Corporate Banner
Satellite Banner
Immunology
Scientific Community
 
Become a Member | Sign in
Home>News>This Article
  News
Return

HIV Testing Increased and Infection Reduced in Africa with Community Intervention

Published: Thursday, March 07, 2013
Last Updated: Wednesday, March 06, 2013
Bookmark and Share
Free mobile HIV testing and counseling, same-day results and post-test support reduces HIV infections by 14 percent.

Community intervention with free mobile HIV testing and counseling, same-day results and post-test support led to a 14 percent reduction in new HIV infections in targeted communities in Sub-Saharan Africa, according to results of a large randomized, controlled trial.

In women between the ages of 25 and 32, the intervention showed an even greater effect, with rates of new infections lowered by almost one-third.

The trial, National Institute of Mental Health “Project Accept” (HIV Prevention Trial Network 043), was conducted in 48 communities at five sites in Zimbabwe, Tanzania, South Africa and Thailand.

The study was undertaken by UC San Francisco at the Zimbabwe site in collaboration with the University of Zimbabwe.

The trial sought to demonstrate a community-level impact on HIV when proven prevention interventions were taken to scale. A primary goal was to increase awareness of HIV status by decreasing barriers to testing.

“HIV testing increased by a quarter overall and we saw a four-fold increase in the detection of new HIV cases at the Sub-Saharan sites.” said Stephen F. Morin, PhD, co-principal investigator of the multi-institution trial and professor of medicine at the UCSF Center for AIDS Prevention Studies.

Morin continued, “The trial was particularly effective in increasing HIV testing among men. At baseline, women were far more likely to have been tested than men and the intervention increased their testing by 15 percent. However, the study’s success in substantially increasing HIV testing in men, by 45 percent, erased the gender gap.”

In addition, Morin said, the trial found that men who learned they were infected reduced their overall number of sexual partners by one-fifth and reduced their concurrent partnerships by almost one-third.

Many epidemiological studies have identified concurrent partnerships as a major impetus for high rates of HIV infections in Sub-Saharan Africa.

“The trial demonstrated that a well designed and implemented intervention can change behavior that leads to an effect at a community level. We were particularly successful in changing behavior in men after they learned they were infected, and we saw the impact in the sharp reduction in the rate of new infections in women in the intervention communities,” said Morin.

The results of the trial were presented at the Conference on Retroviruses and Opportunistic Infections in Atlanta.

Multilayer Intervention Efforts
The trial was conducted over a 36-month period and involved large numbers of participants: 33,774 households were visited by field teams at baseline and 84,947 were visited at the post-intervention assessment. All of the sites, except Soweto, South Africa, were predominately rural. The Chiang Mai, Thailand, site was notable for the very low percentage of people in the community living with HIV - less than 1 percent.

Community mobilization activities included dispatching outreach workers and community-based volunteers door-to-door, holding large community meetings and the creation of “community working groups,” composed of local leaders who assisted in developing plans to increase utilization of testing services.

Testing was provided either at community sites or by mobile vans and provided same-day results. Counseling included individualized risk reduction assessments and referrals to a variety of local services.

Extensive post-test support services were delivered to individuals who tested positive. These included individual counseling, information sharing sessions, support groups, coping effectiveness workshops and/or stigma reduction workshops.

The UCSF Center for AIDS Prevention Studies served as the Intervention Core for the multisite study. The Intervention Core was responsible for the actual implementation of the different components over the 36-month duration of the trial.

For the successful implementation of a trial based upon community mobilization, a key element was to create and sustain a supportive environment in the community.

At the time Project Accept started, many communities had little or no access to HIV testing and stigma was pervasive.

“We built strong relationships with community leaders and elders, which was essential in rural settings. We also engaged the early adopters of the intervention as community outreach volunteers. Living in the community and accessible to the community for questions, they also provided us with feedback as to what the community was thinking and that allowed us to adapt the intervention to better fit each community,” said Gertrude Khumalo-Sakutukwa, MSSW, MMS, director of the Intervention Core and research specialist at the UCSF Center for AIDS Prevention Studies.

David Celentano from Johns Hopkins University, Michael Sweat from the Medical University of South Carolina and Thomas J. Coates from UCLA were co-principal investigators of the trial. Sten Vermund and Wafaa El-Sadr are the principal investigators of the HIV Prevention Trials Network.

Project Accept was funded by the U.S. National Institute of Mental Health and through the HIV Prevention Trials Network as HPTN 043 by the Division of AIDS of the U.S. National Institute of Allergy and Infectious Diseases and by the Office of AIDS of the U.S. National Institutes of Health.

The UCSF Center for AIDS Prevention Studies is affiliated with the AIDS Research Institute (ARI) at UCSF.

UCSF ARI houses hundreds of scientists and dozens of programs throughout UCSF and affiliated labs and institutions, making ARI one of the largest AIDS research entities in the world.


Further Information

Join For Free

Access to this exclusive content is for Technology Networks Premium members only.

Join Technology Networks Premium for free access to:

  • Exclusive articles
  • Presentations from international conferences
  • Over 2,900+ scientific posters on ePosters
  • More than 4,200+ scientific videos on LabTube
  • 35 community eNewsletters


Sign In



Forgotten your details? Click Here
If you are not a member you can join here

*Please note: By logging into TechnologyNetworks.com you agree to accept the use of cookies. To find out more about the cookies we use and how to delete them, see our privacy policy.

Related Content

Tricked-Out Immune Cells Could Attack Cancer
New cell-engineering technique may lead to precision immunotherapies.
Wednesday, February 03, 2016
Agricultural Intervention Improves HIV Outcomes
A multifaceted farming intervention can reduce food insecurity while improving HIV outcomes in patients in Kenya, according to a randomized, controlled trial led by researchers at UC San Francisco.
Thursday, August 20, 2015
How Early Childhood Vaccination Reduces Leukemia Risk
Chronic infections push ‘pre-leukemia’ cells, common in newborns, into malignancy.
Thursday, May 21, 2015
Human Cancer Prognosis Is Related to Newly Identified Immune Cell
A rare population of tumor-associated “good” cells slows cancer.
Monday, October 20, 2014
Type 1 Diabetes Drug Proves Effective in Clinical Trial
Drug developed by UCSF researcher shows promise for blocking advance of disease in earliest stages.
Thursday, August 08, 2013
Stem Cell Survival Strategy Is Key to Blood and Immune System Health
Stem cells of the aging bone marrow recycle their own molecules to survive and keep replenishing the blood and immune systems as the body ages.
Monday, February 18, 2013
Multiple Sclerosis ‘Immune Exchange’ Between Brain and Blood is Uncovered
UCSF finding of movement by disease-causing B cells gives hope for new treatments and diagnostics.
Thursday, November 22, 2012
NIH Awards $15 Million Grant to UCSF-CFAR
UCSF-CFAR awarded more than $15 million over the next five years to continue UCSF-Gladstone AIDS research.
Thursday, October 18, 2012
Research Offers New Hope for HIV/AIDS Patients with Cancer
Proposed treatment for herpes virus that causes Kaposi's sarcoma receives translational research funding.
Thursday, August 23, 2012
New Standards to Improve Diagnosis of Sjögren’s Syndrome
UCSF-led team of international researchers develop criteria to identify autoimmune disease.
Tuesday, August 14, 2012
Researchers Identify a Potential New HIV Vaccine/Therapy Target
Investigators first determine levels of Th17 cells in the gut of sixteen rhesus macaques and then infected them with SIV.
Monday, June 04, 2012
Scientific News
Tricked-Out Immune Cells Could Attack Cancer
New cell-engineering technique may lead to precision immunotherapies.
Neural Networks Adapt to the Presence of a Toxic HIV Protein
HIV-associated neurocognitive disorders (HAND) afflict approximately half of HIV infected patients.
HIV Protein Manipulates Hundreds of Human Genes
Findings search for new or improved treatments for patients with AIDS.
Breaking the Brain’s Garbage Disposal
The children’s ataxia gene problem turned out to be not such a big deal genetically — it was such a slight mutation that it barely changed the way the cells made the protein.
Flesh-Eating Bacteria Work Together
Scientists recently discovered different strains of deadly flesh-eating bacteria working together to spread infection and they now have a better understanding of the role of the toxins they produce. The discovery could change how the illness and other diseases are treated.
Utilizing Antibodies from Ebola Survivors
A collaborative team from The University of Texas Medical Branch at Galveston, Vanderbilt University, The Scripps Research Institute and Integral Molecular Inc. have learned that antibodies in the blood of people who have survived a strain of the Ebola virus can kill various types of Ebola.
Antibiotic Use in Early Life Disrupts Gut Microbiota
The use of antibiotics in early childhood interferes with normal development of the intestinal microbiota, shows research conducted at the University of Helsinki.
Easier Diagnosis for Fungal Infection of the Lungs
A new clinical imaging method developed in collaboration with a University of Exeter academic may enable doctors to tackle one of the main killers of patients with weakened immune systems sooner and more effectively.
Mitochondrial Troublemakers Unmasked in Lupus
Drivers of autoimmune disease inflammation discovered in the traps of pathogen-capturing white blood cells.
Important Regulator of Immune System Decoded
Plasma cells play a key role in our immune system. Now scientists at the Research Institute of Molecular Pathology (IMP) in Vienna, Austria, and at the Walter and Eliza Hall Institute (WEHI) in Melbourne, Australia, succeeded in characterizing a central regulator of plasma cell function.
SELECTBIO

Skyscraper Banner
Go to LabTube
Go to eposters
 
Access to the latest scientific news
Exclusive articles
Upload and share your posters on ePosters
Latest presentations and webinars
View a library of 1,800+ scientific and medical posters
2,900+ scientific and medical posters
A library of 2,500+ scientific videos on LabTube
4,200+ scientific videos
Close
Premium CrownJOIN TECHNOLOGY NETWORKS PREMIUM FOR FREE!