You are here

Social and Behavioral Sciences Core

The mission of the Duke CFAR is to maximize the impact of HIV/AIDS research contributions by Duke investigators on the global HIV epidemic. The Social and Behavioral Sciences (SBS) Core contributes to this goal by supporting SBS-focused interdisciplinary research across the University.

Enhancing the quality and quantity of social and behavioral HIV/AIDS research.
Services Offered

The Duke CFAR Social and Behavioral Sciences (SBS) Core Services

  • Early Planning and Grant Preparation
  • Peer Review
  • Post-Award Consultation
  • Training and Capacity Building
  • Networking and Community Engagement
  • Mentoring
  • Dissemination of Study Findings and Manuscript Preparation

Early Planning and Grant Preparation

  • Brainstorm on research ideas, funding opportunities, and framing specific aims to address NIH AIDS priorities
  • Discuss implications of previous study findings to inform new grant applications
  • Provide consultation on selecting study designs and methods, appropriate SBS measures, and data analysis approaches
  • Provide administrative support, including proofreading, compiling supplemental materials, and providing letters of support from the SBS Core

Peer Review

Convene panel of Duke researchers to review and provide feedback on draft NIH grant applications prior to submission

Post-Award Consultation

Provide consultation and continuous support during study implementation, including efficient study startup and project management strategies

Training and Capacity Building

  • Provide scientific guidance in designing and implementing quantitative and qualitative research, including reviewing survey questions and items, refining qualitative question guides, programming online survey platforms and data management systems (e.g., REDCap), training qualitative interviewers, planning for interview transcription, and identifying approaches to qualitative data analysis
  • Partner with Duke’s QualCore to provide qualitative research guidance

Networking and Community Engagement

  • Bring together investigators from across disciplines
  • Build ties with community partners to share ideas and discuss opportunities to initiate new research meaningful to communities
  • Support community outreach in Durham and other research sites, including in global settings, and assist researchers in the community engagement process

Mentorship of early stage investigators

  • Provide mentorship to new CFAR members who are early stage investigators
  • Connect junior investigators with senior faculty

Dissemination of Study Findings and Manuscript Preparation

  • Provide suggestions on dissemination materials
  • Offer advice on community feedback sessions
  • Provide consultations on scientific journals for submission
  • Offer assistance with manuscript review and formatting
Research Highlights

Title: Research Training Program for Low-and Middle-Income Country Institutions
Principal Investigators: John Bartlett, MD
Funding: Fogarty International Center (
D43 TW009595)
The proposed training program will create a Sociobehavioral Sciences Research Core Team at the Kilimanjaro Christian Medical Centre in Moshi, Tanzania through a carefully selected portfolio of training opportunities. This Team will study HIV voluntary counseling and testing, linkage and retention in care, adherence to medications, and co- morbidities of mental illness and substance abuse. The knowledge gained from this research will improve public health by informing health care providers and policymakers about best practices in the management of persons living with HIV infection.

Title: Interdisciplinary Research Training Program in AIDS (IRTPA)
Principal Investigators: Nathan Thielman, MD, MPH and Georgia Tomaras, Ph.D.
Funding: National Institute of Allergy and Infectious Diseases (
T32 AI007392)
In response to the magnitude and course of the AIDS epidemic, the Duke Division of Infectious Diseases successfully competed for an interdisciplinary research-training program to recruit and train promising young investigators in the field of AIDS research. The training program is coordinated by Dr. Nathan Thielman and Dr. Georgia Tomaras, and draws on resources at both Duke and the Durham VA Medical Center. A principal resource is the Center for AIDS Research (CFAR). It assembles the talents of over 60 independent investigators within 13 academic departments and includes research programs in HIV Immunology, HIV/Viral Pathogenesis, Adult Clinical HIV/Infectious Diseases, Maternal/Child HIV Infection, Global HIV/AIDS, and Social and Behavioral Sciences.

Title: A Systems Biology Approach to HIV-Associated Neurocognitive Impairment: Role of Drug Abuse and Neuroinflammation
Principal Investigators: David Murdoch, MD and Christina Meade, Ph.D.
Funding: National Institute on Drug Abuse (
R01 DA043241)
Over half of HIV-infected Americans experience neurocognitive impairments that impact daily functioning. Marijuana and cocaine, two of the mostly commonly abused drugs among HIV-infected persons, may accelerate the development and progression of neurocognitive impairments. Using a systems biology approach, this study will combine neuroimaging, neurocognitive testing, advanced immune profiling, and computational modeling to quantify the neurological impact of marijuana and cocaine use in HIV-infected patients. Results will inform new lines of investigation into the complex biological intersection of HIV and drug abuse, with strong clinical implications for the development innovative therapeutics.

Title: RCT of an Integrated Treatment of Persons with Co-occurring HCV and Alcohol Abuse
Duke Principal Investigator: Rae Jean Proeschold-Bell, Ph.D.
Funding: National Institutes of Alcohol Abuse and Alcoholism (
R01 AA021133)
This randomized control trial is being conducted in three liver clinics in North Carolina with hepatitis C patients who use alcohol. A six-month integrated model of alcohol treatment has been developed and piloted to include brief alcohol counseling, co-locating addictions therapists in the liver clinic, therapy that emphasizes the interplay between alcohol and liver health, and case conferencing between the hepatologists and addictions therapists. The integrated treatment is now being compared to brief counseling only to assess its impact on alcohol abstinence, as well as other alcohol and drug use outcomes, and to calculate its cost effectiveness.

Title: Does Preference-Based HIV Testing Increase Uptake in High Risk Populations?
Duke Principal Investigator: Nathan Thielman, M.D.
Funding: National Institutes of Mental Health (
R01 MH106388)
Despite worldwide efforts to promote HIV Counseling and Testing (HCT), rates of testing remain low. Understanding how high risk groups decide to test and adapting available testing options to their preferences has the potential to broadly improve HCT uptake and cost-effectiveness. This study uses a Discrete Choice Experiment, a survey method increasingly used by health economists for the design of patient-centered health care options, to rigorously quantify HIV testing preferences among two high-risk populations, identify their preferred testing options, and evaluate, in a pragmatic randomized controlled trial (RCT), the effect of a preference-based HIV counseling and testing (PB-HCT) intervention on testing uptake.

Title: Improving Health Outcomes for Orphans by Preventing HIV/STD Risk
Duke Principal Investigator: Kathryn Whetten, Ph.D.
Funding: National Institute of Mental Health (
R01 MH096633)
The primary goal of this R01is to study the effectiveness of Trauma-focused Cognitive Behavioral Therapy (TF-CBT) for treating unresolved grief and traumatic stress for orphaned children and adolescents in two East African countries, Tanzania and Kenya. The mental health gap is substantial, with few individuals in need of treatment receiving even minimal supports. Among those in need, orphaned children and adolescents, who currently number 143 million worldwide, with nearly 50 million in Sub-Saharan Africa alone, often have mental health problems subsequent to parental loss.

Title: Positive Outcomes for Children Orphaned by AIDS (POFO)
Duke Principal Investigator: Kathryn Whetten, Ph.D.
Funding: National Institute of Child Health and Development (
R01 HD090984)
POFO is a 10+-year observational study of orphaned and abandoned children (OAC) and a small cohort of non-OAC in five low and middle-income countries (Cambodia, Ethiopia, India, Kenya, and Tanzania). The objective is to follow children (starting from ages 6 to 12) and their caregivers to examine the influence of orphan placement characteristics, caregiver characteristics, and culture, on: 1) behavioral and emotional adjustment; 2) educational achievement, labor for participation, and civic engagement; 3) relationship outcomes, including HIV risk behaviors and family formation; and 4) health outcomes.

Title: Improving the Health of South African Women with Traumatic Stress in HIV Care
Principal Investigator: Kathleen Sikkema, Ph.D.
Funding: National Institute of Mental Health (
R34 MH102001)
Women in South Africa face dual epidemics of HIV and sexual violence. The resulting traumatic stress may compromise retention in HIV care and adherence to antiretroviral therapy, and increase sexual risk behavior and substance use. This study developed and piloted Improving AIDS Care after Trauma (ImpACT), an intervention based on theories of stress and coping, for women with histories of sexual trauma initiating ART in South Africa. This intervention has the potential to improve care engagement and retention, improve ART adherence, reduce risk behaviors, and therefore prevent HIV transmission within the target population.

Title: Developing a Measure of Caregiver Readiness to Disclose HIV Serostatus
Principal Investigator: Eric Green, Ph.D.
Funding: Eunice Kennedy Shriver National Institute of Child Health & Human Development (
R21 HD076695)
This study aims to develop the first reliable and valid measure of a caregiver's readiness and self-efficacy to disclose to the child his/her own serostatus or his/her child's serostatus. The instrument, the Readiness to Disclose to Children (R2D2-C), is intended to be suitable for administration by lay counselors or trained personnel in a community or clinic setting. The project anticipates that this tool will be useful to researchers and practitioners alike, and envisions that it will inform how existing and future disclosure interventions can be tailored based on an assessment of caregiver readiness and self-efficacy to disclose.

Title: Postpartum HIV Care Engagement in the Context of Option B+ in Tanzania
Principal Investigator: Melissa Watt, Ph.D.
Funding: National Institute of Allergy and Infectious Disease (
R21 AI124344)
Under the Option B+ protocol for prevention of mother to child transmission (PMTCT), all HIV-infected pregnant women initiate antiretroviral therapy (ART) for lifetime use, regardless of clinical staging. Retention in care and sustained adherence to ART following childbirth are vital to the success of the Option B+ protocol. This study will produce implementation science data to examine the facility- and patient-level factors that impact postpartum engagement in care, and to identify innovative implementation solutions to support the scale-up of Option B+ in Tanzania and other high-infection, low-resource settings.

Title: A Stigma Reduction Intervention at time of Entry into Antenatal Care to Improve PMTCT Services in Tanzania
Principal Investigator: Melissa Watt, Ph.D.
Funding: Fogarty International Center (
R21 TW011053)
HIV-related stigma has been identified as a significant reason for loss to follow up in prevention of mother to child transmission of HIV (PMTCT) programs. By addressing HIV stigma during the first antenatal care (ANC) visit, we can impact HIV care engagement among HIV-infected women at a key, early juncture of care. In addition, among those are who HIV-uninfected, we can promote acceptance and empathy towards PLWH during the heightened emotional period of HIV testing. This application proposes to develop and pilot test a brief, scalable intervention called Maisha (Swahili for life), to address HIV stigma for women presenting to ANC in Tanzania.

Title: Integrating Mental Health into an HIV Clinic to Improve Outcomes in Tanzanian Youth
Principal Investigator: Dorothy Dow, Ph.D.
Funding: Fogarty International Center (
K01 TW009985)
This project aims to address the mental health treatment gap that exists in the HIV youth clinic in Moshi, Tanzania with the goal of improving adherence to antiretroviral therapy (ART) and HIV outcomes. Addressing this treatment gap is highly relevant in two important ways. First, improved ART adherence is important not only for one's own health, but as these youth become sexually active, it also decreases the risk of sexual transmission of HIV to their partners. Second, as perinatally HIV-infected children age into adolescence, their mental health difficulties and traumatic experiences must be addressed to facilitate a healthy and productive adulthood.

Title: Decision Making and HIV Risk: New Approaches to NeuroAIDS Research in Drug Users
Principal Investigator: Christina Meade, Ph.D.
Funding: National Institute on Drug Abuse (
DP2 DA040226)
Individuals who abuse stimulant drugs like cocaine and methamphetamine contribute disproportionately to new HIV infections, sub-optimal HIV clinical outcomes, and growing HIV-related health disparities in our society, largely due to engagement in risky behaviors and poor utilization of healthcare services. This study is implementing novel approaches in the field of neuroAIDS to advance our understanding of how HIV infection and drug addiction impact decision-making processes relevant to real-world HIV risk behaviors. The goal of this research is to develop mobile health interventions that improve decision making in high-risk situations.

Title: Increasing HIV Testing & Counseling (HTC) via Adolescent Wellness Visits in Tanzania
Principal Investigator: Joy Noel Baumgartner, Ph.D.
Funding: Core B

Adolescents ages 15-19 are less likely to access HIV testing and counseling (HTC) than adults, yet young women in particular are driving the HIV epidemic in sub-Saharan Africa. Implementation of Adolescent Wellness Visits (AWVs) is an innovative strategy for increasing adolescent uptake of HTC and other preventative health services. This pilot study will assess the feasibility and acceptability of implementing AWVs within two government primary schools matched to nearby public health facilities at one urban site and one rural site in Tanzania.

Title: A Model of Family Therapy for HIV Prevention and Adolescent Emotional Support in Rural Kenya: A Developmental and Pilot Study
Principal Investigator: Eve Puffer, Ph.D.
Funding: Core B

This multi-informant qualitative study was conducted in Eldoret, Kenya to examine associations of family relationship factors with negative or positive adolescent outcomes to identify interaction patterns that should be the focus of family-level treatment. These data provide the foundation for the content and strategies of a family-based treatment intervention utilizing lay counselors from church congregations to target family functioning, mental health, and sexual risk behavior.

Title: PrEP for PWID: Gathering Evidence for Integrating PrEP into Syringe Services Programs
Principal Investigator: Mehri McKellar, MD
Funding: CFAR Administrative Supplement

Daily oral pre-exposure prophylaxis (PrEP) has been proven effective for reducing HIV acquisition among people who inject drugs (PWID). However, the public health benefits, logistics and feasibility of a PrEP program for PWID in the U.S. have not been well-studied. This study partners with syringe services programs (SSPs) in Wilmington, North Carolina to examine the feasibility of PrEP delivery to PWID.

Title: Customizing a Tool to Collect Complex Network Data among HIV-positive Youth in South Africa
Team Leader: Marta Mulawa, Ph.D.
Funding:
Bass Connections
The goal of this Bass Connections project is to customize a novel network data capture tool and to understand the types and structures of social networks among individuals living with HIV. Data collection regarding the social networks of HIV Positive women occurred with participants enrolled in an NIH-funded study titled, “Improving the Health of South African Women with Traumatic Stress in South Africa” (NIH Grant R34 MH102001; PI: Dr. Kathleen Sikkema).

Related News

Thursday, September 5, 2019
NIH Bolsters Funding for HIV Implementation Research in High-Burden U.S. Areas

PrEP-MECK: Identifying community-driven approaches for increasing PrEP uptake, adherence, and persistence among Black men who have sex with men in Mecklenburg County, North Carolina. Duke CFAR investigators have assembled a strong multi-disciplinary team who will identify implementation science projects that address the HIV epidemic among Black men who have sex with men (BMSM) in Mecklenburg County, NC, by 1) creating a local coalition of community groups, BMSM, PrEP providers, and researchers committed to engaging BMSM in PrEP care; 2) engaging BMSM in formative research to describe multi-level factors that influence PrEP uptake, adherence, and persistence among BMSM, and to suggest methods for enhancing engagement among BMSM in PrEP care; and 3) using the formative research findings and the coalition’s expertise to identify community-driven implementation science projects focused on PrEP uptake, adherence, and persistence among BMSM. The team includes three CFAR Investigators: Amy Corneli, PI; Sara LeGrand, co-I; and Susan Reif, co-I. The community partners are Chelsea Gulden with RAIN, a non-profit organization providing PrEP-related services, and Wesley Thompson, a PrEP provider with the Amity Medical Group.  https://www.niaid.nih.gov/research/cfar-arc-ending-hiv-epidemic-supplement-awards
 
Getting to [NO]ne in New Orleans: Enhancing PrEP Uptake among Black Women to End the Epidemic. Duke CFAR is partnering with investigators at Louisiana State University (LSU) as well as community partners and representatives of local populations in New Orleans to 1) identify locally-conceived strategies for engaging Black women in New Orleans in PrEP services, informed by qualitative research, and 2) plan for implementation of the strategies. Duke CFAR will also help to build local research capacity and support the growth of investigators at Louisiana State University Health Sciences Center. Investigators include Amy Corneli, Duke CFAR, PI, and Meredith Clement, former Duke CFAR member, co-I, and now a PrEP provider at the Louisiana State University Medical Center. The community partners are Rebecca Lillis, with the LSU-Crescent Care Sexual Health Center, and Veronica Magee, with Brotherhood, Inc., a community-based organization that focuses on HIV prevention among Black men and women in New Orleans.  https://www.niaid.nih.gov/research/cfar-arc-ending-hiv-epidemic-supplement-awards

Thursday, October 25, 2018
Interviews from CFAR Small Grant in South Africa lend insight into disclosure challenges for pregnant women with HIV

Friday, April 13, 2018
O’Neill Institute report examines federal investment in HIV prevention

Friday, March 2, 2018
SBS Core hosts Chalk Talk and Networking Opportunity: Biomarkers for Behavioral and Clinical Outcomes

Thursday, January 25, 2018
Intent to recruit and hire for the Associate Director for the AIDS Research Program, National Institute on Drug Abuse

News Archives

Core Leadership

SBS Core group email: cfar-sbs-core@duke.edu

Amy Corneli, PhD, MPH, Core Director
amy.corneli@duke.edu
CFAR SBS focus area: Prevention

Dr. Amy Corneli is an Associate Professor in the Departments of Population Health Sciences and Medicine, and a faculty member of the Duke Clinical Research Institute. She has been engaged in the behavioral aspects of biomedical HIV prevention in sub-Saharan Africa since 2001, including contributing to several biomedical HIV prevention clinical trials and leading NIH-funded studies exploring sexual behaviors related to and adherence with pre-exposure prophylaxis (PrEP). Dr. Corneli’s U.S.-based HIV-related research portfolio includes investigating methods to increase PrEP uptake and adherence among Black men who have sex with men (BMSM), and she currently leads two CFAR Administrative “Ending the HIV Epidemic” supplements with BMSM and Black women in the U.S. South.

In addition to her role as Director, Dr. Corneli will collaborate directly with the Biomedical Prevention Scientific Working Group and provide technical support to Core users on HIV prevention, primarily on PrEP. She also advises Core users on engaging key stakeholders in qualitative and mixed-methods research to inform clinical research, socio-behavioral interventions, and material and questionnaire development, and serves as the liaison to QualCore, a group of PhD- and master-level social scientists at Duke that provides technical support in qualitative research to Core users.

Christina Meade, PhD, Associate Director
christina.meade@duke.edu
CFAR SBS focus area: HIV comorbidities

Dr. Meade is an Associate Professor in the Department of Psychiatry and Behavioral Sciences and the Department of Psychology and Neuroscience at Duke University. Dr. Meade’s NIDA-funded research program investigates neurocognitive functioning and risk behavior among drug users living with or at high risk for HIV infection, including the evaluation of HIV prevention approaches for this population. As a licensed psychologist, Dr. Meade integrates neuroimaging, behavioral, and clinical methods, with the goal of translating results to novel treatments that improve neurobehavioral functioning. She currently leads a project funded through NIDA’s Avenir Award Program that utilizes mobile health technology to assess the relationship between decision-making processes and risky behaviors in natural settings. She also serves as PI on multiple R01 neuroimaging studies on the effects of cocaine, cannabis, and other drugs on HIV-associated neurocognitive impairment.

As an Associate Director, Dr. Meade provides technical support to Core users on HIV comorbidities, including HIV and substance use, mental health challenges, and other medical conditions. Her role also includes providing guidance for Core users on engaging hard-to-reach populations for HIV research; providing expertise on incorporating biomarkers into social and behavioral studies of HIV; conducting clinic-based recruitment; and abstracting clinical data from electronic medical records.

Michael Relf, PhD, RN, ANEF, FAAN, Associate Director
michael.relf@duke.edu
CFAR SBS focus area: Care engagement and retention

Dr. Relf is an Associate Professor of Nursing and Global Health and Associate Dean for Global and Community Affairs in Duke’s School of Nursing. Dr. Relf has worked at the forefront of nurse-led research on the psychosocial aspects of HIV/AIDS care since joining the Duke faculty in 2008, with specific emphasis on addressing intimate partner violence, HIV-related stigma, and interventions to promote engagement in HIV-oriented primary care. Dr. Relf is currently a PI on a Fogarty R21 aimed at reducing internalized stigma among women with HIV in Tanzania and was a previous recipient of a CFAR Pilot Grant in Rwanda extending a similar intervention, building upon a past National Institute of Nursing Research project in the U.S. South.

As an Associate Director, Dr. Relf provides technical support to Core users on HIV care engagement and retention. In addition, he leads the CFAR’s growing collaboration with the School of Nursing, and assists investigators in developing global partnerships and disseminating research findings to international collaborators.

Sarah Wilson, PhD, Associate Director
sarah.wilson@duke.edu
CFAR SBS focus area: Community collaboration and engagement, and implementation science

Dr. Wilson is an Assistant Professor in Psychiatry and Behavioral Sciences and a Clinical Psychologist with the Durham VA Health Care System. She is also an investigator at the VA Center of Innovation to Accelerate Discovery and Practice Transformation, and a 2018-2020 Fellow in the Implementation Research Institute at Washington University. Dr. Wilson’s research program focuses on testing and implementation of interventions for substance use, psychological symptoms, and health behavior change in at-risk populations, including an active research program in smoking cessation among Veterans Living with HIV. Dr. Wilson also has expertise in HIV community mobilization efforts, and has established valuable extensive networks with community organizations in the areas of health, policy, and human services.

As an Associate Director, Dr. Wilson provides technical support to Core users in the areas of community collaboration and engagement, and provides consultations on implementation science. She also advises on the development of training standards for community intervention study protocols, and assists with the development and dissemination of study findings to non-scientific communities.