UCT medical historian awarded global AIDS research grant

"It's an opportunity to work together with a remarkable team of collaborators, and to immerse myself in the many challenges presented by the rollout of antiretroviral treatment - one of the greatest public health interventions in history." This is how Dr Rebecca Hodes, a medical historian and postdoctoral fellow at the University of Cape Town, describes what it meant for her to receive a prestigious research grant from the International AIDS Society earlier this week.

Dr Hodes was awarded the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) grant on 1 July 2013 at the 7th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, in Kuala Lumpur, Malaysia. At the conference, she also presented her research, focusing on the HIV treatment of South African teenagers.

The number of eligible children receiving ARV therapy has increased in African countries

According to the United Nations Children's Fund (UNICEF), Southern Africa is home to 1.2 million HIV-infected adolescents whose long-term health depends on them strictly following antiretroviral therapy (ART). As adolescence is a time of increased risk-taking and experimenting, HIV-positive teenagers represent an especially vulnerable and challenging group for HIV service providers. The number of eligible children receiving ARV therapy has increased in African countries. Dr Hodes argues that although the South African government describes the antiretroviral treatment rollout in the country as a success story, ongoing research shows that this rollout has been problematic, especially in poor and rural areas.

Researchers have also found that adolescent ART-users in Africa show low adherence and have poor access to sexual and reproductive health services. For this reason Dr Hodes will next year undertake a study on improving South African adolescents' access to antiretroviral treatment and reproductive healthcare services. Her collaborators include academics from UCT and Oxford University, UNICEF, South African government officials, as well as members of NGOs and community-based organisations. Making use of her new CIPHER grant, Dr Hodes' research will focus on the health needs of young people growing up in contexts of extreme risk.

'Very few programming approaches have been led by youth themselves'

Dr Hodes hopes the study will bring the experiences of youth into the arena of policymaking. "Despite the crucial role HIV-positive adolescents play in preventing the transmission of HIV, very few programming approaches have been led by youth themselves." She says the research group aims to work closely with the teenagers to design youth-friendly support tools which will be piloted at clinics and support groups.

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS) the pace of decline in some of the Global Plan priority countries has been slow and in Angola, new HIV infections have even risen. The UNAIDS report on the Global Plan towards elimination of new HIV infections among children by 2015 calls for innovative studies such as the one Dr Hodes will be undertaking.

Taking place over the next two years in the Eastern Cape, the study aims to investigate lived experiences of antiretroviral treatment combined with sexual and reproductive healthcare, in order to tackle the comparatively low rates of adherence among adolescents. "We're shifting the focus away from well-resourced, metropolitan centres of health provision, and looking at how the rollout is progressing in more marginal healthcare settings," she says.

One of the movers behind SHARC

Dr Hodes' interest in HIV research was sparked during her very early university years. As a first-year student at Rhodes University, she found that the struggle for public access to antiretroviral treatment was gaining momentum, but student HIV advocacy hadn't yet emerged on campus. Together with a friend, she started an organisation called SHARC (Students HIV/AIDS Resistance Campaign), based largely on the Student HIV and AIDS Resistance Programme (SHARP) model at UCT. In 2010, she began a postdoctoral fellowship at UCT's AIDS and Society Research Unit, where her research focuses on access to HIV and reproductive health medicines. Last year she started a second postdoctoral fellowship at the Institute for Humanities in Africa, developing her research on the history of reproductive health in South Africa.

Dr Hodes holds a BA and BA (Honours) in History from Rhodes University, as well as an MSc in the History of Medicine, Science and Technology and a DPhil - both from Oxford University. Her doctoral thesis was about HIV on South African television, and has been converted into a book manuscript with the working title, Broadcasting the Pandemic.

*Information retrieved from CIPHER Research Grant Proposal by Dr Hodes.