MHRP and local partners in Manila, Philippines, enrolled the first participant in the site’s Multinational Observational Cohort of HIV and other Infections (MOCHI) study in May.
The Philippines site is the third to launch the MOCHI study to characterize the regional incidence of HIV and other sexually transmitted infections(STIs); the study is already underway at sites in Kenya and Uganda. MOCHI is the first MHRP clinical study in the Philippines, establishing new collaborations with Armed Forces of the Philippines, the LoveYourself non-governmental organization, and other regional stakeholders in the HIV response. The study is enrolling at National Institutes of Health Institute of Clinical Epidemiology at the University of the Philippines
The Philippines is experiencing the fastest-growing HIV epidemic in the Western Pacific region. While HIV is declining globally, from 2012 to 2023 there was a 411% increase in daily incidence reported to the HIV/AIDS and ART Registry of the Philippines.'
Characterizing HIV in the region
MOCHI is designed to provide one unified protocol and set of data collection instruments for deployment across multiple sites in diverse regions of world, with a target of enrolling 400-500 participants without HIV at each site. In addition to estimating HIV and STI incidence and tracking the evolution of risk and healthcare-seeking behaviors, the study will also facilitate the sites’ preparedness for future HIV and STI prevention studies by building capacity, evaluating site recruitment and retention and maintaining relationships with affected communities.
Every 12 weeks, participants receive clinic-based HIV testing, counseling and PrEP referrals, and are provided HIV home testing kits for use between scheduled visits. They also complete behavioral questionnaires and undergo testing for other STIs. Participants diagnosed with HIV are offered antiretroviral therapy (ART) according to the local standard of care and continue follow-up visits. This cohort could eventually provide a foundation for potential future trials of new HIV therapeutics.
A key pillar of the MOCHI study involves engaging community stakeholders to provide input on MOCHI recruitment, objectives and information sharing. Prior to study launch, public service specialists, policy developers, medical doctors, community members, trainers, researchers, academicians, and strategic planners attended a stakeholder meeting to discuss research concerns and enhance collaboration.
Military-to-military PEPFAR expansion
The launch of MOCHI follows upon the 2021 expansion of MHRP implementation of the President’s Emergency Plan for AID Relief (PEPFAR) into the Philippines. MHRP, along with the Armed Forces Research Institute for Medical Sciences (AFRIMS) and the Department of Defense HIV/AIDS Prevention Program (DHAPP), provide military-to-military HIV prevention, care and treatment services in close collaboration with the Armed Forces of the Philippines (AFP).
The primary aim is to help the AFP reach sustainable HIV epidemic control by strengthening the military capacity to establish policies and systems to provide quality HIV prevention, testing, treatment, and laboratory services anchored in the Victoriano Luna Medical Center. These activities directly contribute to building a sustainable AFP-wide HIV program.
The collaboration also helps inform HIV policy updates. In spring 2024, the AFP Chief of Staff officially approved HIV/AIDS Prevention and Control Guidelines, marking the culmination of two years of effort by a steering committee, with the guidance and support of the PEPFAR Philippines team.
Of significance is the removal of dismissal based on HIV status; any AFP service member who acquires HIV during active service will be assured of continued opportunity to serve if all other fitness standards are met. In addition, the policy now extends HIV services not only to military personnel, but also to military dependents, civilian human resources and authorized civilians.