South Africa carries one of the largest HIV burdens in the world. On a global scale, nearly 54% of the population living with HIV in low- and middle-income countries reside in eastern and southern Africa, and 13% reside in western and central Africa. The growing prevalence of substance use in South Africa is also associated with poor HIV treatment outcomes and stresses the need to consider substance use interventions as part of HIV care.
Project Khanya, a five-year NIDA K23-funded study, seeks to expand HIV treatment in South Africa through evidence-based interventions for substance use and antiretroviral therapy (ART) adherence. Leading this study is Dr. Jessica Magidson, assistant professor at the University of Maryland and lab director of the Global Mental Health and Addiction Program. Her project will adapt and evaluate the effectiveness of a peer-delivery model of care in which the tasks of the intervention are shared among a team made of people with lived experiences and trained healthcare workers.
In Phase 3 of her study, Dr. Magidson utilized the CHERISH Consultation Service to incorporate a cost-effectiveness component. She worked with CHERISH Director Dr. Bruce Schackman to refine a healthcare utilization questionnaire that captures intervention costs. “Dr. Schackman provided important guidance and expertise at a perfect time in our start-up period,” says Dr. Magidson. “He selected assessments that would be feasible and relevant to the local context, and appropriate for the aims and stage of our work.” Dr. Schackman also provided additional cost-effectiveness resources and training for her to build on.
In March 2020, Implementation Science Communications published Dr. Magidson’s study protocol on Project Khanya. She credits the CHERISH Consultation Service for contributing to her success and has since initiated another consultation to prepare her R01 grant proposal. Following her K23 study, Dr. Magidson’s R01 proposal will continue to assess the value of using peer support and a stepped-care approach to improve HIV care and reduce substance use in Cape Town, South Africa.
“I feel fortunate to have benefited from the initial design consultation that provided strong pilot data for the upcoming R01 submission,” Dr. Magidson shares. “Dr. Murphy at CHERISH is now helping to conduct an economic evaluation using the assessment measures recommended by Dr. Schackman, which we plan to submit for publication. After this consultation, I look forward to collaborating with the team — hopefully with a funded R01 from our pilot Khanya trial!”
The Methodology Core at CHERISH offers consultation to researchers on the design and implementation of observational and interventional studies related to treatment interventions for substance use disorder, HCV, and HIV, to ensure that planned economic analyses are sound and feasible. To request or learn more about the CHERISH Consultation Service, visit https://cherishresearch.org/consultation/.