Five HIV trials in South Africa during 2017

‘They tried to make me go to the clinic and I said no‚ no‚ no’

In what could be the most depressing HIV news locally‚ a five-year study showed that testing people in their homes didn’t translate into HIV-positive people going to a clinic to get their antiretroviral medication. The study‚ conducted by the Africa Health Research Institute‚ was published in The Lancet journal.

It concluded that South Africa won’t beat HIV if it expects people‚ especially men‚ to present themselves at a clinic to collect their own drugs

The researchers made testing available to more than 27 000 people in the privacy of their homes in the northern KwaZulu-Natal community of Hlabisa. Researchers also made getting ARVs easier for people by providing more mobile clinics to the area. It was hoped that 70% of those who tested positive and had immediate access to treatment would collect it at the nearby mobile clinics. But only 30% did.

It was hoped that if treatment increased‚ people would be less infectious and new infections in the area would drop. But infections didn’t drop because treatment didn’t increase. Men were less likely to access ARVs than women.

Professor Deenan Pillay‚ director of the Africa Health Research Institute said: “To get so many people onto treatment for life … we have got to increasingly look outside of formal health facilities.”

Can you prevent HIV with a jab?

Researchers are trying to find ways to free woman from having to rely on men using condoms to prevent contracting HIV.

The National Institutes of Health has launched a trial of an ARV preventative injection‚ using a drug called Cabotegravir‚ to see whether it could provide a reduced risk of contracting HIV‚ if given every two months

The trial‚ which runs for three years and involves 3‚200 women in southern and eastern Africa including South Africa‚ will give half the women the preventative Truvada pill to take daily and the other half the injection every few months. It will then assess which group has fewer HIV infections.

South Africa’s second HIV vaccine trial

Researchers have been testing vaccines on people since 1998‚ without success. On World Aids Day‚ a new vaccine trial‚ Imbokodo‚ was launched.

Fauci explained to TimesLIVE that the new vaccine on trial is called a “mosaic” vaccine‚ meaning it is designed to protect against a wide range of HIV strains.

The trial is enrolling women aged 18 to 35 in southern Africa because they are at the highest risk of contracting the disease. Some South Africans participants have already received the vaccines. Regulatory processes are in place to conduct the study in Malawi‚ Mozambique‚ Zambia and Zimbabwe.

Results are expected in 2021. Even if this vaccine trial works‚ it would still require a phase three study that could take a few years.

The vaccine closest to a being licensed

The world’s only Phase 3 trial vaccine trial‚ HVTN 702‚ continued in South Africa after kicking off in late 2016. Phase three means the trial is in its last leg before the drug qualifies to be licensed for medication‚ if the final trial is successful. Results are expected in 2020.

Fauci told TimesLIVE that HVTN 702 is based on the results of a vaccine trial conducted in Thailand at beginning of the century. The vaccine wasn’t good enough to use in Thailand because it only provided 31 % protection against the virus.

The vaccine being trialed in South Africa has been modified and strengthened.

Fauci said the vaccine needs to offer at least a 50% reduced risk of contracting HIV for scientists “to deploy a vaccine”.

He explained that two vaccines were being tested in southern Africa because “only by testing each approach with the help of participants and researchers in Southern Africa will scientists be able to tell if one‚ both‚ or neither approach can safely and effectively prevent HIV infection.”