Ford School professor Dean Yang will conduct research on antiretroviral adherence in Mozambique. Yang and his collaborators will study interventions aimed at increasing therapy use among HIV-positive individuals. It is a continuation of research he has been doing in Mozambique since 2019.
Through the African Social Research Initiative (ASRI), Yang was awarded a seed grant for his collaborative work titled “Interventions to Improve HIV Antiretroviral Therapy Adherence in Beira, Mozambique.” Yang and his collaborators have recognized that adherence to antiretroviral treatment is far lower than it ought to be among HIV positive individuals.
The African Studies Center (ASC) at U-M has a deep commitment to fostering collaborative research and scholarship in Africa, and with its scholars. Through its seed grant competition, the ASC supports early-stage joint research projects bringing together U-M faculty and researchers affiliated with universities on the continent. The ASC wants to showcase the breadth of that scholarship and to encourage other U-M-based scholars to consider applying for a seed grant award with one or more colleagues on the continent.
Speaking to ASC, Yang outlined the problem he and his research team seek to understand and improve. “There are a huge number of questions around why people do not adhere at the levels they need to.” When people do not adhere to the treatment by missing more than one day a month it is “problematic in terms of one’s own health and problematic in terms of (HIV) transmission. Imperfect virus control means one is more likely to transmit it to others. Also, non-adherence leads to viral strains that become resistant to the medication.”
Yang told ASC that he and his collaborators have a sample of 1000 HIV positive individuals who are just beginning their treatment. In order to promote higher levels of adherence, the research team is assessing different possible interventions. Some individuals will receive “standard of care” treatment, while others will get a reminder call once a month to take their medication. Other interventions will include financial incentives to refill medication on time, and a combination of phone calls and incentives. Additionally, different groups of people will be exposed to an anti-stigma treatment, or they will receive detailed information on antiretroviral therapy treatment or will receive both information and the anti-stigma programming. These interventions will be run in order to understand the barriers to adherence to antiretroviral therapy treatments.
Yang said they will elucidate whether non-adherence occurs because of lack of information, stigma, or barrier costs like time away from work. Ultimately, this project aims to “understand how to remove barriers to antiretroviral adherence in order to address one of the most important public health issues worldwide.”
Despite COVID-19, Yang mentioned how the research has proceeded smoothly and all in-person collections and interactions are now being conducted by phone. This project is committed to being a collaborative one, and Yang emphasized the importance of the team that is committed to understanding and improving HIV antiretroviral therapy adherence in Beira: Hang Yu (Peking University), James Riddell (U-M), Arlete Mahumane (Beira Operational Research Center), and Jared Stolove (BA '20), who is now working on this project as a co-author and was previously awarded ASC funding to conduct undergraduate work in Mozambique for this project.