ICAP News - October 2009

ICAP Launches New Research Site in Harlem, New York
ICAP turns its attention to the often-forgotten HIV epidemic in the United States with the initiation of two HIV prevention studies in the Harlem neighborhood of New York City at ICAP’s new Harlem Prevention Center research site.

The site will focus on two large multi-city, National Institutes of Health-funded HIV prevention studies, the Women’s HIV Seroincidence Study (ISIS) and the Broadening the Reach of Testing, Health Education, Resources and Services for Black Men who have Sex with Men (BROTHERS) Project. In addition, the new facility will house the U.S. Centers for Disease Control and Prevention-funded Tuberculosis Epidemiologic Studies site, which will conduct tuberculosis epidemiologic research.

ISIS will recruit 2,000 HIV-negative women at risk for HIV from ten U.S. cities. Ethnographic research has already been conducted to identify venues within communities where such women are likely to be encountered. The goal is to establish an accurate estimate of the overall HIV incidence among at-risk women in these communities. The study will also assess individual and partner behaviors, as well as social factors that influence HIV risk.

The BROTHERS Project will examine HIV infection among black men who have sex with men. The study will recruit 400 such individuals from each of six U.S. cities. The goal is to assess the feasibility of recruiting a large number of black men who have sex with men for HIV prevention studies, including their acceptability of HIV testing and screening for sexually transmitted infections. The study will also gauge the feasibility of utilizing peer health educators to navigate these men to health and other community services.

“HIV remains a critical problem in the United States, a hidden and sadly forgotten epidemic,” said ICAP Global Director Wafaa El-Sadr, MD. “These two studies will allow us to develop key information that will help inform the design of future HIV prevention intervention studies in the United States.” El-Sadr also serves as chair of the Domestic HIV Prevention Working Group of the HIV Prevention Trials Network, a worldwide effort that aims to evaluate promising, non-vaccine HIV prevention interventions. Sharon Mannheimer, MD, chief of infectious diseases at Harlem Hospital, will lead both the ISIS and BROTHERS studies.

In addition to these pilot studies, the Harlem site will conduct wide-ranging research on TB, including adherence to TB treatment and early diagnosis, prevention, and treatment of TB in the African-American community.

‘Pharmacovigilance’ Initiative Focuses on Antiretroviral Therapy Side Effects
ICAP South Africa is collaborating with the Eastern Cape Department of Health on a ‘pharmacovigilance’ (referring to the understanding and prevention of adverse effects of medicine) mentoring initiative to improve healthcare providers’ reporting of adverse effects of antiretroviral therapy (ART).

Currently, little information exists on the side effects of ART in resource-limited settings. To address this issue, ICAP has been working with sites in the Port Elizabeth region to mentor healthcare providers on the assessment and accurate reporting of adverse drug events. Providers submit their reports, which are then collated and analyzed to identify issues for discussion at multidisciplinary team meetings.

“Active identification and management of adverse effects is central to quality management of patients on ART,” said Kidwell Matshotyana, ICAP senior pharmacy advisor. “We expect this mentoring initiative will increase the number of reported adverse event cases and ultimately help improve patient treatment outcomes.”

For more about ICAP South Africa, visit here.

Nurses Graduate from HIV/AIDS Clinical Management Program in South Africa
Twenty-seven nurses recently graduated from an ICAP-supported advanced certificate program in HIV/AIDS clinical management at the University of Fort Hare and Stellenbosch University in South Africa. The program, which covers all aspects of HIV/AIDS clinical management, builds nurses’ skills to function independently as clinical nurse specialists and is designed to help address the severe shortage of healthcare providers who can deliver HIV services in South Africa. In some provinces in South Africa, greater than 60 percent of medical practitioner posts in the public sector are estimated to be vacant.

For more about ICAP South Africa, visit here.

Family Day Events Raise Awareness of HIV Services at Swaziland Clinics

In September, more than 1,500 adults and children attended Family Day events supported by ICAP Swaziland to raise awareness of HIV services at Sigangeni and Lamvelase Zomobodze Clinics.

Family Day speakers described the services available and explained the importance of safer sex, HIV testing, status disclosure to partners, and adherence to HIV treatment. At the Lamvelase Family Day, people living with HIV also provided testimonials about the importance of family and community support in disclosing HIV status and obtaining HIV services.

“The positive experiences of these individuals made strong impressions and went a
long way in reducing stigma, which is one of main barriers to accessing HIV services,” said Joris Vandelanotte, MD, ICAP Swaziland’s technical director.

HIV counseling and testing were provided to attendees at both Family Day events. A total of 149 individuals obtained tests, of whom 23 people tested positive and were linked to follow-up care.

ICAP supports Family Days to sensitize communities about new HIV services available at healthcare facilities and to encourage family members of those already on treatment to obtain HIV counseling and testing. Also supporting the events were the Swaziland Ministry of Health and Social Welfare, Population Services International, the Family Life Association of Swaziland, Nazarene Compassionate, and local communities.

Photo caption: ICAP Clinical Advisor Peter Preko, MD, (left) with the Regional HIV
Coordinator for Hhohho Nonhlahla Dlamini at Singangeni Family Day

For more about ICAP Swaziland, visit here.

First ICAP Laboratory Meeting Convenes in Johannesburg
In September, laboratory advisors from ten ICAP-supported countries gathered with senior ICAP technical leadership for the first ICAP laboratory meeting in Johannesburg, South Africa. The three-day meeting focused on developing laboratory skills such as mentoring, monitoring and evaluation, quality assurance and accreditation. It also provided laboratory staff with the opportunity to learn about new diagnostic technologies, such as an investigational point-of-care CD4 cell count test, and results from recent clinical trials examining two approaches to laboratory monitoring of patients on antiretroviral therapy in resource-limited settings.

“The meeting allowed us to take a big step forward in integrating lab support into HIV care and treatment,” said Jessica Justman, MD, ICAP senior technical director.

For more information and resources about ICAP’s laboratory program, email icap@columbia.edu

Photo caption: ICAP Senior Technical Director Jessica Justman delivers a presentation at the laboratory meeting.

ICAP Global Director Elected to Institute of Medicine
ICAP Global Director Wafaa El-Sadr, MD, has been elected a member of the Institute of Medicine (IOM) of the National Academy of Sciences, one of the highest honors in the fields of health and medicine. IOM Membership recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.

ICAP in the News
Jessica Justman, MD, ICAP senior technical director, was recently interviewed by PBS’s “Worldfocus” after the release of results of the recently completed HIV vaccine study in Thailand. She also will be featured in similar interviews on Austrian Public Radio and the German radio outlet Deutsche Welle.