INFO

Mission

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.

SEARCH SAPPHIRE

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

What is SEARCH?

SEARCH (Sustainable East Africa Research in Community Health) is a multinational, multidisciplinary consortium assembled to conduct research that evaluates bold health interventions at the community level that inform policy makers and funding agencies through the inclusion of health, economic and education parameters and through innovative, efficient study designs. SEARCH currently is located in multiple communities in rural Uganda and Kenya.​

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. In the upcoming SAPPHIRE study, the team 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.

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The results of SEARCH will help to guide the global effort to end AIDS. 

Background

Despite effective treatments, in 2018, only 24.5 million of the 38 million people living with HIV globally receive treatment. This gap exists largely because health workers in developing countries struggle to reach HIV-infected individuals. SEARCH interventions are designed to improve the entire continuum of care, to reduce structural barriers for all populations including those most “at risk” and build upon evidence based prevention interventions.  This information will guide a global effort to end AIDS.  

OPPORTUNITY

Now & the Future

The SEARCH Collaboration 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.  SEARCH showed 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. 

See SEARCH profiled in the Emmy-winning episode of the PBS Newshour  click below

SEARCH study exceeds U.N.  'test and treat' goal for ending HIV pandemic

SEARCH Research has produced Over 70 peer-reviewed publications since 2014

SEARCH Program Highlights

Click on Article Title to Get PDF File of publication.

• HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda. Koss et al. PLOS Med. 2021 Feb 9;18(2):e1003492. ​PMID: 33561143 PMCID: PMC7872279

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• 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.​​

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• 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

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• 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

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• 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: Epub 2016 Jan 26. PMID: 26939734; PMCID: PMC4780220

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• 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