1. ADAPT Update AfriCan Forum Entebbe, 17-19 January 2013

2. A African D Development of A AIDS P Prevention T Trials Capacity

3. Goal of ADAPT: Build local capacity so that Africans can plan, conduct and analyse large scale, multi-centred AIDS prevention trials

4. Lack of prevention evidence from RCTs More than 6000 HIV prevention studies published between 2000 and end of 2012 Less than 300 were RCTs

5. Lack of African involvement

7. 2007-2009 2010-2014

8. ADAPT training SADC researchers 2007, 2009 HIV prevention epidemiology RCT techniques SADC researchers 2013 HIV prevention epidemiology Research proposals UNAM faculty 2012, 2013 Systematic reviews SADC laboratory staff 2013 HIV serology for DBS HIV incidence testing Botswana parliamentarians 2011, 2012 Using evidence for decision making

9. First course participants 23 researchers from 11 African countries Botswana, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe From government (via NAAs), universities, and NGOs

10. Where are they now?

11. Left HIV prevention work and joined a bank Moved from NGO to National AIDS Authority Prominent in National AIDS Authorities Elected – became Minister – NAA in remit With CIET in Nigeria – on faculty for next course Head of department in University Promoted within research organisation Coordinating CIET work in Botswana Post-doctoral fellowship Completing MSc Epidemiology and Statistics

12. Who has multiple concurrent sexual partnerships in Botswana? Results of a national cross sectional survey. Laetsang D, Ho-Foster A, Masisi M, Anderson M, Tlhoiwe D, Cockcroft A, Andersson N Community views of inter-generational sex: findings from focus groups in Botswana, Namibia and Swaziland. Kunda JL, Kgakole L, Cockcroft A, Masisi M, Laetsang D, Ho-Foster A, Marokoane N, Andersson N Characteristics and attitudes of the choice-disabled in Namibia. Van Rooy G, Mitchell S, Masisi M, Cockcroft A, Andersson N Socio-economic status and HIV and AIDS stigma in Tanzania. Mbaraka A, Mitchell S, Cockcroft A, Andersson N Choice disability and HIV prevention knowledge, attitudes and practices in Botswana. Ho-Foster A, Andersson N, Cockcroft A, Masisi M, Laetsang D, Kgakole L What has happened to multiple sexual partnerships in Swaziland between 2002 and 2008? Cockcroft A, Andersson N, Ho-Foster A, Marokoane N, Mziyako B ADAPT presentations at AIDS impact conference

13. Ho-Foster A, Laetsang D, Masisi M, Anderson M, Tlhoiwe D, Cockcroft A, Andersson N.. Gender-specific patterns of multiple concurrent sexual partnerships: a national cross sectional survey in Botswana. AIDS Care 2010: 1-6 (doi: 10.1080/09540121003758598) Cockcroft A, Lengwe Kunda J, Kgakole L, Masisi M, Laetsang D, Ho-Foster A, Marokoane N, Andersson N. Community views of inter-generational sex: findings from focus groups in Botswana, Namibia and Swaziland. Psychology, Health and Medicine 2010 (in press) Amuri B, Mitchell S, Cockcroft A, Andersson N. Socio-economic status and HIV and AIDS stigma in Tanzania. AIDS Care 2010 (in press) Cockcroft A, Andersson N, Ho-Foster A, Marokoane N, Mziyako B What happened to multiple sexual partnerships in Swaziland? Analysis of five linked national surveys between 2002 and 2008. AIDS Care 2010: 1-6 (doi: 10.1080/09540121.2010.482123) ADAPT publications in peer reviewed journals

14. Second course Nominations from SADC NAAs 1st three week block 28 Jan–15 Feb 2013 20 participants: –4 Botswana, 1 Mauritius, 3 Namibia, 4 Swaziland, 2 Tanzania, 2 Zambia, 4 Zimbabwe Epidemiology and statistics relevant to RCTs Support to develop fundable HIV prevention research proposals

15. Research topics Multiple concurrent partnerships in young women HIV risks in female sex workers Sexual behaviour after male circumcision Sexual behaviour among college students Condition cash transfers and HIV trial HIV infection through breastfeeding Role of older people in youth HIV prevention

16. Systematic review module 16-20 July 2012 School of Nursing and Public Health, UNAM 10 participants – mostly SNPH faculty

17. Systematic review module Methods of analysis of RCTs RCTs and non-experimental study designs Elements of SR and meta- analysis –data extraction –dealing with heterogeneity between studies –interpretation of forest plots –assessment of quality of studies and SRs

18. Systematic review module Practical experience –navigating Cochrane website –searching literature –using Revman software to conduct meta analysis

19. Systematic review module The Dean of the SNPH presented certificates on the final day

20. Capacity building for Botswana parliamentarians Participants in the first session – November 2011

21. Botswana parliamentarians Evidence-based decision making Two training sessions –31 October/1 November 2011 –12 and 14 November 2012 Logistic organisation by NACA Attended by –36 of 61 MPs –Including 7 ministers

23. Laboratory skills training National Institute for Communicable Diseases, Johannesburg, S Africa Two SADC one-week courses:  HIV serology on dried blood spots  New techniques for estimating HIV incidence Participants: >With basic laboratory skills

24. ADAPT training SADC researchersHIV prevention epidemiology RCT techniques SADC researchersHIV prevention epidemiology Research proposals UNAM facultySystematic reviews SADC laboratory staffHIV serology for DBS HIV incidence testing Botswana parliamentariansUsing evidence for decision making

25. Challenges Retaining trained individuals in system Organisations not allowing time out for higher qualifications SADC bureaucracy (laboratory courses) Obtaining funding for African led research

26. By end of ADAPT Network of trained HIV researchers in SADC countries Improved institutional capacities for research Several fundable proposals for RCTs led by African researchers Better informed and equipped decision makers