An Evaluation of Selected Populations for HIV-1 Vaccine Cohort Development in Nigeria.

Development of a globally effective HIV-1 vaccine will need to encompass Nigeria, one of the hardest hit areas, with an estimated 3.2 million people living with HIV. This cross-sectional Institutional Review Board (IRB) approved study was conducted in 2009-12 at four market sites and two highway settlements sites in Nigeria to identify and characterize populations at high risk for HIV; engage support of local stakeholders; and assess the level of interest in future vaccine studies. Demographic, HIV risk data were collected by structured interviewer-administered questionnaires. Blood samples were tested on site by HIV rapid diagnostic tests, followed by rigorous confirmatory testing, subtype evaluation and testing for HBV and HCV markers in a clinical reference laboratory. Of 3229 study participants, 326 were HIV infected as confirmed by Western Blot or RNA, with a HIV prevalence of 15.4%-23.9% at highway settlements and 3.1%-9.1% at market sites. There was no observable correlation of prevalence of HIV-1 (10.1%) with HBV (10.9%) or HCV (2.9%). Major HIV-1 subtypes included CRF02_AG (37.5%); G (27.5%); G/CRF02_AG (25.9%); and non-typeable (8.9%), with 0.3% HIV-2. Univariate analysis found age, gender, marital status, level of education, and sex under substance influence as significant risk factors for HIV (p<0.001). Educating and winning the trust of local community leadership ensured high level of participation (53.3-77.9%) and willingness to participate in future studies (95%). The high HIV prevalence and high risk of HIV infection at highway settlement and mammy markets make them well suited for targeting future vaccine trials in Nigeria

Willingness of volunteers to participate in future studies.

<p>Willingness of volunteers to participate in future studies.</p

Unadjusted Odds Ratios for Selected Behavioral Risk Factors.

<p>Unadjusted Odds Ratios for Selected Behavioral Risk Factors.</p

Distribution of major HIV-1 subtypes in the six study sites as analyzed by Multi-region Hybridization Assay (MHA).

<p>Distribution of major HIV-1 subtypes in the six study sites as analyzed by Multi-region Hybridization Assay (MHA).</p

Univariate Analysis of HIV Risk Factors at the various study sites.

<p>The Highway Settlement sites were added after study initiation, and included more risk factors and focused sexual activity questions only on the past 3 months.</p