HIV Care Research in Lesotho

We conduct randomized clinical trials, observational and molecular studies addressing current challenges and knowledge-gaps around HIV care provision in rural, resource-limited settings. Our studies aim at providing insights relevant for future HIV guidelines and policies in sub-Saharan African with a particular focus on differentiated care. Aside from research, our group is committed to improving HIV diagnostics and treatment services through training, capacity building, mentoring and infrastructural support in Butha-Buthe and Mokhotlong Districts in Lesotho.

Link to Project

Chronic Diseases Clinic Ifakara

The Chronic Diseases Clinic Ifakara CDCI in Ifakara, Tansania, takes care of currently about 3’500 HIV-positive individuals as an integral part of the St. Francis Referral Hospital. The Kilombero and Ulanga Antitretroviral Cohort (KIULARCO) addresses scientific questions such as treatment outcomes, adherence, resistance, co-morbidities and implementation. 

Chronic Diseases Clinic Ifakara CDCI

HIV Incidence in Pregnancy in Soweto

In South Africa Swiss TPH investigates HIV incidence in pregnancy together with researchers from the University of the Witwatersrand in a cohort of pregnant women living in and around Soweto, Johannesburg. The overall aim of the study is to determine early HIV infection among pregnant women, and to understand their sexual risk behaviors and that of their partners.

Home-based testing in Lesotho
St. Francis Hospital Ifakara
Home-Based HIV Testing in Lesotho

Target 1: 90% of people living with HIV know their status

In collaboration with the Ministry of Health and SolidarMed, Swiss TPH tests different approaches of community-based HIV testing and counselling in rural Lesotho. To assess the coverage that can be achieved by home-based HIV testing, >6000 households in remote villages with >18'000 household members were visited in 2016 for home-based HIV testing.

By offering voluntary testing and counselling as well as a hospital-wide provider-initiated testing and counselling SwissTPH enrols monthly 60-120 newly diagnosed patients into care in a district hospital in rural Tanzania (St. Francis Referral Hospital, Ifakara).

Target 2: 90% of people living with HIV who know their status are receiving treatment

Overall, in Tanzania 53% of HIV-positive people are on antiretroviral treatment. In a Swiss TPH-based project in Tanzania 89% of patients attending are under antiretroviral treatment. In October 2016 Tanzania launched the recommendation of universal antiretroviral treatment for all HIV-positive individuals, irrespective of the CD4 count.

With the CASCADE-trial – a randomized controlled trial conducted in Lesotho, Swiss TPH tests if home-based same-day start of antiretroviral therapy in individuals who test HIV-positive improves linkage to care and leads more quickly to viral suppression.

Mobile CD4-cell count during home-based testing trial in Lesotho

Target 5: 90% of women and men have access to HIV combination prevention and sexual and reproductive health services

One of the most cost effective approaches to combat the HIV epidemic consists in increasing and assuring the use of condoms among the sexually active population. Social marketing through offering subsidized products is a commonly used strategy in HIV prevention. In consequence, Swiss TPH supports the social marketing of male and female condoms by national marketing associations along behavioural changes among adolescents and high risks groups such as lorry drivers or female sex workers.  In Congo, the Central Africa Republic, Cameroun and Chad, Swiss TPH could over the last decade contribute to improve the accessibility and use of male and female condoms thereby making a significant contribution to the reduction of new HIV/AIDS cases.

Read more about the PPSAC project

Target 6: 90% of women and girls live free from gender inequality and gender-based violence to mitigate the risk and impact of HIV

Swiss TPH is committed to contributing to global efforts controlling the HIV/AIDS epidemic. We set a particular focus on equity in access to prevention and care with particular emphasis on disadvantaged communities in rural areas and vulnerable groups, such as women and children. Activities build on longstanding partnerships with governmental and non-governmental institutions in different low- to middle income countries, particularly in Sub-Sahara Africa. In these partnerships Swiss TPH provides support through technical expertise, funding of infrastructure and human resources, capacity building and consultancies.

Our projects and activities are aligned to the UNAIDS 2016-2021 Strategy to end AIDS.

HIV Aids

Target 3: 90% of people on treatment have suppressed viral loads

Since 2015 Swiss TPH, SolidarMed and Molecular Virology of the Department of Biomedicine of the University Basel support the laboratory in Butha-Buthe District (Northern Lesotho) in the implementation of routine viral load monitoring for all HIV infected persons who are taking antiretroviral therapy. This early detection of unsuppressed viral load allows targeted adherence interventions to improve treatment outcomes [link to VL project].

In Tanzania, within a Cohort of HIV positive persons attending the Chronic Diseases Clinic of Ifakara on a regular basis, the virological suppression rate was 91%.

Hightech Lab-Facility to test the Viral Load in Butha-Buthe, Lesotho.

Target 4: Zero new HIV infections among children

Prevention of Mother to Child transmission is a mainstay of HIV care. Tanzania was one of the first countries to implement the so called ‚Option B+ Plan’ in 2013. Option B+ implies antiretroviral treatment for all HIV positive pregnant women during and after pregnancy irrespective of CD4 cell count together with an intrapartum treatment of the mother and a postpartum treatment of the baby for the first 6 weeks of life. With this, transmission rates fell from 30% to 9%. Within a specific programme run by SwissTPH – the One Stop Clinic – offering care for HIV-positive pregnant women and their families, the rate could be reduced further to 2%.

One Stop Mother and Child Clinic in Ifakara, Tansania