Creating an African HIV Clinical Research and Prevention Trials Network: HIV Prevalence, Incidence and Transmission

• Type of Material: Article
• Authors: Anatoli Kamali, Uganda Virus Research Institute; Matt A. Price, University of California San Francisco; Shabir Lakhi, Emory University; Etienne Karita, Project San Francisco; Mubiana Inambao, Zambia-Emory HIV Research Project; Eduard J. Sanders, University of Oxford; Omu Anzala, Kenya AIDS Vaccine Institute; Mary H. Latka, Aurum Institute; Linda-Gail Bekker, University of Cape Town; Pontiano Kaleebu, Uganda Virus Research Institute; Gershim Asiki, Uganda Virus Research Institute; Ali Ssetaala, IAVI-UVRI HIV Vaccine Program; Eugene Ruzagira, Uganda Virus Research Institute; Susan Allen, Emory University; Paul Farmer, Emory University; Eric Hunter, Emory University; Gaudensia Mutua, Kenya AIDS Vaccine Institute; Heeran Makkan, Aurum Institute; Amanda Tichacek, Emory University; Ilene K. Brill, University of Alabama at Birmingham; Pat Fast, International AIDS Vaccine Initiative; Gwynn Stevens, International AIDS Vaccine Initiative; Paramesh Chetty, International AIDS Vaccine Initiative; Pauli N. Amornkul, International AIDS Vaccine Initiative; Jill Gilmour, Imperial College London
• Language: English
• Date: 2015-01-20
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2015 Kamali et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0116100
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 10
• Issue: 1
• Start Page: e0116100
• End Page: e0116100
• Grant/Funding Information: This work is made possible by the generous support of the American people through USAID.; Family Health International (now FHI360) supported some of the cohort study work in Rustenburg, and the European and Developing Countries Clinical Trials Partnership helped fund some of the cohorts in the Ugandan fishing communities.; The full list of IAVI donors is available at www.iavi.org.; IAVI’s work is made possible by generous support from many donors including: the Bill & Melinda Gates Foundation; the Ministry of Foreign Affairs of Denmark; Irish Aid; the Ministry of Finance of Japan; the Ministry of Foreign Affairs of the Netherlands; the Norwegian Agency for Development Cooperation (NORAD); the United Kingdom Department for International Development (DFID), and the United States Agency for International Development (USAID).; Several grants funded the HIV incidence and early infection studies, particularly in Rwanda and Zambia, including the Emory CFAR: P30 AI050409, NIH-FIC TW001042, NIH-NIAID R01 AI040951, NIH-NIMH R01 MH066767, NIH-NICHD R01 HD040125, NIH-NIAID R01 AI064060, and NIH-NIAID R37 AI51231.; Funding was also provided by the OPEC Fund for International Development (OFID), a development finance institution of the OPEC Member States, established to provide financial support for socio-economic development, particularly for low-income countries.
• Keywords: EPIDEMIOLOGY; VIRUS ANKARA MVA; Men who have sex with men; HIV; NEUTRALIZING ANTIBODIES; Health services research; Multidisciplinary Sciences; Uganda; SOUTHERN AFRICA; SUB-SAHARAN AFRICA; Kenya; VACCINE; HIV/AIDS; ANTIRETROVIRAL THERAPY; DISCORDANT COUPLES; Science & Technology; HIV infections; HIV epidemiology; Science & Technology - Other Topics; HIV prevention; IMMUNOGENICITY
• Research Categories: Health Sciences, Epidemiology; Biology, Virology; Health Sciences, Public Health

Abstract

HIV epidemiology informs prevention trial design and program planning. Nine clinical research centers (CRC) in sub-Saharan Africa conducted HIV observational epidemiology studies in populations at risk for HIV infection as part of an HIV prevention and vaccine trial network. Annual HIV incidence ranged from below 2% to above 10% and varied by CRC and risk group, with rates above 5% observed in Zambian men in an HIV-discordant relationship, Ugandan men from Lake Victoria fishing communities, men who have sex with men, and several cohorts of women. HIV incidence tended to fall after the first three months in the study and over calendar time. Among suspected transmission pairs, 28% of HIV infections were not from the reported partner. Volunteers with high incidence were successfully identified and enrolled into large scale cohort studies. Over a quarter of new cases in couples acquired infection from persons other than the suspected transmitting partner.