Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study

 

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dc.contributor.author van Loggerenberg, Francois en_ZA
dc.contributor.author Mlisana, Koleka en_ZA
dc.contributor.author Williamson, Carolyn en_ZA
dc.contributor.author Auld, Sara C en_ZA
dc.contributor.author Morris, Lynn en_ZA
dc.contributor.author Gray, Clive M en_ZA
dc.contributor.author Karim, Quarraisha Abdool en_ZA
dc.contributor.author Grobler, Anneke en_ZA
dc.contributor.author Barnabas, Nomampondo en_ZA
dc.contributor.author Iriogbe, Itua en_ZA
dc.date.accessioned 2015-12-28T06:47:47Z
dc.date.available 2015-12-28T06:47:47Z
dc.date.issued 2008 en_ZA
dc.identifier.citation van Loggerenberg, F., Mlisana, K., Williamson, C., Auld, S. C., Morris, L., Gray, C. M., ... & Karim, S. A. (2008). Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PloS one, 3(4), e1954. doi:10.1371/journal.pone.0001954 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16051
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0001954
dc.description.abstract Objectives To describe the baseline demographic data, clinical characteristics and HIV-incidence rates of a cohort at high risk for HIV infection in South Africa as well as the challenges experienced in establishing and maintaining the cohort. Methodology/Principle FINDINGS: Between August 2004 and May 2005 a cohort of HIV-uninfected women was established for the CAPRISA 002 Acute Infection Study, a natural history study of HIV-1 subtype C infection. Volunteers were identified through peer-outreach. The cohort was followed monthly to determine HIV infection rates and clinical presentation of early HIV infection. Risk reduction counselling and male and female condoms were provided. After screening 775 individuals, a cohort of 245 uninfected high-risk women was established. HIV-prevalence at screening was 59.6% (95% CI: 55.9% to 62.8%) posing a challenge in accruing HIV-uninfected women. The majority of women (78.8%) were self-identified as sex-workers with a median of 2 clients per day. Most women (95%) reported more than one casual sexual partner in the previous 3 months (excluding clients) and 58.8% reported condom use in their last sexual encounter. Based on laboratory testing, 62.0% had a sexually transmitted infection at baseline. During 390 person-years of follow-up, 28 infections occurred yielding seroincidence rate of 7.2 (95% CI: 4.5 to 9.8) per 100 person-years. Despite the high mobility of this sex worker cohort retention rate after 2 years was 86.1%. High co-morbidity created challenges for ancillary care provision, both in terms of human and financial resources. Conclusions/Significance Challenges experienced were high baseline HIV-prevalence, lower than anticipated HIV-incidence and difficulties retaining participants. Despite challenges, we have successfully accrued this cohort of HIV-uninfected women with favourable retention, enabling us to study the natural history of HIV-1 during acute HIV-infection. Our experiences provide lessons for others establishing similar cohorts, which will be key for advancing the vaccine and prevention research agenda in resource-constrained settings. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other HIV en_ZA
dc.subject.other Sexually transmitted diseases en_ZA
dc.subject.other HIV-1 en_ZA
dc.subject.other HIV diagnosis and management en_ZA
dc.subject.other HIV epidemiology en_ZA
dc.subject.other HIV prevention en_ZA
dc.subject.other South Africa en_ZA
dc.title Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2008 van Loggerenberg et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Institute of Infectious Disease and Molecular Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation van Loggerenberg, F., Mlisana, K., Williamson, C., Auld, S. C., Morris, L., Gray, C. M., ... Iriogbe, I. (2008). Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. <i>PLoS One</i>, http://hdl.handle.net/11427/16051 en_ZA
dc.identifier.chicagocitation van Loggerenberg, Francois, Koleka Mlisana, Carolyn Williamson, Sara C Auld, Lynn Morris, Clive M Gray, Quarraisha Abdool Karim, Anneke Grobler, Nomampondo Barnabas, and Itua Iriogbe "Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study." <i>PLoS One</i> (2008) http://hdl.handle.net/11427/16051 en_ZA
dc.identifier.vancouvercitation van Loggerenberg F, Mlisana K, Williamson C, Auld SC, Morris L, Gray CM, et al. Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PLoS One. 2008; http://hdl.handle.net/11427/16051. en_ZA
dc.identifier.ris TY - Journal Article AU - van Loggerenberg, Francois AU - Mlisana, Koleka AU - Williamson, Carolyn AU - Auld, Sara C AU - Morris, Lynn AU - Gray, Clive M AU - Karim, Quarraisha Abdool AU - Grobler, Anneke AU - Barnabas, Nomampondo AU - Iriogbe, Itua AB - Objectives To describe the baseline demographic data, clinical characteristics and HIV-incidence rates of a cohort at high risk for HIV infection in South Africa as well as the challenges experienced in establishing and maintaining the cohort. Methodology/Principle FINDINGS: Between August 2004 and May 2005 a cohort of HIV-uninfected women was established for the CAPRISA 002 Acute Infection Study, a natural history study of HIV-1 subtype C infection. Volunteers were identified through peer-outreach. The cohort was followed monthly to determine HIV infection rates and clinical presentation of early HIV infection. Risk reduction counselling and male and female condoms were provided. After screening 775 individuals, a cohort of 245 uninfected high-risk women was established. HIV-prevalence at screening was 59.6% (95% CI: 55.9% to 62.8%) posing a challenge in accruing HIV-uninfected women. The majority of women (78.8%) were self-identified as sex-workers with a median of 2 clients per day. Most women (95%) reported more than one casual sexual partner in the previous 3 months (excluding clients) and 58.8% reported condom use in their last sexual encounter. Based on laboratory testing, 62.0% had a sexually transmitted infection at baseline. During 390 person-years of follow-up, 28 infections occurred yielding seroincidence rate of 7.2 (95% CI: 4.5 to 9.8) per 100 person-years. Despite the high mobility of this sex worker cohort retention rate after 2 years was 86.1%. High co-morbidity created challenges for ancillary care provision, both in terms of human and financial resources. Conclusions/Significance Challenges experienced were high baseline HIV-prevalence, lower than anticipated HIV-incidence and difficulties retaining participants. Despite challenges, we have successfully accrued this cohort of HIV-uninfected women with favourable retention, enabling us to study the natural history of HIV-1 during acute HIV-infection. Our experiences provide lessons for others establishing similar cohorts, which will be key for advancing the vaccine and prevention research agenda in resource-constrained settings. DA - 2008 DB - OpenUCT DO - 10.1371/journal.pone.0001954 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study TI - Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study UR - http://hdl.handle.net/11427/16051 ER - en_ZA


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.