Understanding the current epidemiology of COVID-19 is of urgent importance in light of the continued pandemic. Given current testing guidelines, the number of individuals within the Charleston, South Carolina area who have had COVID-19 is unknown. Many such individuals may have been asymptomatic or mildly symptomatic. Thus, the number of confirmed cases, those who are or have been symptomatic and tested for COVID-19, is most likely a significant underrepresentation of the community seroprevalence of the virus. The purpose of this study is to determine the number of prior COVID-19 infections that are present in the Charleston area among adults, and to evaluate characteristics associated with infection with SARS-CoV-2, the virus which causes COVID-19.

HIV testing is often shunned in community settings due to the stigma of HIV-centric services. Our recent pilot study strongly suggest that integration of a package of screening that include HIV, diabetes, and hypertension hold promise of substantially increasing the uptake of HIV testing while simultaneously providing direly needed community screening for non-communicable disease (NCDs) like diabetes and hypertension, which themselves are at epidemic levels in Sub-Saharan Africa. This study will examine whether integrating HIV screening with NCD screening will improve uptake of HIV testing and whether integrating HIV and NCD care will improve retention.

To maximize the public health benefit of expenditures on HIV prevention, treatment and care in Sub Saharan Africa programs are needed that synergistically combine intervention strategies, target the intensity of interventions to attributable risk, support couples to reduce their risk of HIV transmission within the partnership, and facilitate safe and acceptable uptake of available treatment and prevention services. The goal of this study is to advance methodological innovations in the support of cost- effective combination HIV prevention programs.

The study will develop reliable indicators for intervention exposure using biometric identifiers, develop indicators that capture dynamic multi-component risk reduction strategies, establish proof of concept for the combination and scalability of proven HIV intervention components never before brought to scale (HIV self-testing, PrEP for discordant couples), carefully assess the safety and acceptance of the strategy, and examine important operational issues related to comparative cost and efficiency of competing strategies.

The study will be conducted in Kisarawe, Tanzania. The intervention, if found efficacious, would provide needed program and policy guidance highly significant to public health. In addition, if these strategies being explored are proven to be effective it could lead to substantial savings to US programs that support
global AIDS control and treatment.