The UPTAKE consortium came together for the long-awaited first in-person meeting in Kampala, Uganda from 11-13 April. This followed 18 months of online meetings since the start of the study in November 2020 in the midst of the COVID-19 pandemic. Twenty-nine team members, representing all partners, attended the three-day workshop in-person, with others tuning in online, for more than a dozen dynamic sessions to share progress, team build, and review and strengthen project management structures and partner roles. A site visit on the third day to the AIDS Information Centre in Kampala, which hosts the MUL team, was a particular highlight, providing important context on the services and communities that the study seeks to benefit.
The below executive summary provides a high-level overview of the meeting by subject area and is supplementary to the full meeting report
As attendees settled in for the first day following introductions by Yvonne Wangũi Machira (IAVI), Ivy Kayesu (MUL) and Bernadette Kina (KAVI-ICR), shared an overview of the Stage 1 preliminary findings. Forty-seven transcripts have so far been analysed since the completion of the in-depth interviews with end users and key informants, exploring the awareness, influencing factors, and accessibility of existing family planning (FP) and HIV prevention products and future long-acting (LA) technologies. Discussions were fruitful, with attention paid to the self-efficacy of participants, power dynamics between partners and clients, and the influence of awareness of PrEP toward future LA technologies. Analysis of the remaining transcripts is underway, with the findings to inform the upcoming stages.
Stage 2, which seeks to design and improve uptake of new interventions by understanding existing and potential users of current HIV and FP products, was addressed through several sessions during the first two days. First up, Lang Gao (Busara) provided an overview of the quantitative behavioral design methods, which include a quantitative survey, discreet choice experiment, and behavioural lab experiment. The resulting end user segmentation will be key to informing Stages 3 and 4. A complementary discussion on ethical considerations led by Stephen Muhudhia (IAVI consultant) largely explored identifying and addressing social harm, such as through establishing a referral arrangement for counselling in cases where social harm is invoked.
On the second morning, Brian Baraza (Busara) presented on the implementation design and partnership arrangements. The discussion focused on recruitment and data collection, including the hiring and training of enumerators, access to mobile phones by participants, and the possibility of an online portal for confidential screening. Peach Indravudh (LSHTM) then led a review of the Discrete Choice Experiment (DCE), which will use the joint attributes of HIV and pregnancy to explore preferences of products, services, and facilities. The content of the DCE will be further refined and supporting resources, such as digital health tools for health care professionals, are under consideration.
Stages 3 and 4
With the proposals still under development, the team spent considerable time discussing the design and preparations for Stages 3 and 4, which are set to take place concurrently. Stage 3 involves the design and evaluation of an intervention, while Stage 4 will model the cost-effectiveness of products and the intervention. The discussion focused largely on the feasibility of including long-acting cabotegravir (CAB-LA) and the dapivirine ring (DR). It was noted that a descriptive study without new products that uses oral PrEP as a proxy is more feasible and would provide important insights on access to and use of services. Ahead of finalising the protocols for Stages 3 and 4, the teams at KAVI-ICR and MUL have been tasked with assessing the feasibility of procuring CAB-LA and/or DR in the context of time, budget, and product availability constraints.
The four scholars (2 PhD and 2 MSc) enrolled at LSHTM updated the team on day 1. All are progressing well, with Kenneth Katumba (PhD candidate, MUL) having completed his upgrading with a conditional pass and Laura Lusike (PhD candidate, KAVI-ICR) preparing for her own. The purpose of the upgrade is to assess the scholars’ progress and ability to complete their PhD programme in a reasonable time frame. Laura also led the successful submission of a poster presentation for AIDS 2022 in July. The scholars continue to work closely with the study leadership to identify opportunities to develop their leadership and research skills.
In light of earlier COVID-related delays, the team seeks to apply for a no-cost extension. Marcel Stahl (IAVI) joined via videocall on day 1 to discuss this, also noting that to avoid further delays and meet the EDTCP2 timeline, the proposals for Stages 3 and 4 will need to be finalised in the coming months so both Stages can commence later this year.
Anatoli Kamali (IAVI) later led a discussion on the project management structure and partner roles, where he stressed the importance of ongoing co-creation, communication, and review in facilitating equitable partnerships. The need to shift power to experts in the field in global health research was also raised, with requests for clear procedures and guideline documents to support this.
Activities under the dissemination, exploitation, and communication plan were reviewed by Shaun Palmer (IAVI). Milestones reached so far include the launch of the project website, the first issue of the consortium newsletter, three blog posts, and a poster presentation at the 10th EDCTP Forum in October 2021. Supporting resources, including publication guidelines, are under development, as well as video content featuring interviews with team members during the workshop.
The workshop provided a long overdue opportunity for the team to come together and collaborate face-to-face. While there is much work still to be done, the team left Kampala having made important progress in designing the remaining stages and identified key next steps to help advance the study. Further, while virtual meetings will remain the principle format for UPTAKE, the workshop serves as a reminder of the value of meeting in-person to facilitate motivation, ownership, and interpersonal connections that are key to effective collaboration.