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.
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:
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
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.
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
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: