PROJECT SUMMARY/ABSTRACT Despite the highest Kaposi’s sarcoma (KS) burden in the world, treatment outcome data is scarce in sub- Saharan Africa (SSA), making meaningful comparisons of SSA with other regions difficult. The 5-year survival rate of HIV-associated KS is reportedly as low as 9%. Failure to keep PLWH closely connected to healthcare beyond ART leads to loss of follow-up that contributes to poor treatment response and outcomes. Reports in SSA have documented up to 40% loss to follow-up leading to poor data quality and making outcome measures unfeasible. Lack of proper documentation of sociodemographic, clinicopathological characteristics, and objective assessment of treatment responses and outcomes have led to the limited interpretation of outcomes in SSA. Currently, ORCI attends ~120 KS patients annually, however, it is evident that there is a limited linkage between HIV and KS care leading to the scattering of important clinical and outcome information. Therefore, there is a need to develop, test, and implement strategies to enhance the linkages and outcomes. This need is further compounded by a lack of well- trained researchers in HIV-associated cancers to address this area of need. We are proposing to mentor a junior oncologist who can lead a study in establishing a clinical cohort of KS patients at Ocean Road Cancer Institute (ORCI) in Tanzania, and test whether the engagement of the HIV care and treatment clinic (CTC) and community healthcare workers enhance follow-ups of KS patients and improve data on KS treatment response and outcomes. We have now identified a talented junior oncologist who is committed to a clinical and operational research career in HIV-associated cancers to lead the proposed study. We hypothesize that surrounding KS patients with a clinical team that maintains contact and answers questions will enable the investigation of short- and long-term outcomes in KS treatment and will help define barriers against and facilitators of connection to care. To test this hypothesis, the project team will: a) determine socio-demographic and clinical characteristics of a cohort of Kaposi’s sarcoma patients at ORCI, b) determine the treatment patterns and outcomes of Kaposi’s Sarcoma patients in relation to sociodemographic and clinical characteristics, and c) evaluate barriers and facilitators of retention in care for KS patients attending ORCI. The proposed supplement project is significant as it provides a unique opportunity for a new investigator to acquire new skills in HIV clinical, operational, and implementation research as a stepping-stone to embark on HIV/AIDS research career and improve research capacity in Tanzania. Moreover, the study will provide outcomes and barriers information for future HIV research studies, and for designing strategies to improve the health outcomes of PLWH in Tanzania and beyond.

NARRATIVE Despite the highest Kaposi’s sarcoma (KS) burden in the world, treatment outcome data is scarce in sub- Saharan Africa (SSA), making meaningful comparisons of SSA with other regions difficult. This application provides a unique opportunity for a new investigator to acquire new skills in HIV clinical research through a mentored project focusing on KS, to develop, test, and implement strategies to enhance the linkages of KS to care and to enhance the disease outcomes. This supplement project will provide career development opportunity and improve research capacity in Tanzania as well as generating information that will be crucial in designing future strategies to improve health outcomes for PLWH in SSA.