In a new study in Mozambique, ICAP, a major research centre located at Columbia’s Mailman School of Public Health, will assess the potential for pre-exposure prophylaxis (PrEP), an anti-retroviral drug regimen taken before potential HIV exposure, to prevent HIV in a specific population: the female partners of mining workers.
The study will take place in Gaza Province, on Mozambique’s border with South Africa, where one in four people has HIV. The area is a source of migrant labour for South Africa’s mining industry; many men there work in mines across the border for extended periods of time, only returning home for family visits during holidays such as Christmas and Easter. With such long separations from their families, it is common for the migrant miners to have sex with several partners – including sex workers – which puts them, and in turn, their partners back home at risk of contracting HIV. It is during these periods of home visits when ICAP researchers will look at the feasibility of using PrEP.
With support from the Bill and Melinda Gates Foundation, ICAP researchers, in collaboration with World Health Organisation (WHO), will use quantitative and qualitative methods to assess the knowledge, understanding, and perceptions of PrEP among migrant miners’ female partners, miners themselves, and healthcare providers. The study will explore the willingness of female partners to take periodic PrEP during the time when their partners are visiting, and will assess possible structural and individual level barriers to accessing PrEP in this setting. In 2012, WHO released recommendations on the use of PrEP for HIV-serodiscordant couples and men who have sex with men, and called on countries to undertake demonstration projects to assess the feasibility of PrEP implementation and scale-up.
To recruit study participants, ICAP will collaborate with the Employment Bureau of Africa (TEBA), a labour recruitment organisation for mines in the region. This collaboration builds on ICAP’s previous work with TEBA in Lesotho, where recruitment offices were used as point of care to provider miners and their families with much-needed TB/HIV services.
“The findings from this pilot study, the first phase of this effort, will inform the design of a larger-scale HIV prevention study on the periodic use of PrEP in this population,” said Wafaa El-Sadr, ICAP’s director and professor of epidemiology and medicine, “hopefully offering another option for this population at risk and contributing to future HIV prevention strategies in Mozambique.”Columbia University Mailman School of Public Health