ResearchIn Kenya, as in other countries in eastern Africa, the declining prevalence of HIV demonstrates the potential for currently available prevention options to significantly reduce the transmission of HIV and alter the course of the epidemic. Whether this reflects the success of public health policies, the power of watching one’s friends and family die, or simply the decline in the size and impact of the higher prevalence middle age populations we do not know for sure. We do know that many surveys do show self-reported declines in HIV-related risk behaviors among youth in the general population. While the concern with desirability bias is always present with such data, the corresponding declines in HIV strongly suggest we are observing something real, and remarkable. As behavior changes are beginning to make progress in prevention, a range of new biomedical prevention interventions are coming online. Increasingly, it is recognized that the biomedical and social/behavioral prevention efforts must work together, not in parallel, for HIV prevention and treatment efforts to succeed. Current Phase III vaccines, for example, will not provide sterilizing immunity from HIV, but instead modulate the course of the infection. As a result, vaccination strategies must be pursued simultaneously with prevention of secondary HIV transmission. HIV protocols for preventing mother-to-child transmission are encountering significant obstacles at the stage of service delivery. It is clear we need an integrated scientific approach to ensure that our biomedical advances reach their full potential in reducing the population burden of HIV and AIDS. The purpose of KeFA is to provide a mechanism to facilitate the cross-disciplinary research needed to develop the next generation of integrated HIV/AIDS prevention strategies. We seek to build on the long term partnerships between UW researchers and Kenyan colleagues in the field of HIV/AIDS prevention research. The long term research objective is to provide the scientific support for the development of HIV prevention initiatives that will lead to a Kenya Free of AIDS. This will require collaboration between health and population scientists to share results of current research, to identify gaps and needs, to define joint and complementary research agendas, and to determine strategic intervention opportunities. This, in turn, requires removing the obstacles to collaboration, and establishing a mechanism for interdisciplinary activities. We seek to establish this institutional mechanism, based on the very successful model used by the NICHD and NIA funded "population centers" in the US: a center that serves as the scholarly home for and support of high quality interdisciplinary research. These US centers, funded by NIH over the past 30 years, have contributed to the emergence of a vibrant, intellectually rigorous, methodologically innovative, and fundamentally interdisciplinary scholarly community in Population Studies. KeFA is currently supporting four foundational research projects:
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