HIV PREVENTION TRIALS UNIT, RAKAI, UGANDA

Rakai项目是乌干达卫生部与Makerere大学、哥伦比亚大学和约翰霍普金斯大学合作开展的项目，自1988年以来，在乌干达Rakai农村地区开展了艾滋病毒/TD流行病学和行为研究以及艾滋病毒预防的随机试验。(The随机试验的目的是控制性病以预防艾滋病毒和治疗绒毛膜炎以防止母婴传播。目前，我们与沃尔特里德陆军研究所（WRAIR）合作，对12，000名年龄在15-59岁之间的受试者进行了监测。Rakai队列提供了一个多能人群，使我们能够解决大多数HPTN议程的艾滋病毒预防研究的优先事项，无论是作为一个单一的网站，或在多个网站的研究，由HPTN开发。HPTN可处理的优先议程项目包括围产期哺乳期MTC艾滋病毒传播、杀微生物剂试验、在艾滋病毒低流行率环境中通过假定和综合征治疗的混合进行的社区随机性传播疾病控制、行为干预和不和谐夫妇的抗逆转录病毒治疗。我们已证明有能力招募受试者（一般人群中90%，孕妇中95%），获得提供样本和接受治疗的高依从性（大于或等于90%），并长期保留受试者（一般人群80%随访30个月，孕妇95%产后随访）。我们拥有实验室和数据管理设施，以及经验丰富的实地工作人员，并制定了在受访者家中收集样本的创新方法，以最大限度地扩大覆盖面和遵守规定。人群可以很容易地扩大，以满足HPTN的要求，选择性招募可以针对优先亚组，如高风险的“核心群体”，孕妇95%产后随访）。我们拥有实验室和数据管理设施，以及经验丰富的实地工作人员，并制定了在受访者家中收集样本的创新方法，以最大限度地扩大覆盖面和遵守规定。人口可以很容易地扩大，以满足HPTN的要求，选择性招募可以针对优先亚组，如高风险的“核心群体”，孕妇和哺乳期妇女，或不和谐的夫妇，我们建议在当前的应用程序中这样的扩展。我们得到了卫生部长和国内相关合作者的支持（例如，乌干达的PI包括Makerere大学医学院院长和公共卫生研究所所长），以及美国（例如，杰克逊博士和奎因博士负责HPTN核心实验室设施）。总之，Rakai是非洲最大的基于人口的艾滋病毒/性病队列，非常适合HPTN议程的优先事项。

The Rakai Project, a collaboration between the Uganda Ministry of Health, and Makerere, Columbia and Johns Hopkins Universities, has conducted HIV/TD epidemiologic and behavioral research and randomized trials of HIV prevention of HIV prevention in rural Rakai District, Uganda since 1988. (The randomized trials addresses addressed STD control for HIV prevention and the treatment of chorioamnionitis to prevent mother-to-child (MTC) transmission). We currently have a representative cohort of 12,000 subjects aged 15-59 under surveillance in collaboration with the Walter Reed Army Institute of Research (WRAIR). The Rakai cohort provides a pluripotential population allowing us to address most HPTN agenda priorities for HIV prevention research either as a single site, or in multi-site studies to developed by HPTN. The HPTN priority agenda items that can be addressed include perinatal lactational MTC HIV transmission, microbicide trials, community- randomized STD control by a hybrid of presumptive and syndromic treatment in low HIV prevalence settings, behavioral interventions and antiretroviral therapy in discordant couples. We have demonstrated the ability to enroll subjects (90% in the general population, 95% in pregnant women), to obtain high compliance with provision of samples and acceptance of treatment (greater than or equal to 90%), and to retain subjects for prolonged periods of time (general population 80% follow up 30 months, pregnant women 95% postpartum follow up). We have laboratory and data management facilities, and experienced field personnel, and have established innovative methods of sample collection in the respondent's homes to maximize coverage and compliance. The population can readily be expanded to meet HPTN requirements, and selective recruitment can target priority subgroups such as high risk "core groups", pregnant women 95% postpartum follow up). We have laboratory and data management facilities, and experienced field personnel, and have established innovative methods of sample collection in the respondent's homes to maximize coverage and compliance. The population can readily be expanded to meet HPTN requirements, and selective recruitment can target priority subgroups such as high risk "core groups", pregnant and lactating women, or discordant couples, and we propose such expansion in the current application. We have support from the Minister of Health and relevant collaborators in-country (e.g., Ugandan PIs include the Dean of Medicine and Director of the Institute of Public Health, Makerere University), as well as in the US (e.g., Drs. Jackson and Quin who direct the HPTN Core Laboratory Facility). In summary, Rakai is the largest established population-based HIV/STD cohort in Africa and is ideally suited for HPTN agenda priorities.