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Research on HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) has advanced significantly since the retrovirus’s discovery in the 1980s. AIDS results from HIV infection, and complications from AIDS have led to the deaths of 35 million people since it was identified in 1981. This discovery led to the creation of the first global health awareness day, World AIDS Day, in 1988. Held annually on December 1st, it aims to support the 38 million people living with HIV, combat stigma against HIV-positive individuals, and enhance worldwide HIV awareness and education.

The Gates Foundation are committed to advancing research into HIV and AIDS, with the goals of accelerating the decline in HIV infection worldwide and saving lives by ensuring expanded and simplified HIV treatment and improved and effective use of interventions to prevent new infections. Read on to learn more about HIV/AIDS research funded by the Gates Foundation and published on Gates Open Research.

An Open Letter on Advancing HIV prevention: Augmenting an ecosystem-based approach to understand prevention decision-making

In the last two decades, HIV programs have been able to avert millions of AIDS-related deaths and reduce HIV incidence. However, the 1.3 million new HIV infections in 2022 remain significantly above the UNAIDS target of fewer than 370,000 new infections by 2025. Within this broader picture, HIV continues to disproportionately affect key and at-risk populations, including gay men and other men who have sex with men, female sex workers, and adolescent girls and young women. As HIV incidence declines and biomedical advances continue, it will become critical for public-health practitioners to reach key and at-risk populations with prevention services and limit primary transmission.

The following Open Letter published on Gates Open Research highlights the ongoing challenges in HIV prevention, noting that despite significant progress, new infections remain well above targets. It emphasizes the need for a dynamic approach to understanding decision-making in HIV prevention, focusing on individual, interaction, and systemic factors that influence the uptake of prevention products and services. The authors argue that current frameworks are insufficient for addressing the complexities of user behavior and suggest incorporating dynamic elements to better inform program implementation.

Read the full Open Letter here.

Expanding options for HIV testing: A process evaluation of a community-led HIV self-testing intervention among men who have sex with men (MSM) in Kenya

HIV testing is a necessary first step in the HIV care process. Knowing one’s HIV status provides a vital opportunity to engage in HIV care and treatment, as well as impacting HIV prevention behaviors, such as consistent condom use or use of Pre-Exposure Prophylaxis (PreP) medication. The World Health Organization recommends HIV testing and counseling as part of comprehensive HIV prevention and treatment services, however access to HIV testing among these populations remains a challenge in the global south.

HIV testing is a key component of the key population programme in Kenya and the official guidelines recommend quarterly testing for MSM. The country’s existing routine monitoring data show significant gaps in service uptake throughout the treatment cascade. Treatment programme outcomes showed that 52% of MSM living with HIV knew their HIV status, 80% of MSM living with HIV received antiretroviral therapy (ART), and 74% of those who received ART demonstrated viral suppression.

The following Research Article published on Gates Open Research evaluated a community-led HIV self-testing intervention aimed at increasing HIV testing among men who have sex with men (MSM) in Kenya, addressing barriers to testing. The intervention showed high acceptability and feasibility, with significant increases in testing frequency and successful linkages to care, particularly among infrequent testers and non-testers. The involvement of MSM organizations was crucial to the intervention’s success.

Read the full Research Article here.

Preferences for services in a patient’s first six months on antiretroviral therapy for HIV in South Africa and Zambia (PREFER): research protocol for a prospective observational cohort study

Rapid, same-day, and community-based initiation of ART for HIV has shifted the challenge of achieving optimal outcomes in HIV treatment onto retention in care after a patient has started ART. The highest risk for loss from care consistently remains a patient’s first six months after ART initiation, when patients are not yet eligible for differentiated service delivery (DSD) models that offer lower-burden, patient-centred care, thus improving treatment outcomes.

The following Study Protocol provides an overview of the PREFER study, which aims to understand the characteristics, needs, and preferences of patients in South Africa and Zambia during the first six months of antiretroviral therapy (ART) to improve early treatment outcomes and reduce disengagement from care. Using a mixed-methods approach, the study will gather data through surveys, medical records, focus groups, and blood samples to inform the design of differentiated service delivery models tailored to patients’ needs.

Read the full Study Protocol here.

Publish your Gates Foundation-funded research today 

If you’re conducting Gates-funded water and sanitation research, join other Gates grantees already publishing their sanitation and water research with Gates Open Research this World Toilet Day and benefit from: 

• No author publishing charges 
• Open access, open data, and open peer review 
• Article-level metrics and indexation in major indexers such as PubMed and Scopus 

Find out more and submit your research today. Please note that all publications on Gates Open Research are initially posted as preprints on VeriXiv, the Gates Foundation’s preprint server. Peer review is carried out on the VeriXiv platform, and once an article passes peer review it is then published as a final version on Gates Open Research. As a Gates grantee, you can preprint all of your Gates-funded work on VeriXiv, and submit to any other external journals for peer review. For more information about the Gates Foundation’s revised Open Access policy, please visit this link. 

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