14 May Article Advances in Preventive Medicine

Long-distance truck drivers are at risk of acquiring and transmitting HIV and have suboptimal access to care. New HIV prevention strategies using antiretroviral drugs to reduce transmission risk (early antiretroviral therapy (ART) at CD4 count >350 cells/μL) have shown efficacy in clinical trials. Demonstration projects are needed to evaluate “real world” programme effectiveness.

Dr. Gabriela B. Gomez, a post-doctoral researcher at AIGHD, said that such programs can be evaluated through operational research but there are important ethical and logistical challenges to overcome. ”If we can find ways to address these challenges of implementation through demonstration projects, we will generate insights that can inform policy decisions on strategies to reduce health inequalities in access to HIV services” said Dr. Gomez.

In this paper, co-investigators from AMC/AIGHD (The Netherlands) and Wits Reproductive Health and HIV Institute (South Africa), present the protocol for a demonstration study to evaluate the feasibility, acceptability, and cost of an early ART intervention for HIV-positive truck drivers.

This study would take place along a transport corridor across South Africa, Zimbabwe, and Zambia, as part of an enhanced strategy to improve treatment adherence and retention in care. Service expansion to include ART will be the first step toward the early ART implementation. The paper is particularly useful in highlighting questions specific to the design of tailored early ART programmes.

North-South Corridor Demonstration Project: Ethical and Logistical Challenges in the Design of a Demonstration Study of Early Antiretroviral Treatment for Long Distance Truck Drivers along a Transport Corridor through South Africa, Zimbabwe, and Zambia.

Authors: Gomez GB, Venter WDF, Lange JMA, Rees H, Hankins C,

In: Advances in Preventive Medicine, Volume 2013 (2013), Article ID 190190