Sustainable East Africa Research in Community Health

NCT01864603 | Completed Results DMC

• 1 other identifier: SEARCH
• Study Type: interventional
• Target: 150,395
• Locations: 2 countries
• Sites: 3

Brief Summary

The SEARCH study aims to test evidenced-based innovative community based interventions that lead to the elimination of HIV in rural communities in East Africa using a multi-disease approach. The first phase of the study will quantify the impact of early HIV diagnosis using a streamlined and immediate ART (antiretroviral therapy). The second phase of the study, will quantify the impact of targeted Pre-Exposure Prophylaxis (PrEP) in the context of universal treatment and streamlined care. The study intervention is designed to improve the entire continuum of care, to reduce structural barriers for all populations including those most "at risk".

Conditions

HIV; Tuberculosis; Hypertension; Diabetes; Maternal Child Health; Cost Effectiveness

Keywords

HIV treatment and prevention; Tuberculosis; Community health campaign; PrEP

Outcome Measures

Primary Outcomes (2)

• Cumulative HIV Incidence

  Cumulative 3 year HIV incidence in men and women ages ≥15 years after the start of Phase I intervention. Mean was calculated as the average across clusters of the cluster-level cumulative incidence.

  3 years follow up

• HIV Incidence

  HIV incidence rate in men and women ages ≥15 years after the start of Phase II intervention (started after 3 years of Phase I).

  3 years follow up

Secondary Outcomes (15)

• Incident TB Associated With HIV

  3 years follow up

• Overall Mortality

  3 years follow up

• HIV-free Infant Survival

  3 years follow up

• Percent of HIV+ Adults With HIV RNA <=500 c/mL

  3 years follow up

• Time in Care for HIV+ Adults With Baseline Viremia

  3 years follow up

Study Arms (2)

1st: universal test and treat; 2nd: targeted PrEP and cascade

EXPERIMENTAL

Intervention arm first phase: annual universal community-based HIV and multi-disease testing; ART for all HIV+ using streamlined care delivery Intervention arm second phase: baseline universal community-based HIV and multi-disease testing; ART for all HIV+ using streamlined care delivery + targeted PrEP, and targeted HIV testing interventions

Other: Universal ART in a streamlined care model; Other: Annual Community Health Campaigns; Other: Targeted PrEP and Targeted testing interventions

1st: baseline community testing; 2nd: None

ACTIVE COMPARATOR

Comparator arm first phase: baseline community-based HIV and multi-disease testing; ART by country standard of care

Other: Universal ART in a streamlined care model; Other: Baseline community-based HIV and multi-disease testing

Interventions

Universal ART in a streamlined care model OTHER

immediate ART start for all HIV+ in community with streamlined care

1st: baseline community testing; 2nd: None; 1st: universal test and treat; 2nd: targeted PrEP and cascade

Annual Community Health Campaigns OTHER

HIV and multi-disease testing for all community members

1st: universal test and treat; 2nd: targeted PrEP and cascade

Targeted PrEP and Targeted testing interventions OTHER

1st: universal test and treat; 2nd: targeted PrEP and cascade

Baseline community-based HIV and multi-disease testing OTHER

HIV and multi-disease testing for all community members at baseline only

1st: baseline community testing; 2nd: None

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Non-adjacent geopolitical units in south-western and eastern Uganda and western Kenya.
• Most recent census population between 9,000 and 11,000 individuals.
• Served by an ART providing health center.
• Community leader commitment for study participation and implementation.
• Accessibility to health center via a maintained transportation route.
• Community location with sufficient distance from other potential study communities to limit contamination of intervention or control conditions (buffer zone)
• Residency of individual in community, defined as present in household for at least 6 months of the calendar year.

You may not qualify if:

• Presence of ongoing community-based ART intervention strategies that provide treatment outside of the current in-country treatment guidelines.
• An urban setting defined as a city with a population of 100,000 or more inhabitants.
• Absence of a health center able to provide ART.

Sponsors & Collaborators

• University of California, San Francisco: lead
• Infectious Diseases Research Collaboration, Uganda: collaborator
• Makerere University: collaborator
• Kenya Medical Research Institute: collaborator
• Gilead Sciences: collaborator
• World Bank: collaborator
• National Institute of Allergy and Infectious Diseases (NIAID): collaborator
• United States President's Emergency Plan for AIDS Relief: collaborator
• Bill and Melinda Gates Foundation: collaborator

Study Sites (3)

Nyanza Province Kenya

Nyanza Province, Kenya

Location

Eastern Uganda

Mbale/Tororo Region, Uganda

Location

Southwestern Uganda

Mbarara Region, Uganda

Location

Related Publications (80)

• Balzer LB, Petersen ML, van der Laan MJ; SEARCH Consortium. Adaptive pair-matching in randomized trials with unbiased and efficient effect estimation. Stat Med. 2015 Mar 15;34(6):999-1011. doi: 10.1002/sim.6380. Epub 2014 Nov 25.

  PMID: 25421503 BACKGROUND

• Camlin CS, Seeley J, Viljoen L, Vernooij E, Simwinga M, Reynolds L, Reis R, Plank R, Orne-Gliemann J, McGrath N, Larmarange J, Hoddinott G, Getahun M, Charlebois ED, Bond V. Strengthening universal HIV 'test-and-treat' approaches with social science research. AIDS. 2016 Mar 27;30(6):969-70. doi: 10.1097/QAD.0000000000001008. No abstract available.

  PMID: 26959355 BACKGROUND

• SEARCH Collaboration. Evaluating the feasibility and uptake of a community-led HIV testing and multi-disease health campaign in rural Uganda. J Int AIDS Soc. 2017 Mar 30;20(1):21514. doi: 10.7448/IAS.20.1.21514.

  PMID: 28406269 BACKGROUND

• Balzer LB, van der Laan MJ, Petersen ML; SEARCH Collaboration. Adaptive pre-specification in randomized trials with and without pair-matching. Stat Med. 2016 Nov 10;35(25):4528-4545. doi: 10.1002/sim.7023. Epub 2016 Jul 19.

  PMID: 27436797 BACKGROUND

• Balzer L, Staples P, Onnela JP, DeGruttola V. Using a network-based approach and targeted maximum likelihood estimation to evaluate the effect of adding pre-exposure prophylaxis to an ongoing test-and-treat trial. Clin Trials. 2017 Apr;14(2):201-210. doi: 10.1177/1740774516679666. Epub 2017 Jan 26.

  PMID: 28124579 BACKGROUND

• Tram KH, Mwangwa F, Atukunda M, Owaraganise A, Ayieko J, Plenty A, Kwariisima D, Clark TD, Petersen ML, Charlebois ED, Kamya MR, Chamie G, Havlir DV, Marquez C; SEARCH Collaboration. Isoniazid Preventive Therapy Completion in the Era of Differentiated HIV Care. J Acquir Immune Defic Syndr. 2017 Dec 15;76(5):e115-e117. doi: 10.1097/QAI.0000000000001540. No abstract available.

  PMID: 28885271 BACKGROUND

• Puryear SB, Balzer LB, Ayieko J, Kwarisiima D, Hahn JA, Charlebois ED, Clark TD, Cohen CR, Bukusi EA, Kamya MR, Petersen ML, Havlir DV, Chamie G. Associations between alcohol use and HIV care cascade outcomes among adults undergoing population-based HIV testing in East Africa. AIDS. 2020 Mar 1;34(3):405-413. doi: 10.1097/QAD.0000000000002427.

  PMID: 31725431 BACKGROUND

• Balzer LB, Havlir DV, Kamya MR, Chamie G, Charlebois ED, Clark TD, Koss CA, Kwarisiima D, Ayieko J, Sang N, Kabami J, Atukunda M, Jain V, Camlin CS, Cohen CR, Bukusi EA, Van Der Laan M, Petersen ML. Machine Learning to Identify Persons at High-Risk of Human Immunodeficiency Virus Acquisition in Rural Kenya and Uganda. Clin Infect Dis. 2020 Dec 3;71(9):2326-2333. doi: 10.1093/cid/ciz1096.

  PMID: 31697383 BACKGROUND

• Marcus JL, Sewell WC, Balzer LB, Krakower DS. Artificial Intelligence and Machine Learning for HIV Prevention: Emerging Approaches to Ending the Epidemic. Curr HIV/AIDS Rep. 2020 Jun;17(3):171-179. doi: 10.1007/s11904-020-00490-6.

  PMID: 32347446 BACKGROUND

• Balzer LB, Ayieko J, Kwarisiima D, Chamie G, Charlebois ED, Schwab J, van der Laan MJ, Kamya MR, Havlir DV, Petersen ML. Far from MCAR: Obtaining Population-level Estimates of HIV Viral Suppression. Epidemiology. 2020 Sep;31(5):620-627. doi: 10.1097/EDE.0000000000001215.

  PMID: 32452912 BACKGROUND

• Jewell BL, Balzer LB, Clark TD, Charlebois ED, Kwarisiima D, Kamya MR, Havlir DV, Petersen ML, Bershteyn A. Predicting HIV Incidence in the SEARCH Trial: A Mathematical Modeling Study. J Acquir Immune Defic Syndr. 2021 Aug 1;87(4):1024-1031. doi: 10.1097/QAI.0000000000002684.

  PMID: 33770065 BACKGROUND

• Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, Petersen ML, Thirumurthy H, Kamya MR, Havlir DV, Charlebois ED; SEARCH Collaboration. Leveraging rapid community-based HIV testing campaigns for non-communicable diseases in rural Uganda. PLoS One. 2012;7(8):e43400. doi: 10.1371/journal.pone.0043400. Epub 2012 Aug 20.

  PMID: 22916256 RESULT

• Thirumurthy H, Chamie G, Jain V, Kabami J, Kwarisiima D, Clark TD, Geng E, Petersen ML, Charlebois ED, Kamya MR, Havlir DV; SEARCH Collaboration. Improved employment and education outcomes in households of HIV-infected adults with high CD4 cell counts: evidence from a community health campaign in Uganda. AIDS. 2013 Feb 20;27(4):627-34. doi: 10.1097/QAD.0b013e32835c54d8.

  PMID: 23169332 RESULT

• Jain V, Liegler T, Kabami J, Chamie G, Clark TD, Black D, Geng EH, Kwarisiima D, Wong JK, Abdel-Mohsen M, Sonawane N, Aweeka FT, Thirumurthy H, Petersen ML, Charlebois ED, Kamya MR, Havlir DV; SEARCH Collaboration. Assessment of population-based HIV RNA levels in a rural east African setting using a fingerprick-based blood collection method. Clin Infect Dis. 2013 Feb;56(4):598-605. doi: 10.1093/cid/cis881. Epub 2012 Dec 12.

  PMID: 23243180 RESULT

• Namusobya J, Semitala FC, Amanyire G, Kabami J, Chamie G, Bogere J, Jain V, Clark TD, Charlebois E, Havlir DV, Kamya M, Geng EH. High retention in care among HIV-infected patients entering care with CD4 levels >350 cells/muL under routine program conditions in Uganda. Clin Infect Dis. 2013 Nov;57(9):1343-50. doi: 10.1093/cid/cit490. Epub 2013 Jul 29.

  PMID: 23899683 RESULT

• Jain V, Byonanebye DM, Liegler T, Kwarisiima D, Chamie G, Kabami J, Petersen ML, Balzer LB, Clark TD, Black D, Thirumurthy H, Geng EH, Charlebois ED, Amanyire G, Kamya MR, Havlir DV; SEARCH Collaboration. Changes in population HIV RNA levels in Mbarara, Uganda, during scale-up of HIV antiretroviral therapy access. J Acquir Immune Defic Syndr. 2014 Mar 1;65(3):327-32. doi: 10.1097/QAI.0000000000000021.

  PMID: 24146022 RESULT

• Chamie G, Kwarisiima D, Clark TD, Kabami J, Jain V, Geng E, Balzer LB, Petersen ML, Thirumurthy H, Charlebois ED, Kamya MR, Havlir DV. Uptake of community-based HIV testing during a multi-disease health campaign in rural Uganda. PLoS One. 2014 Jan 2;9(1):e84317. doi: 10.1371/journal.pone.0084317. eCollection 2014.

  PMID: 24392124 RESULT

• Kotwani P, Kwarisiima D, Clark TD, Kabami J, Geng EH, Jain V, Chamie G, Petersen ML, Thirumurthy H, Kamya MR, Charlebois ED, Havlir DV; SEARCH Collaboration. Epidemiology and awareness of hypertension in a rural Ugandan community: a cross-sectional study. BMC Public Health. 2013 Dec 9;13:1151. doi: 10.1186/1471-2458-13-1151.

  PMID: 24321133 RESULT

• Kotwani P, Balzer L, Kwarisiima D, Clark TD, Kabami J, Byonanebye D, Bainomujuni B, Black D, Chamie G, Jain V, Thirumurthy H, Kamya MR, Geng EH, Petersen ML, Havlir DV, Charlebois ED; SEARCH Collaboration. Evaluating linkage to care for hypertension after community-based screening in rural Uganda. Trop Med Int Health. 2014 Apr;19(4):459-68. doi: 10.1111/tmi.12273. Epub 2014 Feb 3.

  PMID: 24495307 RESULT

• Jain V, Byonanebye DM, Amanyire G, Kwarisiima D, Black D, Kabami J, Chamie G, Clark TD, Rooney JF, Charlebois ED, Kamya MR, Havlir DV; SEARCH Collaboration. Successful antiretroviral therapy delivery and retention in care among asymptomatic individuals with high CD4+ T-cell counts above 350 cells/mul in rural Uganda. AIDS. 2014 Sep 24;28(15):2241-9. doi: 10.1097/QAD.0000000000000401.

  PMID: 25022596 RESULT

• Kwarisiima D, Balzer L, Heller D, Kotwani P, Chamie G, Clark T, Ayieko J, Mwangwa F, Jain V, Byonanebye D, Petersen M, Havlir D, Kamya MR. Population-Based Assessment of Hypertension Epidemiology and Risk Factors among HIV-Positive and General Populations in Rural Uganda. PLoS One. 2016 May 27;11(5):e0156309. doi: 10.1371/journal.pone.0156309. eCollection 2016.

  PMID: 27232186 RESULT

• Chamie G, Clark TD, Kabami J, Kadede K, Ssemmondo E, Steinfeld R, Lavoy G, Kwarisiima D, Sang N, Jain V, Thirumurthy H, Liegler T, Balzer LB, Petersen ML, Cohen CR, Bukusi EA, Kamya MR, Havlir DV, Charlebois ED. A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study. Lancet HIV. 2016 Mar;3(3):e111-9. doi: 10.1016/S2352-3018(15)00251-9. Epub 2016 Jan 26.

  PMID: 26939734 RESULT

• Katrak S, Day N, Ssemmondo E, Kwarisiima D, Midekisa A, Greenhouse B, Kamya M, Havlir D, Dorsey G. Community-wide Prevalence of Malaria Parasitemia in HIV-Infected and Uninfected Populations in a High-Transmission Setting in Uganda. J Infect Dis. 2016 Jun 15;213(12):1971-8. doi: 10.1093/infdis/jiw057. Epub 2016 Feb 10.

  PMID: 26908725 RESULT

• Kadede K, Ruel T, Kabami J, Ssemmondo E, Sang N, Kwarisiima D, Bukusi E, Cohen CR, Liegler T, Clark TD, Charlebois ED, Petersen ML, Kamya MR, Havlir DV, Chamie G; SEARCH team. Increased adolescent HIV testing with a hybrid mobile strategy in Uganda and Kenya. AIDS. 2016 Sep 10;30(14):2121-6. doi: 10.1097/QAD.0000000000001180.

  PMID: 27258399 RESULT

• Jain V, Chang W, Byonanebye DM, Owaraganise A, Twinomuhwezi E, Amanyire G, Black D, Marseille E, Kamya MR, Havlir DV, Kahn JG. Estimated Costs for Delivery of HIV Antiretroviral Therapy to Individuals with CD4+ T-Cell Counts >350 cells/uL in Rural Uganda. PLoS One. 2015 Dec 3;10(12):e0143433. doi: 10.1371/journal.pone.0143433. eCollection 2015.

  PMID: 26632823 RESULT

• Balzer LB, Petersen ML, van der Laan MJ; SEARCH Collaboration. Targeted estimation and inference for the sample average treatment effect in trials with and without pair-matching. Stat Med. 2016 Sep 20;35(21):3717-32. doi: 10.1002/sim.6965. Epub 2016 Apr 18.

  PMID: 27087478 RESULT

• Thirumurthy H, Jakubowski A, Camlin C, Kabami J, Ssemmondo E, Elly A, Mwai D, Clark T, Cohen C, Bukusi E, Kamya M, Petersen M, Havlir D, Charlebois ED. Expectations about future health and longevity in Kenyan and Ugandan communities receiving a universal test-and-treat intervention in the SEARCH trial. AIDS Care. 2016;28 Suppl 3(Suppl 3):90-8. doi: 10.1080/09540121.2016.1178959.

  PMID: 27421056 RESULT

• Maeri I, El Ayadi A, Getahun M, Charlebois E, Akatukwasa C, Tumwebaze D, Itiakorit H, Owino L, Kwarisiima D, Ssemmondo E, Sang N, Kabami J, Clark TD, Petersen M, Cohen CR, Bukusi EA, Kamya M, Havlir D, Camlin CS; SEARCH Collaboration. "How can I tell?" Consequences of HIV status disclosure among couples in eastern African communities in the context of an ongoing HIV "test-and-treat" trial. AIDS Care. 2016;28 Suppl 3(Suppl 3):59-66. doi: 10.1080/09540121.2016.1168917.

  PMID: 27421052 RESULT

• Camlin CS, Ssemmondo E, Chamie G, El Ayadi AM, Kwarisiima D, Sang N, Kabami J, Charlebois E, Petersen M, Clark TD, Bukusi EA, Cohen CR, R Kamya M, Havlir D; SEARCH Collaboration. Men "missing" from population-based HIV testing: insights from qualitative research. AIDS Care. 2016;28 Suppl 3(Suppl 3):67-73. doi: 10.1080/09540121.2016.1164806.

  PMID: 27421053 RESULT

• Jain V, Petersen ML, Liegler T, Byonanebye DM, Kwarisiima D, Chamie G, Sang N, Black D, Clark TD, Ladai A, Plenty A, Kabami J, Ssemmondo E, Bukusi EA, Cohen CR, Charlebois ED, Kamya MR, Havlir DV; SEARCH Collaboration. Population levels and geographical distribution of HIV RNA in rural Ugandan and Kenyan communities, including serodiscordant couples: a cross-sectional analysis. Lancet HIV. 2017 Mar;4(3):e122-e133. doi: 10.1016/S2352-3018(16)30220-X. Epub 2016 Dec 16.

  PMID: 27989576 RESULT

• Brown LB, Havlir DV, Ayieko J, Mwangwa F, Owaraganise A, Kwarisiima D, Jain V, Ruel T, Clark T, Chamie G, Bukusi EA, Cohen CR, Kamya MR, Petersen ML, Charlebois ED; SEARCH Collaboration. High levels of retention in care with streamlined care and universal test and treat in East Africa. AIDS. 2016 Nov 28;30(18):2855-2864. doi: 10.1097/QAD.0000000000001250.

  PMID: 27603290 RESULT

• Chang W, Chamie G, Mwai D, Clark TD, Thirumurthy H, Charlebois ED, Petersen M, Kabami J, Ssemmondo E, Kadede K, Kwarisiima D, Sang N, Bukusi EA, Cohen CR, Kamya M, Havlir DV, Kahn JG. Implementation and Operational Research: Cost and Efficiency of a Hybrid Mobile Multidisease Testing Approach With High HIV Testing Coverage in East Africa. J Acquir Immune Defic Syndr. 2016 Nov 1;73(3):e39-e45. doi: 10.1097/QAI.0000000000001141.

  PMID: 27741031 RESULT

• Brown LB, Ayieko J, Mwangwa F, Owaraganise A, Kwarisiima D, Jain V, Ruel T, Clark T, Black D, Chamie G, Bukusi EA, Cohen CR, Kamya MR, Petersen ML, Charlebois ED, Havlir DV. Predictors of Retention in HIV Care Among Youth (15-24) in a Universal Test-and-Treat Setting in Rural Kenya. J Acquir Immune Defic Syndr. 2017 Sep 1;76(1):e15-e18. doi: 10.1097/QAI.0000000000001390. No abstract available.

  PMID: 28394821 RESULT

• Ssemmondo E, Mwangwa F, Kironde JL, Kwarisiima D, Clark TD, Marquez C, Charlebois ED, Petersen ML, Kamya MR, Havlir DV, Chamie G; SEARCH Collaboration. Implementation and Operational Research: Population-Based Active Tuberculosis Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda. J Acquir Immune Defic Syndr. 2016 Nov 1;73(3):e46-e50. doi: 10.1097/QAI.0000000000001142.

  PMID: 27741032 RESULT

• Petersen M, Balzer L, Kwarsiima D, Sang N, Chamie G, Ayieko J, Kabami J, Owaraganise A, Liegler T, Mwangwa F, Kadede K, Jain V, Plenty A, Brown L, Lavoy G, Schwab J, Black D, van der Laan M, Bukusi EA, Cohen CR, Clark TD, Charlebois E, Kamya M, Havlir D. Association of Implementation of a Universal Testing and Treatment Intervention With HIV Diagnosis, Receipt of Antiretroviral Therapy, and Viral Suppression in East Africa. JAMA. 2017 Jun 6;317(21):2196-2206. doi: 10.1001/jama.2017.5705.

  PMID: 28586888 RESULT

• Zheng W, Balzer L, van der Laan M, Petersen M; SEARCH Collaboration. Constrained binary classification using ensemble learning: an application to cost-efficient targeted PrEP strategies. Stat Med. 2018 Jan 30;37(2):261-279. doi: 10.1002/sim.7296. Epub 2017 Apr 6.

  PMID: 28384841 RESULT

• Mwangwa F, Chamie G, Kwarisiima D, Ayieko J, Owaraganise A, Ruel TD, Plenty A, Tram KH, Clark TD, Cohen CR, Bukusi EA, Petersen M, Kamya MR, Charlebois ED, Havlir DV, Marquez C. Gaps in the Child Tuberculosis Care Cascade in 32 Rural Communities in Uganda and Kenya. J Clin Tuberc Other Mycobact Dis. 2017 Dec;9:24-29. doi: 10.1016/j.jctube.2017.10.003.

  PMID: 29291251 RESULT

• Camlin CS, Charlebois ED, Geng E, Semitala F, Wallenta J, Getahun M, Kampiire L, Bukusi EA, Sang N, Kwarisiima D, Clark TD, Petersen ML, Kamya MR, Havlir DV. Redemption of the "spoiled identity:" the role of HIV-positive individuals in HIV care cascade interventions. J Int AIDS Soc. 2017 Dec;20(4):e25023. doi: 10.1002/jia2.25023.

  PMID: 29210185 RESULT

• Koss CA, Ayieko J, Mwangwa F, Owaraganise A, Kwarisiima D, Balzer LB, Plenty A, Sang N, Kabami J, Ruel TD, Black D, Camlin CS, Cohen CR, Bukusi EA, Clark TD, Charlebois ED, Petersen ML, Kamya MR, Havlir DV; SEARCH Collaboration. Early Adopters of Human Immunodeficiency Virus Preexposure Prophylaxis in a Population-based Combination Prevention Study in Rural Kenya and Uganda. Clin Infect Dis. 2018 Nov 28;67(12):1853-1860. doi: 10.1093/cid/ciy390.

  PMID: 29741594 RESULT

• Camlin CS, Koss CA, Getahun M, Owino L, Itiakorit H, Akatukwasa C, Maeri I, Bakanoma R, Onyango A, Atwine F, Ayieko J, Kabami J, Mwangwa F, Atukunda M, Owaraganise A, Kwarisiima D, Sang N, Bukusi EA, Kamya MR, Petersen ML, Cohen CR, Charlebois ED, Havlir DV. Understanding Demand for PrEP and Early Experiences of PrEP Use Among Young Adults in Rural Kenya and Uganda: A Qualitative Study. AIDS Behav. 2020 Jul;24(7):2149-2162. doi: 10.1007/s10461-020-02780-x.

  PMID: 31955361 RESULT

• Heller DJ, Balzer LB, Kazi D, Charlebois ED, Kwarisiima D, Mwangwa F, Jain V, Kotwani P, Chamie G, Cohen CR, Clark TD, Ayieko J, Byonanabye DM, Petersen M, Kamya MR, Havlir D, Kahn JG. Hypertension testing and treatment in Uganda and Kenya through the SEARCH study: An implementation fidelity and outcome evaluation. PLoS One. 2020 Jan 15;15(1):e0222801. doi: 10.1371/journal.pone.0222801. eCollection 2020.

  PMID: 31940346 RESULT

• Brown LB, Balzer LB, Kabami J, Kwarisiima D, Sang N, Ayieko J, Chen Y, Chamie G, Charlebois ED, Camlin CS, Cohen CR, Bukusi E, Kamya MR, Moody J, Havlir DV, Petersen ML. The Influence of Social Networks on Antiretroviral Therapy Initiation Among HIV-Infected Antiretroviral Therapy-Naive Youth in Rural Kenya and Uganda. J Acquir Immune Defic Syndr. 2020 Jan 1;83(1):9-15. doi: 10.1097/QAI.0000000000002199.

  PMID: 31809357 RESULT

• Olilo WA, Petersen ML, Koss CA, Wafula E, Kwarisiima D, Kadede K, Clark TD, Cohen CR, Bukusi EA, Kamya MR, Charlebois ED, Havlir DV, Ayieko J; SEARCH Collaboration. Pre-exposure Prophylaxis (PrEP) Uptake Among Older Individuals in Rural Western Kenya. J Acquir Immune Defic Syndr. 2019 Dec 1;82(4):e50-e53. doi: 10.1097/QAI.0000000000002150. No abstract available.

  PMID: 31490343 RESULT

• Chamie G, Kamya MR, Petersen ML, Havlir DV. Reaching 90-90-90 in rural communities in East Africa: lessons from the Sustainable East Africa Research in Community Health Trial. Curr Opin HIV AIDS. 2019 Nov;14(6):449-454. doi: 10.1097/COH.0000000000000585.

  PMID: 31589172 RESULT

• Havlir DV, Balzer LB, Charlebois ED, Clark TD, Kwarisiima D, Ayieko J, Kabami J, Sang N, Liegler T, Chamie G, Camlin CS, Jain V, Kadede K, Atukunda M, Ruel T, Shade SB, Ssemmondo E, Byonanebye DM, Mwangwa F, Owaraganise A, Olilo W, Black D, Snyman K, Burger R, Getahun M, Achando J, Awuonda B, Nakato H, Kironde J, Okiror S, Thirumurthy H, Koss C, Brown L, Marquez C, Schwab J, Lavoy G, Plenty A, Mugoma Wafula E, Omanya P, Chen YH, Rooney JF, Bacon M, van der Laan M, Cohen CR, Bukusi E, Kamya MR, Petersen M. HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa. N Engl J Med. 2019 Jul 18;381(3):219-229. doi: 10.1056/NEJMoa1809866.

  PMID: 31314966 RESULT

• Tram KH, Mwangwa F, Chamie G, Atukunda M, Owaraganise A, Ayieko J, Jain V, Clark TD, Kwarisiima D, Petersen ML, Kamya MR, Charlebois ED, Havlir DV, Marquez C; SEARCH collaboration. Predictors of isoniazid preventive therapy completion among HIV-infected patients receiving differentiated and non-differentiated HIV care in rural Uganda. AIDS Care. 2020 Jan;32(1):119-127. doi: 10.1080/09540121.2019.1619661. Epub 2019 Jun 10.

  PMID: 31181961 RESULT

• Kwarisiima D, Atukunda M, Owaraganise A, Chamie G, Clark T, Kabami J, Jain V, Byonanebye D, Mwangwa F, Balzer LB, Charlebois E, Kamya MR, Petersen M, Havlir DV, Brown LB. Hypertension control in integrated HIV and chronic disease clinics in Uganda in the SEARCH study. BMC Public Health. 2019 May 6;19(1):511. doi: 10.1186/s12889-019-6838-6.

  PMID: 31060545 RESULT

• Mayer CM, Owaraganise A, Kabami J, Kwarisiima D, Koss CA, Charlebois ED, Kamya MR, Petersen ML, Havlir DV, Jewell BL. Distance to clinic is a barrier to PrEP uptake and visit attendance in a community in rural Uganda. J Int AIDS Soc. 2019 Apr;22(4):e25276. doi: 10.1002/jia2.25276.

  PMID: 31037845 RESULT

• Camlin CS, Akullian A, Neilands TB, Getahun M, Bershteyn A, Ssali S, Geng E, Gandhi M, Cohen CR, Maeri I, Eyul P, Petersen ML, Havlir DV, Kamya MR, Bukusi EA, Charlebois ED. Gendered dimensions of population mobility associated with HIV across three epidemics in rural Eastern Africa. Health Place. 2019 May;57:339-351. doi: 10.1016/j.healthplace.2019.05.002. Epub 2019 May 29.

  PMID: 31152972 RESULT

• Ayieko J, Petersen ML, Charlebois ED, Brown LB, Clark TD, Kwarisiima D, Kamya MR, Cohen CR, Bukusi EA, Havlir DV, Van Rie A. A Patient-Centered Multicomponent Strategy for Accelerated Linkage to Care Following Community-Wide HIV Testing in Rural Uganda and Kenya. J Acquir Immune Defic Syndr. 2019 Apr 1;80(4):414-422. doi: 10.1097/QAI.0000000000001939.

  PMID: 30807481 RESULT

• Brown LB, Getahun M, Ayieko J, Kwarisiima D, Owaraganise A, Atukunda M, Olilo W, Clark T, Bukusi EA, Cohen CR, Kamya MR, Petersen ML, Charlebois ED, Havlir DV, Camlin CS. Factors predictive of successful retention in care among HIV-infected men in a universal test-and-treat setting in Uganda and Kenya: A mixed methods analysis. PLoS One. 2019 Jan 23;14(1):e0210126. doi: 10.1371/journal.pone.0210126. eCollection 2019.

  PMID: 30673744 RESULT

• Shade SB, Osmand T, Luo A, Aine R, Assurah E, Mwebaza B, Mwai D, Owaraganise A, Mwangwa F, Ayieko J, Black D, Brown LB, Clark TD, Kwarisiima D, Thirumurthy H, Cohen CR, Bukusi EA, Charlebois ED, Balzer L, Kamya MR, Petersen ML, Havlir DV, Jain V. Costs of streamlined HIV care delivery in rural Ugandan and Kenyan clinics in the SEARCH Studys. AIDS. 2018 Sep 24;32(15):2179-2188. doi: 10.1097/QAD.0000000000001958.

  PMID: 30134294 RESULT

• Marquez C, Atukunda M, Balzer LB, Chamie G, Kironde J, Ssemmondo E, Ruel TD, Mwangwa F, Tram KH, Clark TD, Kwarisiima D, Petersen M, Kamya MR, Charlebois ED, Havlir DV. The age-specific burden and household and school-based predictors of child and adolescent tuberculosis infection in rural Uganda. PLoS One. 2020 Jan 29;15(1):e0228102. doi: 10.1371/journal.pone.0228102. eCollection 2020.

  PMID: 31995631 RESULT

• Havlir D, Lockman S, Ayles H, Larmarange J, Chamie G, Gaolathe T, Iwuji C, Fidler S, Kamya M, Floyd S, Moore J, Hayes R, Petersen M, Dabis F; (Universal Test, Treat Trials) UT3 Consortium. What do the Universal Test and Treat trials tell us about the path to HIV epidemic control? J Int AIDS Soc. 2020 Feb;23(2):e25455. doi: 10.1002/jia2.25455.

  PMID: 32091179 RESULT

• Muiru AN, Charlebois ED, Balzer LB, Kwarisiima D, Elly A, Black D, Okiror S, Kabami J, Atukunda M, Snyman K, Petersen M, Kamya M, Havlir D, Estrella MM, Hsu CY. The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. PLoS One. 2020 Mar 4;15(3):e0229649. doi: 10.1371/journal.pone.0229649. eCollection 2020.

  PMID: 32130245 RESULT

• Koss CA, Charlebois ED, Ayieko J, Kwarisiima D, Kabami J, Balzer LB, Atukunda M, Mwangwa F, Peng J, Mwinike Y, Owaraganise A, Chamie G, Jain V, Sang N, Olilo W, Brown LB, Marquez C, Zhang K, Ruel TD, Camlin CS, Rooney JF, Black D, Clark TD, Gandhi M, Cohen CR, Bukusi EA, Petersen ML, Kamya MR, Havlir DV; SEARCH Collaboration. Uptake, engagement, and adherence to pre-exposure prophylaxis offered after population HIV testing in rural Kenya and Uganda: 72-week interim analysis of observational data from the SEARCH study. Lancet HIV. 2020 Apr;7(4):e249-e261. doi: 10.1016/S2352-3018(19)30433-3. Epub 2020 Feb 19.

  PMID: 32087152 RESULT

• Chamie G, Hickey MD, Kwarisiima D, Ayieko J, Kamya MR, Havlir DV. Universal HIV Testing and Treatment (UTT) Integrated with Chronic Disease Screening and Treatment: the SEARCH study. Curr HIV/AIDS Rep. 2020 Aug;17(4):315-323. doi: 10.1007/s11904-020-00500-7.

  PMID: 32507985 RESULT

• Kabami J, Balzer LB, Saddiki H, Ayieko J, Kwarisiima D, Atukunda M, Charlebois ED, Clark TD, Koss CA, Ruel T, Bukusi EA, Cohen CR, Musoke P, Petersen ML, Havlir DV, Kamya MR, Chamie G. Population-level viral suppression among pregnant and postpartum women in a universal test and treat trial. AIDS. 2020 Jul 15;34(9):1407-1415. doi: 10.1097/QAD.0000000000002564.

  PMID: 32472768 RESULT

• Hickey MD, Ayieko J, Kwarisiima D, Opel FJ, Owaraganise A, Balzer LB, Chamie G, Jain V, Peng J, Camlin C, Charlebois ED, Cohen CR, Bukusi EA, Kamya MR, Petersen ML, Havlir DV. Improved Viral Suppression With Streamlined Care in the SEARCH Study. J Acquir Immune Defic Syndr. 2020 Dec 15;85(5):571-578. doi: 10.1097/QAI.0000000000002508.

  PMID: 32991337 RESULT

• Camlin CS, Charlebois ED, Getahun M, Akatukwasa C, Atwine F, Itiakorit H, Bakanoma R, Maeri I, Owino L, Onyango A, Chamie G, Clark TD, Cohen CR, Kwarisiima D, Kabami J, Sang N, Kamya MR, Bukusi EA, Petersen ML, V Havlir D. Pathways for reduction of HIV-related stigma: a model derived from longitudinal qualitative research in Kenya and Uganda. J Int AIDS Soc. 2020 Dec;23(12):e25647. doi: 10.1002/jia2.25647.

  PMID: 33283986 RESULT

• Koss CA, Havlir DV, Ayieko J, Kwarisiima D, Kabami J, Chamie G, Atukunda M, Mwinike Y, Mwangwa F, Owaraganise A, Peng J, Olilo W, Snyman K, Awuonda B, Clark TD, Black D, Nugent J, Brown LB, Marquez C, Okochi H, Zhang K, Camlin CS, Jain V, Gandhi M, Cohen CR, Bukusi EA, Charlebois ED, Petersen ML, Kamya MR, Balzer LB. HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda. PLoS Med. 2021 Feb 9;18(2):e1003492. doi: 10.1371/journal.pmed.1003492. eCollection 2021 Feb.

  PMID: 33561143 RESULT

• Nyabuti MN, Petersen ML, Bukusi EA, Kamya MR, Mwangwa F, Kabami J, Sang N, Charlebois ED, Balzer LB, Schwab JD, Camlin CS, Black D, Clark TD, Chamie G, Havlir DV, Ayieko J. Characteristics of HIV seroconverters in the setting of universal test and treat: Results from the SEARCH trial in rural Uganda and Kenya. PLoS One. 2021 Feb 5;16(2):e0243167. doi: 10.1371/journal.pone.0243167. eCollection 2021.

  PMID: 33544717 RESULT

• Shade SB, Osmand T, Kwarisiima D, Brown LB, Luo A, Mwebaza B, Mwesigye AR, Kwizera E, Imukeka H, Mwanga F, Ayieko J, Owaraganise A, Bukusi EA, Cohen CR, Charlebois ED, Black D, Clark TD, Petersen ML, Kamya MR, Havlir DV, Jain V. Costs of integrating hypertension care into HIV care in rural East African clinics. AIDS. 2021 May 1;35(6):911-919. doi: 10.1097/QAD.0000000000002834.

  PMID: 33821821 RESULT

• Chamie G, Kwarisiima D, Ndyabakira A, Marson K, Camlin CS, Havlir DV, Kamya MR, Thirumurthy H. Financial incentives and deposit contracts to promote HIV retesting in Uganda: A randomized trial. PLoS Med. 2021 May 4;18(5):e1003630. doi: 10.1371/journal.pmed.1003630. eCollection 2021 May.

  PMID: 33945526 RESULT

• Camlin CS, Gutin SA, Charlebois ED, Neilands TB, Balzer LB, Petersen ML, Chamie G, Cohen CR, Bukusi EA, Kamya MR, Havlir DV, Ayieko J. Metrics of Mobility by Sex are Associated with HIV Incidence in Rural Kenya and Uganda. AIDS Behav. 2025 Sep;29(9):2869-2881. doi: 10.1007/s10461-025-04743-6. Epub 2025 May 6.

  PMID: 40327268 DERIVED

• Abbott R, Landsiedel K, Atukunda M, Puryear SB, Chamie G, Hahn JA, Mwangwa F, Kakande E, Petersen ML, Havlir DV, Charlebois E, Balzer LB, Kamya MR, Marquez C. Incident Tuberculosis Infection Is Associated With Alcohol Use in Adults in Rural Uganda. Clin Infect Dis. 2025 Mar 17;80(3):562-565. doi: 10.1093/cid/ciae304.

  PMID: 38824440 DERIVED

• Marquez C, Atukunda M, Nugent J, Charlebois ED, Chamie G, Mwangwa F, Ssemmondo E, Kironde J, Kabami J, Owaraganise A, Kakande E, Ssekaynzi B, Abbott R, Ayieko J, Ruel T, Kwariisima D, Kamya M, Petersen M, Havlir DV, Balzer LB. Community-Wide Universal HIV Test and Treat Intervention Reduces Tuberculosis Transmission in Rural Uganda: A Cluster-Randomized Trial. Clin Infect Dis. 2024 Jun 14;78(6):1601-1607. doi: 10.1093/cid/ciad776.

  PMID: 38226445 DERIVED

• Ayieko J, Charlebois ED, Maeri I, Owino L, Thorp M, Bukusi EA, Petersen ML, Kamya MR, Havlir DV, Camlin CS. Improving care engagement for mobile people living with HIV in rural western Kenya. PLoS One. 2023 Nov 22;18(11):e0288087. doi: 10.1371/journal.pone.0288087. eCollection 2023.

  PMID: 37992063 DERIVED

• Puryear SB, Ayieko J, Hahn JA, Mucunguzi A, Owaraganise A, Schwab J, Balzer LB, Kwarisiima D, Charlebois ED, Cohen CR, Bukusi EA, Petersen ML, Havlir DV, Kamya MR, Chamie G. Universal HIV Testing and Treatment With Patient-Centered Care Improves ART Uptake and Viral Suppression Among Adults Reporting Hazardous Alcohol Use in Uganda and Kenya. J Acquir Immune Defic Syndr. 2023 Sep 1;94(1):37-45. doi: 10.1097/QAI.0000000000003226.

  PMID: 37220015 DERIVED

• Maeri I, Eyul P, Getahun M, Hatchett K, Owino L, Akatukwasa C, Itiakorit H, Gutin SA, Johnson-Peretz J, Ssali S, Cohen CR, Bukusi EA, Kamya MR, Charlebois ED, Camlin CS. Nothing about us without us: Community-based participatory research to improve HIV care for mobile patients in Kenya and Uganda. Soc Sci Med. 2023 Feb;318:115471. doi: 10.1016/j.socscimed.2022.115471. Epub 2022 Oct 28.

  PMID: 36628879 DERIVED

• Camlin CS, Getahun M, Koss CA, Owino L, Akatukwasa C, Itiakorit H, Onyango A, Bakanoma R, Atwine F, Maeri I, Ayieko J, Atukunda M, Owaraganise A, Mwangwa F, Sang N, Kabami J, Kaplan RL, Chamie G, Petersen ML, Cohen CR, Bukusi EA, Kamya MR, Havlir DV, Charlebois ED. Providers' Attitudes and Experiences with Pre-Exposure Prophylaxis Implementation in a Population-Based Study in Kenya and Uganda. AIDS Patient Care STDS. 2022 Oct;36(10):396-404. doi: 10.1089/apc.2022.0084. Epub 2022 Oct 5.

  PMID: 36201226 DERIVED

• Jakubowski A, Kabami J, Balzer LB, Ayieko J, Charlebois ED, Owaraganise A, Marquez C, Clark TD, Black D, Shade SB, Chamie G, Cohen CR, Bukusi EA, Kamya MR, Petersen M, Havlir DV, Thirumurthy H. Effect of universal HIV testing and treatment on socioeconomic wellbeing in rural Kenya and Uganda: a cluster-randomised controlled trial. Lancet Glob Health. 2022 Jan;10(1):e96-e104. doi: 10.1016/S2214-109X(21)00458-7.

  PMID: 34919862 DERIVED

• Mwangwa F, Getahun M, Itiakorit H, Jain V, Ayieko J, Owino L, Akatukwasa C, Maeri I, Koss CA, Chamie G, Clark TD, Kabami J, Atukunda M, Kwarisiima D, Sang N, Bukusi EA, Kamya MR, Petersen ML, Cohen CR, Charlebois ED, Havlir DV, Camlin CS. Provider and Patient Perspectives of Rapid ART Initiation and Streamlined HIV Care: Qualitative Insights From Eastern African Communities. J Int Assoc Provid AIDS Care. 2021 Jan-Dec;20:23259582211053518. doi: 10.1177/23259582211053518.

  PMID: 34841945 DERIVED

• Hickey MD, Ayieko J, Owaraganise A, Sim N, Balzer LB, Kabami J, Atukunda M, Opel FJ, Wafula E, Nyabuti M, Brown L, Chamie G, Jain V, Peng J, Kwarisiima D, Camlin CS, Charlebois ED, Cohen CR, Bukusi EA, Kamya MR, Petersen ML, Havlir DV. Effect of a patient-centered hypertension delivery strategy on all-cause mortality: Secondary analysis of SEARCH, a community-randomized trial in rural Kenya and Uganda. PLoS Med. 2021 Sep 20;18(9):e1003803. doi: 10.1371/journal.pmed.1003803. eCollection 2021 Sep.

  PMID: 34543267 DERIVED

• Ayieko J, Petersen ML, Kabami J, Mwangwa F, Opel F, Nyabuti M, Charlebois ED, Peng J, Koss CA, Balzer LB, Chamie G, Bukusi EA, Kamya MR, Havlir DV. Uptake and outcomes of a novel community-based HIV post-exposure prophylaxis (PEP) programme in rural Kenya and Uganda. J Int AIDS Soc. 2021 Jun;24(6):e25670. doi: 10.1002/jia2.25670.

  PMID: 34152067 DERIVED

• Kamya MR, Petersen ML, Kabami J, Ayieko J, Kwariisima D, Sang N, Clark TD, Schwab J, Charlebois ED, Cohen CR, Bukusi EA, Peng J, Jain V, Chen YH, Chamie G, Balzer LB, Havlir DV. SEARCH Human Immunodeficiency Virus (HIV) Streamlined Treatment Intervention Reduces Mortality at a Population Level in Men With Low CD4 Counts. Clin Infect Dis. 2021 Oct 5;73(7):e1938-e1945. doi: 10.1093/cid/ciaa1782.

  PMID: 33783495 DERIVED

• Ayieko J, Brown L, Anthierens S, Van Rie A, Getahun M, Charlebois ED, Petersen ML, Clark TD, Kamya MR, Cohen CR, Bukusi EA, Havlir DV, Camlin CS. "Hurdles on the path to 90-90-90 and beyond": Qualitative analysis of barriers to engagement in HIV care among individuals in rural East Africa in the context of test-and-treat. PLoS One. 2018 Aug 30;13(8):e0202990. doi: 10.1371/journal.pone.0202990. eCollection 2018.

  PMID: 30161172 DERIVED

• Camlin CS, Akullian A, Neilands TB, Getahun M, Eyul P, Maeri I, Ssali S, Geng E, Gandhi M, Cohen CR, Kamya MR, Odeny T, Bukusi EA, Charlebois ED. Population mobility associated with higher risk sexual behaviour in eastern African communities participating in a Universal Testing and Treatment trial. J Int AIDS Soc. 2018 Jul;21 Suppl 4(Suppl Suppl 4):e25115. doi: 10.1002/jia2.25115.

  PMID: 30027668 DERIVED

• Jakubowski A, Snyman K, Kwarisiima D, Sang N, Burger R, Balzer L, Clark T, Chamie G, Shade S, Cohen C, Bukusi E, Charlebois E, Kamya M, Petersen M, Havlir D, Thirumurthy H. High CD4 counts associated with better economic outcomes for HIV-positive adults and their HIV-negative household members in the SEARCH Trial. PLoS One. 2018 Jun 26;13(6):e0198912. doi: 10.1371/journal.pone.0198912. eCollection 2018.

  PMID: 29944678 DERIVED

• Kwarisiima D, Kamya MR, Owaraganise A, Mwangwa F, Byonanebye DM, Ayieko J, Plenty A, Black D, Clark TD, Nzarubara B, Snyman K, Brown L, Bukusi E, Cohen CR, Geng EH, Charlebois ED, Ruel TD, Petersen ML, Havlir D, Jain V. High rates of viral suppression in adults and children with high CD4+ counts using a streamlined ART delivery model in the SEARCH trial in rural Uganda and Kenya. J Int AIDS Soc. 2017 Jul 21;20(Suppl 4):21673. doi: 10.7448/IAS.20.5.21673.

  PMID: 28770596 DERIVED

Related Links

• SEARCH Collaboration website

MeSH Terms

Conditions

Tuberculosis; Hypertension; Diabetes Mellitus

Condition Hierarchy (Ancestors)

Mycobacterium Infections; Actinomycetales Infections; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Infections; Vascular Diseases; Cardiovascular Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Limitations and Caveats

In the second stage, following re-randomization, there was a DSMB approved study modification due to policy changes in standard of care. As a result, outcomes were only assessed among participants in the intervention arm who were offered PrEP. No data were collected in the control arm.

Results Point of Contact

• Title: Tamara Clark
• Organization: University of California, San Francisco

Tamara.Clark@ucsf.edu

628-206-8790

Study Officials

• Diane Havlir, MD

  University of California, San Francisco

  STUDY CHAIR

• Moses Kamya, MBChB, PhD

  Makerere University

  PRINCIPAL INVESTIGATOR

• Maya Petersen, PhD

  University of California, Berkeley

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 26, 2013
• First Posted: May 29, 2013
• Study Start: April 1, 2013
• Primary Completion: April 1, 2021
• Study Completion: April 1, 2021
• Last Updated: March 2, 2022
• Results First Posted: March 2, 2022

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will not share

Locations

KE (1); UG (2)