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The National Institutes of Health

The National Institutes of Health

The main focus of the National Institutes of Health (NIH) is science in pursuit of fundamental knowledge about the nature and behaviour of living systems and the application of that knowledge to extend the healthy life and reduce the burdens of illness and disability.

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Projects

  • HIV Treatment Outcomes and Guidelines

    South Africa’s national antiretroviral therapy (ART) treatment program, the largest in the world with roughly 2.4 million people on treatment, has made substantial impact on reducing morbidity and mortality for HIV-infected people. As the national program matures, it faces significant challenges in expanding access to harder to reach populations while also maintaining quality of care for those for whom HIV has become a manageable chronic disease, including treatment fatigue, resistance 
  • Rewards for TB Contact Screening (RECON)

    Because of the high risk of both TB and HIV among the household contacts of TB patients and the importance of early case detection for both diseases and especially for DR-TB, improving TB case finding is a high priority. Recent studies have shown that having healthcare workers make multiple visits to the homes of TB patients in order to screen household contacts is a logistically challenging and resource- intensive strategy, and it is not routinely undertaken in most public sector settings in 
  • Rapid Initiation of Antiretroviral Treatment (RapIT) for Pregnant Women

    Alongside the primary RapIT study, we are enrolling pregnant women at a public clinic in Johannesburg in a prospective study of the impact of the guidelines on retention on ART for the duration of pregnancy. We are comparing our main outcome, adherence to ART until delivery, for these women to a retrospective comparison group who received PMTCT under earlier 
  • RapIT: Rapid Initiation of Antiretroviral Therapy to Promote Early HIV/AIDS Treatment in South Africa

    The RapIT study was a randomized strategy evaluation of the feasibility, effectiveness, and cost-effectiveness of rapid ART initiation using accelerated clinic procedures and point-of-care laboratory tests. Outpatient, non-pregnant, HIV-positive adults who came to two South African clinics for an HIV test or CD4 count, consented to study participation, and were eligible for ART under 2010 guidelines were randomized 1:1 to rapid ART initiation or to standard care. Those who were assigned to 
  • Retention and Attrition from HIV Care

    With the rapid expansion of access to antiretroviral therapy (ART) in sub-Saharan Africa, the number of HIV-positive people on treatment has increased dramatically. In South Africa, scale-up of services has put pressure on the ability of treatment programs to maintain care for existing patients while continuing to expand access to new patients. With increased demand and limited capacity, many HIV-positive patients never access care, and many who do discontinue treatment. HE2RO staff, 
  • Southern African Treatment Programme Evaluation

    Understanding HIV epidemic in the wider Southern African region provides context and valuable insight for the National treatment programme. To this end, HE2RO contributes data to the International Epidemiologic Databases to Evaluate AIDS Southern Africa network. This collaboration collects key data and implements methodology to effectively analyse data from large generated datasets to address high priorty HIV/AIDS related questions that are not answerable by a single 
  • Pregnant Women

    Treatment outcomes among pregnant women remain a critical indicator for monitoring and evaluation of the national treatment program over time. A long-standing collaboration with researchers from the University of North Carolina has enriched the analysis of longitudinal data on pregnant women by the researchers at 
  • Paediatric and Adolescent Populations

    Children and adolescents have been identified as priority populations with the greatest potential impact on the development of the HIV epidemic. HE2RO has used multiple sources of data to evaluate the outcomes of children and adolescents initiating ART at multiple clinics across Gauteng and Mpumalanga. We also utilize prospective cohorts to identify factors associated with treatment adherence and missed clinic visits among adolescents and plan to use national level laboratory data to produce 
  • RapIT-NCD: Prevalence of NCD risks and conditions in patients on ART

    South Africa, like many other middle income countries, faces very high rates of NCDs and NCD risks but there are virtually no studies looking at NDCs in ART patients and none that have considered the effect of NCDs and NCD risk factors on long term retention on ART. RapIT-NCD is estimating the prevalence of NCDs and NCD risk factors in patients who are stable on ART and examining associations between NCDs and ART outcomes, including mortality, loss to follow up, viral suppression and