MHRP

Research

MHRP is a broad-based, highly collaborative, and highly integrated research program with strong epidemiology, preclinical and clinical research capabilities.

MHRP defines the HIV epidemic in terms of military impact and is an important partner in international efforts to combat this devastating disease.

Threat Assessment

Threat Assessment and Global Epidemiology

Highlights | Future Work

MHRP threat assessment and global epidemiology activities are aimed at tracking the HIV epidemic in active duty forces and assessing the risk of HIV and HIV-related infections to U.S. and allied forces deployed overseas.

In addition to Africa and Thailand, MHRP assesses the HIV threat to U.S. military forces in the former Soviet Union and in Eastern Europe/Central Asia, South America and the Caribbean.

Defining the Threat

By defining the HIV threat to the U.S. Military, MHRP helps inform targeted prevention and also helps defines the requirements for an effective vaccine. In contrast to the U.S. civilian population, which has exposure to a relatively low prevalence of HIV, the U.S. Military, through travel and deployment, can potentially be exposed to high prevalence populations and the whole range of HIV diversity in the global epidemic.

Characterization of threat includes HIV studies in regions of the world where the global epidemic has not yet been adequately defined, with emphasis on areas of potential or actual U.S. Military personnel deployment. In addition, a comprehensive description of HIV-1 infections in U.S. Military personnel, including those plausibly associated with deployment will be crucial for defining requirements for vaccines and prevention. Our program recently defined the peri-deployment time period, the geographic location, and the mode of transmission and fully characterized the molecular epidemiology of all incident HIV infections acquired among Army soldiers deployed to Iraq and Afghanistan during 2001-2007.

Highlights

  • Recently initiated studies aim to characterize the molecular epidemiology of the global HIV-1 epidemic in Bulgaria and to define circulating HIV-1 subtypes and anti-retroviral resistance mutations in Romania. 
  • Researchers are working to better characterize the HIV-1 epidemic in Central and South Asia. The lack of current epidemiologic data highlights the challenges that must be overcome to define the HIV-1 threat to US military forces deployed in the region.
  • Recent and ongoing wartime operations in Afghanistan and Iraq are occurring in regions of the world where information on HIV-1 prevalence, risk groups, and genetic subtypes is extremely scarce. Through a variety of collaborations in different countries in the region, MHRP and others have determined that these countries lie at the crossroads of at least 3 distinct regional epidemics.
  • Since 2005, MHRP and its collaborating partners have conducted HIV seroprevalence research in Afghanistan, focusing on high-risk groups. Isolates of HIV obtained from participants in one such study were fully characterized by investigators at MHRP who made the first complete report of the circulating recombinant, CRF35_AD in 2007.

Future Work

  • Preparing to initiate a biobehavioral study of the Defence Forces in Trinidad and Tobago that will define the HIV prevalence in the Defence Forces and knowledge, attitudes, and behaviors related to general, sexual, and reproductive health. This will be the first study of this kind in the Caribbean. This project is a collaboration with the DoD HIV/AIDS Prevention Program (DHAPP).

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