December 5, 2018 | Erin Bluvas, bluvase@sc.edu

Health promotion, education, and behavior (HPEB) assistant professor Donaldson Conserve has been awarded an R00 grant from the National Institute of Mental Health. The $746,989 award will fund a three-year extension of the two-year K99 grant he received as part of a National Institutes of Health (NIH) Pathway to Independence Award—a training grant designed to facilitate the transition from mentored postdoctoral research to independent research.

Conserve began the K99 phase of his NIH Pathway to Independence Award while completing a postdoctoral fellowship at the University of North Carolina at Chapel Hill with Suzanne Maman. Conserve’s interest in HIV research began when he was undergraduate student participating in the Minority Access to Research Career program at Queens College and the Pennsylvania State University Minority Health and Health Disparities International Training.

Based on these programs, he decided to pursue a doctorate in Biobehavioral Health at Pennsylvania State University under the supervision of doctoral advisor Gary King. Here, Conserve received further training in HIV prevention, treatment and care among multiple populations in the United States, Tanzania, South Africa, and his native country, Haiti.

During the K99 phase of his award, Conserve conducted formative research to examine acceptability and feasibility of unsupervised HIV self-testing among networks of men who socialize in organized social groups referred to as “camps” in Dar es Salaam, Tanzania. Fittingly, this project overlaps with the Tanzania government's recent launch of an HIV testing campaign with a focus on reaching men.   

“HIV testing serves as the gateway to HIV prevention and treatment but remains low among men, particularly in sub-Saharan Africa where men have lower testing rates than women for several reasons, including fear of losing respect, less interaction with the healthcare system, and perceived lack of privacy and confidentiality at healthcare clinics,” explains Conserve. “HIV self-testing has the potential to remove barriers preventing men from testing and increase their HIV testing rates.”

Through the Self-Testing Education and Promotion (STEP) project, Conserve investigates whether HIV self-testing versus testing at a healthcare facility would be an acceptable and feasible means of increasing HIV testing among social networks of men. Based on this initial research, which was recently published in PLOS One, Conserve found that men reported privacy, confidentiality and saving time as their primary reasons for their interest in self-testing. Participants also reported perceptions of a high level of control and self-efficacy to self-test and seek confirmatory HIV testing as well as concerns related to their ability to perform the test and the potential lack of post-test counseling.

Since the initial PLOS One paper was published, Conserve has published a second paper in AIDS Care (focusing on the influence of sexual and social networks) and gave a presentation on the project at the recent American Public Health Association’s annual meeting in San Diego. He has also initiated collaborations with the National AIDS Control Program in Jhpiego, Tanzania and the Tanzania Commission for AIDS to inform the development of the STEP intervention, which will now be implemented during the R00-supported second phase of this research. Conserve and his team will recruit and train young men as peer health leaders about an oral fluid-based HIV self-test known as HIVST. This work is timely as the Tanzania Government just launched an HIV Test and Treat Campaign to reach men with HIV testing services.

While HIVST is an alternative and innovative testing approach recommended by the World Health Organization, Conserve’s preliminary research indicates that men’s willingness to self-test for HIV may be influenced by their social networks. Therefore, he and his team have integrated social networks into the intervention by partnering with peer health leaders.

“HIVST provides an opportunity to identify an alternative testing approach that may increase HIV testing among men and their social networks,” says Conserve. “Once peers have been trained, we will instruct them to educate and promote HIVST among their network members before we evaluate the efficacy of HIVST to increase HIV testing among men versus testing at healthcare clinics.”