“We aim to pave the path to HIV elimination through the entry point of improving community health.”
Diane Havlir, MD,
SEARCH engages communities and local leadership in a multi-disease approach to improve health screening, care delivery and individual and community well-being.
The research study uses bold, new ideas—like multi-disease, community-based testing and treatment—to address more than HIV, including community health, economic productivity, and cultural stigma.
What is SEARCH?
SEARCH is a research study that uses the “Test-and-Treat” strategy for HIV reduction—that is, we screen for HIV in all persons in a community, followed by immediate treatment for those who test positive—in 32 communities in rural Uganda and Kenya, including over 350,000 adults and children.
The study is considering the health, economic and educational impact of new approaches in community HIV testing, treatment, care and prevention. In the first phase of SEARCH (2013-2017), the research team worked with local communities to host mobile, community-wide health fairs that included health education; screenings for HIV and diseases like hypertension, diabetes, and tuberculosis; and immediate care or referral for any health problems. In the second phase (2017-2020), the team used targeted HIV prevention (i.e., PrEP, or Pre-Exposure Prophylaxis), targeted HIV testing, and targeted care interventions on top of universal treatment and streamlined care.
The results of SEARCH will help to guide the global effort to end AIDS.
The SEARCH team is excited to announce a new 5-year NIH-funded research program designed to design and test evidence based treatment and prevention interventions that will guide a global effort to end AIDS using a multi-disease, multi-sector approach. The new program, SEARCH Sapphire: “A Multisectoral Strategy to Address Persistent drivers of the HIV epidemic in East Africa” aims to accelerate the path to HIV elimination with new innovative combination strategies for HIV prevention and treatment that are effective, efficient, scalable and reduce preventable infections and deaths. Collaborators for this study include Kenya Medical Research Institute in Kenya, Infectious Diseases Research Collaboration and Makerere University in Uganda, University of California Berkeley, University of Massachusetts Amherst, University of Pennsylvania, and University College London and will start in early 2021!
SEARCH team at AIDS 2018 conference in Amsterdam
Despite effective treatments, only 22 million of the 37 million people living with HIV globally receive treatment. This gap exists largely because health workers in developing countries struggle to reach HIV-infected individuals. In the first phase of the SEARCH trial (2013-2017), mobile, community-wide health fairs offered annual testing for HIV, tuberculosis, malaria, high blood pressure and diabetes.
Collaborators & Advisors
SEARCH Phase 1 Main Findings Published in New England Journal of Medicine
The SEARCH Collaboration has recently published its Phase I findings "HIV Testing and Treatment with the Use of a Community Health Approach" in the prestigious New England Journal of Medicine. In conjunction with two other published studies, we now know that a Universal Test and Treat strategy can significantly reduce HIV incidence. We showed in SEARCH that a multi-disease approach adds community health benefits of reducing tuberculosis and mortality along with reductions in new HIV infections. We also know that we will need more than test and treat alone to eliminate HIV and that is why we continue important work in the SEARCH study. This publication adds to the over 50 papers that have been published by the SEARCH Collaboration in the past few years.
You can access the new publication here:
See SEARCH profiled in the Emmy-winning episode of the PBS Newshour
SEARCH study exceeds U.N. 'test and treat' goal for ending HIV pandemic
SEARCH Research has produced Over 50 peer-reviewed publications since 2014
Click on Article Title to Get PDF File of publication.
Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study. Koss,et al. Lancet HIV. 2020 Apr; 7(4): e249–e261. PMID: 32087152, PMCID: PMC7208546
HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa. Havlir et al. N Engl J Med. 2019 Jul 18; 381(3): 219-229. PMID: 31314966, PMCID: PMC6748325
Association of Implementation of a Universal Testing and Treatment Intervention With HIV Diagnosis, Receipt of Antiretroviral Therapy, and Viral Suppression in East Africa. Petersen et al. JAMA. 2017;317(21):2196-2206. PMID: 28586888, PMCID: PMC5734234
A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study. Chamie et al. Lancet HIV. 2016 Mar;3(3):e111-9. doi: 10.1016/S2352-3018(15)00251-9. Epub 2016 Jan 26. PMID:26939734 PMCID: PMC4780220
Implementation and Operational Research: Cost and Efficiency of a Hybrid Mobile Multidisease Testing Approach With High HIV Testing Coverage in East Africa. Chang et al. J Acquir Immune Defic Syndr. 2016 Nov 1;73(3):e39-e45. PMID:27741031, PMCID: PMC5089839
Dr. Catherine Koss of University of California, San Francisco presented at the 2020 AIDS Conference in San Francisco on behalf of the SEARCH team on SEARCH trial Phase II interim results.The results show that population-level PrEP offer (2016-2019) in 16 communities in rural Uganda and Kenya was associated with 79% lower HIV incidence among PrEP initiators with follow-up HIV testing than among recent (2015-2017) matched controls in the absence of PrEP.
Scientific Abstract and Presentation: https://cattendee.abstractsonline.com/meeting/9289/presentation/202
Now & the Future
SEARCH represents an opportunity to realize HIV elimination and to improve community health and productivity.
Phase I of SEARCH (2013-2017) showed that multi-disease, community-based testing and treatment is effective and can reduce deaths and new HIV infections and increase workforce participation.
Phase II (2017-2020) focused on new health and treatment models for adolescents and young adults; HIV Pre-Exposure Prophylaxis (PrEP); treatment models for tuberculosis; and novel electronic technologies for community health.
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