Building Capacity in HIV/TB and Mental Health in Ukraine's Humanitarian Crisis

We propose a multidisciplinary research training model between Brown University (Providence, RI), National University of Kyiv-Mohyla Academy (“NaUKMA;” Ukraine), and the Alliance for Public Health (“Alliance;” Ukraine), in close collaboration with our CFAR partners at Boston University. This initiative will enhance high priority research capacity aiming to improve uniform access to HIV care in humanitarian settings in Ukraine. It will train researchers supporting high quality prevention and care across the HIV care continuum in conflict and post-conflict settings, including the care of persons coinfected with tuberculosis (TB) and other HIV comorbidities, including substance use disorders (SUD) and mental health conditions. Russia’s unjust war against Ukraine has seen unprecedented systematic attacks against health workers and devastating destruction of medical facilities, which has disrupted these processes. Significant rates of internal displacement, affecting over 6 million people, have diminished the availability of medical and research personnel, as well as disrupted treatment for people with HIV (PWH). This is significant as Ukraine has among the highest burden globally of HIV and TB, including multidrug-resistant TB. Expanding clinical innovations in HIV care (including care for people with HIV/TB coinfection and other comorbidities, such as SUD and mental health conditions) is critical to improve health outcomes for individuals in volatile settings. Our training collaboration has potential to develop new models for implementing the HIV care continuum in humanitarian crises. Lessons learned and new models for diagnosis and monitoring, linkage, and maintaining care in settings of severe health systems disruptions are of enormous importance globally. Aim #1: To train a multidisciplinary cohort of Ukrainian researchers working on the HIV care continuum and HIV comorbidities, including TB, SUD, and mental health conditions, in a conflict-affected setting reduced medical infrastructure and large numbers of internally displaced persons (IDPs). We will recruit and train highly promising Ukrainian scholars to pursue advanced degrees, culminating in an HIV-focused thesis (2 doctoral and 7 masters). Aim #2: To strengthen the capacity of Ukrainian faculty and researchers to conduct research in HIV and comorbidities, including innovations in the care continuum that address health systems disruption the specific needs of IDPs, through an innovative faculty fellows training program, with 6-month training provided to 3 Ukrainian faculty. This will encompass clinical, epidemiologic, behavioral, implementation, and laboratory research with funding available for small HIV- focused pilot projects and post-training mentoring. Aim #3: To establish an annual symposium for 20-30 participants for focused research for dissemination of research findings, networking, and enhancing research projects and to develop more intensive one-week training workshops in collaboration with our partners to strengthen research capacity. Modified