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As our country teams have begun preparing to resume some study activities, our team in Uganda has redesigned their offices to limit the spread of the COVID-19 virus and received training on how to screen and report suspected cases to the Masaka District surveillance office. These skills were put to use during the Kyaterekera study’s quarterly Community Collaborative Board meeting, where participating stakeholders had to undergo screening and to observe social distancing measures. At the request of study participants, the SMART Africa-Ghana team is also looking into resuming their Multiple Family Group sessions. Also featured below are some profiles of our Uganda staff’s amazing journeys. You can see the pipeline and commitment of young researchers in Uganda through this talented team.
Speaking of a pipeline, our three (temporarily online) training programs are in full swing as our 25 fellows have completed their first three weeks of training. This has included lectures on health disparities, community engagement as well as sessions on preparing NIH grant applications and manuscripts. We look forward to continuing this packed agenda over the next month or so.
We are also pleased to announce that ICHAD Director Fred Ssewamala and ICHAD Co-Director Proscovia Nabunya have received a new R21, “Suubi4Stigma: Addressing HIV-Associated Stigma Among Adolescents” funded by the National Institute of Mental Health. This grant will examine the feasibility, acceptability and preliminary impact of two evidence-based interventions, Group Cognitive Behavioral Therapy and Multiple Family Group, to address HIV/AIDS associated stigma among adolescents living with HIV in Uganda.
Our teams have used their “break” from study implementation to focus on dissemination activities, and we are pleased to share that four new publications have come out this month. Two of them feature our SMART Africa-Kenya colleagues, Dr. Anne Mbwayo who examined teachers’ perspectives of mental health in Kenyan schools and Dr. Manasi Kumar, who looked at how COVID-19 has impacted pregnant teens in Kenya. Dr. Fred Ssewamala, along with ICHAD Affiliate Larissa Jennings Mayo-Wilson published an article in AIDS and Behavior that examines the effects of a microenterprise intervention on economically-vulnerable African-American young adults. Finally, Drs. Fred Ssewamala, Proscovia Nabunya, Ozge Sensoy Bahar, ICHAD Affiliate Dr. Patricia Cavazos, and PhD Student William Byansi had a publication in AIDS Care that examines the HIV disclosure among in- and out of school adolescents and the effects it has in terms of social isolation, depression and adherence to prescribed medication. More details can be found below.
We wish you all continued health and happiness!
Best regards,
The ICHAD and SMART Africa Teams
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UPDATES FROM THE FIELD
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The Kyaterekera Study team holds their first socially distanced Community Collaborative Board meeting in Masaka, Uganda to discuss study implementation in the time of COVID-19
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Kyaterekera Project
The Kyaterekera Project is focused on reducing new incidences of sexually transmitted infections and HIV, among women engaged in sex work in Uganda, through a combination of economic empowerment, vocational skills training, and HIV risk reduction (HIVRR) sessions. On June 17th, 2020, the Kyaterekera Project held its third quarterly Community Collaborative Board (CCB) meeting, which was held virtually on Zoom. Ten CCB members were joined by the study team in the US (Washington University in St. Louis, Columbia University, Indiana University, and New York University). The meeting sought to share study progress, discuss implementation challenges, experiences of study participants during COVID-19, and plan a way forward.
The women representatives discussed the impact of COVID-19 on their lives and highlighted the financial challenges they have encountered, mostly due to national restrictions placed on truck drivers, one of their main clients. Unfortunately, the majority of COVID-19 cases in Uganda have been confirmed among truck drivers, putting the women at a higher risk of contracting the virus. The ICHAD teams pledged to help the study participants with financial support to meet the cost of basic needs, especially food. Should you wish to provide financial assistance to the participants, please go to our website at https://ichad.wustl.edu/donate.
In terms of study progress, the study team is moving to telephone interviews for follow-up assessments as guided by local IRBs: Uganda Virus Research Institute (UVRI), and the Uganda National Council for Science and Technology (UNCST). The team is currently receiving telephone interview training conducted by the study MPI Dr. Ssewamala. Other field activities will resume with time as the lockdown is being eased.
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Left: ICHAD team members practice taking one another's temperature to ensure workplace safety;
Right: Safety dividers are placed at the main reception desks and conference rooms to ensure staff safety
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ICHAD Uganda: COVID-19 Preparedness Training and New Safety Measures
This month the ICHAD Uganda team received training from Mr. Kaggwa Emmanuel, the District Surveillance Focal person about proper use of thermometer guns. Body temperature readings are one important method to screen for coronavirus symptoms, with normal body temperature ranging between 36 and 37.5 degrees celsius. He also explained the role the Masaka COVID-19 Task Force plays in surveillance. In brief, once the surveillance office receives an alert call, they go to the suspected person’s home. If that person has a confirmed positive test, they provide counseling and allow them to make the necessary arrangements (e.g. identifying who will take responsibility for their homes/animals/finances) before taking them to the local Isolation Centre. If the person tests negative but was in contact with an infected individual, they take them to the institutional quarantine. The ICHAD team was taught how to properly use the temperature gun to avoid spreading COVID-19. Recommendations include:
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Keep a safe distance but position the gun so it is close, but not touching the person;
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Don’t face the thermometer directly at the person;
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Keep the thermometer in a cool place because when it is exposed to excessive heat it will not read the temperature;
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Clean the gun with wipes or sanitizer in case it touches the body.
The training was very informative and the team was able to screen and take thermometer readings for individuals attending the Kyaterekera Community Collaborative Board (CCB) meeting. (See above).
In addition, ICHAD and SMART Africa office spaces were recently restructured and repurposed to prepare for participant follow-up phone interviews, but also to ensure safety of all staff.
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UPDATES FROM ICHAD AND SMART AFRICA
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ICHAD Receives a New NIH Award to Explore Interventions to Reduce HIV/AIDS Associated-Stigma in Adolescent Populations in Uganda
Congratulations to ICHAD Director, Dr. Fred Ssewamala and ICHAD Co-Director, Dr. Proscovia Nabunya, on their new R21 award, “Suubi4Stigma: Addressing HIV-Associated Stigma Among Adolescents” funded by the National Institute of Mental Health. Stigma, a common experience characterized by public blame, moral condemnation and discrimination, has been documented as one of the main challenges to slowing the spread of HIV, and preventing individuals from testing and seeking health care. The Suubi4Stigma study will examine two evidence-informed interventions: 1) group cognitive behavior therapy (G-CBT) that aims at cognitive restructuring and strengthening coping skills at the individual level, and 2) multiple family group (MFG) that strengthens family relationships intended to address HIV-associated stigma at the individual level and within families. More specifically, the study will test the feasibility, acceptability and preliminary impact of both interventions on reducing HIV-associated (internalized and family-level) stigma and its impact on youth and family-level outcomes (stigma, trauma symptoms, depression, sexual risk, family/social support and adherence to medication). The study will also qualitatively examine participants’ and facilitators’ intervention experiences, and identify multi-level facilitators and barriers to G-CBT and MFG intervention implementation and participation. ICHAD Co-Director, Dr. Ozge Sensoy Bahar will serve as a Co-Investigator on this study and will lead the qualitative component.
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A Word from (some of) our Ugandan Team Members
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"I joined ICHAD in May 2018 as a driver. This opportunity gave me a chance to meet and interact with various people. It also opened up my mind in different aspects in the research field. Through good clinical practice and other human subjects protection trainings, I learned how to work with, protect, and interact with study participants, as well as handle participants’ data. Following the training, I was given an opportunity to be one of the data collectors in the field. The hospitality from my supervisors and workmates have made me comfortable in my new role and in ICHAD family. At the beginning of 2019, I was able to join Muteesa I Royal University to complete my undergraduate studies. Special thanks to Professor Fred for continuous support and mentorship."
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Ivan Menya,
Research Assistant and Driver
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"I had no prior experience working with children affected by HIV before I joined ICHAD, and through my work, I witnessed huge numbers of children and families affected. I came to know how people are struggling with poverty during my home visits under the Suubi+Adherence study which sought to improve antiretroviral therapy (ART) adherence among HIV-infected adolescents in Uganda and assessed the impact of a family-based economic empowerment intervention on adherence to ART. ICHAD has also trained me to work with communities of different backgrounds. I also gained knowledge about income-generating activities, including how I can start a small business with my family. The ICHAD team has been very supportive and I learned a lot through the various trainings which have made me grow professionally."
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Jane Namulindwa,
Administrative Assistant
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"I joined ICHAD in 2004 as a study participant under the SEED Project, and in 2012 worked as a student research assistant while pursuing my studies at Muteesa 1 Royal University. I was given a job as a full time staff in August 2016. I am really very proud to work with ICHAD. At the beginning, I had no research experience but I have gained a lot of skills and knowledge about research field activities from different studies. As a result of the multiple family group intervention, a key component of the SMART Africa and Suubi4Her studies, my family practices the 4R’s (Rules, Responsibility, Respectful Communication, and Relationships)."
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Scovia Nassaazi,
Research Assistant
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"Working with ICHAD has made my life different. I have acquired knowledge and skills through various trainings like good clinical practice, the Amaka Amasanyufu (MFG) intervention among others. I came to realize the importance of life when I interacted with children infected with HIV during the Suubi+Adherence study. As a mother, I have learned that listening and talking with children is vital and a leading cause of success in the family."
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Nantaba Applonia,
Medical Nurse and Research Assistant
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"Way back in 2013, I joined the great ICHAD team as a research assistant in the IT department. It was a great opportunity for me to practice what I studied in school. ICHAD has given me an opportunity to grow in all professional aspects. I have engaged in different activities including data entry, interviews, home visits, IT management and logistics. I am currently the deputy study coordinator on the Suubi4Cancer study. There is no doubt, the sky is the limit for me at ICHAD. I have been able to learn more about economic empowerment through the various studies. Due to the income generating activities that we delivered in the Bridges and Suubi+Adherence studies, I started a pig farm which after more than a year is still growing. ICHAD has given me the chance to meet with professional people including Professor Fred Ssewamala (who I refer to as my role model), colleagues and those outside the circle. I have been given an opportunity to travel on professional trips outside Uganda. For example, in 2015 I attended a Wisepill device management training in South Africa (for the Suubi+Adherence study) and there are likely more opportunities like this in the future. I enjoy the work I do at ICHAD because I have a passion for working with and helping others which I see we are doing under the various interventions. I want to have a positive impact on those who need help. I am grateful for the opportunity to be part of a profession that reaches out to our most vulnerable populations and strives to make a difference in so many lives. My next move is furthering my education in an area that will ground me towards my dream."
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Herbert Migadde,
Deputy Study Coordinator
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"I joined ICHAD in 2013 as a part-time interviewer where I worked on several studies. However, in 2019, I got an opportunity to become a full time staff member. I have gone through different trainings such as good clinical practice, and human subjects which have not only shaped my professional life, but also challenged the way I think and see things in day to day life. Generally, having a job with ICHAD is one of the best things that has ever happened in my life - working and living with people of different expertise!"
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Martina Nakanwagi, Research Assistant
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"I joined ICHAD in August 2012 as a receptionist, and then took on more responsibilities in data collection and entry after gaining more experience in field activities. Later I built my self-confidence and became a trainer of trainers. While at ICHAD, I have grown professionally and acquired various skills and opportunities among which are: facilitation and training skills, data entry and management, social networking opportunities, opportunities to attend conferences and training sessions within and outside Uganda, among others."
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Betina Nabisere,
Research Assistant
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Congratulations to ICHAD Associate Director Betsy Abente, for being selected to participate in FOCUS STL, the Saint Louis region’s premier civic leadership organization. FOCUS prepares a diverse base of leaders to work cooperatively for a thriving St. Louis region through a nine-month experience-based leadership training, civic issue education and public engagement initiatives. Please join me in congratulating Ms. Abente for being selected to this prestigious group.
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CAPACITY BUILDING
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Representatives from the NIH present a training session on mission and funding opportunities
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ICHAD Training Programs
The ICHAD/SMART Africa training programs launched the 2020 summer training session on June 8 with a Zoom orientation meeting bringing together all 25 trainees from the three training programs: Researcher Resilience Training (RRT), LEAD Global Training Program (LEAD), and CHILD-Global Research Fellowship (CHILD-GRF). Trainees from across the US and Uganda met each other and shared their research interests, met the program directors and staff, and became oriented with the rigorous multi-disciplinary training schedule for the 8-10 weeks ahead.
Dean Mary McKay, Neidorff Family and Centene Corporation Dean of the Brown School, and Co-Principal Investigator for RRT and CHILD-GRF, facilitated a discussion with the trainees based on her series of lectures on community participation and collaboration in research. The trainees enjoyed learning from Dean Mary’s decades of experience as a community-based mental health researcher and reported gaining new inspiration and ideas to apply to their early careers.
Trainees also attended a webinar co-presented by Dr. Patricia Cavazos-Rehg, LEAD Co-Director and Professor of Psychiatry at Washington University School of Medicine, and Dr. Elvin Geng, Professor of Medicine at Washington University School of Medicine. Together they explored topics in US-based and global health disparities. Other highlights for June include participating in the Brown School’s Summer Institute classes, networking within and beyond their training groups, and participating in webinars with program officials from the National Institutes for Health. Trainees are prepared to continue engagement and transformation with a full July schedule of lectures, discussion, meetings and presentations.
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Supporting CHILD-Global Research Fellows
On June 11, mentors and technical advisory committee (TAC) members for the CHILD-Global Research Fellowship program met for the first time on a zoom call. Mentors and TAC members represent institutions including Makerere University, Rakai Health Sciences Program, Mildmay Uganda, Reach the Youth Uganda, and Kyambogo University. These nine national and global experts will support and mentor our seven first year CHILD-GRF trainees whose research will focus on child mental health and HIV in Uganda.
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Grant supports research on “Real-time assessments of suicidality among Black men: A mixed methods approach"
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Leslie Adams, PhD, MPH, receives grant to study suicidality among Black men
Researcher Resilience Training (RRT) fellow Leslie Adams, PhD, MPH has been awarded a two-year grant from the American Foundation for Suicide Prevention to support her research, titled “Real-time assessments of suicidality among Black men: A mixed methods approach.” This grant will allow her to pursue a mixed methods study in which she will incorporate digital health and smartphone technology to better identify suicide risk in real-time among Black men. Dr. Adams will collaborate on the award with her RRT mentor Dr. Sean Joe the Benjamin E. Youngdahl Professor of Social Development in the Brown School at Washington University and a nationally recognized authority on suicidal behavior among African Americans. Dr. Adams’ research interests include relationships between discrimination, depressive symptoms, and health services utilization using a mixed methods and community-engaged approach. Particularly, she explores the intersections between masculinity, racial identity, and mental health service disparities among Black men.
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Congratulations to William Byansi for Passing Qualifying Exams
Researcher Resilience Training (RRT) fellow William Byansi, MSW, recently completed his qualifying exams, which will allow him to continue on with the next phase of his PhD program. Please join us in congratulating William on this important achievement!
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Congratulations to ICHAD and SMART Africa Center members Drs. Fred Ssewamala, Proscovia Nabunya, Ozge Sensoy Bahar, ICHAD Affiliate Dr. Patricia Cavazos, and PhD student William Byansi for the recent publication “The impact of discomfort with HIV status and hopelessness on depressive symptoms among adolescents living with HIV in Uganda” in AIDS Care. The publication examines the relationship among the level of discomfort with in-school and out-of-school adolescents disclosing their HIV status as well as the effects it has in terms of social isolation, depression and adherence to prescribed medication. Findings indicate that out-of-school adolescents are more likely to suffer depression as compared to in-school adolescents. As adolescents grow older, they become anxious about the future and that contributes to depressive symptoms and poor adherence to medication. You can find the full publication here.
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Please join us in congratulating Dr. Fred Ssewamala and ICHAD Affiliate Dr. Larissa Jennings Mayo-Wilson on their recent publication “Microenterprise Intervention to Reduce Sexual Risk Behaviors and Increase Employment and HIV Preventive Practices Among Economically-Vulnerable African-American Young Adults (EMERGE): A Feasibility Randomized Clinical Trial” published in AIDS and Behavior. The paper explores the feasibility of conducting a randomized clinical trial of a 20-week microenterprise intervention for economically-vulnerable African-American young adults. The experimental group received text messages on job openings plus educational sessions, mentoring, a start-up grant, and business and HIV prevention text messages. The comparison group received text messages on job openings only. The trial demonstrated feasibility of the experimental and comparison interventions with promising changes in employment and HIV-related outcomes. Design of an effectiveness trial should take into account the study’s lessons learned with regard to intervention duration, screening, and measurement as these are likely to be important to the success of a larger study. You can find the full publication here.
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SMART Africa-Kenya In-Country PI, Dr. Anne Mbwayo recently published an article in Global Social Welfare titled “Mental Health in Kenyan Schools: Teachers’ Perspectives.” In this qualitative study, Dr. Mbwayo and her colleagues interviewed public primary and secondary school teachers in Kenya, to better understand the teachers’ experience with mental health problems in schools and how they are handled. Results indicate that teachers are aware of many problems including disruptive behaviors, internalizing or externalizing problems, and substance abuse, yet lack the time and skills required to deal with student mental health problems. You can find the full publication here.
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Congratulations to Dr. Manasi Kumar, SMART Africa-Kenya Co-Investigator and Senior Lecturer and Clinical Psychologist in the Department of Psychiatry at the University of Nairobi, whose impactful work was recently featured in the NIH’s Fogarty International Center’s monthly newsletter. Since the pandemic began, Dr. Kumar has shifted the focus of her research to examine how COVID-19 has affected pregnant teens in Kenya. The results were sobering with a reported increase in food insecurity and gender-based violence as well as increased unemployment and lack of transportation, making it difficult to access health services. As a result of these findings, Dr. Kumar is working with local officials to set up a mental health hotline. You can find the full publication here.
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OPPORTUNITIES
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ICHAD OPPORTUNITIES
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Postdoctoral Fellowship
The T37 LEAD Global Training Program is accepting applications for a 1-2 year postdoctoral fellow. The LEAD Global Fellowship supports trainees from underrepresented groups committed to conducting health disparities research, with a specific focus on global mental health prevention, intervention, services, and implementation research within resource-constrained settings. Eligible candidates should be a U.S. citizen, non-citizen national, or permanent resident, and be from a disadvantaged or underrepresented population in biomedical, behavioral, clinical & social science research as outlined by the NIH. Applications will be accepted on a rolling basis and can be completed on the T37 LEAD Global Fellowship website at https://sites.wustl.edu/lead/apply/. For more information, contact Laura Peer at lpeer@wustl.edu.
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SARS-CoV-2 is a new virus responsible for an outbreak of respiratory illness known as COVID-19, which has spread to several countries around the world causing immense challenges to the lives of people. In response to COVID-19 impact on individuals, families and their communities globally, the Global Social Welfare journal is inviting our global community to contribute research articles sharing stories and experiences (both positive and negative) with our readers who can use this information to inform the development and implementation of future programs. We encourage the submission of both original science and conceptual pieces—that would inform the practice and policy frameworks across the global community. The Global Social Welfare journal brings together research that informs the fields of global social work, social development, and social welfare policy and practice. It serves as an outlet for manuscripts and brief reports of interdisciplinary applied research that advance knowledge about global threats to the well-being of individuals, groups, families, and communities. Submissions will be accepted on a rolling basis and reviewed by experts in the field.
Rapid peer review and prompt editorial decisions will ensure that quality manuscripts are published in a timely manner and disseminated widely to inform additional research and policymaking on COVID-19-related issues. Read more about the Global Social Welfare journal or submit a manuscript now through the Manuscript Submission Portal.
Questions can be sent to Fred M. Ssewamala PhD.
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EXTERNAL OPPORTUNITIES
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Research Associate (Implementation Science) at Boston College School of Social Work
Research Associate (Gender) at Boston College School of Social Work
St. Louis County Government
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COVID-19 RELATED OPPORTUNITIES
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NOSI regarding the Availability of Administrative Supplements and Urgent Competitive Revisions for Research on the 2019 Novel Coronavirus and the Behavioral and Social Sciences
NOSI regarding the Availability of Administrative Supplements and Urgent Competitive Revisions for Mental Health Research on the 2019 Novel Coronavirus
NOSI: Competitive and Administrative Supplements for the Impact of COVID-19 Outbreak on Minority Health and Health Disparities
NIH POCTRN: Fast-Track Program for COVID-19 Test Development and Distribution
NOSI: Emergency Competitive Revisions for Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
NOSI: Limited Competition for Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
NOSI: Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
Alcohol-HIV/AIDS Program Project Comorbidities, Coinfections, and Complications Research: Intervention and Cross-Cutting Foundational Research
Community Interventions to Address the Consequences of the COVID-19 Pandemic among Health Disparity and Vulnerable Populations
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