scholarly journals Exploring the Use of Oral Pre-exposure Prophylaxis (PrEP) Among Women from Durban, South Africa as Part of the HIV Prevention Package in a Clinical Trial

2020 ◽  
Author(s):  
Ivana Beesham ◽  
Renee Heffron ◽  
Shannon Evans ◽  
Jared M. Baeten ◽  
Jenni Smit ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
South African ◽  
Medical Research Council ◽  
Trial Site ◽  
Study Staff ◽  
Prevention Trials ◽  
Post Trial ◽  
Exposure Prophylaxis ◽  
First Time

Abstract HIV endpoint-driven clinical trials in Africa enroll women who are at heightened risk of acquiring HIV. In 2017, the South African Medical Research Council recommended the provision of oral pre-exposure prophylaxis (PrEP) in HIV prevention trials, at which time the Evidence for Contraceptive Options and HIV Outcomes trial was ongoing and began to provide PrEP on-site at some trial sites. We interviewed 132 women who initiated PrEP on-site at the Durban, South Africa trial site to explore PrEP use, and conducted phone-based interviews 4–6 months post-trial exit to explore post-trial PrEP access. PrEP uptake was high (42.6%). Among women initiating PrEP on-site, 87.9% felt at risk of acquiring HIV. Most women (> 90%) heard of PrEP for the first time from study staff and three-quarters who initiated PrEP on-site continued at trial-exit. PrEP use declined post-trial exit with more than 50% of women discontinuing PrEP, and barriers relating to access emerged.

scholarly journals Meeting report: South African Medical Research Council Standard of Care in Clinical Research in Low- And Middle-Income Settings Summit, November 2017

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maurine D. Miner ◽  
Linda-Gail Bekker ◽  
Tamara Kredo ◽  
Niresh Bhagwandin ◽  
Lawrence Corey ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Hiv Prevention ◽  
South African ◽  
Medical Research Council ◽  
Standard Of Care ◽  
Hiv Vaccine ◽  
Middle Income ◽  
Hiv Vaccine Trials ◽  
Vaccine Trials ◽  
Prevention Trials

AbstractA cornerstone of HIV prevention clinical trials is providing a combination prevention package to all trial participants. The elements included in that standard of care (SoC) package evolve as new prevention modalities are developed. Pre-exposure prophylaxis (PrEP) was recommended by the World Health Organization for persons at high risk of acquiring HIV, but not all countries immediately adopted those recommendations. The South African Medical Research Council (SAMRC) convened a summit to discuss issues relating to SoC and PrEP in HIV prevention clinical trials taking place in lower- to middle-income countries (LMIC). Policymakers, regulators, ethicists, experts in law, researchers, representatives of advocacy groups, and the HIV Vaccine Trials Network (HVTN) presented a framework within which SoC principles could be articulated. A group of subject matter experts presented on the regulatory, ethical, scientific, and historic framework of SoC in clinical trials, focusing on PrEP in South Africa. Summit participants discussed how and when to include new HIV treatment and prevention practices into existing clinical guidelines and trial protocols, as well as the opportunities for and challenges to scaling up interventions. The summit addressed challenges to PrEP provision, such as inconsistent efficacy amongst different populations and various biological, virological, and immunological explanations for this heterogeneity. Advocates and community members propagated the urgent need for accessible interventions that could avert HIV infection. The meeting recommended supporting access to PrEP in HIV prevention trials by (1) developing PrEP access plans for HIV vaccine trials, (2) creating a PrEP fund that would supply PrEP to sites conducting HIV prevention trials via a central procurement mechanism, and (3) supporting the safety monitoring of PrEP. This report summarizes the presentations and discussions from the summit in order to highlight the importance of SoC in HIV prevention clinical trials.

scholarly journals Meeting Report: South African Medical Research Council Standard of Care in Clinical Research in Low- And Middle-Income Settings Summit, November 2017

2020 ◽  
Author(s):  
Maurine Miner ◽  
Linda-Gail Bekker ◽  
Tamara Kredo ◽  
Niresh Bhagwandin ◽  
Lawrence Corey ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Medical Research ◽  
South African ◽  
Medical Research Council ◽  
Standard Of Care ◽  
Hiv Vaccine ◽  
Hiv Vaccine Trials ◽  
Treatment And Prevention ◽  
Vaccine Trials ◽  
Prevention Trials

Introduction: The South African Medical Research Council (SAMRC) convened a summit to discuss issues relating to standard of care (SoC) in HIV prevention clinical trials, both for treatment and prevention of disease. Policymakers, regulators, ethicists, experts in the law (as it pertains to medical research), researchers, representatives of advocacy groups, and the HIV Vaccine Trials Network (HVTN) presented a framework within which SoC principles could be articulated. Discussion: Summit participants discussed how and when to include new modalities of HIV treatment and prevention into existing clinical practice guidelines, and by extension in clinical trial protocols. Participants involved in the execution of care and the scale-up of new interventions, in particular, the roll out of pre-exposure prophylaxis (PrEP), presented the opportunities for and challenges to scaling up interventions, and their experience with demonstration projects of PrEP. Advocates and community members propagated the need to make interventions that could avert HIV infection available as soon as possible. Experts in evidence-based guideline development discussed the nuances in evaluating evidence for policy and the mechanisms for getting medicines on the Essential Medicines List in South Africa. Given the variability in clinical trial efficacy of PrEP amongst different populations, scientists and statisticians discussed the various biological, virological and immunological reasons for this heterogeneity. Conclusions: Input was given as to the impact of introducing PrEP in other HIV prevention trials, and the considerations for the design of both antiretroviral (ARV)-based and non-ARV based HIV prevention trials. The meeting recommended supporting access to PrEP in HIV prevention trials by 1) developing PrEP access plans for HIV vaccine trials; 2) creating a PrEP fund that would supply PrEP to sites conducting HIV prevention trials via a central procurement mechanism; and 3) support the safety monitoring of PrEP.

Implications for the age of South African Devonian rocks in which Tropidoleptus (Brachiopoda) has been found

1983 ◽  
Vol 120 (1) ◽  
pp. 51-58 ◽  
Author(s):  
A. J. Boucot ◽  
C. H. C. Brunton ◽  
J. N. Theron
Keyword(s):  
South Africa ◽  
North America ◽  
South African ◽  
Early Carboniferous ◽  
Fossil Plants ◽  
Geological Time ◽  
Marine Sedimentation ◽  
History Of ◽  
Near Shore ◽  
First Time

SummaryThe Devonian brachiopod Tropidoleptus is recognized for the first time in South Africa. It is present in the lower part of the Witteberg Group at four widely separated localities. Data regarding the stratigraphical range of the genus elsewhere, combined with information on recently described fossil plants and vertebrates from underlying strata of the upper Bokkeveld Group, suggest that a Frasnian or even Givetian age is reasonable for the lower part of the Witteberg Group. The recognition of Tropidoleptus in a shallow water, near-shore, molluscan association, at the top of the South African marine Devonian sequence, is similar to its occurrence in Bolivia, and suggests a common Malvinokaffric Realm history of shallowing, prior to later Devonian or early Carboniferous non-marine sedimentation. It is noteworthy that Tropidoleptus is now known to occur in ecologically suitable environments around the Atlantic, but is absent from these same environments in Asia and Australia. Tropidoleptus is an excellent example of dispersal in geological time — first appearing in northern Europe and Nova Scotia, then elsewhere in eastern North America and North Africa, followed by South America and South Africa, while continuing in North America.

scholarly journals Population irruption of the clam Meretrix morphina in Lake St Lucia, South Africa

2017 ◽  
Vol 113 (7/8) ◽  
Author(s):  
Nelson A. F. Miranda ◽  
Nasreen Peer ◽  
Renzo Perissinotto ◽  
Nicola K. Carrasco ◽  
Salome Jones ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
East Coast ◽  
Severe Drought ◽  
Freshwater Input ◽  
Large Populations ◽  
Ocean Region ◽  
West Indian Ocean ◽  
First Time ◽  
Eastern Seaboard

The thick-shelled clam Meretrix morphina, previously referred to as Meretrix meretrix, now occurs in the west Indian Ocean region, along the eastern seaboard of Africa, from the Red Sea to the Mlalazi Estuary, close to the Tugela River. Its presence in South Africa is only of recent recording. Meretrix morphina was detected for the first time in Lake St Lucia in 2000. The population declined and was not detected from 2005 until 2011, most likely as a result of a severe drought that resulted in widespread desiccation and hypersalinity in the lake. The system then experienced increased freshwater input resulting in lower salinities from 2011 until 2014, during which time M. morphina reappeared and their population gradually increased. In 2015, M. morphina became abundant in St Lucia, attaining unprecedented densities of 447 ind./m2. Biomass, expressed as a fresh weight, varied in the different basins of St Lucia, ranging from 195 g/m2 at Lister’s Point to 1909.8 g/m2 at Catalina Bay. However, in 2016, when drought conditions returned, M. morphina disappeared. This species appears to thrive under brackish salinities and high temperatures. It is able to establish large populations with high biomass and can become dominant. However, M. morphina is sensitive to desiccation and hypersaline conditions. This clam has substantial commercial value and is exploited along the African east coast, particularly in Mozambique. In future, it may feature more prominently in South African estuaries. However, the ecology of M. morphina is still largely unknown.

Implementing post-trial access plans for HIV prevention research

2018 ◽  
Vol 44 (5) ◽  
pp. 354-358 ◽  
Author(s):  
Amy Paul ◽  
Maria W Merritt ◽  
Jeremy Sugarman
Keyword(s):  
Hiv Prevention ◽  
Large Scale ◽  
Healthcare Systems ◽  
System Level ◽  
Planning Under Uncertainty ◽  
Work Related ◽  
Prevention Trials ◽  
Practical Experiences ◽  
Post Trial ◽  
Local Healthcare

Ethics guidance increasingly recognises that researchers and sponsors have obligations to consider provisions for post-trial access (PTA) to interventions that are found to be beneficial in research. Yet, there is little information regarding whether and how such plans can actually be implemented. Understanding practical experiences of developing and implementing these plans is critical to both optimising their implementation and informing conceptual work related to PTA. This viewpoint is informed by experiences with developing and implementing PTA plans for six large-scale multicentre HIV prevention trials supported by the HIV Prevention Trials Network. These experiences suggest that planning and implementing PTA often involve challenges of planning under uncertainty and confronting practical barriers to accessing healthcare systems. Even in relatively favourable circumstances where a tested intervention medication is approved and available in the local healthcare system, system-level barriers can threaten the viability of PTA plans. The aggregate experience across these HIV prevention trials suggests that simply referring participants to local healthcare systems for PTA will not necessarily result in continued access to beneficial interventions for trial participants. Serious commitments to PTA will require additional efforts to learn from future approaches, measuring the success of PTA plans with dedicated follow-up and further developing normative guidance to help research stakeholders navigate the complex practical challenges of realising PTA.

New and Interesting Records of South African Fungi, Part VII

Bothalia ◽  
1971 ◽  
Vol 10 (3) ◽  
pp. 411-416 ◽  
Author(s):  
W. F. O. Marasas ◽  
G. C. A. Van der Westhuizen
Keyword(s):  
South Africa ◽  
Medicago Sativa ◽  
South African ◽  
Parastizopus Armaticeps ◽  
First Time

Four species of fungi recorded for the first time in South Africa, are described and illustrated. These are:  Acremoniella verrucosa  Togn. from roots of  Medicago sativa; Coniella pulchella Hohn. from roots of pine-apple;  Periconia igniaria  Mason Ellis from seed of  Medicago sativa;  and  Stachybotrys subsimplex  Cooke from the cocoon of  Parastizopus armaticeps.

scholarly journals Contraceptives and sexual behaviours in predicting pregnancy rates in HIV prevention trials in South Africa: Past, present and future implications

2020 ◽  
Vol 26 ◽  
pp. 100531
Author(s):  
Handan Wand ◽  
Tarylee Reddy ◽  
Reshmi Dassaye ◽  
Jothi Moodley ◽  
Sarita Naidoo ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Pregnancy Rates ◽  
Sexual Behaviours ◽  
Prevention Trials

Revision of the South African genus Neopimus (Coleoptera: Staphylinidae: Paederinae)

Zootaxa ◽  
2019 ◽  
Vol 4577 (2) ◽  
pp. 361
Author(s):  
JIŘÍ JANÁK
Keyword(s):  
South Africa ◽  
South African ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
The South ◽  
Additional Material ◽  
Kwazulu Natal ◽  
First Time ◽  
African Genus

A revision of the south African genus Neopimus Özdikmen, Demir & Türkeş, 2008 is presented. Based on revision of the type and additional material, three species are recognised. The genus Neopimus is redescribed and all species are described or redescribed and illustrated, two of them for the first time: Neopimus capensis Janák, sp. nov., from Eastern Cape Province, South Africa and N. zulu Janák, sp. nov., from KwaZulu-Natal Province, South Africa. The distribution of the genus is mapped and a key of species is presented. 

Review of South African Euryphyminae 

Zootaxa ◽  
2020 ◽  
Vol 4820 (1) ◽  
pp. 70-104
Author(s):  
PRECIOUS TSHILILO
Keyword(s):  
South Africa ◽  
South African ◽  
Museum Specimens ◽  
Distribution Maps ◽  
Available Information ◽  
First Time

Euryphyminae is a Southern African endemic subfamily, which to date consists of 23 genera. We collected all available information from historic literature accounts, 626 positively identified museum specimens from 16 genera and 624 fresh field-collected specimens from eight genera to review the Euryphyminae genera of South Africa. Three genera are recorded for the first time to occur in South Africa; Rhodesiana Dirsh, 1959, Acrophymus Uvarov, 1922 and Plegmapteropsis Dirsh, 1956, while Aneuryphymus rhodesianus species is also recorded for the first time in South Africa. This brings the total number of genera occurring in South Africa from 14 to 16 genera of Euryphyminae. Finally, distribution maps for each genus are provided along with an updated key to genera.

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