Project Summary Dr. Gabriel Chamie is an infectious diseases physician and Associate Professor of Medicine in the Division of HIV, Infectious Diseases and Global Medicine at the University of California, San Francisco (UCSF). His research has focused on developing effective approaches to promote community-based diagnosis of HIV, TB and SARS-CoV-2, and engagement in HIV and TB prevention and treatment, with a more recent focus on persons with unhealthy alcohol use in East Africa. He has over a decade of experience mentoring numerous early-stage investigators (ESI), including pre- and post-doctoral investigators and junior faculty, and now seeks the protected time of a K24 award to focus greater attention and time on mentoring, mentorship training and expanding his research program at the intersection of HIV and alcohol use. In this application, Dr. Chamie proposes a comprehensive mentorship, mid-career development, and research plan to address the challenge of reaching and engaging populations at increased risk of HIV in biomedical HIV prevention from alcohol drinking venues in East Africa. Despite a growing number of efficacious biomedical HIV prevention options, a major challenge remains reaching persons at highest risk of HIV – such as adults at alcohol drinking venues – who do not routinely engage in medical care, to overcome barriers to HIV prevention initiation and retention, including alcohol use. To further develop and expand his patient-oriented research (POR) program and mentoring, he proposes mid-career training in methods that support the application of quantitative preference elicitation and human-centered design for intervention development, and additional training in mentorship. Leveraging the infrastructure of his recently awarded R01 (the OPAL trial) and the ongoing SEARCH- SAPPHIRE trial, Dr. Chamie proposes research in this application to: a) elicit preferences for biomedical HIV prevention service delivery among adults at high risk of HIV who attend drinking venues in rural Kenya and Uganda, b) to adapt the SAPPHIRE trial’s clinic-based “dynamic PrEP/PEP choice” intervention for community- based delivery to this population at or near drinking venues, and c) to assess uptake, retention, and adherence to biomedical prevention in a pilot trial of community-based biomedical prevention delivery among adults who attend or work at drinking venues in rural Kenya and Uganda. With the guidance of an experienced senior mentorship team, Dr. Chamie will utilize multiple ongoing research projects, and long-standing research collaborations between UCSF and Makerere University in Uganda and the Kenya Medical Research Institute in Kenya, to provide mentees with a robust infrastructure on which to develop their research interests and support US-East African ESI partnerships in POR. The K24 award is instrumental to supporting him in achieving his long-term goals of becoming a global leader in HIV and alcohol use research and mentoring future leaders in patient-oriented research from the US and East Africa.

Project Narrative Alcohol use is a common risk factor for both HIV acquisition and poor uptake and use of effective biomedical HIV prevention options, including pre- and post-exposure prophylaxis, in sub-Saharan Africa. Moving HIV services out of health facilities and into community settings is a key innovation that has increased reach and engagement in HIV testing and treatment services, but remains underdeveloped for biomedical HIV prevention services. This K24 award will support Dr. Chamie by providing him protected time to mentor early career researchers with an interest in patient-oriented research at the intersection of HIV prevention and alcohol use, including community-based HIV prevention for adults at alcohol drinking venues, in East Africa.