title: An Evaluation of Selected Populations for HIV-1 Vaccine Cohort Development in Nigeria.
abstract: 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.
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Ogbonnaya S
authors.initials: OS
authors.lastname: Njoku
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Mark M
authors.identifier: http://orcid.org/0000-0002-9217-9129
authors.initials: MM
authors.lastname: Manak
authors.affiliation: Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: O'Connell
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Ashley L W
authors.initials: AL
authors.lastname: Shutt
authors.affiliation: U.S. Military HIV Research Program, Walter Reed Army Institute of Research, MHRP-WRAIR, Silver Spring, MD, United States of America.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Malia
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Heipertz
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Sodsai
authors.initials: S
authors.lastname: Tovanabutra
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Milazzo
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Gideon Akindiran
authors.initials: GA
authors.lastname: Akintunde
authors.affiliation: CERMEL Albert Schweitzer International Foundation Hospital, Lambarene, Gabon.
authors.forename: Abraham S
authors.initials: AS
authors.lastname: Alabi
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Aminu
authors.initials: A
authors.lastname: Suleiman
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Amos A
authors.initials: AA
authors.lastname: Ogundeji
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Terfa S
authors.initials: TS
authors.lastname: Kene
authors.affiliation: Walter Reed Program, Nigeria, Abuja, Nigeria.
authors.forename: Robbie
authors.initials: R
authors.lastname: Nelson
authors.affiliation: Nigerian Ministry of Defense Health Implementation Programme, Abuja, Nigeria.
authors.forename: Ojor R
authors.initials: OR
authors.lastname: Ayemoba
authors.affiliation: Uniformed Services University of Health Sciences (USUHS), Bethesda, MD, United States of America.
authors.forename: Darrell E
authors.initials: DE
authors.lastname: Singer
authors.affiliation: Henry Jackson Foundation, MHRP-HJF, Silver Spring, MD, United States of America.
authors.forename: Merlin L
authors.initials: ML
authors.lastname: Robb
authors.affiliation: U.S. Military HIV Research Program, Walter Reed Army Institute of Research, MHRP-WRAIR, Silver Spring, MD, United States of America.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Peel
authors.affiliation: U.S. Military HIV Research Program, Walter Reed Army Institute of Research, MHRP-WRAIR, Silver Spring, MD, United States of America.
authors.forename: Nelson L
authors.initials: NL
authors.lastname: Michael
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage / Q000276:immunology*; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology* / Q000517:prevention & control / Q000821:virology; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D015497:HIV-1 / Q000276:immunology* / Q000502:physiology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D054884:Host-Pathogen Interactions / Q000187:drug effects / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines