AFRO-NETS> The Drum Beat - 81 - Horizons Project: Global HIV/AIDS Operations Research

[Warren Feek <wfeek@comminit.com>]

The Drum Beat - 81 - Horizons Project: Global HIV/AIDS Operations Research
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There is work to be done to improve global communication on research 
in development and health. In HIV/AIDS research, communicators can 
play a critical role in transforming research results into powerful 
tools to counter the epidemic, particularly in hard-hit regions. Of 
particular interest is operations research (OR), which studies the 
operational aspects of programmes and policies and proposes cost-
effective solutions to problems in service delivery. This issue high-
lights an international OR effort that examines many of the key is-
sues in HIV/AIDS prevention, care, and support.


THE HORIZONS PROJECT: Global HIV/AIDS Operations Research 

1. More than 20 years into the global HIV/AIDS pandemic, research has 
revealed a great deal about how the HIV virus is transmitted, opening 
the door to the development of drug therapies, behavior change 
strategies, and other approaches to preventing HIV and mitigating 
AIDS. Yet far less research has been devoted to understanding the ba-
sic operational, policy, and cost barriers that affect whether and 
how HIV/AIDS prevention, care, and support services are delivered. In 
developing countries - where more than 90% of HIV-infected people 
live - such interventions remain the primary tools for addressing the 
pandemic.


2. The Horizons Project is a comprehensive research effort that ap-
plies operations research (OR) to many of the most pressing global 
issues affecting HIV/AIDS service delivery programmes. Launched in 
1997, Horizons sponsors more than 60 research activities in 21 coun-
tries in Africa, Asia, Latin America, and the Caribbean. The pro-
ject's teams use qualitative and quantitative methods to identify 
barriers to effective programme design and delivery, test new ap-
proaches, and recommend best practices to improve policies and pro-
grammes. Cost-effectiveness is often a major element of the research. 
Because OR is applied research that places a premium on involving key 
stakeholders, Horizons builds partnerships with NGOs, community-level 
service delivery programmes, universities, research institutes, gov-
ernments, and health organizations in every country where it works. 
Please note that several of the research studies below are still in 
progress.


ACTIVITIES

3. Prevention of Mother-to-Child Transmission (MTCT) of HIV - New re-
search has shown that antiretrovirals administered to pregnant HIV-
positive women can lower the risk of transmission to the infant. What 
are the feasibility, acceptability, cost, and impact of a package of 
medical and psychosocial services to prevent MTCT in resource-poor 
regions? In 6 antenatal clinics in Kenya and Zambia, a study tests a 
potential model. 
http://www.popcouncil.org/pdfs/horizons/rs/re_mtctc.pdf 
Contact Dr. Ruth Nduati (Kenya) 
mailto:nduati@iconnect.co.ke 
or Dr. Margaret Siwale (Zambia) 
mailto:mtct@zamnet.zm


4. HIV & Partner Violence: Implications for HIV Voluntary Counselling 
& Testing (VCT) Programmes - A key part of VCT programmes is encour-
aging disclosure of test results to partners. Does the fear of vio-
lence inhibit women from telling their partners their serostatus, and 
do women experience violence when they do reveal test results? A 
study in Tanzania examines these issues. 
http://www.popcouncil.org/horizons/ressum/vct_violence.html 
Dr. Suzanne Maman 
mailto:smaman@jhsph.edu


5. Youth & HIV Voluntary Counselling & Testing (VCT) Programmes - VCT 
programmes for adults have been shown to increase the adoption of 
safer sexual behaviors and link them with care and support services. 
But is VCT appropriate for young people? If so, how can it be adapted 
to their needs? In Kenya and Uganda, researchers have found that cur-
rent programmes don't always serve young people effectively. 
http://www.popcouncil.org/horizons/ressum/vct_youth.html 
Contact Dr. Edward Kirumira 
mailto:kirumira@starcom.co.ug


6. Improving Support to Children Affected by AIDS - Communities 
across sub-Saharan Africa struggle to cope with a growing number of 
orphans. Can support programmes be improved by reaching children and 
their families before parents die? In Uganda, an intervention study 
is evaluating a succession planning programme that involves HIV-
positive parents in planning for their children's future. 
http://www.popcouncil.org/horizons/ressum/orphans.html 
Contact Dr. Rebecca Nyonyintono 
mailto:anppcan@infocam.co.ug


7. 100 Percent Condom Use in Sex Establishments - In Thailand, a gov-
ernment policy helped lower STI rates by requiring condom use for all 
acts of commercial sex. Can this policy success story be adapted to 
other settings? An intervention study in the Dominican Republic exam-
ines 2 different models. 
http://www.popcouncil.org/horizons/ressum/dr.html 
Contact Luis Moreno 
mailto:coin@codetel.net.do


8. The Female Condom: Dynamics of Use - Zimbabwe was the 1st country 
in Africa where the female condom was widely marketed. How has social 
marketing affected women's and men's views of the female condom? For 
what reasons and with which types of partners have they used the de-
vice? A study in Harare analyzes attitudes and patterns of use. 
http://www.popcouncil.org/pdfs/horizons/fcz.pdf 
Contact Dr. Deanna Kerrigan 
mailto:dkerrigan@pcdc.org


9. Involving People Living with HIV/AIDS (PLHA) in Community-based 
Programmes - PLHA are becoming increasingly involved as providers and 
managers of prevention, care, and support activities. What kinds of 
PLHA participation are associated with high-quality and effective 
community programmes? A research project looks at PLHA involvement in 
5 organizations in Burkina Faso. The study is also investigating 
similar organizations in Zambia, India, and Ecuador. 
http://www.popcouncil.org/horizons/ressum/plha.html 
Contact Christophe Cornu 
mailto:ccornu@aidsalliance.org


10. Prevention & Treatment of Sexually Transmitted Infections (STIs) 
- The presence of other STIs increases vulnerability to HIV and is a 
often a key factor for the spread of the virus. How can resource-poor 
governments create effective and affordable STI management pro-
grammes? 2 large-scale studies in southern Africa test different hy-
brid approaches. 
http://www.popcouncil.org/horizons/newsletter/horizons(1)_2.html 
Contact Dr. Lewis Ndhlovu 
mailto:lndhlovu@pcjoburg.org.za


11. HIV/AIDS Peer Education - Peer education has long been a pillar 
of HIV/AIDS prevention. Which components and principles of peer edu-
cation are important for programme quality and effectiveness, and 
what challenges remain to be addressed? A global workshop examined 
these issues and recommended new directions for research. 
http://www.popcouncil.org/pdfs/peer_ed.pdf 
Contact Ellen Weiss 
mailto:eweiss@pcdc.org


12. Male Circumcision & HIV Prevention - Interest is growing in the 
hypothesis that male circumcision may reduce HIV transmission. What 
has biomedical and social science research shown so far about male 
circumcision and HIV/AIDS? An international consultation examined the 
evidence and suggested new directions for research. 
http://www.popcouncil.org/horizons/reports/circumcision/default.html
Contact Dr. Johannes van Dam 
mailto:jvandam@pcdc.org


13. Promoting Reproductive Health by Radio - Radio is one of the best 
and most cost-effective ways to reach a wide audience in developing 
countries. How can this medium be used to promote better reproductive 
health, including HIV/AIDS prevention? A popular call-in show in 
Kenya answers some sensitive questions. 
http://www.popcouncil.org/publications/momentum/momentum1200_3.html 
Contact Kwame Asiedu 
mailto:kasiedu@popcouncil.org.ke


14. Horizons AIDSQuest: The HIV/AIDS Library - This on-line library 
of AIDS-related surveys and other data collection tools covers such 
topics as risk and prevention behaviors, stigma, care and support, 
and gender and sexuality. Also includes information on methodological 
and survey design issues. With contributions from NGO, academic, and 
governmental institutions, the library is an excellent resource for 
researchers. 
http://www.popcouncil.org/horizons/AIDSQuest/index.html 
Contact Dr. Julie Pulerwitz 
mailto:jpulerwitz@pcdc.org 
or Scott Geibel 
mailto:sgeibel@pcdc.org


15. Gender, Sexuality, & HIV/AIDS: The What, the Why, and the How - 
We know that gender and sexuality are significant factors in the sex-
ual transmission of HIV. How can programmes transform gender roles 
and create more equitable sexual relationships between women and men? 
A plenary address at the 13th International AIDS Conference in Durban 
by Dr. Geeta Rao Gupta provides concrete examples. 
http://www.icrw.org/pdf/DurbanSpeech.pdf 
Contact:
mailto: info@icrw.org

***

Material for this issue provided by the Horizons Project. Funded by 
the U.S. Agency for International Development, the project is imple-
mented by the Population Council in collaboration with the Interna-
tional Center for Research on Women (ICRW), the Program for Appropri-
ate Technology in Health (PATH), the International HIV/AIDS Alliance, 
the University of Alabama at Birmingham, and Tulane University. Visit 
the Horizons web page:
http://www.popcouncil.org/horizons/horizons.html
or e-mail <horizons@pcdc.org>. To view the Horizons Report, the pro-
ject's newsletter, go to:
http://www.popcouncil.org/horizons/newsletter/horizons_report.html 

***

Please send items for The Drum Beat to 
The Editor
Deborah Heimann 
mailto:dheimann@comminit.com

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