HIV and sexually transmitted infections

HIV has become a chronic condition thanks to improvements in treatment and care, and people living with the virus increasingly navigate complex health, social and economic issues. Within this evolving landscape, the Bixby Center is transforming HIV/AIDS prevention, treatment and care through our innovative research worldwide.

Enhancing health services

The Bixby Center is pioneering research examining how to improve HIV/AIDS services and care systems. Our Family AIDS Care and Education Services (FACES) program is a major innovator of HIV care and treatment in Kenya, with an impact throughout sub-Saharan Africa. FACES research has provided evidence on how to effectively build sustainable HIV/AIDS care systems for women, men, children and families.

Other FACES research is answering important questions about how best to provide HIV, reproductive, maternal and child health care. This research showed that integrating family planning and HIV care for women in a “one-stop shop” led to significantly improved health outcomes for patients and increased program effectiveness.

In 2013, FACES provided HIV/AIDS care to more than 140,000 patients. The program’s HIV testing and counseling services have reached more than 740,000 people since 2005, and prevention of mother-to-child transmission services have reached more than 200,000 women.

Advancing comprehensive care

Bixby Center researchers are examining how to provide comprehensive care for HIV-positive people affected by related conditions. For more than 20 years, Bixby’s University of Zimbabwe College of Health Sciences Clinical Trials Unit (UZCHS-CTU), formally University of Zimbabwe-UCSF Collaborative Research Programme (UZ-UCSF), has helped define policies on comprehensive care for HIV and AIDS-related illnesses. UZCHS-CTU research has informed national and global guidelines on the treatment and clinical management of HIV/AIDS and related conditions, such as co-infection with tuberculosis.

Cervical cancer and HIV are also intersecting epidemics that largely affect low-income women. FACES research in Kenya is looking at low-cost and effective screening methods for cervical cancer, as well as community-driven prevention strategies, to improve care in the region.

Part of comprehensive care is helping women and their partners living with HIV make conception, pregnancy, childbirth and child care safer. UZCHS-CTU has been a leader in developing and testing biomedical prevention for mother-to-child HIV transmission during pregnancy, delivery and the postpartum period. UZCHS-CTU has also led groundbreaking research on initiation and monitoring of antiretroviral therapy for children.

Our FACES team is evaluating a toolkit for health care providers in safer conception strategies that will be used to create standardized counseling, guide policy and influence the scale-up of safer conception strategies in East Africa.

Innovating research methods

There is growing recognition that even the most effective HIV/AIDS prevention and treatment medicines or programs truly work only when individuals and communities respond to them positively. That's why Bixby Center HIV/AIDS experts are spearheading the integration of social science methods into biomedical research.

For example, Bixby researchers are part of the SEARCH project – the largest trial ever to test the concept of HIV treatment as prevention. Bixby researchers are integrating rigorous social science methods into SEARCH, evaluating how a universal HIV testing and treatment strategy influences HIV-related beliefs and behaviors in East Africa.

Another innovative social science research program at Bixby is examining the effect of an agricultural program on household earnings, food insecurity and HIV/AIDS outcomes.

Reaching neglected populations

Social, gender and economic discrimination can result in marginalized communities that have limited access to health care settings or services. These neglected populations need tailored efforts to make care more accessible. To help improve HIV services for these groups, our investigators are breaking ground among traditionally marginalized populations.

For instance, cutting-edge Bixby Center research is examining HIV/AIDS among transgender populations in the Middle East, previously uncharted territory in prevention research. Other groundbreaking research examines the overlooked role that women’s mobility plays in sustaining HIV epidemics in Africa, including the impact of migration on HIV transmission, risk and care outcomes.

Additional Bixby research is examining mental health treatment for HIV-positive women affected by gender-based violence, depression and post-traumatic stress disorder.

Developing new prevention tools

HIV prevention research has seen remarkable changes over the past several years, expanding ideas of what belongs in the prevention toolbox. The Bixby Center is at the forefront of efforts to develop innovative prevention tools. For instance, UZCHS-CTU is a leader in state-of-the-art clinical trials through its NIH-sponsored Clinical Trials Unit. Its groundbreaking research in HIV prevention tools includes:

• Vaccines.
• Female-controlled methods, including microbicides and vaginal rings.
• Pre-exposure prophylaxis.
• Prevention of mother-to-child transmission.
• Prevention for couples with one HIV-positive and one HIV-negative partner.

Our Bixby investigators are developing new tools that can help women prevent multiple health issues simultaneously, such as preventing both HIV and other reproductive tract infections.