PROJECT SUMMARY/ABSTRACT Globally, there were an estimated 36.9 million people living with HIV in 2017. As a result of the increased availability of antiretroviral therapy, life expectancy for these patients has increased, resulting in an expansion and aging of the HIV-infected population. Data from both high- and low-resource countries have shown an escalating burden of heart, lung, blood, and sleep (HLBS) disorders among HIV patients. Care for this now aging cohort requires modifying service delivery models towards the prevention, diagnosis, treatment, and control of chronic HLBS disorders. The successful implementation of various solutions developed in response to the global HIV/AIDS pandemic can serve as the foundation to transform global healthcare delivery systems towards HLBS disorder care. The overarching goals of this Research Coordinating Center are: (1) provide scientific, organizational, statistical, quality control, capacity building and operational leadership for the Implementation Science projects to be funded by the companion RFA-HL-20-025 and (2) promote and teach Implementation Research strategies to advance collaborative dialogue across projects and ensure up-to-date conceptualization, specification and measurement of implementation strategies and outcomes. In support of these goals, we have assembled a highly experienced and multidisciplinary research team. Our team, with expertise in running multicenter trials, dissemination and implementation research, biostatistics and research design, HIV, HLBS disorders, capacity building, and data management, will pursue the following specific aims: 1. To oversee management, organizational, and communication activities across all research sites including working with NHLBI to prepare meeting agendas, develop the study website, provide administrative support for research projects, and organize face-to-face meetings. 2. To collaborate with all research sites in developing the scientific and operational details of their implementation science research protocols. These efforts will include: a. Assisting study sites in designing, testing, and maintaining password protected data entry and management systems and ensuring that such systems implement robust quality control features. b. Harmonizing (a) demographic, clinical, and questionnaire measurements across research sites and (b) the conceptualization and measurement of implementation strategies and implementation outcomes. c. In collaboration with research sites, to statistically analyze harmonized data and to assist in the analysis of site-specific data as reports, manuscripts, and abstracts are prepared. 3. To measure critical contextual Implementation Science factors in each research setting in order to enable conceptualization of the mechanism of effect and, by extension, enable formalized assessments of external validity. To oversee the development and implementation of training and capacity building activities.

PROJECT NARRATIVE The goal of the proposed Alliance is to employ late-stage implementation research strategies to deliver proven- effective interventions for heart, lung, blood, and sleep comorbid diseases and disorders in people living with HIV in low and middle-income countries (LMICs). In support of that goal, our Research Coordinating Center will provide scientific, organizational, statistical, quality control, capacity building and operational leadership. We will do so using a carefully assembled investigative team that has extensive experience and expertise coordinating large multicenter clinical and epidemiologic research projects, in dissemination and implementation research, organizing and implementing training programs in LMICs, and in the critical domains of biostatistics, research design, HIV/AIDS, and non-communicable diseases.