The Centre for the AIDS Programme of Research in South Africa(CAPRISA) conducts research that is globally relevant and locally responsive, contributing to understanding HIV pathogenesis, prevention and epidemiology as well as the links between tuberculosis and AIDS care. Collaboration with the HVTN to find a safe, effective HIV vaccine is integral to this work.
The eThekwini CAPRISA Research Clinic adjoins the Prince Cyril Zulu Communicable Disease Centre, which is the largest government out-patient TB and sexually transmitted diseases treatment facility in Durban. The clinic is in the Durban city centre transport hub next to the main train station, bus rank and taxi station, in a city with a population of 3,442,361 people, most of whom speak isiZulu.
In 2013 the estimated HIV prevalence in Durban was 40% (antenatal data) with an HIV incidence of 9.1% in at risk women in the control arm of a CAPRISA microbicide trial. This site has an extensive community presence built up since its inception over a decade and uses an ethics approved pre-screening protocol that allows the site to assess risk for HIV acquisition, potential for retention, major health problems and family planning desires. As a result the screening to enrolment ratio is lowered and site efficiency is improved.
Research activities are supported by an active Community Advisory Board (CAB), comprised of approximately 15 members that meet bi-monthly and includes an HVTN working group of 3 members who participate in GCAB calls. The CER team works in a large catchment area, which ranges from Tongaat, north of Durban, to Inchanga, west of Durban and Adams Mission, south of Durban and includes two large townships, namely, the INK area (Inanda, Ntuzuma and KwaMashu), and Umlazi.
Recruitment strategies include street recruitment, partnering with stakeholders in outreach programs and, working at specific areas e.g. communal taps and health and social services points. The site has also identified bars where gay and lesbian people meet, and now partner with the Durban Gay and Lesbian Centre, to engage the LGBTI communities. Men are recruited at taxi ranks and recreational areas. The site utilises a Facebook page, to create awareness and provide education around HIV and HIV Vaccine research. Quarterly retention events and male involvement sessions are also conducted to enhance retention, address participant concerns and communicate important information.
Currently the site is actively enrolling for HVTN 703, 702, 108 and 107, part B of HVTN 100 and HVTN 705 led by PI, Dr Kathy Mngadi, who sits on the Scientific Governance Committee, the Protocol Review Committee and the Efficacy working group. She is also the co-chair and national PI for HVTN 107 and the co-chair for HVTN 705. Dr Nigel Garrett, who is the Head of Pathogenesis and Vaccines, is also the chair for HVTN 108.