1. Using Your Expertise in Social and Behavioural Sciences for an NIH Grant Application: Perspective from a Lower Middle-Income Country 
Le Minh Giang
Hanoi Medical University, Vietnam
NIH Symposium, Tuesday 23 July, 2019
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2. Disclosure and Acknowledgment
I have no conflict of interest
Over the past 15 years, my work in Vietnam have been supported through grants awarded by NIH, ANRS, PEPFAR, US CDC and SAMHSA:
R03DA (PI: Le);
ANRS12351 (PI: Le and Laureillard)
ANRS (PI: Nagot and Le)
R01DA (PIs: Goldsamt, Clatts and Le);
R01DA (PI: Michael Clatts);
R01DA (PI: Michael Clatts);
R24HD (PIs: Jennifer Hirsch & Richard Parker);
R01DA (PI: Todd Korthuis);
R01DA (PI: Gavin Bart)
DW43TW (PI: Li Li)
SAMSHA UD1-TI (PI: Richard Rawson from 2011 – 2014; Sherry Larkins )

3. My first exposure to HIV-related social science research
1986
MD at Hanoi Medical University (1992)
1998
MA in medical anthropology at Columbia University (2004)
PhD in sociomedical sciences at Columbia University (2012)
2004
Social Science Research Council Dissertation Fellowship for PhD Dissertation: “Governing Masculinity:  How Structures Shape the Lives and Health of Dislocated Men In Post-Doi Moi Vietnam»
2003 -
First involvement in an NIH application/funded study
R01 DA (PI: Michael Clatts) “Male Injecting Drug Users in Vietnam: Ethno-Epidemiology of HIV Risk”, (Project Director)

4. Moving within social sciences
2003
R01 DA (PI: Michael Clatts) “Male Injecting Drug Users in Vietnam: Ethno-Epidemiology of HIV Risk” (Project Director)
2008
R01 DA (PI: Michael Clatts) “Diffusion of HIV-1 in Emerging Male Sex Work Venues in Southeast Asia”, (Project Director, Co-Investigator)
2012
R01 DA (PIs: Goldsamt, Clatts and Le) “Implementation of a Sexual Health Intervention for Young MSM in Two Vietnamese Cities”, (Co-PI)
2008 & 2014
R24 HD (PIs: Jennifer Hirsch & Richard Parker) “Social Science Research and Training on HIV/AIDS: Department of Sociomedical Sciences and Hanoi Medical University Partnership (STAR-I & STAR II)” (Project Director and Co-Investigator)

5. Some innovations:
In 2010: “Pain and Hope: 20 years of HIV/AIDS in Vietnam” The first-ever museum exhibition telling stories about HIV in Vietnam
In 2013: Social and Policy Dimensions of AIDS in Vietnam in Global Public Health, Vol 8 (Suppl. 1), September 2013
In 2017: Sexual Heath Promotion Clinic: The first-ever health clinic for MSM/MSW in the country

6. We have become a premier resource for HIV-related social science research in Vietnam
RO1DA041978/ANRS (PIs: Des Jarlais and Nagot) “Drugs and Viral Infections in Vietnam” (DRIVE Study). While NIDA fund the interventions, ANRS (French Agency for Research on HIV/Hepatitis) fund social science research component
ANRS12351 (PIs: Le and Laureillard) “Determinants of Very Late Presentation to HIV Care: A Social Science Study Embedded in the STATIS Clinical Trial.”

7. Moving between social and behavioural sciences
2014
R03 DA (PI: Le) “The Family as Recovery Capital for HIV-Infected Injection Drug Users in Vietnam” (awarded)
2017
1 U01 DA (PI: Le & Shoptaw) “Screen, Treat and Retain Methamphetamine Users in Primary Care Settings in Vietnam (STAR-M)” (unscored)
2018
1 R01 DA (PIs: Le & Korthuis) “Supporting Expansion of Buprenorphine to Improve HIV Prevention, Care and Outcomes: A Cluster Randomized Trial” (scored, awaiting decision)
2019
1 R01 DA (PIs: Le & Shoptaw) “Screen, Treat and Retain Meth-Using People with Opioid Use Disorders at MMT Clinics (STAR-OM)” (scored, awaiting decision)

8. Developing theory-based behavioural interventions
Figure 2: Conceptual Framework of SE-BRAVO (adapted from Andersen’s Model)
1 R01 DA (PIs: Le & Korthuis) Using Andersen’s conceptual framework on health service services for vulnerable populations to design and assess community- and family- level interventions to address barriers for access and retention in OUD and HIV care in rural, mountainous settings
1 R01 DA (PIs: Le & Shoptaw) Using adaptive therapy conceptual framework for an adaptive design to assess optimal combinations of evidence-based interventions for methamphetamine use among people with OUD
Frontline Interventions
to maximize short-term improvements
Short-term outcome: No improvement in SUD outcome
Ehanced Rx
Plan A
Improved HIV and SUD outcomes
Enhanced Rx
Plan B
Short-term ourcome: Improvement in SUD outcome
Maintenance Rx
Figure 1 Conceptual Framework of STAR-OM Intervention

9. Lessons Learned
To improve the results of the increasingly complex and efficacious biomedical responses to the epidemic, there is an increasing need to understand and to address social and behavioural determinants, including those related to substance use, of HIV outcomes
While our work in Vietnam started with (and still continue) using social sciences to improve our understandings of these determinants, we need to quickly build the capacity to develop behavioral interventions to improve HIV outcomes
And once we have adapted behavioural interventions and shown they are ready for scale-up, social sciences can help to understand what work, why they work and what may prevent/facilitate successful scale-up (Implementation Science)

10. Lessons Learned
In leading the development of an NIH application, one doesn’t need (and it may be impossible) to become an expert in both social and behavioural sciences. But it is important to be able to engage in informed dialogue with colleagues who are experts in these areas
An HIV-focused NIH application requires a multi-disciplinary team, including those with medical, public health, social, behavioral, implementation science and other background. This is often not easy to build in low-and-middle income settings
I have been very fortunate to have many excellent US mentors, who help me to connect with their colleagues who provide expertise that we don’t have. And therefore, NIH grants have helped to build local capacity to address global issues

11. THANK YOU FOR YOUR ATTENTION