HIV Research




FPD has worked in the HIV field for more than two decades now promoting community awareness, strengthening healthcare services, and building public health capacity. This is done through a combination of direct service delivery, technical assistance, and research. Our research portfolio includes a broad spectrum of research types including clinical trials, investigator-driven research, and operational evaluations. We conduct projects at the Ndevana Clinical Research Site (CRS) in the Eastern Cape, within primary healthcare facilities and communities across South Africa. All projects are conducted in close partnership with the Department of Health, non-governmental and community-based organisations, and other relevant stakeholders. Community advisory boards are in place.

South Africa has the largest HIV epidemic in the world with almost 8 million people living with HIV Read More. Despite the massive progress in providing antiretroviral therapy (ART), and reduction in new HIV infections, the incidence of new HIV infections remains high. Adolescent girls and young women (AGYW), pregnant women and key populations are disproportionally affected. Therefore, in addition to the ART programme, a strong HIV prevention programme is imperative to achieve HIV epidemic control.

The FPD research unit has a portfolio of projects in the HIV prevention field with strong focus on HIV pre-exposure prophylaxis (PrEP). This includes evaluation of novel options for HIV prevention, such as long-acting injectable lenacapavir, at our Ndevana CRS, in the PURPOSE-1 and PURPOSE-2 trials. These trials build on previous studies of community-based HIV testing campaigns and community-based models of out-of-facility delivery of HIV PrEP (‘Community PrEP study’). Furthermore, we are conducting the ‘PrEP Choice’ project which aims better understand PrEP preferences, choices and options for PrEP delivery models for pregnant and breastfeeding women. This is really important because there is paucity of data of PrEP in pregnancy, HIV incidence is high, and newly acquired HIV infection during pregnancy is responsible for a large proportion of the newborns with HIV.

The SOAR projects acknowledge the importance of stigma and disclosure of HIV status for ART adherence and outcomes in men who have sex with men (MSM) and transgender people. In this project, the FPD team have adapted a behavioural intervention to local and cultural context. Acceptability and feasibility of online delivery of the intervention was assessed. At present, we are evaluation the intervention in a pilot randomized-controlled trial, with the first results expected to be available in 2024.



Our Research Staff




Ms Lindsey de Vos

LindseyD@foundation.co.za

Qualitative Research Manager


Buntu Mahlobisa

buntum@foundation.co.za

Study coordinator


Avuyonke Gebeng

Qualitative researcher

Current projects



SOAR projec

Start Date : 2021-03-01 End Date : 2025-02-28

Site : Buffalo City Municipality

“A Pilot Randomized Controlled Trial of Speaking Out and Allying Relationships (SOAR) Intervention to improve antiretroviral therapy adherence for gay, bisexual, and men who have sex with men (GBMSM) and transgender women (TW) living with HIV in South Africa

Donor: National Institues of Health, grant number NIMH R34MH125790.



PrEP Choice project

Start Date : 2023-01-01 End Date : 2024-09-30

Evaluation of pregnant and breastfeeding women’s preferences and attitudes towards long-acting pre-exposure prophylaxis: a discrete choice experiment.

Donor: MERCK through USC



PURPOSE 1

Start Date : 2022-10-30 End Date : 2027-08-31

Site : Ndevana Clinical Research Site

A Phase 3, Double-Blinded, Multicenter, Randomized Study to Evaluate Safety and Efficacy of Twice-Yearly Long Acting Subcutaneous Lenacapavir, and Daily Oral Emtricitabine/Tenofovir Alafenamide for Pre-Exposure Prophylaxis in Adolescent Girls and Young Women at Risk of HIV Infection.

ClinicalTrials.gov ID NCT04994509



PURPOSE 2

Start Date : 2023-08-01 End Date : 2027-12-31

Site : Ndevana Clinical Research Site

A Phase 3, Double-Blinded, Multicenter, Randomized Study to Evaluate Safety and Efficacy of Twice-Yearly Long Acting Subcutaneous Lenacapavir, and Daily Oral Emtricitabine/Tenofovir Alafenamide for Pre-Exposure Prophylaxis in Adolescent Girls and Young Women at Risk of HIV Infection.

ClinicalTrials.gov ID NCT04994509

Past projects



Molecular epidemiology and antimicrobial resistance of Neisseria gonorrhoeae isolates in East London

Start Date : 2022-01-01 End Date : 2023-03-31

Donors : SA MRC through GARDP.

Screening and treating pregnant women for STIs.

Start Date : 2016-01-01 End Date : 2018-12-31

Donors : Eunice Kennedy Shriver Institute of Child Health and Human Development (NICHD) of the National Institutes of Health (NIH) under award number: R21HD084274.

Publications



Daniels J, Peters RPH, Portle S, Mashabela N, Struthers H, Radebe O, Nel D, Medina-Marino A, Bongo C, Stephenson R. Developing the Speaking Out and Allying Relationships intervention on videoconference for HIV-positive GBMSM in Eastern Cape, South Africa. Am J Mens Health 2023; 17(5): 15579883231197335.

Daniels J, de Vos L, Bezuidenhout D, Atujuna M, Celum C, Hosek S, Bekker LG, Medina-Marino AM. “I know why I am taking this pill”: young women navigation of disclosure and support for PrEP uptake and adherence in Eastern Cape Province, South Africa. PLOS Glob Public Health 2023; 3(1): e0000636.

Smith PJ, Daniels J, Bekker LG, Medina-Marino AM. What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo city municipality, South Africa. BMC Public Health 2023; 23(1):418.

Mudimu E, Sardinia J, Momin S, Medina-Marino A, Bezuidenhout C, Bekker LG, Barnabas RV, Peebles K. Incremental costs of integrated PrEP provision and effective use counselling in community-based platforms for adolescent girls and young women in South Africa: an observational study. J Int AIDS Soc 2022; 25: e25875.

Daniels J, Peters RPH, Medina-Marino A, Bongo C, Stephenson R. A skills-based HIV serostatus disclosure intervention for sexual minority men in South Africa: protocol for intervention adaptation and a pilot randomized controlled trial. JMIR Res Protoc 2022; 11: e36845.

Krogstad Mudzingwa E, de Vos L, Atunja M, Fynn L, Mugore M, Hosek S, Celum C, Bekker LG, Daniels J, Medina-Marino A. Factors influencing adolescent girls and young women’s uptake of community-based PrEP services following home-based HIV testing in Eastern Cape, South Africa: a qualitative study. AIDS Behav 2022; 26(11): 3729-3739.

Medina-Marino A, Bezuidenhout D, Ngwepe P, Bezuidenhout C, Facente SN, Mabandla S, Hosek S, Little F, Celum CL, Bekker LG. Acceptability and feasibility of leveraging community-based HIV counselling and testing platforms for same-day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa. J Int AIDS Soc 2022; 25(7): e25968.

Medina-Marino, Bezuidenhout D, Hosek S, Barnabas RV, Atujuna M, Bezuidenhout C, Ngwepe P, Peters RPH, Little F, Celum CL, Daniels J, Bekker LG. The Community PrEP Study: a randomized controlled trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa – study protocol. Trials 2021; 22(1): 489.

Medina-Marino A, Daniels J, Bezuidenhout D, Peters R, Farirai T, Slabbert J, Guloba G, Johnson S, Bekker LG, Nkhwashu N. Outcomes from a multimodal, at-scale community-based HIV counseling and testing programme in twelve HIV high burden districts in South Africa. J Int AIDS Soc 2021; 24(3): e25678.

Shamu S, Shamu P, Khupakonke S, Farirai T, Chidarikire T, Guloba G, Nkhwashu N. Pre-exposure prophylaxis (PrEP) awareness, attitudes, and uptake willingness among young people: gender differences and associated factors in two South African districts. Glob Health Action 2021; 14(1): 1886455.

Shamu S, Khupakonke S, Farirai T, Slabbert J, Chidarikire T, Guloba G, Nkhwashu N. Knowledge, attitudes, and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two HIV high burden districts, South Africa. BMC Public Health 2020; 20(1): 1249.

Shamu S, Farirai T, Slabbert J, Guloba G, Masihlelo N, Kamara J, Nkhwashu N. A community-based HIV counselling and testing programme found a decreasing proportion of new HIV testers in South Africa. Afr J AIDS Res 2020; 19(1): 34-39.

Shamu S, Chasela C, Slabbert J, Farirai T, Guloba G, Nkhwashu N. Social franchising of community-based HIV counselling and testing services to increase HIV testing and linkage to care in Tshwane, South Africa: study protocol for a non-randomised implementation trial. BMC Public Health 2020; 20(1): 118.

Shamu S, Farirai T, Kuwanda L, Slabbert J, Guloba G, Khupakonke S, Johnson S, Masihlelo N, Kamera J, Nkhwashu N. Comparison of community-based HIV testing and counselling (CBCT) through index client tracing and other modalities: outcomes in 13 South African high HIV prevalence districts by gender and age. PLoS One 2019; 14(9): e0221215.

Lebina L, Seatlholo N, Taruberekera N, Radebe M, Kinghorn A, Meyer T, Mhazo M, Otwombe K, Hlongwane K, Ringane A, Koloane N, Nkuta M, Nkhwashu N, Farirai T, Kweza P, Chidarikire T, Shamu S, Kufa T, Puren A, Martinson N, Milovanovic M. Feasibility of community-based HIV self-screening in South Africa: a demonstration project. BMC Public Health 2019; 19(1): 898.

Rwafa T, Shamu S, Christofides N. Relationship power and HIV sero-status: an analysis of their relationship among low-income urban Zimbabwean postpartum women. BMC Public Health 2019; 19(1): 792.

Shamu S, Slabbert J, Guloba G, Blom D, Khupakonke S, Masihlelo N, Kamera J, Johnson S, Farirai T, Nkhwashu N. Linkage to care of HIV-positive clients in a community-based HIV counselling and testing programme: a success story of non-governmental organisations in a South African district. PLoS One 2019; 14(1): e0210826.

Shamu S, Shamu P, Zarowsky C, Temmerman M, Shefer T, Abrahams N. Does a history of sexual and physical childhood abuse contribute to HIV Infection risk in adulthood? A study among post-natal women in Zimbabwe. PLoS One 2019; 14(1): e0198866.

Shamu S, Farirai T, Kuwanda L, Slabbert J, Goluba G, Johnson S, Khupakonke S, Masihlelo N, Kamera J, Nkhwashu N. Social franchising of community-based HIV testing and linkage to care and treatment services: an evaluation of a pilot study in Tshwane, South Africa. J Int AIDS Soc 2018; 21(12): e25216.

Karat AS, Maraba N, Tlali M, Charalambous S, Chihota VN, Churchyard GJ, Fielding KL, Hanifa Y, Johnson S, McCarthy KM, Kahn K, Chandramoham D, Grant AD. Performance of verbal autopsy methods in estimating HIV-associated mortality among adults in South Africa. BMJ Glob Health 2018; 3(4): e000833.

Daniels J, Peters RPH, Portle S, et al. Developing the Speaking Out and Allying Relationships Intervention on videoconference for HIV-positive GBMSM in Eastern Cape, South Africa. Am J Mens Health 2023; 17(5): 15579883231197355. Access

De Vos L, Mudzingwa EK, Fynn L, et al. Factors that influence adolescent girls and young women’s re-initiation or complete discontinuation from daily oral PrEP us: a qualitative study from Eastern Cape Province, South Africa. J Int AIDS Soc 2023; 26(9): e26175. Access

Daniels J, de Vos L, Bezuidenhout D, et al. “I know why I am taking this pill”: young women navigation of disclosure and support for PrEP uptake and adherence in Eastern Cape Province, South Africa. PLOS Glob Public Health 2023; 3(1): e0000636. Access

Smith PJ, Daniels J, Bekker LG, et al. What motivated men to start PrEP? A cross-section of men starting PrEP in Buffalo City municipality, South Africa. BMC Public Health 2023; 23(1): 418. Access

Medina-Marino A, Bezuidenhout D, Ngwepe P, et al. Acceptability and feasibility of leveraging community-based HIV counselling and testing platforms for same-day oral PrEP initiation among adolescent girls and young women in Eastern Cape, South Africa. J Int AIDS Soc 2022; 25(7): e25968. Access

Daniels J, Peters RPH, Medina-Marino A, et al. A skills-based HIV serostatus disclosure intervention for sexual minority men in South Africa: protocol for intervention, adaptation, and a pilot randomized controlled trial. JMIR Res Protocol 2022; 11(5): e36845. Access

Mudzingwa EK, de Vos L, Atujuna M, et al. Factors influencing adolescent girls and young women’s uptake of community-based PrEP services following home-based HIV testing in the Eastern Cape, South Africa: a qualitative study. AIDS Behav 2022; 26(11): 3726-3739. Access

Mudimu E, Sardinia J, Momin S, et al. Incremental costs of integrated PrEP provision and effective use counselling in community-based platforms for adolescent girls and young women in South Africa: an observational study. J Int AIDS Soc 2022; 25(2): e25875. Access

Medina-Marino A, Bezuidenhout D, Hosek S, et al. The Community PrEP Study: a randomized controlled trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa – a study protocol. Trials 2021; 22(1): 489. Access

Medina-Marino A, Daniels J, Bezuidenhout D, et al. Outcomes from a multimodal, at-scale community-based HIV counselling and testing programme in twelve high burden districts in South Africa. J Int AIDS Soc 2021; 24(3): e25678. Access

Peters RPH, Joseph Davey DL, Bekker LG, et al. Antiretroviral therapy, sexually transmitted infections, and adverse pregnancy outcomes in South Africa. Clin Infect Dis 2021; 73(3): e851-e852. Access

Shamu S, Shamu P, Khupakonke S, Farirai T, Chidarikire T, Guloba G, Nkhwashu N. Pre-exposure prophylaxis (PrEP) awareness, attitudes, and uptake willingness among young people: gender differences and associated factors in two South African districts. Glob Health Action 2021; 14(1): 1886455. Access

Burke HM, Chen M, Murray K, et al. The effects of the integration of an economic strengthening and HIV prevention education programme on the prevalence of sexually transmitted infections and savings behaviors among adolescents: a full-factorial randomised controlled trial in South Africa. BMJ Glob Health 2020; 5(4): e002029. Access

Peters RPH, Kestelyn PG, Zierhut M, et al. The changing global epidemic of HIV and ocular disease. Ocul Immunol Inflamm 2020; 28(7): 1007-1014. Access

Shamu S, Khupakonke S, Farirai T, et al. Knowledge, attitudes, and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two HIV high burden districts, South Africa. BMC Public Health 2020; 20(1): 1249. Access

Shamu S, Farirai T, Slabbert J, et al. A community-based HIV counselling and testing programme found a decreasing proportion of new HIV testers in South Africa. Afr J AIDS Res 2020; 19(1): 34-39. Access .

Shamu S, Chasela C, Slabbert J, et al. Social franchising of community-based HIV counselling and testing services to increase HIV testing and linkage to care in Tshwane, South Africa: study protocol for a non-randomised implementation trial. BMC Public Health 2020; 20(1): 118.Access

Shamu S, Farirai T, Kuwanda L, et al. Comparison of community-based HIV testing and counselling (CBCT) through index client tracing and other modalities: outcomes in 13 South African high HIV prevalence districts by gender and age. PLoS One 2019; 14(9): e0221215. Access

Lebina L, Seatlholo N, Taruberekera et al. Feasibility of community-based HIV self-screening in South Africa: a demonstration project. BMC Public Health 2019; 19(1): 898. Access .

Shamu S, Slabbert J, Guloba G, et al. Linkage to care of HIV-positive clients in a community-based HIV counselling and testing programme: a success story of non-governmental organisations in a South African district. PLoS One 2019; 14(1): e0210826. Access

Shamu S, Farirai T, Kuwanda L, et al. Social franchising of community-based HIV testing and linkage to care and treatment services: an evaluation of a pilot study in Tshwane, South Africa. J Int AIDS Soc 2018; 21(12): e25216. Access .