Effectively engaging men in HIV prevention remains one of the greatest challenges to driving the HIV epidemic towards elimination in Sub-Saharan Africa.
Professor Frank Tanser, a distinguished epidemiologist and Director: Population Health Innovation at the Centre for Epidemic Response and Innovation (CERI) at Stellenbosch University (SU), has just been awarded R40 million by the National Institutes of Health (NIH) to conduct an innovative community randomised controlled trial in Eastern Zimbabwe aimed at increasing male engagement with HIV prevention and reducing new HIV infections among men.
At the heart of the study, referred to as a “Harnessing male peer networks to enhance engagement with HIV prevention" (Imperative) trial, lies the promotion of Pre-Exposure Prophylaxis (PrEP) as a highly effective method for preventing HIV infection. PrEP involves the use of antiretroviral medication by individuals who are at high risk of acquiring the virus. By adhering to a daily regimen, men can significantly reduce their chances of acquiring HIV infection, enabling them to take control of their sexual health and ultimately prevent onward transmission of HIV to their partners.
In collaboration with the Manicaland Centre for Public Health in Zimbabwe and other international partners from Africa, the United Kingdom, Germany and the USA, the team of researchers seeks to establish the population impact of HIV self-test distribution through male social networks, coupled with innovative community-based support on PrEP uptake.
“The level of new HIV infections is still unnecessarily high in many African countries, but we possess the knowledge and tools to make a significant impact. By engaging men through innovative strategies like PrEP, we can empower them to protect their sexual health and ultimately prevent onward transmission to their partners and contribute to curbing the HIV epidemic," said Tanser. The Imperative trial is the first to measure the impact of such a strategy on the uptake of PrEP at scale.
The trial seeks to engage hard-to-reach men through their peer networks and enable them to self-test for HIV. The trial will recruit over 3,500 men living in 44 communities in Eastern Zimbabwe. It utilises innovative community support structures to decrease barriers to the uptake of PrEP by reducing the need for engagement with clinics. Zimbabwe, like many other countries in sub-Saharan Africa, faces the harsh reality of the HIV epidemic. With a substantial portion of the population affected by the virus, innovative approaches are urgently needed to combat its devastating impact. By leveraging male peer networks for HIV self-testing distribution, men can be empowered to take charge of their sexual health.
Combining innovative technology and community-driven initiatives, the team challenges the existing stigma surrounding HIV prevention and empowers men to make informed decisions about their sexual wellbeing. Initial distributors, identified by the team, will receive an HIV self-test kit for personal use and additional kits to distribute to their peers, creating a ripple effect of awareness and prevention throughout the community.
With the potential to shape HIV prevention approaches in high-incidence regions, the project has the power to save countless lives and drive countries in Africa towards a future where the risk of acquiring HIV is negligible, explained Tanser.
“According to the HIV World Health Organisation (WHO) African region data, there were 1,1 million people newly infected with HIV in 2018. By 2021 there was an estimated 25,6 million people living with HIV in the African region. Sub-Saharan Africa remains the most highly affected region within the continent. Prevention of HIV amongst men will help reduce the burden amongst African countries in the long run and I would like to congratulate Prof Tanser for successfully acquiring the grant. It will contribute to driving our research excellence and relevance to society through translational research and scaling of these within Africa and beyond," said Prof Sibusiso Moyo, Deputy Vice-Chancellor: Research, Innovation and Postgraduate Studies at SU.
“The research findings hold promise for the development of a generalisable, multicomponent male peer-based HIV self-testing and PrEP uptake model that could be applied in other high HIV incidence settings, bringing hope for progress in the global fight against HIV," concluded Tanser.
