Author: Kyle Hamilton

More North Carolinians living with, or at risk of, HIV/AIDS will have access to testing and treatment services thanks to a $2.5 million grant awarded to Duke’s Center for Health Policy and Inequalities Research (CHPIR). The new project, Carolinas Alcohol and Drug Resources (CADRE), builds on services currently offered in Durham and is funded by the Substance Abuse and Mental Health Services Administration. Over the next five years, the CADRE program will target racial and ethnic minorities, primarily African Americans, for substance use treatment services and HIV/Hepatitis C testing. Under the leadership of researchers Sara LeGrand and Susan Reif, CADRE will introduce peer outreach and expand its territory to Charlotte, where no such program currently exists.

Editor’s Note: this grant announcement was originally published in Duke Global Health Institute’s Nov. 27, 2012 newsletter. 



DeVondia Roseborough, Access Coordinator with NC Positive Charge Initiative ( at the  Mecklenburg County Health Department, and Dr. Susan Reif’s work with the Southern HIV/AIDS Strategy Initiative ( are both featured in “HIV/AIDS disproportionately affecting blacks in Charlotte” by Christine Nelson of WBTV Charlotte.

To learn more about Susan Reif’s work with the Southern HIV/AIDS Strategy Initiative, please read the publication, “HIV/AIDS Epidemic in the South Reaches Crisis Proportions in Last Decade.”


Check Out 3 infographics summarizing CHPIR’s research presented at the XIX International AIDS Conference in Washington, D.C. (July 22-27, 2012). Click on the links below to access each infographic.

A rural-urban comparison of outcomes following implementation of an access to care initiative for HIV-infected persons in southeastern USA

  • Client populations in both areas analyzed were comparable in terms of income, race, sex, and age
  • Rural clients face additional barriers to care in terms of geography, lack of coordinated transportation systems, and fewer community-supported resources
  • The rural site was more successful at enrolling clients
  • Rural clients were linked to medical care at a higher rate than urban clients
  • Rural clients enrolled in the program at a higher rate and received greater health outcomes from engaging in this access to care program than did those clients from the urban area
  • Implementa0on of this access to care study in the rural area requires more resources even though the population density and HIV case rates are lower
  • The value of this access to care program in rural regions may be due in part to the visibility of HIV+ peers and the addition of resources to a community with limited HIV services.!

Reducing barriers to mental health treatment among individuals with HIV

Findings from the CHAMP Pilot Study indicate that the in-home mental health treatment model was feasible to implement, widely accepted by the study participants, and demonstrated preliminary benefit in addressing mental health issues among individuals with HIV. Additional research using a randomized controlled design is needed to more rigorously examine the effectiveness of the in-home treatment model in improving outcomes such as psychiatric symptoms and adherence.

The Loliondo phenomenon: Reduced adherence to antiretroviral therapy following mass visits to “Babu wa Loliondo” in Tanzania

  • A striking proportion of persons living with HIV and participating in a longitudinal cohort study sought HIV cure from a spiritual herbal healer, despite the remote location and associated burdens of travel
  • Results indicate that treatment fatigue and hope for a cure may be key factors in understanding motivations of persons in care for HIV
  • A marked decline in ART adherence occurred among those who traveled to seek the antidote, highlighting the importance of ongoing conversations with patients about adherence