HIV PREVENTION & EPIDEMIOLOGY PROGRAMME
The Unit is one of the leading and oldest institutions that have conducted HIV epidemiological research in Africa. The rural general population cohort (GPC) has provided important data (over 20 years) on HIV trends of prevalence and incidence, and socio-demographic impact of the epidemic that have been used for planning by the National HIV/AIDS programmes of the Ministry of Health, Uganda, and contributed to the international global AIDS epidemic reports by the UNAIDS. The programme has expanded epidemiological research into high-risk populations (fishing, high risk women), enabling us to address cutting edge research questions and to generate a wealth of epidemiology and behavioural data. Valuable specimens from these groups have also enabled the conduct of virological and immunological studies, which are important components for the development of prevention technologies including HIV vaccine, and for research on viral resistance to ART.
The epidemic in Uganda is mature and HIV infection has been declining for years, but this process seems to be reversing, thus raising a host of new research questions. The increased uptake of voluntary counselling and testing and subsequent knowledge of one’s HIV status and introduction of ART is also changing the HIV epidemiology and its impact in Africa. We thus need to study the HIV epidemic as it reaches a mature stage. The epidemiology component of the research programme addresses five major areas: i) investigate the current HIV transmission networks and linkages between HIV infected persons by examining the molecular epidemiology of HIV prevalent and incident cases in the GPC to understand what sources of infection are driving continuing transmission, and to inform HIV prevention strategies in Uganda; ii) investigate the feasibility of Universal Counselling and Testing (UCT) in the GPC and fishing communities iii) monitor HIV trends in the post-ART era; iv) examine the feasibility of, and prepare for, HIV prevention efficacy trials among high risk populations; and v) investigate the epidemiology of non communicable diseases.
The HIV epidemiological trends suggest that the current HIV interventions are not sufficiently effective in reducing the number of new HIV infections. These interventions are still only partially implemented in most sub Saharan African countries and there is an urgent need for accelerated implementation of existing HIV prevention tools, as well as identification and evaluation of new prevention technologies. The evaluation and implementation of effective HIV interventions relevant to developing countries remains a top priority for the Unit. The HIV prevention research focuses in the following areas: i) vaginal microbicides research; ii) HIV vaccines research; iii) evaluation of innovative interventions that could improve the health of, and prevent prevalent co-morbidity among HIV-infected individuals; iv) implementation and evaluation of HIV interventions among high risk population cohorts.
The Programme has extensive collaboration with other scientific groups to address broader epidemiological research. The Programme collaborates with the Wellcome Trust Sanger Institute and Cambridge University to undertake research on the epidemiology of metabolic risk factors in the GPC, and collaboration with University of York on the epidemiology around biomarkers of malignancies. We have long standing collaboration with International AIDS Vaccine Initiative (IAVI) on HIV Vaccine research work.