A recently-published study conducted by researchers from the U.S. Military HIV Research Program (MHRP) found that high HIV-1 prevalence in two communities in Nigeria, along with a reported high-level of willingness to participate in future HIV intervention studies, indicate favorable epidemiological and logistic conditions for cohort development for HIV vaccine studies in the region.
Development of a globally effective HIV vaccine will need to encompass Nigeria, which, with an estimated 3.2 million people living with HIV, carries the second highest burden of HIV/AIDS in the world. The MHRP study, published online earlier this month in PLOS One, was conducted from 2009–2012 at four market sites and two highway settlements sites in Nigeria to identify and characterize populations at high risk for HIV, engage support of local stakeholders and assess the level of interest in future vaccine studies.
Dr. Ogbonnaya Njoku of the Walter Reed Program-Nigeria, led the Nigerian team in recruitment, collection of specimens and the collection of demographic HIV risk data. Blood samples were tested on-site by HIV rapid diagnostic tests, followed by confirmatory testing and subtype evaluation at MHRP.
Of 3,229 study participants, 326 were HIV infected, with an HIV prevalence of 15.4%-23.9% at highway settlements and 3.1%-9.1% at market sites. Analysis found that age, gender, marital status, level of education and sex under substance influence as significant risk factors for HIV in these populations.
Females between 18–30 years were more than three times more likely to be HIV infected than males. Volunteers with only primary school education had a significantly higher HIV risk compared to those who completed secondary school or higher. A high percentage of HIV infected (96.0%) and HIV non-infected (95.7%) volunteers expressed willingness to participate in future studies involving regular blood draws.
“Educating and winning the trust of local community leadership ensured high level of participation in this study and willingness to participate in future studies,” said Dr. Mark Manak, Chief Scientist in MHRP’s Department of Laboratory Diagnostics and Monitoring and co-author of the paper. “Conducting successful population based research studies in Nigeria will require a high level of advocacy, community engagement and co-operation among all stakeholders.”
With more than 50% of participants indicating uncertainty around how long they would be staying at their current location, the mobility of populations will need to be considered when planning clinical trials as transient populations impact retention and success of studies requiring long term commitments from participants.