Sustainable East Africa Research In Community Health | Search

“We aim to pave the path to HIV elimination through the entry point of improving community health.”

Diane Havlir, MD,

Principal Investigator

Mission

The research study uses bold, new ideas—like multi-disease, community-based testing and treatment—to address more than HIV. We are addressing other health conditions (hypertension, tuberculosis, diabetes, HPV vaccination), economic productivity, and cultural stigma.

What is SEARCH?

INFO

SEARCH team at Working Retreat in Kampala

The newest addition to SEARCH, SEARCH Sapphire: “A Multisectoral Strategy to Address Persistent drivers of the HIV epidemic in East Africa” aims to accelerate the path to HIV elimination with new innovative combination strategies for HIV prevention and treatment that are effective, efficient, scalable and reduce preventable infections and deaths. The NIH-funded research program will design and test evidence-based treatment and prevention interventions, including long-acting Cabotegravir, that will guide a global effort to end AIDS using a multi-disease, multi-sector approach using a community precision health model.

Community precision health is a new concept being introduced by the SEARCH team that builds on tenets of population health, implementation science, and precision medicine. It brings 21st century technology and data systems to reach the right persons with the right interventions. A central goal of our community precision health intervention is to build the capacity of community health workers to extend the reach of the Ministry of Health systems.

SEARCH (Sustainable East Africa Research in Community Health) is a multinational, multidisciplinary consortium assembled to conduct research that evaluates bold health interventions at the community level that inform policy makers and funding agencies through the inclusion of health, economic and education parameters and through innovative, efficient study designs. SEARCH currently is located in multiple communities in rural Uganda and Kenya. Collaborators for this study include Kenya Medical Research Institute in Kenya, Infectious Diseases Research Collaboration and Makerere University in Uganda, University of California Berkeley, University of Pennsylvania, and University College London.

Background

Despite effective treatments, nearly one in four of the 40 million people living with HIV are still not accessing treatment. This gap exists largely because health workers in developing countries struggle to reach HIV-infected individuals. SEARCH interventions are designed to improve the entire continuum of care, to reduce structural barriers for all populations including those most “at risk” and build upon evidence based prevention interventions. This information will guide a global effort to end AIDS.

OPPORTUNITY

Now & the Future

SEARCH represents an opportunity to realize HIV elimination and to improve community health and productivity.

SEARCH Phase I (2013-2017) showed that multi-disease, community-based testing and treatment is effective and reduces stigma and HIV disease. This strategy improved control of hypertension and reduced deaths among adults with hypertension. We also showed that this strategy increased workforce participation.

SEARCH Phase II (2017-2020) focused on new health and treatment models for adolescents and young adults; HIV Pre-Exposure Prophylaxis (PrEP); treatment models for tuberculosis; and novel electronic technologies for community health.

SEARCH SAPPHIRE (2021-2026) aims to accelerate the path to HIV elimination with new innovative combination strategies for HIV prevention and treatment that are effective, efficient, scalable and reduce preventable infections and deaths associated with HIV, hypertension and TB in children and adults using a community precision health model.

The results of SEARCH will help to guide the global effort to end AIDS, putting the person at the center of services.

IMPACT

SEARCH Science

PEOPLE

Leadership

Diane Havlir, MD

Co-Principal Investigator

Professor of Medicine and Chief, Division of HIV, Infectious Diseases, and Global Medicine at Zuckerberg San Francisco General Hospital, University of California, San Francisco

Moses Kamya, MBChB, MMed, MPH, PhD

Co-Principal Investigator

Professor of Medicine and past Dean of the School of Medicine at Makerere University College of Health Sciences and Director or the Infectious Diseases Research Collaboration in Kampala, Uganda

Maya Petersen, MD, PhD

Co-Principal Investigator

Professor of Epidemiology and Biostatistics

Co-Director of Joint Program in Computational Precision Health

Co-Director for Targeted Machine Learning and Causal Inference

at the School of Public Health, University of California, Berkeley

Simplified Isoniazid Preventive Therapy (IPT) Strategy to Reduce TB Burden

Investigative Team

Gabriel Chamie, MD, MPH

Study Vice Chair / Investigator

University of California, San Francisco

James Ayieko, MBChB, MPH, PhD

Investigator

Kenya Medical Research Institute

Theodore Ruel, MD

Study Vice Chair / Investigator

University of California, San Francisco

Jane Kabami, MPH

Investigator

Infectious Diseases Research Collaboration, Uganda

Laura Balzer, PhD

Study Statistician / Investigator

University of California, Berkeley

Elijah Kakande, MBChB, MPH

Investigator

Infectious Diseases Research Collaboration

Carol Camlin, MPH, PhD

Investigator

University of California, San Francisco

Andrew Phillips, MSc, PhD

Modelling / Investigator

University College London

Matthew Hickey, MD

Investigator

University of California, San Francisco

Tamara Clark, MHS

Executive Administrator /Investigator

University of California, San Francisco

Judy Hahn, MA, PhD

Investigator

University of California, San Francisco

Priscilla Hsue, MD

Investigator

University of California, San Francisco

Norton Sang, MA

Investigator

Kenya Medical Research Institute

Catherine Koss, MD

Investigator

University of California, San Francisco

Florence Mwangwa, MBChB, MPH

Investigator

Infectious Diseases Research Collaboration

Marilyn Nyabuti, MBChB

Investigator

Kenya Medical Research Institute

Asiphas Owaraganise, MBChB, MMed

Investigator

Infectious Diseases Research Collaboration

Starley Shade, MPH, PhD

Investigator

University of California, San Francisco

Harsha Thurimurthy, PhD

Economist / Investigator

University of Pennsylvania

Elizabeth Bukusi, MBChB, MMed, MPH, PhD

Kenya Site PI / Investigator

Kenya Medical Research Institute

The SEARCH collaboration conducted a cluster randomised trial in Uganda among district-level health managers. The intervention convened managers into mini-collaboratives facilitated by Ugandan experts in tuberculosis and HIV. In a recent publication in Lancet HIV from Dr. Ejiah Kakande, et al., it was reported that the intervention led to significantly increased IPT rates, suggesting that interventions centered on mid-level health managers can improve IPT implementation on a large, subnational scale.

You can read the full article here

INFO

Results of SEARCH SAPPHIRE “Dynamic Choice” intervention presented at CROI 2024

Professor Moses Kamya of Makerere University presented results of the second phase of SEARCH SAPPHIRE's Dynamic Choice Prevention intervention at CROI 2024, which included the addition of Long-Acting Cabotegravir (CAB-LA) alongside oral PrEP and PEP. The SEARCH intervention increased the amount of time a person was taking a HIV product by five-fold and dramatically reduced the number of new HIV infections versus the standard of care.

You can read the full results here.

SEARCH engages communities and local leadership in a multi-disease approach to improve health screening, care delivery and individual and community well-being.

Population-Level Improvements of Hypertension Control with Integrated Community Strategy

At the 2025 International AIDS conference in Kigali, Rwanda, Dr. Matt Hickey shared early results of the SEARCH population-level community precision health strategy. By extending care into the community via community health workers supervised by clinic-based providers, we observed improvement of blood pressure control on a population level of 14,000 adults.

You can read the full results here.

At the 2026 Conference on Retroviruses and Opportunistic Infections (CROI), Dr. Gabriel Chamie (top right) of the University of California, San Francisco presented results of the SEARCH SAPPHIRE study's "community precision health" intervention among 80,000 living in rural communities in Kenya and Uganda. The intervention reduced new HIV infections by 70% compared to communities that received standard of care. There was a 4-fold increase in the use of oral PrEP and PEP prevention medications. The intervention leveraged existing Ministries of Health infrastructure by empowering community health workers to deliver HIV testing and care coordination, enabled by a smartphone health app. These results build on prior SEARCH studies research which began in 2010.

Jon Cohen of Science describes the results from the presentation here.

Highly Anticipated Results of SEARCH “Community Precision Health" Intervention

Obesity Trends by HIV Status in the SEARCH Study

At CROI 2026, Dr. Elijah Kakande of the Infectious Diseases Research Institute presented results of population-level obesity trends among people living with HIV. The research found that despite a shift to dolutegravir-based therapies, an increase in obesity was not seen in rural communities in Uganda and Kenya.

SEARCH Research has produced ~150 peer-reviewed publications since 2012

SEARCH Program Highlights

Click on article title to get PDF file of publication.

A prospective cohort study of the SEARCH integrated HIV/hypertension community health worker-led intervention in rural Kenya and Uganda. Hickey et al. JIAS. 2025 Jul;Suppl 3(Suppl 3):e26500. PMID: 40622370. PMCID: PMC12232486.

Dynamic choice HIV prevention with cabotegravir long-acting injectable in rural Uganda and Kenya: A randomized trial extension. Kamya et al. Lancet HIV. 2024 Nov;11(11):e736-e745. PMID: 39395424. PMCID: PMC11753513.

Randomized trial of dynamic choice prevention at antenatal and postnatal care clinics in rural Uganda and Kenya. Kabami, et al. J Acquir Immune Defic Syndr. 2024 Apr 15; 95(5);447-455. PMID: 38489493; PMCID: PMC10927304.

Dynamic choice HIV prevention intervention at outpatient departments in rural Kenya and Uganda: a randomized trial. Koss, et al. AIDS. 2023 Oct 20. PMID: 37861683.

A community-based dynamic choice model for HIV prevention improves PreP and PEP coverage in rural Uganda and Kenya: a cluster randomized trial. Kakande, et al. J Int AIDS Soc. 2023 Dec;26(12):e26195. PMID: 38054535; PMCID: PMC10698808.

The association between social network characteristics and tuberculosis infection among adults in 9 rural Ugandan communities. Marquez et al. Clin Infect Dis. 2023 Feb 8;76(3):e902-e909. PMID: 35982635. PMCID: PMC10169405.

HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda. Koss et al. PLOS Med. 2021 Feb 9;18(2):e1003492. PMID: 33561143. PMCID: PMC7872279.

HIV Testing and Treatment with the Use of a Community Health Approach in Rural Africa. Havlir et al. N Engl J Med. 2019 Jul 18; 381(3): 219-229. PMID: 31314966. PMCID: PMC6748325.

Association of implementation of a universal testing and treatment intervention with HIV diagnosis, receipt of antiretroviral therapy, and viral suppression in East Africa. Petersen et al. JAMA. 2017;317(21):2196-2206. PMID: 28586888. PMCID: PMC5734234.

A hybrid mobile approach for population-wide HIV testing in rural east Africa: an observational study. Chamie et al. Lancet HIV. 2016 Mar: 3(3): e111-9: Epub 2016 Jan 26. PMID: 26939734. PMCID: PMC4780220.

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