Investing in the future

Communicating HIV trial results in South Africa

Randomised controlled trials are considered the gold standard for evaluating the effectiveness of new interventions. Communicating the results of these trials presents challenges for researchers who need to work with stakeholders to prepare for potentially positive outcomes, while at the same time living with the knowledge that trials may show no effect.

Donors are placing increasing emphasis on the need to communicate research results to policymakers. In an ideal world, researchers conduct research to provide evidence to guide policy change. Once the research is completed, there is an expectation that policymakers will either accept the evidence or that informed advocates will use the evidence to lobby for policy change. There may be challenges to this model.

In many low-and middle-income countries for example, there may be mistrust of science, shortage of skills in government to interpret research results, and a weak media which hampers debates. In these situations, researchers are often required to mediate these tensions and go beyond their traditional role.

In South Africa, several important lessons have been learnt about communicating the results of four HIV prevention trials which evaluated the potential role of acyclovir treatment in preventing HIV transmission. Acyclovir is a widely available antiviral drug that is used to suppress genital herpes and is mainly taken in tablet form.

These trials showed that treatment with acyclovir did not prevent HIV acquisition or transmission—results which were disappointing and which meant that no change to policy would be required. Yet the investments in building partnerships and communicating these research results did lead to some positive outcomes.

• Researchers demonstrated the importance of research for informing policy. 
• Communities developed a greater understanding of the research process and gained the confidence to handle multiple outcomes. 
• Stakeholders from government and communities and researchers came together to discuss the implications of these results. 
• Important bodies, such as the National AIDS Council, were supported to anticipate these results and consider the implications.

These processes built trust between policymakers, researchers and communities, creating an enabling environment for future partnerships.

Sinead Delany-Moretlwe
Reproductive Health and HIV Research Unit, Johannesburg National Office, University of the Witwatersrand, PO 18512, Hillbrow 2038, South Africa
T +27 (0)11 3585300
sdelany@rhru.co.za
www.rhru.co.za/

The Reproductive Health and HIV Research Unit is a partner in the Programme for Research and Capacity Building in Sexual and Reproductive Health and HIV in Developing Countries