Battling an invisible pandemic: five ways researchers are fighting AIDS
Since the HIV virus was first identified in 1984, more than 35 million people have died from HIV or AIDS related illnesses, making it one of the most devastating pandemics in history.
Globally, there are an estimated 38 million people who are living with HIV. And the pandemic is still active — an estimated 1.5 million people acquired HIV in 2021.
South Africa is the global epicentre of the HIV epidemic with over 7 million people living with HIV. Although it’s preventable, 300,000 people are contracting HIV there each year.
And it’s not just adults who are suffering. Across Sub-Saharan Africa an estimated 85 million children are AIDS-affected, sick themselves, orphaned, living with someone with AIDS, or are caring for AIDS-sick parents or caregivers.
Here in the UK, on Worlds Aids Day 2022, there are more than 105,000 people living with HIV. But research shows that 63% of the UK public do not remember seeing or hearing about HIV in the past six months.
HIV testing and treatment can prolong lives and reduce HIV transmission, but there are still some barriers to testing and care. Here are some of the ways researchers around the world are continuing to raise awareness, shape policy change and find novel ways to improve the lives of those suffering, or at risk of, HIV.
A vaccine for HIV?
Researchers in Uganda are conducting the first ever trial of HIV vaccine efficacy. Working with collaborators across the world, the MRC/UVRI and LSHTM Uganda Research Unit is also leading on the East Africa Point of Care Viral Load Study examining using monitoring to improve suppression among children and adolescents, aged 19 and under, living with HIV in Kenya, Rwanda, Tanzania and Uganda.
The work of the Unit has enabled scientists to identify acute and early HIV infected patients out of individuals with negative rapid diagnostic test results, and supported research influencing sexual risk behaviours among adolescents in East and Southern Africa.
There’s an app for that
University College London (UCL), Imperial College London and the Africa Health Research Institute are developing a low cost, user friendly mobile phone app for diagnostic tests to enable online prevention for the local South African communities hardest hit by HIV.
The user can perform a finger prick blood test, and then through the app send a photo of their result to a main outlet for diagnosis. By using these ultra-sensitive techniques the mobile tests could detect HIV at the very early stages of infection when transmission is most likely and prevention most important.
A survey of 100,000 people showed high levels of enthusiasm for mobile phone testing, because it saves time, provides privacy, and means tests can be done away from clinics.
The project now has more than 60 fieldworkers trained to take photos and create a library of images that will train a machine learning model to read test results. It is also significantly easing the burden on local healthcare systems.
Protecting women and girls
UCL is also active in Zimbabwe where HIV remains the leading cause of death. UNAIDS has reported that in sub-Saharan Africa, 5 in 6 new infections among adolescents aged 15–19 years are among girls.
Dr Valentina Cambiano, Lecturer in Infectious Disease Modelling and Biostatistics at UCL, is working with researchers, adolescent girls and young women in Zimbabwe to improve targeting of HIV testing and uptake of HIV prevention.
Professor Lucie Cluver, from the University of Oxford, is leading the Young Carers South Africa project, which has interviewed more than 6,000 children and 2,500 caregivers in the South African provinces of Western Cape, Mpumalanga and KwaZulu-Natal.
The study aims to provide rigorous evidence for social policy for children and adolescents affected by AIDS. It will also help identify the best ways to care and support young people and families living in AIDS-affected communities.
Lifesaving drugs that don’t impact mental health
South Africa has the largest population of people taking antiretroviral drugs in any country in the world. Around 28.7 million people were using antiretroviral therapy in 2021 — but it is still unclear what effect the drug is having on the mental health of HIV patients.
In Cape Town, researchers have set up the CONNECT study to assess the impact of these drugs on patients.
They are looking at how the medications impact cognitive function and mental health, especially a new drug called Dolutegravir, which is linked to fewer side effects. The clinical data generated by this study will inform public policy and ensure health funds are allocated effectively.
So what’s next?
Three years into the COVID-19 pandemic, this is just a snapshot of the work still underway nearly 40 years after HIV AIDS was recognised. It clearly demonstrates just how important scientific research and international collaboration are when combating global health crisis — and how the work has to carry on, continuing to save and influence lives, even when the original threat is no longer big news.
Want to know more?
If you’re a UK taxpayer, your contributions helped fund this work, via UK Research and Innovation — the UK’s largest public funder of research — and the Medical Research Council. You can read more about what we do here.
The Young Carers South Africa study is a collaboration between the universities of Oxford, Cape Town and KwaZulu-Natal, with the South African National Government, USAID-PEPFAR (US President’s Emergency Plan for AIDS Relief), and non-governmental organisations including UNICEF and Save the Children.
MRC/UVRI and LSHTM Uganda Research Unit is funded and run by the Medical Research Council, Uganda Virus Research Institute and the London School of Hygiene and Tropical Medicine.
The Connect Study is run by the University of Liverpool and researchers from South Africa’s University of Cape Town and funded by UKRI and MRC. Read more here
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Global AIDS Strategy 2021–2026 — End Inequalities. End AIDS. (unaids.org)
