The GRADUATE Cape Town team (left to right): Dr. Mary-Ann Davies, Dr. Priscilla Tsondai, and Ms. Nicky Maxwell, of the Centre for Infectious Disease Epidemiology and Research (CIDER) at the University of Cape Town, South Africa (at the Table Mountain Range)The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the US National Institutes of Health (NIH) has awarded amfAR a new Developmental Research Grant to improve how clinical and program data on adolescents living with HIV are organized and studied in resource-limited settings. As adolescents grow up into adults, their HIV care needs change, and they may be transferred to new providers or clinics as part of that transition. The co-Principal Investigators—TREAT Asia Director Dr. Annette Sohn and Dr. Mary-Ann Davies of the University of Cape Town, South Africa—are leading a team to establish a novel HIV data collection and management platform that can guide clinical programs as to the socio-economic, clinical, and laboratory data needed to characterize how adolescents with HIV are transitioning to adult HIV care in resource-limited settings.
The initiative, called GRADUATE: a Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation, will be implemented in Malawi, South Africa, and Thailand over the next two years. The overall objective is to promote a higher level of data granularity that would more reliably inform our understanding of how young women experience transitions in HIV care compared to young men, and of long-term survivors of perinatal infection compared to those infected at older ages. This will be the first broadly implementable and open access data platform to support measurement of adolescent HIV care transition outcomes.
“Transition from adolescent to adult care happens in different ways in different parts of the world.”
“Transition from adolescent to adult care happens in different ways in different parts of the world and it is important to develop a data framework that will allow us to collect and compare adolescent transition outcomes across these different contexts,” says Dr. Davies. “We are very excited that the pilot sites for GRADUATE are in sub-Saharan Africa and Asia, both of which are home to large numbers of HIV-infected adolescents.”
A key strength of the GRADUATE initiative is that it builds on the existing NIH IeDEA (International Epidemiology Databases to Evaluate AIDS) cohort research network, of which TREAT Asia and the University of Cape Town are both members. The initiative will be advised by a group of experts from across IeDEA, other research cohorts in the United States and Europe, and the World Health Organization, as well as young people living with HIV in South Africa and Thailand.
Dr. Annette Sohn, Director of TREAT Asia “This research will hopefully provide a standardized platform to improve the collection of important health-transition information from youth and emerging adults that will be applicable in the United States as well,” said Sonia Lee, Ph.D., of the Maternal and Pediatric Infectious Disease Branch at NICHD.
Developing global capacity to track the progress of adolescents as they move through HIV care programs has not so far been a priority for policymakers or donors. This lack of attention has resulted in extremely limited information at a clinic or national level on what happens to youth after they are merged into the much larger populations of adults with HIV.
“While data harmonization may be one of the less glamorous aspects of epidemiology research, it is an essential foundation for building up adolescent HIV research capacity,” notes Dr. Sohn. “NIH has provided us with a unique opportunity to explore how we can optimize the collection and analysis of transition data.”