History of the Manicaland HIV/STD Prevention Project
The Manicaland HIV/STD Prevention Project began in the early 1990’s in response to the growing concern about high rates of HIV infection and mortality in Zimbabwe. The project was set up to investigate the prevalence of HIV in Manicaland province and the demographic and social effects of the epidemic in the region.
Initially, a comparative study was undertaken comparing a site in Honde Valley, an area severely affected by the HIV epidemic, with a site in Rusitu Valley, a socio-demographically similar area in Manicaland thought to be less affected by the epidemic. The study found high HIV prevalence rates in rural areas of Zimbabwe and provided the first evidence for excess mortality due to AIDS in the country.
Following this, plans were made to expand this comparative study to conduct a community randomised controlled trial to evaluate the effects of a community-based programme of peer-education, free condom distribution, income-generating projects and clinic-based STI treatment and counseling services targeted at commercial sex workers and their clients on HIV incidence in Manicaland over a three year period. In order to ensure a large enough sample of study sites for the community-randomised trial, the project was expanded to include 12 study sites from across three districts in Manicaland. The sites were selected to ensure a reasonable geographic spread across the region without posing too great of a logistical challenge to move between them. Due to the remote positioning of the Rusitu Valley site, it was not included in the trial.
The study was piloted in February 1998 and the full study was launched in July 1998 and was completed in February 2000. Nearly 12,000 adults were interviewed in the baseline survey in 1998. Respondents answered questions relating to demographics, sexual behavior and HIV prevention. A sample of blood was collected onto filter papers from each respondent and tested for HIV. The second round of the survey, conducted from July 2001 to February 2003 collected similar data and was used to evaluate the success of the community-based intervention. The trial found reductions in HIV risk amongst male participants but failed to lower HIV incidence at the population level.
Since then, the cohort study has continued and grown in Manicaland. Our questionnaire now covers diverse topics ranging from marital and sexual relationships, health and access to treatment and knowledge and awareness of HIV/AIDS. Our current research interests include monitoring trends in HIV prevalence, incidence and mortality in the context of scale-up of prevention, treatment and other HIV services, investigating HIV prevalence and incidence amongst children and the potential for addressing supply-side and demand-side constraints on uptake and adherence to services. There have also been a number of spin-off studies conducted as part of the HIV/STD Prevention Project – Household Impact Study, Woman at Risk, Church Group and Stigma, Children and Stigma, Cash Transfer Programme, Orphan Study, Service Mapping and Service User Interface. For further information about the general Manicaland HIV/STD Prevention Project cohort study, click here.
Initially, a comparative study was undertaken comparing a site in Honde Valley, an area severely affected by the HIV epidemic, with a site in Rusitu Valley, a socio-demographically similar area in Manicaland thought to be less affected by the epidemic. The study found high HIV prevalence rates in rural areas of Zimbabwe and provided the first evidence for excess mortality due to AIDS in the country.
Following this, plans were made to expand this comparative study to conduct a community randomised controlled trial to evaluate the effects of a community-based programme of peer-education, free condom distribution, income-generating projects and clinic-based STI treatment and counseling services targeted at commercial sex workers and their clients on HIV incidence in Manicaland over a three year period. In order to ensure a large enough sample of study sites for the community-randomised trial, the project was expanded to include 12 study sites from across three districts in Manicaland. The sites were selected to ensure a reasonable geographic spread across the region without posing too great of a logistical challenge to move between them. Due to the remote positioning of the Rusitu Valley site, it was not included in the trial.
The study was piloted in February 1998 and the full study was launched in July 1998 and was completed in February 2000. Nearly 12,000 adults were interviewed in the baseline survey in 1998. Respondents answered questions relating to demographics, sexual behavior and HIV prevention. A sample of blood was collected onto filter papers from each respondent and tested for HIV. The second round of the survey, conducted from July 2001 to February 2003 collected similar data and was used to evaluate the success of the community-based intervention. The trial found reductions in HIV risk amongst male participants but failed to lower HIV incidence at the population level.
Since then, the cohort study has continued and grown in Manicaland. Our questionnaire now covers diverse topics ranging from marital and sexual relationships, health and access to treatment and knowledge and awareness of HIV/AIDS. Our current research interests include monitoring trends in HIV prevalence, incidence and mortality in the context of scale-up of prevention, treatment and other HIV services, investigating HIV prevalence and incidence amongst children and the potential for addressing supply-side and demand-side constraints on uptake and adherence to services. There have also been a number of spin-off studies conducted as part of the HIV/STD Prevention Project – Household Impact Study, Woman at Risk, Church Group and Stigma, Children and Stigma, Cash Transfer Programme, Orphan Study, Service Mapping and Service User Interface. For further information about the general Manicaland HIV/STD Prevention Project cohort study, click here.
