a one-year MPH training at the University of Washington (UW). The advanced training in epidemiology, biostatistics and implementation science coupled with high-quality mentorship by Kenyan and the US faculty will equip her with skills to conduct locally

relevant mental health research and set her on path to be an independent researcher in her home county. We will in addition offer advanced Epidemiology and Biostatistics training to a new trainee from Turkana with a background in statistics and who has interest in research on mental health or diabetes or hypertension comorbidity among PLWH. The trainee will undertake a 3-month

training in Epidemiology and Biostatistics course at UW that will include hands-on data analysis. Thereafter the trainee will undertake a mentored research project that will utilize secondary data from Turkana County. This will build their skills for future research in NCD among PLWH/ The two trainees have diverse educational backgrounds and lived experiences (from living and working in

Turkana county and being of Turkana ethnic background) that can advance research to optimize non-communicable diseases and HIV care in Kenya and at the same time promote inclusion of traditionally underserved population in research.