s) to determine the effectiveness of targeting individuals with high viral loads. Using this method can indicate whether new infections originated within a particular village, for example. Identifying viral gene signatures could also determine how much the study interventions are able to reduce infections that can be traced to individuals with high viral loads.
Researchers will also analyze cost savings realized from using the prevention strategies in the study. "The hope is that the strategies will help countries cut costs dramatically," said Essex. "Conducting a study of this type in southern Africa is more logical because HIV infection rates are much higher than those in the U.S. and the results can be obtained sooner."
The study will be conducted in collaboration with the Botswana Harvard AIDS Institute Partnership (BHP), a 15-year-old collaborative research and training initiative between the Harvard School of Public Health AIDS Initiative and the Botswana Ministry of Health.
In spite of Botswana's significant efforts to curtail the incidence of HIV/AIDS, 25 percent of adults in this southern African country are HIV-positive. To home in on ways to optimize HIV prevention strategies, HSPH and BHP researchers will conduct a randomized study of nearly 50,000 people22,000 in the village of Mochudi, and roughly 28,000 in 16 rural communities. HSPH and BHP researchers, working with Botswana's Ministry of Health, will examine the effects of combining a number of prevention strategies over a four-year period. In addition to treating high viral load, the interventions include
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