Communities Selected For Groundbreaking Research To Reduce HIV Transmission


Communities selected for various arms of the trial were chosen through a random draw. Labelled soccer balls were drawn from a bag to decide which communities would get the various services.

People from nine communities in the Western Cape and 12 in Zambia been selected for various interventions in a study that ultimately aims to bring down the rate of HIV infections in South Africa and Zambia.

The Population Effects of Antiretroviral Therapy to reduce HIV Transmissions (PopART) trial will be carried out in communities with a total population of about a million people, and is the most extensive HIV prevention study to be launched in Africa.

“The PopART trial offers the possibility to test whether there is a way of truly turning off the tap of HIV transmission,’ said Professor Nulda Beyers, director of the Desmond Tutu TB Centre (DTTC), which is part of the Department of Paediatrics and Child Health at Stellenbosch University.

During a public, fair and open randomization event on WEDNESDAY (FEBRUARY 6), the communities were assigned to one of three different programmes of care, with varying levels of support.

In South Africa, people in the Cape Town communities of Town 2 in Khayelitsha, and Bloekombos, as well as Cloetesville in the Cape Winelands area will have access to the same HIV/AIDS services as per national and provincial guidelines which have been implemented to close the gaps in health services and to ensure that clinics function optimally.

The communities of Kuyasa in Khayelithsa, Delft South and Wellington in the Cape Winelands are to be visited by community health care workers at their homes over a few years. They’ll be provided with condoms and voluntary HIV counseling and testing and given information about treatment for pregnant women with HIV, as well as male circumcision. HIV treatment will be offered to those eligible according to national guidelines.

The areas of Luvuyo in Khayelitsha, Ikhwezi in the Cape Town area and Daleville in the Cape Winelands, will receive a full package of support, including home visits from community health care workers. On top of this, people testing positive for HIV will be referred to clinics and offered immediate anti-retroviral treatment (ART).

The rate of new HIV infections will be compared between the different study groups in both Zambia and South Africa at the end of the research.

The study will be done by the DTTC and the ZAMBART project in Zambia, in collaboration with the London School of Hygiene and Tropical Medicine (LSHTM) and Imperial College, London.

“The number of HIV positive people needs to start coming down. While we are making inroads, it’s not decreasing fast enough, and we hope this study will help us,” the Director of HIV/AIDS and TB in the Western Cape government, Juanita Arendse, said at the randomisation ceremony near Stellenbosch.

The Vice Rector for Community Interaction at Stellenbosch University, Professor Julian Smith, said the trial was in keeping with the university’s ideals to blend knowledge with community involvement.

“We know we can bank on the expertise and knowledge in universities and we are able to supplement this with indigenous knowledge in communities. The PopART study is also in tune with the university’s Hope Project, which aims to practise science for a better world and create hope through science and strategic partnerships.”

The Executive Head of  Paediatrics and Child Health at Stellenbosch University, Professor Mariana Kruger, has welcomed the research study and has thanked people in communities across the Western Cape for their involvement.

The PopART trial, with an expected research budget of more than US$60million, is being funded through the HIV Prevention Trials Network (HPTN), by the Office of the United States Global AIDS Coordinator (OGAC), the Bill and Melinda Gates Foundation, National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, and National Institute of Health, National Institutes on Drug Abuse.

“This is extremely exciting. The approach that the Desmond Tutu TB Centre and its partners in Zambia are taking in involving the communities, has the greatest promise to reduce the rate of HIV infections,” said Sam Griffith, the Senior Clinical Research manager for fhi360, which is the link between the funders of the trial and the research team.

The head of TB and HIV for the City of Cape Town, Dr Karen-Ann Jennings, said building mutual trust, creating transparency and sharing responsibility were key going forward in the five-year-long trial.