HIV Epidemiology and Biostatistics Group

The Group is based at the Royal Free Campus, and is led by Andrew Phillips, Professor of Epidemiology, and Caroline Sabin, Professor of Medical Statistics and Epidemiology

Any enquiries related to the group should contact the Group Administrator, Pat Withington, at p.withington@ucl.ac.uk

For research group staff profiles, click here

Our current research includes the following studies:

ASTRA (Antiretrovirals, Sexual Transmission Risk and Attitudes)

Alison Rodgers, Fiona Lampe, Andrew Speakman, Janey Sewell, Marina Daskalopoulou, Andrew Phillips and Jemma O’Connor

ASTRA (Antiretrovirals, Sexual Transmission Risk and Attitudes) is an observational questionnaire study among UK HIV outpatients. The study aims to assess current levels of sexual risk behaviours, beliefs about HIV transmission risk, and attitudes to use of early antiretroviral treatment, among HIV-diagnosed individuals attending for care, and to investigate trends over time in these factors. In particular, ASTRA will investigate whether antiretroviral treatment and viral suppression are associated with sexual risk behaviour. Two cross-sectional self-administered questionnaires will be conducted among HIV outpatients in five UK centres, in 2010/11 and 2013/14, and linked to virological and clinical data. Each questionnaire study aims to include a representative sample of outpatients attending for care at each centre, irrespective of antiretroviral treatment status.

See the Astra website - http://www.astra-study.org/

AURAH / AURAH2 (Attitudes to and Understanding Risk of acquisition of HIV over Time)

Alison Rodgers, Fiona Lampe, Andrew Speakman, Andrew Phillips, Janey Sewell and Ada Miltz

The AURAH  study used a cross sectional questionnaire to assess knowledge of, and attitudes to HIV transmission risks and the role of ART, and to assess the prevalence of medical and psychological symptoms (e.g. hepatitis C, depression and anxiety), quality of life, lifestyle factors (e.g. drug and alcohol use) and their possible links to sexual risk behaviours, in a large sample of HIV-negative patients attending Genito-Urinary Medicine (GUM) clinics in the UK, and among key demographic subgroups (MSM; Black African men and women).  The AURAH2 study builds on the work of AURAH1 by providing further longitudinal data on HIV transmission risk using a series of online questionnaires which are completed by the recruited HIV negative (at baseline) MSM participants over a 3 year period.

Centre of Excellence for personalised medicine of infectious complications in immune deficiency (PERSIMUNE)

Amanda Mocroft, Alessandro Cozzi-Lepri and Andrew Phillips

This is a newly established centre of excellence led by Professor Jens Lundgren and funded by the Danish National Research Foundation. The multidisciplinary centre at Rigshospitalet works from the hypothesis that across patient with impaired immune function, there is a common pattern of un-discovered risk factors explaining the variation in risk of infectious complications. Initially we aim at understanding the mechanisms explaining the variation in risk using a diverse set of methodologies, including pattern recognition from big data from routine care, studies of host and microbial genetics, imaging, and immunological characterization. The discovery phase will likely identify novel mechanisms of host defence, which will be used to characterize groups of immuno-compromised patients and identify clusters of factors associated with comparable types of infectious complications. From this, we will formulate a series of immunodeficiency indices encapsulating the variation in risk for of infectious complications. The indices will be validated and used to personalise interventions aimed at reducing infectious complications.

Comorbidity in Relation to AIDS (COBRA)

Caroline Sabin and Davide de Francesco (in collaboration with Imperial College London)

Persons with HIV on combination antiretroviral therapy (cART) are at increased risk of the premature development of age-associated non-communicable comorbidities (AANCC), including cardiovascular, chronic kidney, liver and pulmonary disease, diabetes mellitus, osteoporosis, non-AIDS associated malignancies, and neurocognitive impairment. It has therefore been hypothesised that such individuals, despite effective cART, may be prone to accelerated ageing. The underlying pathogenesis is likely to be multifactorial and include sustained immune activation, both systemically and within the central nervous system.

The aim of the COBRA study is to undertake a detailed, prospective evaluation of AANCC among HIV-infected patients suppressed on cART and appropriately chosen and comparable non-infected controls. In this way, the study aims to provide a robust estimate of the effect of treated HIV infection on the prevalence, incidence and age of onset of AANCC.

For more information, visit: http://fp7-cobra.eu/

Collaboration of observational HIV Epidemiological Research Europe (COHERE)

Andrew Phillips, Caroline Sabin, Amanda Mocroft, Alessandro Cozzi-Lepri and Jemma O’Connor

COHERE is an international collaboration of the major HIV cohort studies in Europe.  The study was initiated in 2005 with the mission to conduct epidemiological research on the prognosis and outcome of HIV-infected people from across Europe including pregnant mothers, children, and adults. The research focuses on scientific questions requiring a large sample size of patients which the contributing cohorts cannot answer individually and which do not overlap with existing collaborations between participating COHERE cohorts.  

The PLATO II project is a study of triple class virologic failure (TCVF): failure of the three original antiretroviral drug classes. Using data from both adult and paediatric cohorts in the COHERE collaboration, the objectives of PLATO II are to study: i) incidence and predictors of TCVF; ii) outcomes in people with TCVF; iii) and antiretroviral resistance in people with TCVF.

Data Collection on Adverse events of Anti-HIV Drugs (D:A:D)

Caroline Sabin, Andrew Phillips, David Kamara, Colette Smith and Amanda Mocroft

The Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) is a prospective multi-cohort study of HIV-infected persons under active follow up. The purpose of the study is to assess the incidence of cardiovascular disease among HIV/AIDS patients and to investigate whether treatment with antiretroviral drugs is associated with the development of this cardiovascular disease. The remit of the study has now broadened to include analyses of the incidence of several further serious non-AIDS events (liver and renal failure and malignancies). The study is coordinated by the Copenhagen HIV Program (Prof Jens Lundgren) and all statistical support is provided from the Unit. Financial support for the study is provided by 'The Oversight Committee for The Evaluation of Metabolic Complications of HAART', to which a number of pharmaceutical companies producing antiretroviral drugs contribute financially. The D:A:D Study is now embarking in its 16th year and is projected to continue at least until 2017. Further details at www.cphiv.dk


Andrew Phillips, Caroline Sabin, Amanda Mocroft, Fiona Burns and Fumiyo Nakagawa

EuroCoord is a Network of Excellence established by several of the biggest HIV cohorts and collaborations within Europe - CASCADE, COHERE, EuroSIDA, and PENTA. This large, integrated network exploits the scientific strengths of each collaboration to ensure that the best, most competitive HIV research is performed. The main advantage of this collaborative method of working is the formation of a common virtual database, which currently has access to data from over 300,000 HIV positive people from many different settings in Europe and beyond.

EuroCoord is made up of 24 beneficiaries chosen from 16 countries to ensure representativeness across Europe. The nature of the collaboration means that apart from these partners, there is also an associated network of numerous affiliated sites – more than 100 collaborating centres, or third parties. The tasks of EuroCoord are organised into 15 different workpackages, all of which are interrelated, and unified through the scientific oversight workpackage.

EuroCoord is funded for a period of 5 years from 2011 as part of the European Commission’s Framework Programme 7.

For further details visit: www.eurocoord.net


Amanda Mocroft, Andrew Phillips, Alessandro Cozzi-Lepri, Colette Smith, Daniel Grint, Leah Shepherd and Anna Schultze

The EuroSIDA study is a prospective observational cohort study of more than 18791 patients followed in 107 hospitals in 37 European countries plus Israel and Argentina. The main objective of the study is to follow the long-term clinical prognosis for the general population of HIV-infected patients living in Europe and to assess the impact of antiretroviral drugs on the long-term prognosis for these patients. The EuroSIDA study was initiated in 1994 and continues to expand in multiple ways. Being an observational study, the type of data collected has diversified tremendously since the start, as advances in the medical management of HIV has allowed for HIV-infected patients to foresee a good life prognosis. Early in the study, EuroSIDA initiated a focus on reliably collecting data on end-organ diseases and non-AIDS cancers, and confounders relevant for predicting risk factors for their occurrence. Much of the work relating to predicting the risk of cardiovascular disease (including the design of the D:A:D study) was a result of this foresight. Subsequently, the study has expanded the scope of research focus to also address liver disease, renal disease, and non-AIDS defining cancers. The study has recently started recruiting to cohort 10, including 5000 patients coinfected with hepatitis C.

The study is led by Amanda Mocroft and Ole Kirk and is coordinated by CHIP, Centre for Health and Infectious Disease Research.  Further information can be found at www.cphiv.dk.

Feasibility and acceptability of home sampling kits to increase the uptake of HIV testing among black Africans in the United Kingdom: The Haus Study

Fiona Burns (in collaboration with Catherine Dodds, Paul Flowers, Lisa McDaid, Greta Rait, Nick Freemantle, Rachael Hunter, Jane Anderson, Ibi Fakoya, Sonali Wayal and Peter Weatherburn)

The Haus study (Feasibility and acceptability of home sampling kits to increase the uptake of HIV testing among black Africans in the United Kingdom) is an NIHR HTA funded study that aims to develop and trial an HIV home sampling based intervention in African communities in the UK that is sustainable, cost effective, and will improve the availability, acceptability and uptake of HIV testing. The intervention will be embedded within existing health care and community services.

To establish how best to embed HSK within existing services extensive formative research will be undertaken with African communities and service providers.  Having identified appropriate mechanisms for intervention delivery, a phase II evaluation will determine if the interventions can in fact be delivered and evaluated to ensure they reach black Africans and that we can collect outcome data, including health economic data. In this phase existing NHS staff, pharmacists, and or community outreach teams will be trained to distribute HSK alongside their existing service. We aim to distribute 400 HSK in each setting, in each city, totalling 1600 HSKs distributed.

See the Haus website: www.haus.org.uk

Health Protection Research Unit (HPRU)

Caroline Sabin

The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections is a partnership between UCL and Public Health England (PHE) in collaboration with the London School of Hygiene and Tropical Medicine.  Researchers in the HPRU aim to conduct state-of-the-art research to improve the health of the population, and to help develop practical policy guidelines for those working in health protection.  The NIHR HPRU has received almost £4 million to invest in collaboration across three research themes to undertake research that addresses three key health protection priorities for the prevention and control of STIs and BBVs, notably understanding risk and risk reduction, reducing the burden of under-diagnosis, and improving care and management of those diagnosed with infections. Examples of proposed work include assessing the feasibility of offering sexual health testing within routine general practice, and developing recommendations for care for people living with HIV, HBV and HCV. A diverse team of researchers from clinical medicine, epidemiology, medical statistics, qualitative science, social science, health economics, mathematical modelling and laboratory science have been brought together to create an innovative culture of working across different disease areas, populations, and academic institutions. 

Further details can be found at:  http://bbsti.hpru.nihr.ac.uk


Alessandro Cozzi-Lepri and Milensu Shanyinde

HepaICONA has the potential to become the largest study ever conducted in Italy in the field of HIV-HCV co-infection. Since the end of 2013, HepaICONA has been enrolling both antiretroviral (ART)-naïve and ART-experienced patients who are however naive to direct-acting antivirals (DAA), with the objective of providing data to the scientific community and the institutions to help them with the optimization of treatment strategies and clinical management of HIV-HCV co-infection.

HIV Indicator Diseases Across Europe Study (HIDES II) study

Amanda Mocroft

HIDES II is a study aiming at developing focused HIV testing in patients presenting with certain indicator diseases (ID). ID’s are diseases and/or clinical conditions often connected to HIV infection - also in the early stage of the infection. The objective is, to build evidence of HIV prevalence for the specific conditions and diseases where HIV prevalence is thought to be higher than in the general population. The concept of indicator disease guided testing is, to encourage health care practitioners to test more patients based on suspicion of HIV, in order to diagnose and treat HIV infection earlier and decrease the number late presenters as well as reduce the risk of transmission.

The HIDES II study is part of the HIV in Europe initiative, coordinated by Professor Jens Lundgren.  Further details are available at http://hiveurope.eu/Ongoing-Projects/HIDES/HIDES-2.

Italian Cohort of Antiretroviral Naïve Patients (ICONA)

Alessandro Cozzi-Lepri and Milensu Shanyinde

The project is currently promoted by the Icona Foundation and it was born as a roll-out of the Icona cohort study. The Icona cohort study began in 1997 as an observational study conducted on a large cohort of HIV-positive individuals seen for care In Italy. As of December 2014, the Icona Foundation Study consists of more than 12,000 HIV-positive individuals enrolled after April 1, 1997 in over 70 clinical sites (45 of which are still actively enrolling) operating throughout Italy and coordinated by 6 University Centres. The only eligibility criterion for participants is that they must be ART-naive at enrolment. A repository of plasma and cell samples (collected from patients at enrolment and at least once a year) is also available. The main research focus of ICONA is the outcome of antiretroviral therapy in people who commence triple combinations when ART-naive. ICONA Foundation Study is supported by unrestricted educational grants coming from a number of pharmaceutical companies:  Abbvie, Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp and Dohme and ViiV. The study is coordinated from Italy by Professor Antonella d’Arminio Monforte (email at antonella.darminio@unimi.it). Further details can be found at www.fondazioneicona.org

MATCH study (Management of Post-Transplant Infections in Collaborating Hospitals)

Amanda Mocroft

MATCH (Management of Post-Transplant Infections in Collaborating Hospitals), is a prospectively established transplantation database of collaborating hospitals in Denmark. The database serves as a quality assurance and safety tool for evaluating the risk of developing viral infections among >2500 transplant recipients. As such, research is ongoing to improve the clinical care and management of transplanted patients.  The MATCH database captures routine daily data from all analytic and pathology laboratories, as well as from medication systems and all imaging data.  

The MATCH study is led by Professor Jens Lundgren with statistical support based at UCL led by Amanda Mocroft. Further information can be found at www.cphiv.dk.

Partners of people on ART: a New Evaluation of the Risks (PARTNER)

Andrew Philips, Alison Rodger, Valentina Cambiano, Fiona Lampe and Janey Sewell

A study in HIV discordant partnerships to estimate the rate of transmission of HIV and to investigate factors associated with condom use.

It is consistently reported that a proportion of people with diagnosed HIV do not always use a condom when having sexual intercourse with partners of negative or unknown HIV status. There are likely to be many reasons for this, and these reasons may have changed over time. It is important to study HIV sero-different partnerships (where one partner is HIV positive and the other HIV negative) that report having unprotected sex to understand the reasons why condoms are not used, and to see what factors are associated with partnerships beginning to adopt consistent condom use.

Increasingly, one reason for not using condoms is likely to be due to the person being on antiretroviral therapy with the plasma viral load being < 50 copies/mL, and statements on the likely reduced infectiousness of people in this situation have been issued. There is increasingly strong evidence that antiretroviral therapy (ART) reduces infectiousness of people with HIV. However, precise estimates of this risk of transmission from unprotected intercourse when the infected person is on ART with a low viral load are not available, particularly for men who have sex with men. It is extremely important that more precise estimates are obtained, both for counselling purposes, and for investigations into the potential prevention effects of a policy of expanding ART coverage to be offered to all people with diagnosed HIV.

The PARTNER study is a multi-centre observational study taking place in 14 European countries. It has been running since 2011 enrolling both heterosexual and MSM couples.  In 2014, the study moved to the next phase, PARTNER 2 a continuation of the main PARTNER study which aims to recruit a further 450 MSM couples to the study over the next 3 years to provide the additional evidence required to have better confidence in the risks from anal sex.

The PARTNER study aims to follow sero-different partnerships who initially report recently having had unprotected sexual intercourse. The study includes questionnaires on behaviour linked to clinical information on the HIV positive partner.

The aims are to understand:

(i) the risk of HIV transmission to partners, in particular in partnerships that continue not to use condoms consistently and the HIV-positive partner is on therapy with a viral load < 50 copies/mL

(ii) why some partnerships do not use condoms, and to describe the proportion who begin to adopt consistent condom use, and factors associated with this.

For further details see the PARTNER website: http://www.cphiv.dk/PARTNER/tabid/406/Default.aspx

POPPY (Pharmacokinetic and clinical Observations in PeoPle over fiftY)

Caroline Sabin

The POPPY study aims to describe the impact of older age on the experience of living with HIV in England and Ireland. In particular, the research group will document the medical conditions that cause particular problems in older individuals who are living with HIV, and the effect of these medical conditions (and any treatment received) on their lives and their HIV care. The study is following a large group of individuals over the age of 50 who are living with HIV, along with two control groups: younger (<50 years) people living with HIV, and older (>50 years) people without HIV infection. The people living with HIV are being recruited from six clinics in the UK, and one in Ireland. All study participants will be followed over two years, and will undergo a clinical examination (including neurocognitive testing) and be asked to complete questionnaires about their health, lifestyles and quality-of-life at each visit. 

Retention and Engagement Across Care services for HIV positive patients: the REACH study

Fiona Burns and Caroline Sabin (in collaboration with Vanessa Apea, Valerie Delpech, Amanda Evans, Susan Michie, Stephen Morris, Memory Sachikonye)

In the UK we have good clinical outcomes for HIV positive people engaged with care and on treatment, almost 20% of the people living with diagnosed HIV appear not to be engaged with HIV services. Detailed understanding of why patients are unable to fully engage with care or how to facilitate this process are currently lacking. This NIHR HS & DR funded study will systematically define the complex patterns of HIV OPA in the UK, calculate the health and financial costs of disengaging or partially disengaging from care, develop a retention-risk assessment tool, and undertake exploratory work to inform the design of future interventions to meet the diverse needs of PLWH. The project will consist of quantitative and qualitative studies implemented over 3 years. 

The project consists of three phases: (1) A detailed analysis of the UK CHIC database and predictive modelling; (2) An examination of patient experience using quantitative and qualitative methods across five HIV clinics in London and community settings, and; (3) A key informant study again using qualitative methods. The researcher will be supported by a strong multidisciplinary management team, an advisory group, and community representatives.

Royal Free Hospital Cohort

Fiona Lampe, Colette Smith, Clinton Chaloner, Andrew Phillips, Andrew Speakman and Lisa Burch

Over 5,000 patients with HIV have been seen at the Royal Free Hospital since the onset of the HIV epidemic in the early 1980s. Information about all the patients seen at the HIV outpatient clinic (the Ian Charleson Day Centre) is included in a database which is used to help researchers understand the HIV epidemic in the UK. Ongoing projects address questions concerning HIV prognosis and management; in particular the use and effects of current treatment, development of toxicities, and trends over time in morbidity, mortality and treatment response. The Royal Free HIV Cohort contribute to a number of national and international collaborations of observational databases, including UK CHIC, ART-CC, UK Register for Seroconverters.

The Royal Free HIV Cohort Database is managed jointly by clinicians at the Royal Free hospital and researchers in the HIV Epidemiology and Biostatistics Group of the Research Department of Infection and Population Health at University College London.

The clinical lead for this project is Professor Margaret Johnson. The statistical and data management leads are Fiona Lampe, Colette Smith, Andrew Phillips and Rob Tsintas. Please see the Royal Free HIV Cohort website (http://www.ucl.ac.uk/royalfreehivdb) for a full list of the study team.

Stochastic computer simulation modelling of HIV transmission, progression and the effect of ART

Andrew Phillips, Valentina Cambiano, Fumiyo Nakagawa and Loveleen Bansi-Matharu (with Debbie Ford)

A series of individual-based stochastic computer simulation models (HIV Synthesis model) of HIV transmission, progression and the effect of ART have been developed in order to address questions of clinical and public health relevance in both low and high income settings. Funding sources include the NIHR, Bill and Melinda Gates Foundation, European Commission and UNITAID. The models simulate at the level of variables that can be measured such as condomless sex, HIV testing and diagnosis, CD4 count, viral load, specific drugs, adherence and resistance, risk of AIDS and death from HIV and non-HIV causes. 

Our modelling group is a key partner in the HIV Modelling consortium (www.hivmodelling.org/) funded by the Bill and Melinda Gates Foundation and lead from Imperial College London. 

The model is also used to answer questions concerning diagnostics development for low income settings (funded by the Bill and Melinda Gates Foundation). 

The SSOPHIE (Stochastic Simulation of Outcomes of People with HIV in Europe) project, funded by the European Commission, is the modelling work package within EuroCoord. The aims of the project are to develop and use a stochastic simulation model for the purpose of reconstructing and projecting the status of HIV infected individuals in a given country and to then work with epidemiologists and those responsible for public health in each European country to produce consensus estimates based on the model.

Publications using these models:

  • Phillips, A.N., Cambiano, V., Miners, A., Revill, P., Pillay, D., Lundgren, J.D., et al. Effectiveness and cost-effectiveness of potential responses to future high levels of transmitted HIV drug resistance in antiretroviral drug-naïve populations beginning treatment: modelling study and economic analysis. Lancet HIV. 2014, 1(2):e85-93
  • Phillips AN, Cambiano V, Nakagawa F, Ford D, Lundgren JD, et al. Potential Future Impact of a Partially Effective HIV Vaccine in a Southern African Setting. PLoS ONE. 2014. 9(9): e107214. doi: 10.1371/journal.pone.0107214
  • Phillips, A., Cambiano, V., Nakagawa, F., Magubu, T., Miners, A., Ford, D, et al. Cost-Effectiveness of HIV Drug Resistance Testing to Inform Switching to Second Line Antiretroviral Therapy in Low Income Settings. PLoS One. 2014, 9 (10), e109148. doi:10.1371/journal.pone.0109148
  • Cambiano V, Bertagnolio S, Jordan M, Pillay D, Perriens J, Venter F, et al. Predicted levels of HIV drug resistance: potential impact of expanding diagnosis, retention, and eligibility criteria for antiretroviral therapy initiation. AIDS. 2014, 28 (Suppl 1):S15–S23 
  • Cambiano V, Bertagnolio , Jordan M, et al. Transmission of Drug Resistant HIV and Its Potential Impact on Mortality and Treatment Outcomes in Resource-Limited Settings. J Infect Dis. 2013; 207: S57-62
  • Phillips AN, Cambiano V, Nakagawa F, Brown AE, Lampe F, Rodger A, et al. Increased HIV Incidence in Men Who Have Sex with Men Despite High Levels of ART-Induced Viral Suppression: Analysis of an Extensively Documented Epidemic. PLoS ONE. 2013;8(2).
  • Nakagawa F, Lodwick RK, Smith CJ, Smith R, Cambiano V, Lundgren JD, et al. Projected life expectancy of people with HIV according to timing of diagnosis. AIDS. 2012, 26:335–343
  • Phillips AN, Pillay D, Garnett G, Bennett D, Vitoria M, Cambiano V, et al. Effect on transmission of HIV-1 resistance of timing of implementation of viral load monitoring to determine switches from first to second-line antiretroviral regimens in resource-limited settings. AIDS. 2011; 25(6):843-850. 
  • Bansi L, Sabin C, Delpech V, et al. Trends over calendar time in antiretroviral treatment success and failure in HIV clinic populations. HIV Med. 2010;11(7):432-8.
  • Phillips AN, Pillay D, Miners AH, Bennett DE, Gilks CF and Lundgren JD. Outcomes from monitoring of patients on antiretroviral therapy in resource-limited settings with viral load, CD4 cell count, or clinical observation alone: a computer simulation model.Lancet 2008; 371:1443-51.
  • Phillips AN, Sabin C, Pillay D and Lundgren JD. HIV in the UK 1980-2006: reconstruction using a model of HIV infection and the effect of antiretroviral therapy. HIV Med. 2007; 8(8):536-46.

TB/HIV Study

Amanda Mocroft, Anna Schultze and Daniel Grint

‘Tuberculosis among HIV-positive Patients: An International Prospective Observational Cohort Study’ is a multicenter cohort study of more than 1400 HIV-positive patients co-infected with tuberculosis (TB) followed over a 5 year time span in 75 sites in Europe, Argentina, Chile and Mexico. The overall aim of the project is to prospectively study the long-term clinical prognosis of HIV-positive patients with active TB disease across Europe and Latin America, temporal changes and regional diversities.

The study is led by Dr Ole Kirk with statistical support led by Anna Schultze, Dan Grint and Amanda Mocroft.  Further details are available at www.cphiv.dk.

UK Collaborative HIV Cohort (CHIC) Study

Caroline Sabin, Teresa Hill, Andrew Phillips

The UK CHIC Study is a collaboration of some of the largest HIV centres in the UK, the Royal Free and UC Medical School, and the Medical Research Council (MRC) Clinical Trials Unit. The study was initiated in 2001 with the aim of pooling routinely collected clinical data on all patients seen at participating clinics since 1st January 1996. Specific objectives are to describe the uptake of and response to HAART, to identify factors associated with virological and immunological response to HAART, and to monitor and describe changes over time in the frequency of AIDS-defining illnesses and survival. To date, over 47,200 patients are included in the study which is coordinated by the Unit. The UK CHIC Study is currently funded by the MRC and the study is linked closely to the UK HIV Drug Resistance Database http://www.hivrdb.org.uk/. Further details are at www.ukchic.org.uk

Clinical Trials

Andrew Phillips, Fiona Lampe, Caroline Sabin, Amanda Mocroft, Colette Smith, Alessandro Cozzi-Lepri, Jemma O’Connor and Anna Schultze

INSIGHT: International Network for Strategic Initiatives in Global HIV Trials. Through our major ongoing collaboration with the Copenhagen HIV Programme (CHIP), we play an active role in design, monitoring and analysis of trials in the INSIGHT network. Trials include SMART, ESPRIT and START. Such trials also lead to important nested analyses based on stored plasma to help to understand factors associated with the major clinical endpoints which are features of INSIGHT trials.

CHIP: Copenhagen HIV Programme. We also provide statistical support to other trials performed by CHIP. This has included the MaxCmin trials and Colate, CASS and PASS (ICU patients).

In addition, members of the unit act as consultants or DSMB members on a number of trials led by other research groups in the UK and pharmaceutical-sponsored trials. 

Other collaborations

Members of the unit are also involved as grant holders and collaborators in several other national and international collaborations. Organisations and projects which we are involved with include:

  • Within UCL:  MRC Clinical Trials Unit, Centre for Virology, Bioinformatics Unit, Farr Institute
  • Other academic and research institutions: Copenhagen HIV Programme (CHIP), LSHTM, University of York, Imperial College London, Stichting HIV Monitoring
  • Public Health England (PHE)
  • ART Cohort Collaboration of observational HIV clinic cohorts
  • CASCADE collaboration of HIV seroconverter studies
  • HIV-CAUSAL Collaboration
  • HIV in Europe
  • World Health Organisation
  • Industry for educational purposes and training courses (including Gilead, BMS and Viiv)

LHPP Evaluation

The HIV epidemic in the UK is concentrated in London and in two at risk communities, men who have sex with men (MSM) and black African heterosexual men and women.

UCL is working with Public Health England to evaluate the London-wide HIV Prevention Programme (LHPP). The LHPP is an evidence-based behavioural intervention that aims is to reduce new HIV infections (incidence) and late diagnosis of HIV infection (and thus reduce the prevalence of those with undiagnosed HIV). It has three key elements:

· Media and communications on HIV for all Londoners, with specific campaigns for MSM and black African communities, focusing on HIV testing and condom use, with the brand, “Do it London”

· Condom procurement and distribution (for MSM only)

· Targeted digital and risk-focused outreach (for MSM only)

Aim & objectives of evaluation

The overall aim of the evaluation is to establish the extent to which the LHPP meets its aims and objectives and through what methods. We are assessing the evaluation objectives using mixed methods:

(i) Two large scale cross-sectional community surveys among MSM and black Africans. Respondents are asked to complete a short anonymous questionnaire and provide an oral swab, which will be anonymously tested for HIV.

To find out more about the black African survey, visit the Mayisha 2016 web-site or email: mayisha@ucl.ac.uk

To find out more about the Gay Men’s Sexual Health Survey 2016 email:gmshs@ucl.ac.uk

(ii) Analysis of surveillance data including GUMCAD (routinely collected data from English GUM clinics) and data from HIV clinics.

(iii) Focus group discussions with MSM and black Africans.

(iv) Process analysis including examination of process records of those delivering the intervention and in-depth interviews with key stakeholders.

Funder: LHPP and NIHR SPHR

Project duration: November 2015 – March 2017

The project is led by Dr Fiona Burns and Dr Alison Rodger.

For more information, please contact the project manager: Dr Alison Howarth

Page last modified on 20 nov 15 13:05