Study in Tanzania Tests Way to Reduce Stigma of HIV Testing

Children waiting outside a health clinic in Tanzania
Children waiting outside a health clinic in Tanzania

Dr. Michael Sweat, director of the MUSC Center for Global HealthIn October, MUSC’s Center for Global Health received a $3.1 million grant from the National Institutes of Health to study an integrated approach to screening and treatment for HIV, diabetes, and hypertension in Tanzania. This five-year trial is a collaborative effort between MUSC, Clemson University, and Muhimbili University of Health and Allied Sciences in Tanzania.

Michael D. Sweat, Ph.D., professor of Psychiatry and Behavioral Sciences at MUSC and director of the Center for Global Health, is the principal investigator for the study. “Global health is everyone’s health,” said Sweat. “The greatest burdens of disease in the world — HIV, diabetes, and hypertension, among others — know no borders. This grant will enable us to discover better and more efficient ways to address these threats to health, no matter where they arise.”

Sweat has worked with American and Tanzanian scientists and other colleagues since 1994 to study ways to increase HIV screening and care in Tanzania.

The success of HIV programs depends upon the effective identification, enrollment, and retention of HIV-positive patients, but there are numerous barriers at every point in this care continuum. HIV-centric programs carry a stigma, patients’ transportation to the HIV clinics can be a problem, and patients tire of repeated visits to learn whether they have become eligible for HIV treatment.

Chronic non-communicable diseases such as diabetes and hypertension are another growing global epidemic, accounting for 38 million deaths annually, with three quarters of those deaths occurring in low- and middle-income countries. The study will explore the integration of diabetes and hypertension screening into HIV screening and care. An earlier 12-month study led by Sweat found a 97 percent increase in HIV testing with this approach, a finding that is relevant throughout the world, including rural, poor areas of the U.S.

Sweat’s collaborators will be Clemson University’s Department of Bioengineering, which has worked with Arusha Technical College in Tanzania in the past to develop low-cost health technology solutions for resource-poor settings, and Muhimbili University of Health and Allied Sciences, which will provide clinical services and collaborate on data collection and analysis.

Delphine Dean, Ph.D., Gregg-Graniteville Associate Professor of Bioengineering at Clemson University, will direct the development of low-cost, diagnostic devices in her laboratory, and provide technical support to the health clinics in Tanzania. Dean’s laboratory recently developed a low-cost glucometer designed to print, on an inkjet printer, test strips on filter paper loaded with reagents to which a drop of blood is applied to determine the patient’s blood sugar level. A patent on the glucometer was filed through the Clemson University Research Foundation.

“The lack of medical equipment, devices, and tests in resource-poor areas such as rural Tanzania limits clinicians’ ability to diagnose and treat,” said Dean. “By working together, we can improve accessibility to technology and improve global health.”

Patient enrollment is projected to begin in the fall of 2017.