Enhance Prevention in Couples (EPIC)

DESCRIPTION (provided by applicant): Program Director/Principal Investigator (Last, First, Middle): El-Sadr, Wafaa M. Project Summary The HIV epidemic continues to rage uncontained in many countries around the world, particularly in sub Saharan Africa. Lesotho, a small country in Southern Africa, has been severely affected with an estimated HIV seroprevalence of 23% among adults, the third highest rate in the world. Discordant couples for HIV where one partner is HIV infected and the other HIV negative represent a situation where the HIV negative partner is at high risk for acquiring HIV. Such transmission within married or cohabitating couples has been recognized as a major contributor to the spread of HIV. Thus, effective interventions that aim at prevention of transmission within HIV sero-discordant heterosexual couples are likely to have an important public health impact. We propose an innovative clinical trial, the Enhanced Prevention in Couples Study (EPIC Study), that aims at evaluating the effect of Enhanced Prevention Package (EPP) versus Standard of Care (SOC) on risk of HIV acquisition in HIV negative partners within HIV discordant couples enrolled from antenatal clinics (ANCs) in Lesotho. The Enhanced Prevention Package will include the following interventions: 1) antiretroviral therapy (ART) for the HIV infected partners at threshold of