HIV Interventions

Lead Research Organisation: MRC/UVRI Uganda Research Unit on AIDS

Abstract

Globally, there have been gains in HIV prevention. In sub-Saharan Africa (SSA), new HIV infections have reduced from 2.3 million in 2000 to 1.4 million in 2014 (41% reduction). Similarly, fewer AIDS-related deaths have been reported in SSA from 1.2 million in 2000 to 790,000 in 2014 (34% reduction)39. Though these trends are encouraging, the epidemic is still of great public health concern and calls for more investment and research to determine the best ways to deliver proven prevention strategies, to evaluate new interventions, to assess the impact of combination prevention, and to find ways to improve treatment and care for people living with HIV.Globally, there have been gains in HIV prevention. In sub-Saharan Africa (SSA), new HIV infections have reduced from 2.3 million in 2000 to 1.4 million in 2014 (41% reduction). Similarly, fewer AIDS-related deaths have been reported in SSA from 1.2 million in 2000 to 790,000 in 2014 (34% reduction)39. Though these trends are encouraging, the epidemic is still of great public health concern and calls for more investment and research to determine the best ways to deliver proven prevention strategies, to evaluate new interventions, to assess the impact of combination prevention, and to find ways to improve treatment and care for people living with HIV.

Technical Summary

Work under the HIV Intervention Programme has two broad aims. Firstly, to prevent acquisition of new infections, and secondly to improve survival and quality of life among people living with HIV. To address these aims several scientific projects will be undertaken partly by the Unit, and partly through scientific collaboration with our long-term partners and institutions in Europe, USA and Africa.
Access to HIV prevention remains inadequate and does not necessarily prioritize key populations such as female sex workers (FSWs) and fishing communities (FC). Prevention of new HIV infections in such populations is a high priority for Uganda and elsewhere. We aim to conduct HIV intervention research in these populations by building on recent advances in biomedical interventions, some of which we participated in, such as oral and topical pre-exposure prophylaxis (PrEP), and HIV combination prevention. This programme of work builds on our past successes and expertise in conducting HIV epidemiological research in key populations and, work on designing and evaluating HIV prevention, treatment and care strategies in Africa. For example, we have been part of the work that recently showed efficacy of the Dapivirine vaginal ring in HIV prevention, and of the START trial that showed the benefit of initiating ARVs whenCD4+ count >500 cells above starting treatment in patients after the CD4+ count had declined to =350 cells/mm.
The prevention research will include: i) continuation of research on evaluating HIV vaccines in early phase I and II trials, and new microbicides - especially combination and long acting products in collaboration with other research partners; ii) a pragmatic, randomized open-label wait-listed trial evaluating the effectiveness of tenofovir without the presence of a placebo-control to reduce the risk of HIV acquisition among high risk women, iii) assessing the long term safety profile and adherence of Dapivirine Vaginal Ring

Publications

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