Patient-Centered Care Project (PCCP) Promoting HIV Testing and Care in sub-Saharan AfricaPrincipal Investigator: Robert Remien, PhDK Rivet Amico, PhDElizabeth A. Bukusi, MBChB, MMed, MPH, PhDBenjamin Young, MD, PhDCo-Investigator(s):Joanne Mantell, PhDKenneth Ngure, MPH, MSc, PhDZachary Kwena, MA, PhD Nelly Mugo, MBChB, MPHNadia Nguyen, MSPHFunding Agency:National Institute of Mental Health (NIMH)Collaborating Institution: University of Michigan International Association of Physicians in AIDS Care (IAPAC) Kenya Medical Research Institute (KEMRI)Study Location:Kisumu, SiayaHoma Bay, KenyaDescription:This qualitative study seeks to identify individual, community and structural level factors influencing uptake, use, and patient-centered delivery of HIV-testing and HIV-care services from the perspective of groups at elevated risk for HIV-infection and transmission. We are currently conducting over 500 in-depth interviews (IDIs) with (1) HIV-negative/status unknown individuals, (2) HIV-positive individuals in care, and (3) HIV-positive individuals not in care. Within these three cohorts, we are focusing on the following target populations: (a) heterosexual men aged 18 and older, (b) adolescent/young women aged 15 to 24, and (c) men who have sex with men (MSM) aged 18 and older. We are sampling from both fishing and non-fishing communities in three high-prevalence counties in Kenya (Homa Bay, Kisumu, Siaya). We will also conduct up to 12 focus group discussions (FGDs) with key informants in these communities. Participants will complete a one-time, semi-structured interview or focus group conducted by Kenyan collaboration teams in the community. IDIs and FGDs will be transcribed using de-identification procedures, translated to English, and coded for main themes within each of the areas targeted in the interview guides. Themes emerging from discourse with people at risk of/affected by HIV and key informants within and across localities will guide intervention efforts in countries served by PEPFAR and support progress toward 90-90-90 goals.