Vietnam clinical trials help HIV patients

UNC Gillings School of Global Public Health researchers Vivian Go and Dr. Bill Miller are running multiple clinical trials in Vietnam to prevent HIV spread and support people living with the disease.

Go is a professor in the health behavior department, and Miller is a professor in the epidemiology department. Both are members of Carolina’s Institute for Global Health and Infectious Diseases.

In one recent study, Go and Miller sought the best way to counsel people who inject drugs to stay in HIV care.

“We found that clinics that were given support more tailored to the clinic’s specific needs did better implementing the counseling intervention than clinics that used a more standard ‘top-down’ approach,” Miller said. They also found that short counseling sessions helped build patients’ trust in the medical system and their understanding of the importance of taking their medication.

Four other HIV-related trials are in progress to test:

• A new drug for preventing tuberculosis in people living with HIV
• A new vaccine for hepatitis B for people living with HIV
• An intervention that helps people with HIV who drink too much alcohol to stay in HIV care and take their medication effectively
• A similar intervention for alcohol reduction among men who have sex with men to encourage them take a medicine called PrEP to reduce their HIV risk.

Miller is helping Vietnam’s health ministry implement the completed trial’s counseling intervention in clinics.

“We always work with the ministry to get buy-in before we start a study, inform them along the way and then have a dissemination workshop to share the outcomes,” Miller said. “We’ll have discussions with the ministry to see in what form they’d like to implement the counseling intervention and provide any guidance that they request.”

The two also have a grant from the National Institutes of Health to train people in Vietnam to implement interventions that have been shown to work in trials. Trainees include staff from three universities, policymakers and ministry workers.

Go and Miller cultivate a strong relationship with the health ministries where they work. In Vietnam, for example, ministry officials asked the researchers to apply for an NIH grant to continue their work.

The pair’s work has influence beyond the goals of treatment and prevention. In St. Petersburg, Russia, the team worked with people with HIV who injected drugs. Study participants came to the small research space without an appointment. “They just wanted a warm, nonjudgmental, safe space. They trusted us, and we welcomed them,” Miller said.

Miller said that it’s too early to tell what discoveries the current trials will yield. He and Go spoke with Endeavors magazine about their hopes for future trials. “One of them will likely focus on helping people who are vulnerable to diseases manage the stigma that they face in their daily lives and within the health care system,” they said.

To them, the most important part of the research is getting it into the hands of the people who can use it effectively. “In our global research, that usually means collaborating with the Ministry of Health to ensure our efforts are sustained and implemented in meaningful ways in the places we are working,” they said.