Medical research is widely thought of in the context of biomedical sciences. An approach that merges the strengths of biomedical and socio-behavioural research may just be the combination that can generate new insights to prevent major health problems such as HIV.
A Burnet research collaboration is seeking to uncover the causes of extreme rates of HIV among young women in the sub-Saharan African region. The Mucosal Injury from Sexual Contact (MISC) study will evaluate the findings from a sample of 365 adolescent and young women. A unique strength of the study is the concurrent investigation of biological and socio-behavioural factors that influence the very high risk of acquiring Human Immunodeficiency Virus (HIV) among adolescent and young South African women.
Dr Lindi Masson, Head of the HIV, Inflammation and Microbiome Group at Burnet said that sub-Saharan Africa is the epicentre of the HIV pandemic in the region. “In some regions, by the time a woman is in her early 20s, she has a one in three chance of being infected with HIV. This infection rate is much higher than that among their male counterparts,” Dr Masson said.
“In some regions, by the time a woman is in her early 20s, she has a one in three chance of being infected with HIV.
Although socio-behavioural factors explain some of this risk, previous studies suggest that biological factors also play a critical role. Young women in sub-Saharan Africa have very high rates of sexually transmitted infections, bacterial vaginosis, and a high prevalence of inflammation in the genital tract – all risk factors for HIV and potential drivers of HIV infection in this population. It was essential that both factors were assessed in the same study.
To achieve this, the research is evaluating socio-behavioural aspects such as depression, gender-based violence, sexual activity and the use of vaginal products, to understand their role in acquiring HIV.
The biological arm of the research is primarily investigating the causes of genital tract inflammation and disruption of the epithelial barrier, including sexually transmitted infections and bacterial vaginosis. In addition, the research team is searching for markers of inflammation and bacterial vaginosis to inform the development of diagnostic tools.
Dr Masson said the findings will lead to a complete understanding of HIV in adolescent and young sub-Saharan African women to develop suitable prevention tools and strategies for this key population.
“We are working on the development of inexpensive, point-of-care tests to identify women who have high inflammation and are at really high risk of HIV infection. We are also isolating bacteria that can potentially be used as bases for treatments”, Dr Masson added.
“By including socio-behavioural research, we can inform education strategies that can modify risk behaviours.”
“In 2020, there were 1.5 million new HIV infections globally and two-thirds of people living with HIV are in sub-Saharan Africa, with women and young girls most frequently affected. It’s critical to support research like this, if we are to address this major health issue.”
- University of Cape Town
- Seattle Children’s Hospital
- Desmond Tutu Health Foundation
- Centre for the AIDS Programme of Research in South Africa
- University of Kwazulu-Natal