HPTN 075 study shows high risk of HIV infection among MSM and TGW in sub-Saharan Africa

Reviewed by James Ives, M.Psych. (Editor)Oct 24 2018

Researchers from the HIV Prevention Trials Network (HPTN) today presented results from the HPTN 075 Study at the HIV Research for Prevention (HIVR4P) conference in Madrid, Spain. The study evaluated the feasibility of HIV prevention research among men who have sex with men (MSM) and transgender women (TGW) in three countries in sub-Saharan Africa. Findings from the study showed participants were at an alarming risk for getting HIV. The incidence among study participants was substantially higher than the estimated incidence among heterosexual men and women in the general population in the same countries.

"Several studies have shown the burden of HIV is quite high among MSM and TGW, but little is known about the rate of new infections, or HIV incidence, among these groups in sub-Saharan Africa," said Theo Sandfort, PhD, HPTN 075 protocol chair and research scientist, HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University in New York. "The exceptionally high HIV incidence we found indicates an urgent need for increased access to HIV prevention approaches that consider all the factors that put this vulnerable population at such high risk."

A total of 401 MSM and TGW, regardless of HIV infection status, were enrolled at four sites in Kenya, Malawi and South Africa. Each participant was followed for 12 months, during which five study visits were conducted. These visits included interviewing participants about behaviors that may put them at risk for HIV infection, medical examinations and collection of blood samples. Of the 401 enrolled, 329 were HIV-negative at the time of enrollment. By the end of the study, 21 of them had become infected with HIV. This translates to an overall incidence rate of 6.96 per 100 person-years. Incidence rates differed substantially by study site: Malawi: 1.3; Kenya: 3.75; Soweto, South Africa: 8.97; and Cape Town, South Africa: 14.44.

"HPTN 075 provides compelling findings that indicate an urgent need for further HIV prevention studies for men who have sex with men and transgender women in sub-Saharan Africa," said Wafaa El-Sadr MD, MPH, MPA, HPTN co-principal investigator and professor of epidemiology and medicine at Columbia University in New York. "These studies must examine the realities in which these groups exist and develop integrated intervention strategies that are effective and feasible."

"MSM and TGW in sub-Saharan Africa face distinct structural barriers to accessing HIV prevention and treatment," said Myron Cohen, MD, HPTN co-principal investigator and director of the University of North Carolina at Chapel Hill Institute for Global Health and Infectious Diseases in Chapel Hill, NC. "The HPTN is poised to tackle these barriers as we prioritize this population in our prevention agenda."