“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 is using 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.
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:
SEARCH Presents Intervention Results Showing 27% Reduction in Mortality among HIV infected Men at CROI 2019 Conference
Dr. Moses Kamya of Makerere University, Uganda presented at the 2019 International Conference on Retroviruses and Opportunistic Infections in Seattle on behalf of the SEARCH Test-and-Treat trial showing that the study’s approach to streamlined HIV care significantly accelerated treatment start and reduced mortality at a population level among HIV+ persons with advanced disease with strong effects particularly among men.
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.
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.
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. doi:10.1001/jama.2017.5705
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
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) is focusing 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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