The current and substantial efforts to combat the HIV epidemic in South Africa do not adequately address injection drug use. Research is needed to understand how to access this hidden epidemic, understand the HIV prevention and treatment needs of this population and how to better engage them into care.  The study aimed to:

1. Pilot the use of respondent driven sampling (RDS) to access PWID in KwaZulu-Natal to assess the feasibility and acceptability of this sampling approach; and gather demographic and socio-behavioral data to gain a preliminary understanding of this population and its risk for HIV acquisition, morbidity, and transmission
2. Using qualitative methods, to assess access to and acceptability of HIV prevention and treatment services among PWID in KwaZulu-Natal.
3. Using mixed methods, to evaluate impact of the criminalization of substance use on PWID and evaluate how their interactions with the legal system affect health seeking. 

Ten key informants participated in an in-depth interview prior to the recruitment of people who inject drugs. 45 PWIDs were recruited via respondent driven sampling and participated in a survey, and 11 of these PWIDs also participated in an in-depth interview. Data analysis is currently underway.

      Collaborators: Emory University

The overall goal of the evaluation study was to assess the degree to which project activities build protective assets, resilience, and coping strategies of migrant and disabled AGYW in Durban and Johannesburg. The evaluation design  employed qualitative methods. Focus group discussions and brief socio-demographic questionnaires were conducted with a sample AGYW participants and their parents.

Participants in this study include migrant and disabled adolescent girls and young women (AGYW) aged 14-19 years, participating in the Community Media Trust (CMT), DREAMS intervention and  parents of participating AGYW. The project has  been completed and is being written up for publication

The study used a cluster stepped-wedge evaluation design whereby 18 clusters (communities) were randomized to when they initiate the CR intervention. A cohort of approximately 1500 men (aged 18–35) and women (aged 18–24) in evaluation communities was  followed over the course of approximately 30 months. Survey interviews were completed at baseline and at three additional time points at 7-8 month intervals. In addition, qualitative interviews  were conducted with programme implementers and a selection of study participants to gain a deeper understanding of the process, experiences, challenges, and benefits of adapting and scaling up the Stepping Stones intervention. Data collection was completed in May 2019 and analysis is underway.

Project SOAR is a five-year (September 2014–September 2019) cooperative agreement funded by the President’s Emergency Plan for AIDS Relief and the U. S. Agency for International Development (Agreement No. AID-OAA-A-14-00060). Population Council leads the Project SOAR consortium in collaboration with Avenir Health, Elizabeth Glaser Pediatric AIDS Foundation, the Johns Hopkins University, Palladium, and The University of North Carolina at Chapel Hill.

MRU and the HIV Center for Clinical and Behavioral Studies at Columbia University are conducting a study to explore female sex workers’ (FSW) knowledge, attitudes, and experiences with pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP), and other prevention options. No one strategy will likely be effective in eradicating HIV among FSW; rather a combination of context-specific targeted strategies, including ARV-based prevention/treatment and condoms, will be needed to reduce HIV incidence. However, combination prevention models for FSW have not been sufficiently developed and tested. This formative, qualitative research study on ARV-based HIV prevention and treatment for FSW will identify the structural, health system, interpersonal and individual-level barriers and facilitators that influence access to, use of, and adherence to ARV-based prevention and treatment among FSWs.

Data has been collected through a combination of focus discussions  and In depth interviews with FSWs. In addition in-depth interviews have been conducted with Policy makers,  Health Care Providers, Hotel Managers and Bouncers. Data have been collected, and are currently being analysed.

DIFFER: Diagonal Interventions to Fast-Forward Enhanced Reproductive Health

The “Diagonal Interventions to Fast Forward Enhanced Reproductive Health” (DIFFER) research project tests the hypothesis that combining vertical Sexual and Reproductive Health (SRH) interventions, such as services targeted to Female Sex Workers (FSW), with horizontal strengthening of health systems for SRH within existing health facilities, is synergistic, feasible, and likely to be more effective and cost-effective than providing them separately. This multi-country study consists of a consortium of three African, one Indian and two European partners. The research activities are being undertaken in the African sites (Durban, South Africa; Mombasa, Kenya; and Tete, Mozambique) and in Mysore India.

The formative research phase was completed in 2012 and activities included a detailed situational and policy analysis which informed the development of site and context-specific intervention packages to strengthen SRH services. The intervention sought to build FSWs capacity to access much needed SRH and HIV services and assess the feasibility of combining and providing both targeted and horizontal interventions for FSW. The intervention phase ended in March 2016  which was followed up by a comprehensive evaluation exploring empowerment, SRH and HIV healthcare needs, service access and barriers. The study is currently being written up and disseminated.

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This study developed a cohort of adolescents and young adults in Soweto and Durban aged between 16-24 (AYA) who were either known to be HIV negative or did not know their HIV status. The  study aimed to   identify, understand and link socio-behavioural, clinical, and biomedical patterns of risk for HIV acquisition and vaccine trial preparedness using a mixed method approach. The study was completed in 2017 and dissemination and write up of the results is in progress.

Click on the image below to see a video on the AYAZAZI study.