International Epidemiology Databases to EvaluateAIDS (IeDEA) Renewal 4

Adera, Pessac

Investigators

Linked publications & trials

Abstract

PROJECT SUMMARY/ABSTRACT West Africa holds a significant burden of the HIV epidemic with approximately 3.5 million people living with HIV (PLHIV). Despite calls for action to support access to universal test and treat in the region, West Africa experience major challenges ensuring a continuum of HIV care in adequacy with the latest UNAIDS recommendations. To address these core challenges, the IeDEA West Africa Collaboration relies on a unique network of cohorts in West Africa with a mission to conduct hypothesis-driven epidemiological research on barriers in access to care as well as on the prognosis and outcomes of PLHIV, including adults, adolescents and children in care, as well as HIV-exposed children. Our five-year research plan will focus on scientific questions that contributing cohorts can hardly answer separately with a unique partnership between English-speaking and French-speaking countries in the region. The overarching specific aims of our program will be: 1) To identify an describe individual and structural barriers associated with the continuum of HIV care, from HIV testing to retention in care and viral suppression throughout West Africa, 2) To leverage our existing network to establish a cohort of HIV Key Populations including female sex workers and men who have sex with men in IeDEA West Africa, 3) To determine the burden of non-communicable diseases and evaluate their interplay with HIV infection. Our collaboration has supported one of the most robust epidemiological and clinical research infrastructure in the region, housing data on close to 40,000 adults (including 883 HIV-2 et 843 HIV-1/2) and 15,814 children (6,515 children exposed to HIV, 7,041 on ART and 2,258 children living with HIV not already on ART) in seven countries in the region (Benin, Burkina Faso, Côte d’Ivoire, Ghana, Mali, Togo and Senegal). The next round will involve 21 HIV clinical centers in eight countries (Benin, Burkina Faso, Cote d’Ivoire, Ghana, Mali, Nigeria, Senegal and Togo). Among them, eight clinics are new collaborating centers. The IeDEA West Africa collaboration is coordinated at the University of Bordeaux, France with a regional Office hosted by the PACCI program, a research-oriented non-governmental organization situated in Abidjan, Côte d’Ivoire. This research team has a long-lasting experience in observational HIV research including large-scale prospective cohorts in West Africa. Data will be collected from affiliated cohorts every year according to standardized procedures and will be merged at the coordinating center in Bordeaux. Capacity building in participating centers will include funding for local human resources, training on data quality, on-site technical support and annual meetings to reinforce the technical and scientific network. At the completion of this funding cycle, we intend to address major research gaps including a better knowledge the various comorbidities affecting PLHIV in West Africa. Our cohorts will be more representative of the regional HIV epidemic and will capture important data on Key Populations to inform target interventions for these vulnerable groups.