The HIV Coverage, Quality, and Impact Network (CQUIN) is a multi-country learning network designed to accelerate the implementation of high-quality differentiated service delivery for HIV. CQUIN’s goal is to increase the number of people living with HIV initiating and sustaining highly effective HIV treatment with sustained viral suppression.

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Find out more at cquin.icap.columbia.edu

The UBUNTU study is a research study evaluating the Moderna COVID-19 mRNA vaccine. We already know that this vaccine prevents COVID-19 disease, including severe COVID-19. The United States and many other countries use the Moderna vaccine. We want to know how many doses of vaccine are needed for protection against COVID-19 for adults living with HIV and adults with existing health conditions that may put them at risk for severe COVID-19. We also want to know if people who have already had COVID-19 (and likely have some immunity) need as many vaccine doses as other people to obtain strong protection from COVID-19.

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Web link: https://www.coronaviruspreventionnetwork.org/ubuntu-vaccine-research-study

A Phase 3 Double-Blind Safety and Efficacy Study of Long-Acting Injectable Cabotegravir Compared to Daily Oral TDF/FTC for Pre-Exposure Prophylaxis in HIV-Uninfected Women Link: https://www.hptn.org/research/studies/hptn084

A Randomized Non-Inferiority Study to Assess Immunogenicity, Safety, and Acceptability of Two vs. Three Doses of the Nonavalent Human Papillomavirus (HPV) Vaccine Among Children, Adolescents and Young Adults Living with HIV in Eswatini

A prospective, observational, open-label cohort study to evaluate daily oral PrEP uptake, adherence, persistence and preferences for attributes of PrEP among young women (18-30 y)

ICAP is providing technical assistance to the Ministry of Health to conduct Population-based HIV Impact Assessments to assess HIV prevalence, incidence, and access to HIV prevention, care, and treatment services in Eswatini. Two national surveys, SHIMS 2011 and SHIMS2 (2015), have previously been conducted by the Ministry of Health with technical support from ICAP and funding by PEPFAR through CDC. A third survey, SHIMS3 2020, will be conducted to measure Eswatini’s progress towards global HIV targets. The survey includes household-based interviews and HIV counseling and testing for individuals 15 years and older. Survey findings will be used to assess the impact of Eswatini’s HIV response at the national level, and to help guide and target future investment and programs.

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• SHIMS2 Summary Sheet
• SHIMS2 Final Report

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Find out more at phia.icap.columbia.edu    

The Fleming Fund represents the UK Government’s investment into improving laboratory capacity for diagnosis and surveillance of anti-microbial resistance (AMR) in low-income countries where AMR has a disproportionate impact (the “Fleming Fund”). The Fleming Fund will do this through support to implementation of AMR National Action Plans by making investments in:

• building laboratory capacity;
• collecting drug resistance data;
• enabling the sharing of drug resistance data locally, regionally and internationally;
• collating and analyzing data on the sale and use of antimicrobials medicines, particularly antibiotics;
• advocating the application of these data to promote the rational use of antimicrobials for human health, animal health and agriculture;
• and shaping a sustainable system for AMR surveillance and data sharing.

The Project will use a “One Health” approach which encompasses work in human, animal (agriculture) and environmental health. This approach recognizes that the nature of drug resistant infections and their spread often involved pathogens which spread to and from animals (for example, pigs and poultry) to humans; and that environmental exposure to antimicrobial agents is a key factor in driving the emergence and spread of drug resistant infections.

TRACE aims to establish epidemiological data surveillance systems to monitor the HIV epidemic in real-time—allowing countries to prevent new HIV infections through precise prevention efforts, as well as targeted interventions to improve treatment adherence and retention in HIV care. [BR][BR] With funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC), ICAP is working in collaboration with CDC, ministries of health, and local organizations to roll out rapid HIV recency testing in selected high-burden countries.

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Find out more info at TRACE Website

ICAP supported the Ministry of Health to implement the ECHO Study, a multi-country, open label, randomized clinical trial that assessed the effect of three highly effective, reversible methods of contraception—depot medroxyprogesterone acetate, the levonorgestrel implant, and the copper intrauterine device—on the risk of HIV acquisition in women in sub-Saharan Africa. This study is Swaziland’s first experience with an interventional randomized clinical trial and is being conducted by ICAP in collaboration with the Family Life Association of Swaziland, a local sexual and reproductive health service provider. (funded by consortium of donors via FHI360)

The Global Nurse Capacity Building Program (GNCBP) is a global health initiative that was administered by the Health Resources and Services Administration (HRSA), under the U.S Department of Health and Human Services, with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). It was implemented by ICAP at Columbia University’s Mailman School of Public Health (ICAP) from 2009 to 2018. GNCBP’s goal was to advance the HIV response toward epidemic control and to improve population health in sub-Saharan Africa by fostering individuals, institutions, and networks to expand, enhance, and sustain the nursing and midwifery workforce. The program used a holistic approach to strengthen nursing and midwifery education and practice through two complementary sub-projects: the Nursing Education Partnership Initiative (NEPI), which expanded the health workforce by producing new nurses and midwives; and the General Nursing (GN) project, which supported the maintenance of a skilled health workforce through continuing professional development (CPD), in support of HIV care and treatment scale up and sustainability. Together, NEPI and GN interventions increased the quantity and quality of the nursing and midwifery workforce by addressing seven domains of health workforce development: infrastructure; curriculum; faculty; clinical skills; production; in-service training; and partnership for policy and regulation.

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Find the GNCBP final report here Find out more about General Nursing

Link4Health was a cluster-randomized, controlled trial that evaluated the effectiveness of a combination intervention strategy versus the standard of care on the primary outcome of linkage to care within one month and retention in care at 12 months following HIV diagnosis. The combination intervention included: point-of-care CD4 testing at time of diagnosis, accelerated ART initiation for treatment-eligible individuals, mobile phone appointment reminders, health educational packages, and non-cash financial incentives for linkage and retention. (funded by the NIH)

View the End-of-Project report here

The Link4Health study supplement evaluated the feasibility and acceptability of implementing cardiovascular disease risk factor (CVDRF) screening and management among HIV-positive adults enrolled in care at the Raleigh Fitkin Memorial Hospital ART clinic. It also compared the effectiveness of two CVDRF management strategies—integrated versus referred management—on linkage to and retention in care. Retention in HIV care was high in both arms, with no difference between patients receiving integrated vs. referred management. (funded by NIH)

The MTCT-Plus Initiative, the world’s first multi-country HIV treatment program, aimed to demonstrate to a disbelieving world that it was possible to provide care and antiretroviral (ARV) treatment in resource-limited settings, using programs to prevent mother-to-child transmission of HIV (PMTCT) as an entry point. In December 2003, the MTCT-Plus Secretariat in New York (the precursor to ICAP, headed by ICAP’s Wafaa El-Sadr and Elaine Abrams) received its first grant from the new President’s Emergency Program For AIDS Relief (PEPFAR). Four years later, the MTCT-Plus Initiative of Columbia University’s Mailman School of Public Health was providing HIV care and treatment for nearly 17,000 people at 14 sites in nine countries. MTCT-Plus received expansion funding from USAID in 2003 and 2006. By 2010, ICAP had provided HIV care and treatment to more than one million people.

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Find the MTCT-Plus and MTCT-Plus Expansion reports here.

ICAP worked with the MOH and partners in Hhohho, Lubombo, and Manzini regions to decentralize adult and pediatric HIV services and expand treatment through nurse-initiated ART. ICAP provided technical assistance to strengthen networks of service providers, enhance linkages to care and referral systems, and introduce the Expert Client Program. Additionally, ICAP partnered with the MOH and CDC on the Swaziland HIV Incidence Measurement Survey, established the Health Research Training Program, conducted the first national ART program evaluation, and implemented a study assessing linkage to care after community testing. (funded by PEPFAR through CDC)

View the End-of-Project resources here

ICAP recently completed a two-year study examining the magnitude and determinants of disengagement from care among HIV-positive pregnant women and infants enrolled in prevention of mother-to-child services under Option B+ in Swaziland. The study found substantial numbers of women and infants classified as lost to follow-up under Option B+ were engaged in care. These findings highlighted a need to strengthen systems to improve PMTCT services. (funded by NIH)

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View the Safe Generations End-of-Project Report here

Safe Generations: ICAP collaborated with Swaziland’s Ministry of Health and the University of Cape Town to conduct this stepped-wedge implementation science study at 12 health facilities in Swaziland’s Manzini and Lubombo regions. The study evaluated the impact of Option B+ on maternal retention and mother-to-child transmission of HIV, as well as the approach’s feasibility, acceptability, and cost-effectiveness. (funded by USAID)

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View the Safe Generations End-of-Project Report here

ICAP partnered with the Ministry of Health (MOH) to build Eswatini’ s capacity in epidemiology and research and to strengthen the monitoring and use of data. The work enabled the effective use of health information and disease surveillance to inform policy and programming for a coordinated national health agenda. Under this award, ICAP also implemented Eswatini HIV-1 recent infection surveillance (EHRIS) program with an aim to establish HIV-1 recent infection surveillance among persons newly diagnosed with HIV infection.

EHRIS is part of the TRACE Project.

ICAP provided technical assistance to the Government of the Kingdom of Eswatini to enhance capacity and service delivery at the national level for tuberculosis (TB), multi-drug resistant TB (MDR-TB), and HIV/TB activities; strengthen stewardship and capacity of the Regional Health Management Team in Manzini Region for quality management of HIV/TB service delivery; and improve coverage and quality of adult and pediatric HIV testing, prevention, care, and treatment in health facilities and community settings. (funded by PEPFAR through the CDC).

ICAP provided technical assistance to enhance laboratory systems through the implementation of laboratory quality management systems and accreditation; external quality assessment through proficiency testing of all laboratory testing areas; capacity building of the laboratory workforce; improved access to testing through decentralized laboratory services; and enhanced national sample transport systems. ICAP also strengthened laboratory equipment and supply chain management and networking of laboratories with electronic laboratory information systems. (funded by PEPFAR through the CDC)

ICAP is providing support to the Government of the Kingdom of Eswatini to implement HIV-1 Recent Infection Surveillance (EHRIS) among persons newly diagnosed with HIV Infection in Eswatini; strengthen disease surveillance systems; increasing the capacity of Ministry of Health affiliated research groups to establish enhanced research protocols, improve study implementation, and to better disseminate salient findings. Funded by the President’s Emergency Plan for AIDS Relief (PEPFAR), the project is a continuation of ICAP's work in this area from 2015-2020.

ICAP worked to strengthen the capacity of the MOH and SNAP to use HIV program data to inform public health decision-making and ART programs, design and implement evaluations of priority programs, and strengthen monitoring and evaluation capacity. The first evaluation of Swaziland’s hub-and-spoke decentralization model was conducted under this award. (funded by PEPFAR through CDC)