ADAPT Update AfriCan Forum Entebbe, 17-19 January 2013.
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Transcript of ADAPT Update AfriCan Forum Entebbe, 17-19 January 2013.
Goal of ADAPT:
Build local capacity so that Africans can plan, conduct and analyse large scale, multi-centred AIDS prevention trials
Lack of prevention evidence from RCTs
More than 6000 HIV prevention studies published between 2000 and end of 2012
Less than 300 were RCTs
Lack of African involvement
213 67
0 50 100 150 200 250 300
HIV prevention RCTs published between 2000 & 2012
Outside Africa In Africa
Lack of African involvement
213 51 16
0 50 100 150 200 250 300
HIV prevention RCTs published between 2000 & 2012
Outside Africa In Africa Led by African researchers
ADAPT trainingSADC researchers 2007, 2009
HIV prevention epidemiologyRCT techniques
SADC researchers 2013
HIV prevention epidemiologyResearch proposals
UNAM faculty2012, 2013
Systematic reviews
SADC laboratory staff2013
HIV serology for DBSHIV incidence testing
Botswana parliamentarians2011, 2012
Using evidence for decision making
First course participants
• 23 researchers from 11 African countries• Botswana, Lesotho, Malawi, Mozambique,
Namibia, Nigeria, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe
• From government (via NAAs), universities, and NGOs
Left HIV prevention work and joined a bank
Moved from NGO to National AIDS Authority
Prominent in National AIDS Authorities
Elected – became Minister – NAA in remit
With CIET in Nigeria – on faculty for next course
Head of department in University
Promoted within research organisation
Coordinating CIET work in Botswana
Post-doctoral fellowship
Completing MSc Epidemiology and Statistics
Who has multiple concurrent sexual partnerships in Botswana? Results of a national cross sectional survey.
Laetsang D, Ho-Foster A, Masisi M, Anderson M, Tlhoiwe D, Cockcroft A, Andersson N
Community views of inter-generational sex: findings from focus groups in Botswana, Namibia and Swaziland.
Kunda JL, Kgakole L, Cockcroft A, Masisi M, Laetsang D, Ho-Foster A, Marokoane N, Andersson N
Characteristics and attitudes of the choice-disabled in Namibia.Van Rooy G, Mitchell S, Masisi M, Cockcroft A, Andersson N
Socio-economic status and HIV and AIDS stigma in Tanzania.Mbaraka A, Mitchell S, Cockcroft A, Andersson N
Choice disability and HIV prevention knowledge, attitudes and practices in Botswana.
Ho-Foster A, Andersson N, Cockcroft A, Masisi M, Laetsang D, Kgakole L
What has happened to multiple sexual partnerships in Swaziland between 2002 and 2008?
Cockcroft A, Andersson N, Ho-Foster A, Marokoane N, Mziyako B
ADAPT presentations at AIDS impact conference
Ho-Foster A, Laetsang D, Masisi M, Anderson M, Tlhoiwe D, Cockcroft A, Andersson N. .
Gender-specific patterns of multiple concurrent sexual partnerships: a national cross sectional survey in Botswana.
AIDS Care 2010: 1-6 (doi: 10.1080/09540121003758598)
Cockcroft A, Lengwe Kunda J, Kgakole L, Masisi M, Laetsang D, Ho-Foster A,
Marokoane N, Andersson N. Community views of inter-generational sex:
findings from focus groups in Botswana, Namibia and Swaziland. Psychology, Health and Medicine 2010 (in press)
Amuri B, Mitchell S, Cockcroft A, Andersson N. Socio-economic status and HIV and AIDS stigma in Tanzania.
AIDS Care 2010 (in press)
Cockcroft A, Andersson N, Ho-Foster A, Marokoane N, Mziyako B What happened to multiple sexual partnerships in Swaziland?
Analysis of five linked national surveys between 2002 and 2008.AIDS Care 2010: 1-6 (doi: 10.1080/09540121.2010.482123)
ADAPT publications in peer reviewed journals
Second course
• Nominations from SADC NAAs• 1st three week block 28 Jan–15 Feb 2013• 20 participants:
– 4 Botswana, 1 Mauritius, 3 Namibia, 4 Swaziland, 2 Tanzania, 2 Zambia, 4 Zimbabwe
• Epidemiology and statistics relevant to RCTs• Support to develop fundable HIV prevention
research proposals
Research topics
• Multiple concurrent partnerships in young women• HIV risks in female sex workers• Sexual behaviour after male circumcision• Sexual behaviour among college students• Condition cash transfers and HIV trial• HIV infection through breastfeeding• Role of older people in youth HIV prevention
Systematic review module• 16-20 July 2012• School of Nursing and Public Health, UNAM• 10 participants – mostly SNPH faculty
Systematic review module• Methods of analysis of RCTs• RCTs and non-experimental
study designs• Elements of SR and meta-
analysis– data extraction – dealing with heterogeneity
between studies– interpretation of forest plots – assessment of quality of
studies and SRs
Systematic review module• Practical experience
– navigating Cochrane website – searching literature – using Revman software to conduct meta analysis
Botswana parliamentarians
Evidence-based decision making
Two training sessions– 31 October/1 November 2011– 12 and 14 November 2012
Logistic organisation by NACA
Attended by– 36 of 61 MPs– Including 7 ministers
Laboratory skills training
National Institute for Communicable Diseases, Johannesburg, S Africa
Two SADC one-week courses:
HIV serology on dried blood spots
New techniques for estimating HIV incidence
Participants:
>With basic laboratory skills
ADAPT trainingSADC researchers HIV prevention epidemiology
RCT techniques
SADC researchers HIV prevention epidemiologyResearch proposals
UNAM faculty Systematic reviews
SADC laboratory staff HIV serology for DBSHIV incidence testing
Botswana parliamentarians Using evidence for decision making
Challenges
• Retaining trained individuals in system• Organisations not allowing time out for
higher qualifications• SADC bureaucracy (laboratory courses)• Obtaining funding for African led research