[111] WHAT HAPPENS WHEN A RESEARCH PROJECT CLOSES: HIV INCIDENCE, MORTALITY, AND PERCEPTIONS IN A COUPLES’ COHORT IN LUSAKA, ZAMBIA

2nd International AIDS Society Conference on HIV Pathogenesis and Treatment

Paris, France - July 13 - 16, 2003

[TITLE:] WHAT HAPPENS WHEN A RESEARCH PROJECT CLOSES: HIV INCIDENCE, MORTALITY, AND PERCEPTIONS IN A COUPLES’ COHORT IN LUSAKA, ZAMBIA

[AUTHOR(S):] E Shutes^1,3 and the Rwanda/Zambia HIV Research Group^1,3
¹Project San Francisco (PSF), Kigali, Rwanda; ²University of Alabama in Birmingham (UAB), AL, USA; and ³Zambia-UAB HIV Research Project (ZUHRP), Lusaka, Zambia

IAS Conf HIV Pathog Treat 2003 Jul 13-16;2nd: Abstract No. 111
Antiviral Therapy 2003; 8(Suppl. 1):S211

[ABSTRACT:] Objective: HIV research projects in developing countries often provide services to study participants. When research is concluded, participants are left without the support they have come to depend on. The impact of a 7-month closure of an HIV research study in Lusaka, Zambia is examined.

Methods: Eligible couples were enrolled and followed at 3 monthly intervals between May 1995 and April 2002. Primary health care was provided at the research clinic. The project was closed between December 1998 and June 1999. HIV and syphilis seroincidence and mortality rates are compared before, during and after the closure. Between August 1999 and January 2000, 531 returned study participants answered a two-page questionnaire regarding their experience during the closure.

Results: Couples that returned (75% of those that were actively enrolled at the time the project was closed) were not demographically different from couples that did not. The majority (82%) of respondents reported continued condom use and the incidence of syphilis and HIV was not significantly different during the closure compared with before and after. 84% of respondents reported that the project closure had a negative impact on them, 87% of whom rated lack of medical care as the main reason. The mortality rate among HIV+ participants doubled from 6.7/100 PY (95% CI 5.3–8.3) before to 12.4/100 PY (8.1–18.1) during closure, and decreased again to 7.5/100 PY (5.7–9.7) after the project re-opened.

Discussion: Self-reported and objective data confirmed that risk reduction was maintained in the absence of regular follow-up. The most negative perceived impact on study participants was the loss of health care, which coincided with an increase in mortality rates. HIV research projects should make transition plans and establish functional health referral mechanisms for study participants when research funding ends.

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