After a decade of successful scale-up of HIV prevention and treatment efforts in sub-Saharan Africa, it is a good time to look at what has been accomplished and to assess the effect of HIV programs on the epidemic’s trajectory. The findings may inform decisions to modify the response to the epidemic in the coming years.
The household-based, population-level surveys will use biologic markers to measure HIV prevalence and incidence and to estimate access to prevention, care, and treatment services. The findings will provide a deeper understanding of the effectiveness of the HIV response at a national level. They will guide future investments and help target programs and resources to populations at greatest risk and in most need of services.
“We have an important opportunity to gather and use population-based data, much like a census focused on HIV, to get a better picture of the HIV epidemic in Africa,” says Jessica Justman, MD, associate professor of medicine in epidemiology and principal investigator and senior technical director at ICAP. “This project will yield a body of evidence and lessons learned to inform HIV programs over the next decade.”
ICAP will lead the PHIA project. The other key partners are the African Society for Laboratory Medicine, ICF International, the Statistical Center for HIV/AIDS Research and Prevention at the Fred Hutchinson Cancer Center, University of California San Francisco’s Global Health Sciences, and Westat.
ICAP will provide technical support to strengthen data-collection systems and enhance laboratory infrastructure in the countries where the surveys will be conducted. An important aspect of the project is the enhancement of capacity within countries to design, conduct, and analyze PHIAs and to use findings in policy development and program design.
“This is an opportune moment to take stock of what has been achieved in confronting the HIV epidemic in Africa and to use rigorous methods to collect the type of information we need to guide the way forward,” says Wafaa El-Sadr, MD, MPH, University Professor, professor of medicine and epidemiology, and ICAP director.
The PHIA project builds on ICAP’s experience in conducting similar HIV surveys in Tanzania and Zambia, as well as a survey in Swaziland of more than 13,000 households. ICAP launched the Swaziland HIV Incidence Measurement Survey website earlier this year and has made select findings available online to researchers.
Founded in 2004 and based at Columbia’s Mailman School of Public Health, ICAP at Columbia University collaborates with partners worldwide to support programs and research that address major health issues such as HIV, malaria, tuberculosis, maternal and child health and non-communicable diseases. ICAP is currently working in more than 3,300 health facilities in 21 countries.