Harvard School of Public Health awarded $20 million CDC grant to study HIV prevention in Botswana

September 21, 2011

Boston, MA -- A new four-year, $20 million grant from the U.S. Centers for Disease Control and Prevention (CDC) will enable Harvard School of Public Health (HSPH) researchers to evaluate the impact and cost-effectiveness of a unique combination of HIV prevention strategies in Botswana. The CDC grant is part of a U.S. President's Emergency Plan for AIDS Relief (PEPFAR) initiative that commits $45 million to examine the effectiveness of combination approaches to HIV prevention over four years. The largest evaluation of its kind, the research initiative is poised to help partner countries strengthen their efforts to prevent new HIV infections and save lives. For more information about the combination prevention initiative, visit: http://www.state.gov/r/pa/prs/ps/2011/09/172389.htm.

Principal investigator Max Essex, professor of health sciences and chair of the Harvard School of Public Health AIDS Initiative, and co-principal investigator Victor De Gruttola, professor of biostatistics and chair of the Department of Biostatistics at HSPH, predict that their prevention strategies can reduce HIV infection by at least 50 percent.

Notably, one aspect of the study includes a focused effort to prevent HIV transmission by individuals with a high viral load. "This is the subset of people most likely to transmit the virus," said Essex.

He and his colleagues believe that targeting those mostly likely to transmit HIV can greatly reduce disease incidence and be cost-effective. Essex noted that some researchers have advocated supplying all HIV-positive individuals in a particular group with antiretrovirals, but covering all infected people in populations with high rates of infection can be prohibitively expensive for governments in developing countries.

Another unique aspect of the HSPH study is that researchers will study viral gene signatures (the genomic fingerprint of a virus) to determine the effectiveness of targeting individuals with high viral loads. Using this method can indicate whether new infections originated within a particular village, for example. Identifying viral gene signatures could also determine how much the study interventions are able to reduce infections that can be traced to individuals with high viral loads.

Researchers will also analyze cost savings realized from using the prevention strategies in the study. "The hope is that the strategies will help countries cut costs dramatically," said Essex. "Conducting a study of this type in southern Africa is more logical because HIV infection rates are much higher than those in the U.S. and the results can be obtained sooner."

The study will be conducted in collaboration with the Botswana Harvard AIDS Institute Partnership (BHP), a 15-year-old collaborative research and training initiative between the Harvard School of Public Health AIDS Initiative and the Botswana Ministry of Health.

In spite of Botswana's significant efforts to curtail the incidence of HIV/AIDS, 25 percent of adults in this southern African country are HIV-positive. To home in on ways to optimize HIV prevention strategies, HSPH and BHP researchers will conduct a randomized study of nearly 50,000 people--22,000 in the village of Mochudi, and roughly 28,000 in 16 rural communities. HSPH and BHP researchers, working with Botswana's Ministry of Health, will examine the effects of combining a number of prevention strategies over a four-year period. In addition to treating high viral load, the interventions include These interventions have not been adequately evaluated in combination, said Essex. Using a number of prevention strategies together at the same time should also test whether they have a synergistic effect. According to co-principal investigator De Gruttola, "Studying people as members of village communities rather than as isolated subjects allows for mathematical modeling of the effects of combination prevention strategies in the settings in which they will actually be used."
-end-
Visit the HSPH website for the latest news, press releases, and multimedia offerings.Harvard School of Public Health (http://www.hsph.harvard.edu) is dedicated to advancing the public's health through learning, discovery, and communication. More than 400 faculty members are engaged in teaching and training the 1,000-plus student body in a broad spectrum of disciplines crucial to the health and well being of individuals and populations around the world. Programs and projects range from the molecular biology of AIDS vaccines to the epidemiology of cancer; from risk analysis to violence prevention; from maternal and children's health to quality of care measurement; from health care management to international health and human rights. For more information on the school visit: http://www.hsph.harvard.edu.

Harvard T.H. Chan School of Public Health

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.