The Office of the U.S. Global AIDS Coordinator (OGAC) has outlined a plan of investment in innovation and operations research. The goal is to evaluate impact, improve service delivery and maximize outcomes with PEPFAR partners in Africa. MHRP’s collaboration between research and PEPFAR programs provides an excellent platform from which to implement operational research and public heath evaluations.
African Cohort Study (AFRICOS)
In 2013 MHRP initiated a large, long-term cohort study at multiple African sites to evaluate the HIV prevention, care and treatment services it supports through local facilities, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The first of its kind in sub-Saharan Africa, the African Cohort Study (AFRICOS) takes place at sites in Kenya, Nigeria, Tanzania and Uganda.
Implementation Science
MHRP's PEPFAR implementation science program aims to identify novel ways to implement health systems. Past examples include a peer-to-peer program counseling program for PMTCT and piloting an electronic patient follow up system in Kenya and Tanzania. Current MHRP studies include:
- RV432 - Improving Retention in HIV Care and Treatment Services through the Development of a Network of ART Clinics within the Fishing Communities on Koome Island, Uganda. The study found a high HIV prevalence (> than national 6.2%) and low level of awareness of status indicates continued prioritization of fisherfolk for comprehensive HIV services on both islands is needed
- RV476 - Feasibility of Implementing HIV Pre-exposure prophylaxis among HIV negative Adolescent Girls and Young Women sex workers, aged 18-24 years in Mukono district, Uganda: A pragmatic demonstration project.
- RV465 - Implementing the PMTCT standard of care under routine conditions with and without the Enhanced Mentor Mother ProgrAm (EMMA): A site-randomized impact evaluation study among maternal and child health clinics supported by the South Rift Valley PEPFAR Program in Kenya
- RV518/517 - Prevalence and factors associated with virologic outcome and drug resistance patterns in HIV positive children and adolescents on antiretroviral therapy in Kenya and Tanzania
- Interagency Recency Studies - Using rapid test for recent infection (RTRI) to provide continuous epidemiological data on person, geographical location, and time of newly diagnosed individuals to inform HIV prevention and control strategies.
Basic Program Evaluations (BPEs)
BPE studies focus on operational research to assess program quality and provide mid-course corrections and improvements for a project. The research identifies promising models or best practices for expansion within the program, and indicates whether a specific program model accomplishes its goals.
MHRP has more than ten of the studies underway in our programs, including studies on TB-HIV co-infection, improving viral load suppression in young adults and evaluation of outcomes in Key populations.