Areas of Expertise

The Wits Reproductive Health and HIV Institute is one of the leading multi-disciplinary institutes in Africa with an extensive portfolio that includes research, programmatic support, training, policy development, health systems strengthening and technical assistance at national and international levels. Our areas of expertise encompass HIV, sexual and reproductive health (SRH) and vaccine preventable diseases (VPDs).

HIV

Wits RHI’s comprehensive approach to fighting HIV is informed by innovative research ranging from testing multi-purpose prevention technologies, exploring structural drivers, to improving approaches to care and treatment through health systems strengthening, optimising treatment, and developing appropriate models of care for key populations and marginalised groups.

We respond to emerging trends in the field of HIV.

HIV Prevention

Wits RHI’s work largely focuses on women and girls, and we continue to contribute to global evidence and cutting-edge research as part of an international effort in response to the HIV epidemic.

Our prevention research portfolio includes studies considered among the most important for advancing the field of HIV prevention. Many of these trials focus on assessing ARV-based microbicides and include studies designed to evaluate microbicides along with other promising HIV prevention approaches, such as the daily use of ARVs as pre-exposure prophylaxis (PrEP).

Our work includes:

HSTAR

HPTN 084

OPTIONS

More HIV Prevention Studies

The ADVANCE Programme led by Wits RHI, is the world’s largest set of studies on ARV treatment optimisation. Results coming from this study facilitated the introduction of new ARVs in South Africa. These ARVs are cheaper and have fewer side effects than the drugs that are currently available.

Clinical trials have shown that treatment regimens including dolutegravir work faster, have fewer side effects and demonstrate greater potency against drug resistance than standard HIV drugs used in Africa and other poor countries. Dolutegravir is a highly effective antiretroviral, which is well tolerated by patients and has fewer side effects. Patients are therefore more likely to be adherent and more likely to be virally suppressed – which means that they are not likely to transmit the virus to others.

“ADVANCE Study” – Study launched to test new and safer HIV drugs

Care and treatment in adults

Wits RHI’s research portfolio is contributing to global evidence and cutting-edge research as part of an international response to the HIV epidemic. Despite outstanding achievements in which over three million people are accessing ART in South Africa, there are still an estimated one million in need of ART and an additional three million who are in need of care and support services. Increased access to ART and better TB diagnostics has renewed focus on complex case management.

Referral systems are being stressed by the large number of people being screened and initiated on ART, as well as the surge of multi-drug resistant (MDR)/extremely drug resistant (XDR) patients.

Wits RHI offers technical support to the DoH on DR TB and clinical support and mentoring at decentralised DR treatment sites within The City of Johannesburg Region F.

Our work includes:

OPTIMIZE

Care and treatment in children

HIV and TB in children remains a challenge. Children have limited options with regards to HIV and TB medication, and disease progression is often different to that of adults. According to the Elizabeth Glaser Pediatric AIDS Foundation, children with HIV are 20 times more likely to contract TB and UNAIDS estimates that 700 children worldwide become infected each day, and that almost half of them will die before their second birthday without ARV therapy.

Diagnosis of infant HIV and subsequent initiation onto ART is thus imperative to prevent disease progression and mortality. This is one of the major objectives of the Wits RHI paediatric team, which is working to strengthen health systems to better identify and care for children living with HIV and TB. Technical assistance, training and mentorship are provided to facilities in the districts where we operate, to increase their capacity to treat HIV-infected children and adolescents holistically.

Our work includes:

TB CHAMP

Optirif

Wits RHI’s paediatric clinical research team is located at the Wits RHI Shandukani Research Centre in Hillbrow. Shandukani conducts research with the aim of decreasing the mortality and morbidity associated with HIV disease and infectious diseases in children, adolescents and pregnant women.

The team conducts clinical and network trials of new drugs and evaluates treatment regimens to guide the care and management of HIV-positive infants, children, and adolescents, with a particular interest in TB/HIV co-infected children. This is done in partnership with the International Maternal Paediatric Adolescent Aids Clinical Trials Group (IMPAACT). Shandukani provides secondary level and specialised health services for women, adolescents and children, and includes a 24-hour midwife-led obstetric unit.

Sexual and Reproductive Health

All men and women have the right to quality reproductive health care and access to services such as family planning. In countries where resources are constrained and health systems are overburdened by diseases such as HIV and TB, it remains a challenge to develop reproductive health care strategies that are able to reach populations in need.

Evidence is needed from high quality studies to design and implement these strategies; a gap that Wits RHI is addressing through its research.

In 2017, we received funding support from Unitaid to implement an SRH access project that will provide PrEP to 6,640 adolescent girls and young women aged 15 to 24 in priority areas of South Africa.

This three-year project will be integrated into the National Department of Health’s She Conquers campaign, which works with adolescent women and young girls to reduce HIV incidence, gender-based violence, teenage pregnancy, school drop-out rates and youth unemployment, with a focus on prioritized districts.

Unitaid PrEP Project

Vaccine Preventable Diseases

Vaccines are one of the most powerful, cost-effective public health interventions, responsible for saving millions of lives and catalysing economic growth. Yet, in 2013, WHO estimated that a lack of access to established vaccines contributed to approximately two million childhood deaths worldwide.

Vaccine preventable diseases (VPDs) are a relatively new, but increasingly important focus area for Wits RHI. We are currently conducting tuberculosis (TB) vaccine studies in infants, and are planning to implement a Respiratory Syncytial Virus (RSV) vaccine trial in pregnant women. Wits RHI has published on human papillomavirus (HPV) vaccine implementation and programme feasibility, and has evaluated the National Department of Health’s national HPV vaccine programme. We are developing an adolescent/pre-adolescent platform for vaccines, and maternal infant pair cohorts.

We have also had extensive involvement with international vaccine research partners and global policy. In 2015, we became a lead partner in the African Local Initiative for Vaccinology Expertise (ALIVE); a Wits University project to create a flagship vaccine and immunisation institution. Professor Helen Rees, together with Professor Shabir Madhi of the Respiratory and Meningeal Pathogen Research Unit, is spearheading the initiative, which is supported by a group of eminent South African vaccine researchers and other academics from fields such as implementation science, public health, health economics and social science. ALIVE is being run in conjunction with the National Research Foundation and was launched in May 2016.

Our Work includes:

ALIVE

TEHSA: The Epidemiology of Human Papillomavirus and Associated Disease in HIV Positive Men in South Africa


More VPDs studies

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