Prevention of Mother to Infant Transmission of HIV-1C in Botswana
Currently, there are two clinical trials in Botswana that aim to determine the effectiveness of anti-retroviral treatment therapy, and the effects of infant feeding strategies, on the transmission of HIV-1C from mother to infant. The National Program, established by the Government of Botswana, provides all HIV-infected, pregnant women with ZDV (zidovudine) in order to examine whether administering ZDV has a protective effect on the transmission of HIV through breast milk from mothers to their infants. The "Mashi" (milk in Setswana) study, coordinated by the Botswana-HAI Partnership, offers the standard of care established by the National Program. In addition it also seeks to determine if single dose administration of the drug nevirapine (NVP) to both mother and child during the perinatal period also aids in reducing the transmission of HIV from mother to child. The outcomes of this study will have important ramifications for transmission prevention strategies for women and infants in southern Africa. The Partnership’s study has three study sites: Molepolole, Lobatse and Mochudi. The outcomes of this study will have important ramifications for transmission prevention strategies for women and infants in Southern Africa.

Adult Antiretroviral Treatment and Resistance Study (Tshepo)
AIDS and HIV infection can now be treated with long-term antiretroviral medications. Botswana, along with all of southern Africa, has the highest infection rates of HIV in the world. The Adult Anti-Retroviral Treatment and Resistance Study or the "Tshepo" (meaning hope in Setswana) study, is the first large-scale research study of anti-retroviral therapy to treat AIDS and HIV infection in Botswana.

The specific aims of the Tshepo study are:

• To compare the time to virological failure between randomized groups of patients initially receiving 1 of 4 highly active antiretroviral therapy (HAART) regimens. To compare the time to significant drug resistance between randomized groups of patients initially receiving 1 of 4 HAART regimens. To fully characterize the genotypic patterns of resistance under selective drug pressure in HIV-1C infected individuals, and compare these to HIV-1B primary and secondary resistance mutations
  
  
• To compare the time to virological failure and significant drug resistance between randomized groups of patients initially receiving 1 of 2 adherence strategies, namely: the current Botswana standard-of-care adherence strategy (SOC) versus the current Botswana SOC plus community-based direct observed therapy (Com-DOT).
  
  
• To evaluate the time to development of treatment-related toxicity as measured by a clinical event or a laboratory-determined adverse event among all treatment groups.
  

Tshepo is funded by Secure the Future Foundation, Bristol-Myers Squibb