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In collaboration with the Caribbean HIV/AIDS Alliance and Intrahealth, CAPS is working in four Eastern Caribbean countries to enhance the response to the HIV/AIDS epidemic. The USAID-funded Eastern Caribbean Community Action Project (EC-CAP) supports prevention, development and use of strategic information, roll-out of community-based counseling and testing, and provision of care services (palliative and home based care). As one of three partners, the CAPS team’s specific aims are:

1. To identify the barriers and facilitators to access and delivery of HIV prevention, testing, and treatment services (Antigua-Barbuda, Barbados, St. Vincent-Grenadines)
2. To assess the feasibility and acceptability of prevention interventions for different population groups at risk for HIV (St Kitts-Nevis, Barbados)
3. To provide technical support and capacity building to improve regional, country and programmatic monitoring and evaluation (M&E) systems for assessing the quality and impact of HIV services (all countries)

CAPS is providing specific expertise and technical support to design a series of special studies to:

• Describe HIV risk and health seeking behavior
• Conduct studies on implementation and scale-up community-based HIV counseling and testing
• Train local prevention providers on monitoring and evaluation systems, data use and program planning
• Provide local organizations with technical assistance in strategic information, package findings and recommendations of the evaluations into best practice publications
• Disseminate the publications at the international, regional, and national level

Since 2002, the Institute for Global Health (IGH) has helped CDC’s Global AIDS Program (GAP) to achieve its goals in GAP countries and regions. UCSF faculty and staff have provided technical assistance in several broad component areas including surveillance, monitoring and evaluation, technical and scientific writing, literature digests and reviews, and research design. Our overall goal is to assist GAP to assist countries and regions to reduce HIV transmission, to improve HIV/AIDS care and treatment and to collect and use data to manage national programs effectively and allocate resources rationally, all in a way that builds long-term capacity and sustainability. Beginning in 2009, we plan to build upon these activities, including:

• Development of guideline and resource documents
• Provision of regional training opportunities for country and regional offices
• A series of other technical assistance and capacity-building activities, such as:
  • Surveillance training
  • Monitoring and evaluation
  • Evidence-based HIV prevention strategies
  • Laboratory quality assessment
  • Systems strengthening to address the human resource needs for provision of high-quality HIV treatment and care

In this project we will develop, pilot and evaluate a curriculum for improving HIV research counseling and testing (HRCT) skills among staff working in international prevention and treatment clinical trials. Guided by an assessment of acceptability and feasibility among clinicians and counselors, we are developing a novel self-directed learning (SDL) curriculum including a DVD/e-Learning approach and an enhanced component for training supervisors to support on-going HRCT (train the mentors or TOM). The SDL curriculum and the TOM will be piloted with a sample of trial sites in Peru and South Africa. To measure the relative effectiveness of the two training conditions (SDL alone and SDL plus TOM and supervisor support) we will use an on-line tool able to detect changes in trainee knowledge and competency to conduct risk reduction counseling before and after the training.

The aim of this project is to better understand the capacity of CBOs to conduct outcome monitoring of the Mpowerment Project (MP) for the purpose of improving their implementation of the intervention. To this end, we will collaborate with the Centers for Disease Control and Prevention (CDC) and the three CBOs funded under the CDC FOA 09-947 to participate in this project. We will do this by:

• Assisting the CDC and the three CBOs to assess the feasibility of conducting outcome monitoring of the MP by collecting individual-, program-, and community-level data during a 30-month project period
• Providing expert technical assistance related to the implementation and outcome monitoring of the MP in the form of consultations with the CDC
• Conducting site visits at each of the three CBOs during their community assessment data collection phase
• Conducting reviews of the community-level assessment data that CBOs will collect once annually
• Providing input on the quality of the outcome monitoring data collected by the three CBOs, highlighting ways outcome monitoring data can be used to improve implementation of the MP
• Assisting the CDC in interpreting, summarizing, and reporting the findings of the outcome monitoring activities described above to both the CBOs and the CDC
• Drafting a comprehensive report of the project’s findings, with recommendations for the CDC and the CBOs regarding future implementation and outcome monitoring of the MP

CAPS and the AIDS Project East Bay (APEB) will build a coalition of health sciences investigators at UCSF, community-based organizations that serve the African American community, and community members to answer significant scientific STI/HIV research questions. We aim to:

• Develop a research coalition to identify significant research questions and design, implement and disseminate appropriate and scientifically-rigorous research projects that address STI/HIV health disparities in the African American community
• Increase the capacity of the members of the research coalition to participate in community collaborative research projects through relationship building activities, specialized trainings and forums
• Develop an electronic infrastructure to support, grow and ensure sustainability of the coalition and activities by archiving coalition trainings and forums, facilitating communication among coalition members, and providing a forum for support and problem-solving among the subgroups of the coalition
• Stimulate and develop innovative research by providing funding to conduct pilot research that will yield data for collaborative presentations at national conferences and provide preliminary data for use by academic and CBO researchers when submitting future R01 grant proposals to NIH.