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First-ever community-randomised combination prevention trial produces modest drop in HIV incidence, big increase in testing in men
Gus Cairns, 2013-07-03 13:50:00
The results of a pioneering HIV prevention trial comparing the effects of mobile HIV testing, community mobilisation, and enhanced support for people with HIV versus standard voluntary counselling and testing (VCT) was announced at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur.
Project ACCEPT is the first controlled trial comparing the efficacy of a prevention intervention versus standard of care between two separate, matched communities, rather than between randomised individuals. It was designed to examine how widespread community mobilisation and providing mobile testing changed group behaviour and community norms, as well as whether it produced a drop in HIV infections.
In fact, Project ACCEPT only produced a modest 14% drop in the rate of new HIV infections (incidence) – though HIV incidence in mature epidemics is very hard to change with behavioural interventions. But it produced a greater fall in incidence in older women, and a considerable increase in HIV testing in men, who in Africa have tended to be less engaged with care and more likely to be undiagnosed. It also reported falls in the number of partners reported by people with HIV and in the proportion who had multiple partners.
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