Wits RHI’s research portfolio is designed to contribute to global evidence and cutting edge research as part of an international effort in response to the HIV epidemic. A major proportion of the Institute’s HIV research work has focussed on women, based on the rationale that women have borne the brunt of the epidemic due to a complex mix of biological susceptibility, social and economic vulnerability and behavioural factors. Through our participation in a range of network clinical trials, Wits RHI continues to actively engage with studies that explore these factors, and contribute to the global HIV research agenda.
Key Projects Include
FACTS
(Follow-on African Consortium for Tenofovir Studies) is a South African-led consortium established to develop and conduct a Phase 3 clinical trial to establish the safety and effectiveness of 1% tenofovir gel used before and after sex in protecting women against HIV and genital herpes. The consortium comprises eight South African research institutions and is led by Prof Helen Rees as the Protocol Chair and co-ordinated by Wits RHI.
ASPIRE
This Is a Phase 3 clinical trial evaluating safety and effectiveness of the Dapivirine Ring, a slow-release vaginal ring containing an ARV, in preventing HIV. This study, part of the Microbicide Trials Network, is being conducted across five African countries. Wits RHI’s Dr Thesla Palanee is the international Co-Chair.
Region F TB Blitz
The project uses GeneXpert technology as a point-of-care diagnostic tool at seven PHCs in Region
F, Johannesburg, to determine time to diagnosis and treatment and patient outcomes vs. standard of care. A sub-study is investigating intensified case-finding, comparing contact home visits vs. paper slip contact-tracing.
THINK (TB, HIV, IRIS, nutrition in KIDS)
This is an NIH-funded studywith 2 sub-studies:
• Dosing, Safety and Pharmacokinetic Profile of
Rifabutin in children receiving Concomitant Treatment with Lopinavir / ritonavir.
• GeneXpert in children.
Policy support
Wits RHI offers the South African Government extensive technical support in the area of policy and guidelines development. Wits RHI has an ongoing portfolio of policy support work in the following areas:
• National Contraceptive and Fertility Policy
• Sex Worker Service Delivery
• Adolescent Working Group
• HPV Vaccine Policy
• National Health Data Advisory and
Co-ordination Committee
• National Advisory Group on Immunisation
• Southern African Clinicians Society
• Primary Care Re-engineering Policy
• PMTCT Guidelines
D4T Study
This is a Phase 3 pivotal study to assess the safety and efficacy of low-dose stavudine (D4T) relative to the current standard preferred therapy, tenofovir. The aim is to see if lowering dosages will reduce common side effects of D4T and will allow this much cheaper ARV option to be more safely continued as part of the
country’s ARV treatment regimens. The study will be implemented in three sites across South Africa, Uganda and India and is being led by Prof Francois Venter and co-ordinated by Wits RHI.
MAMA
This is an innovative global initiative to deliver vital health information to new and expectant mothers through mobile phones. MAMA is a public/private partnership launched in May 2011 by founding partners United States Agency for International Development and Johnson & Johnson with supporting partners the United Nations Foundation, mHealth
Alliance, and BabyCenter. Wits RHI is an implementing partner with the local team, MAMA South Africa.
Swa Koteka
The project is an innovative multi-level structural intervention for the prevention of HIV infection in young South African women. School-going girls and one of their parents living in
Agincourt in rural Mpumalanga are randomised to receive a cash transfer conditioned on school attendance. Primary outcomes being studied are HIV and HSV-2 incident infections. In tandem with the cash transfer, villages in the areas are randomised to receive a community mobilisation intervention targeting
young men as the potential sexual partners of young women.
Contraceptive mix in HIV prevention trials
Wits RHI is leading the way in ensuring IUCD uptake is strategically enhanced in central Johannesburg and at all ASPIRE and FACTS sites. The long-term aim is a reduction in the number of patients returning to public sector clinics for repeat hormonal contraceptives, reducing the number of unwanted pregnancies that occur as a consequence of poor adherence to contraceptives and ultimately reducing potential risk of HIV acquisition in women in communities broadly.
VITALS: Vaccine implementation using technology in schools
This is a cluster randomised controlled trial aimed at demonstrating the value of mobile technology in enhancing HPV vaccine
uptake, coverage and logistics as part of a schools-based HPV vaccination programme involving 5,400 girls aged 9-14.
