Climate change, poverty and HIV drug resistance
The HIV Drug Resistance Elimination And Management (H-DREAM) network
The H-DREAM network brings together a multidisciplinary team of researchers comprising clinicians, epidemiologists, computer programmers, social scientists and public health scientists from South Africa, Uganda and the UK. The network aims to set up a sustainable interdisciplinary partnership that will underpin long-term research exchanges, strengthen research capacity in overseas partners and form the basis for large scale research projects that tackle HIV drug resistance. The network undertakes training of health care staff on proper monitoring of people living with HIV on antiretroviral therapy and prevention of HIV drug resistance as well as evaluation of the individual and health system factors that contribute to drug resistance.
Long-term clinical outcomes of HIV-positive individuals treated at high CD4 counts in rural South Africa
The ANRS HIV treatment as Prevention (TasP) trial was implemented between 2012 and 2016 to investigate the impact of home-based HIV testing and immediate offer of antiretroviral therapy on HIV incidence. HIV-positive individuals in this cohort were amongst the first in sub-Saharan Africa to be offered antiretroviral therapy regardless of CD4 counts. These individuals were transitioned back to the public ART programmes at the end of the trial. This study aims to investigate their long-term clinical outcomes, including engagement and retention in care, virological outcomes, drug resistance and mortality.
The ethics of Post-trial access in Interventional Research and potential for Moral Hazard: Arguments for different responsibilities
Legislation and guidelines on Post-trial Access (PTA) are inconsistent and not as forward moving as the rate at which interventional research is developing in Low and middle-income countries (LMIC). The increased globalisation of research poses PTA challenges to research, and sponsors alike with increased ambiguity on who has responsibility for what and to whom. This study explores the issues around PTA, using the recently concluded HIV Treatment as Prevention trial in rural KwaZulu-Natal as a case study.
Drought, Poverty and HIV Drug Resistance: threat to resilience in a vulnerable rural setting
The co-location of HIV and drought has made HIV and diarrhoeal diseases the two leading causes of death in the uMkhanyakude district of South Africa. The project tests the hypothesis that the added shock from drought contributes to HIV-positive individuals prioritising their means of livelihood over their health, resulting in poor engagement with care and greater HIV drug resistance in the district.