AFRICOS Informs HIV Service Delivery in its Ninth Year

MHRP’s African Cohort Study (AFRICOS), a multisite, long-term study that evaluates HIV prevention, care and treatment services it supports through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), is entering its ninth year in 2022. Over the past year, MHRP researchers and collaborators published 13 papers in peer-reviewed journals. A sampling of cohort research reveals the breadth of research conducted under AFRICOS:

• Analysis of longitudinal data revealed that viral load suppression improved dramatically with the transition to the new first line regimen of tenofovir-lamivudine-dolutegravir (TLD), and that even people living with HIV who were well controlled on their old regimen had significantly lower rates of virological failure over time if they switched to TLD than if their treatment remained unchanged.

• AFRICOS also allowed researchers to examine how COVID affected participants’ HIV treatment. They observed decreases in clinic visit adherence early in the pandemic, and an increase in viral suppression later.

• Researchers assessed trends in self-reported experienced stigma and the association of experienced stigma with ART adherence and viral suppression among people living with HIV enrolled in AFRICOS. HIV-associated stigma was associated with poor selfreported ART adherence and unsuppressed viral load.

• AFRICOS collaborators also determined that cumulative time with symptoms of depression is associated with increased mortality in people living with HIV.

The AFRICOS study has enrolled more than 3,700 participants as of September 2021, and in the coming year will evaluate how initiatives like multi-month ART dispensing impact adherence and viral suppression.