Kalisizo

Researchers are studying the latent HIV reservoir in Ugandans living with HIV who have their virus under control with antiretroviral therapy ART. This reservoir consists of hidden HIV in the blood that remains inactive but can persist for many years, posing a challenge to curing HIV. The study aims to measure the size and characteristics of this reservoir and understand factors affecting it in African populations, as existing data mostly come from Western countries. Participants include groups of HIV-positive adults on ART with suppressed viral loads, those with known recent infection dates, and some not currently on ART but with suppressed viral loads. Blood samples will be collected annually for up to 20 years to analyze viral latency, immune activation, and other markers. The study takes place at the Rakai Health Sciences Program in rural Uganda and involves detailed laboratory testing to track changes in the latent reservoir over time. During the study, participants will undergo medical history reviews, physical exams, and blood tests including finger pricks for hemoglobin screening and larger blood draws. Additional tests for other diseases and pregnancy screening for those who can become pregnant will also be done. Researchers will monitor participants health and collect data yearly to evaluate immune responses and viral reservoir size. This long-term observation will help understand HIV latency and inform future cure strategies.

This research aims to evaluate how adding testing for curable sexually transmitted infections cSTIs like chlamydia, gonorrhea, trichomonas, and syphilis to standard HIV risk screening can improve use of pre-exposure prophylaxis PrEP among cis-gender African women aged 15 to 39 years. The study focuses on women in eastern and southern Africa who are at high risk of HIV, often due to relationships with high-risk male partners, and who are often missed by self-reported risk screening tools alone. The goal is to see if integrated cSTI testing can better identify women at risk and increase their self-perceived HIV risk, thereby improving PrEP uptake and persistence. Participants will be randomly assigned to one of two groups one receiving standard self-reported risk screening SRST plus diagnostic cSTI testing, and the other receiving SRST alone. Both groups will get symptom screening and treatment for STIs as needed, plus syphilis testing for pregnant women. Those testing positive for cSTIs or eligible by SRST will be referred for same-day PrEP initiation. The study will be conducted within a population-based HIV surveillance cohort in Uganda, following participants for PrEP use outcomes. During the study, researchers will monitor PrEP uptake, adherence, and persistence up to six months after enrollment through clinical records, surveys, and drug level testing. They will also conduct interviews to understand barriers and facilitators to PrEP use, and use mathematical models to evaluate population-level impacts of different cSTI testing strategies. The study will last several years, providing insights to better integrate HIV prevention and STI testing programs for African women.