DfiD Research Programme Consortium (RPC): Consortium for Research and Capacity Building in Reproductive and Sexual Health and HIV/AIDS in developing countries

• London School of Hygiene & Tropical Medicine (LSHTM)
• National Institute for Medical Research (NIMR), Mwanza, Tanzania
• Navrongo Health Research Centre (NHRC), and School of Medical Sciences of Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
• Medical Research Council’s Social and Public Health Sciences Unit (MRC SPSHU), Glasgow, UK
• International Planned Parenthood Federation (IPPF)

• Development and evaluation of strategies for prevention of risky behaviour;
• Integration of SRH and HIV services
• Evaluation of new tools for the control of STIs or HIV
• Strengthen international research capacity and dissemination on SRH and HIV

Project Activities

Theme 1: Development and evaluation of strategies for prevention of risky behaviour

• Completion of a comprehensive report on results from a National Behavioural, STI and HIV Survey of Long-distance Truck Drivers.
• Completion of a baseline survey and development of a structural intervention to address HIV in a population of migrant men and women living in single sex hostels and adjacent informal settlements respectively in inner city Johannesburg. Three rounds of the intervention have been completed, and work on the final report is in progress. (Ref: Focus on Men: Mpilonhle Mpilonde).

Theme 2: Evaluation of new tools for the control of STIs & HIV

• Completed recruitment for the trial evaluating the role of acyclovir suppression in the reduction of plasma and genital HIV-1 RNA in women not requiring HAART.
• A paper on the effect of epidemiological context on microbicide efficacy was published in colloaboration with Peter Vickerman and Charlotte Watts (LSHTM) using a model based on a local site.
• Recruitment to the MDP 301 trial of PRO-2000 has been initiated in two sites in Johannesburg. (Ref: Microbicide Development Programme).

Theme 3: Strengthen international research capacity and dissemination on SRH & HIV

• Annually the RHRU conduct the Research Methods Course in Sexual and Reproductive Health and HIV. This is an African region 4-week training programme in research methods for doctors, researchers, policy makers and others in the field of reproductive health and HIV/AIDS. The annual course consists of highly relevant content specifically tailored for the African region. The course takes place in Johannesburg, and plays a significant role in the capacity building of high quality researchers within the region. (Ref: Research Methods Course).
• The RHRU hosts the Priorities in Reproductive Health and HIV conference (PHHC), which has since developed into a diennial regional conference for researchers, policy makers and health care service providers.
  • At the 2005 PHHC, a meeting was held with DoH representatives and local investigators regarding research priorities for introducing an HPV vaccine into South Africa.
• RHRU staff convened the first examination for the Higher Diploma in Sexual Health & HIV Medicine in April 2006.
• RHRU was a co-host of the Microbicides 2006 conference which was attended by a range of DoH officials including the Minister of Health.
  • A number of posters and oral presentations on the findings from the microbicide feasibility study were presented at the Microbicides 2006 conference. (Ref: Microbicide Development Programme).
  • Discussions were held with various local and international investigators, DoH representatives and WHO representatives prior to a consultation at the Microbicides 2006 conference on increasing access to acyclovir in countries where trials are currently being implemented.
• Writing workshop held for 10 RHRU staff to increase the number of research reports and dissemination of research findings to all stakeholders.

Anticipated/Actual Results
At the end of 5 years, there will be a substantial output of new knowledge in the fields of behaviour change interventions, improved strategies for the integration of reproductive health services, and the efficacy, impact and cost-effectiveness of new biomedical interventions to improve reproductive health and prevent HIV infection among poor populations in developing countries. This knowledge will provide policy makers, donors and programme managers with the information they require to make evidence-based decisions when deciding on priorities for programmes and for the allocation of resources. Through our comprehensive strategy for dissemination, we will ensure that policy makers at both national and international levels are aware of our research findings, and are able to understand their implications for policy in their own particular context. The project organisations will have been strengthened so that they have the capacity to continue this work in the future, to obtain their own research funding, and to act as regional centres of excellence for training and research.

Additional Outputs

• 2 staff attended the annual RHRU Reproductive Health Research Methods course;
• 4 staff attended twice annually RHRU HIV Management course (HIV prevention, treatment, care and support from the African region);
• RHRU staff convened the first examination for the Higher Diploma in Sexual Health & HIV Medicine in April 2006;
• 4 RHRU staff MSc in Biostatistics and Epidemiology at University of the Witwatersrand - using data generated from studies linked to the RPC through the theme of biomedical tools;
• 2 RHRU staff will complete PhD degrees using data from studies linked to the RPC in the themes of “strategies for behavour change” and “biomedical tools” respectively;
• 3 MSc students from LSHTM will complete their MSc (PHDC) using data from the Mpilonhle Mpilonde programme;

• To disseminate results from the trial evaluating the impact of suppressive treatment for genital herpes (HSV-2) on HIV shedding in South Africa, and model the potential impact of interventions against HSV-2 on HIV in this setting. (Ref: HSV-2 Shedding).
• To develop a research programme to inform the introduction of an HPV vaccine in South Africa, with a particular focus on understanding the epidemiology of HPV, the social implications of introducing this vaccine, and the safety and efficacy of this vaccine in target populations. (Ref: Microbicide Development Programme: HPV Sub Study).
• To develop additional proposals which focus on building the capacity of South African researchers to conduct clinical trials in SRH & HIV.

• A Multi Center Acute HIV-1 Infection Prospective Observational Cohort Study
• DfiD Research Programme Consortium: Consortium for Research and Capacity Building in Reproductive and Sexual Health and HIV/AIDS in developing countries
• A Safety & Acceptability Study of a Vaginal Ring Microbicide Delivery Method for the Prevention of HIV Infection in Women (IPM011)
• Acute HIV infection (AHI) identification
• Contraceptive Research Planning Survey: Comparison of DEPO-PROVERA and IUD Pilot Study
• A phase III randomized, double blind, placebo controlled trial of acyclovir for the reduction of HIV acquisition among high risk HSV2+ HIV- individuals (HPTN039) (known locally as Thembalethu)
• Sub-study to an international multi-centre, randomised, double-blind, placebo-controlled trial to evaluate the efficacy and safety of 0.5% and 2% PRO 2000/5 gels for the prevention of vaginally acquired HPV infection
• A multi-centred randomised trial of therapeutic intervention at primary HIV-1 infection (also known as SPARTAC)
• An international multi-centre, randomised, double-blind, placebo-controlled trial to evaluate the efficacy and safety of 0.5% and 2% PRO 2000/5 gels for the prevention of vaginally acquired HIV infection
• National Research Foundation Thuthuka Programme: Developing & Advancing Excellence in Researchers
• The Safety and feasibility study of the diaphragm used with Acidform gel or KY Jelly
• Evaluation of quadrivalent HPV vaccine in reducing the incidence of anogenital warts and related genital infection in young men
• IPM Microbicide Feasibility Study
• STI/HIV Research Adherence
• STI/HIV Research HSV2 Shedding
• STI/HIV Research Gates PIP
• Focus on Men: A Programme to Improve Male Involvement in Sexual & Reproductive Health (known locally as Mpilonhle-Mpilonde)