Switch to low bandwidth version Close

PopART

PopART / HPTN 071 is a large community-randomised trial that will be carried out in Zambia and South Africa to measure the impact of a universal HIV test-and-treat intervention on population-level HIV incidence.

Background

HIV prevalence and incidence remain at a very high level in many parts of Southern Africa and there is an urgent need for more effective prevention measures. Mathematical models have shown that universal voluntary HIV counselling and testing, with the offer of immediate antiretroviral treatment (ART) for those testing HIV-positive, has the potential to achieve substantial reductions in HIV incidence at population level. Testing the effectiveness of this strategy, in combination with proven preventive interventions, is a key global health priority.

Project Team

The trial will be carried out by a multi-national research consortium, led by the London School of Hygiene and Tropical Medicine in collaboration with the following institutions:

Within the two study countries, the design and delivery of the intervention will be carried out in close partnership with the Ministries of Health, PEPFAR and local implementing agencies.

Study Design

A total of 21 communities (12 in Zambia and 9 in South Africa) will be selected for study. The cluster or community for the purposes of this trial will be defined as the catchment population of a local health unit (through which the intervention will be delivered). These 21 communities will be grouped into 7 matched triplets (4 in Zambia and 3 in South Africa).

In each matched triplet, one community will be randomly selected to receive the full PopART intervention (Arm A), a second community will receive the full PopART intervention except that ART will be offered according to current national guidelines (Arm B) and the third will act as a control community and will receive standard of care (Arm C). Within each country, communities will be matched based on the best available estimates of HIV prevalence, with the aim of minimizing the between-community variance in baseline HIV incidence within matched triplets.

It is expected that the trial will be carried out over a 5-year period from January 2013 to December 2017.

PopART Intervention

The PopART intervention includes the following HIV prevention methods:

Impact Evaluation

To measure the impact of the intervention, a Population cohort consisting of a random sample of 2,500 adults aged 18-44 years will be selected from the general population of each cluster. A baseline survey of the cohort will be carried out at the time the intervention is initiated. Follow-up surveys of the cohort will be carried out after 12, 24 and 36 months and used to measure the impact of the intervention on HIV incidence and other outcomes.

Funding

HPTN 071/PopART is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID) and funded by  the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the International Initiative for Impact Evaluation (3ie) with support from the Bill & Melinda Gates Foundation, NIAID, the National Institute of Mental Heath (NIMH), and the National Institute on Drug Abuse (NIDA).

Back to top