Albert Einstein College of Medicine and Montefiore, in collaboration with the City University of New York (CUNY), have received a $9.4 million grant from the National Institutes of Health (NIH) to lead research in Central Africa to improve clinical care and health outcomes for patients with HIV. The ongoing, five-country observational study, called Central Africa International Epidemiologic Databases to Evaluate AIDS (CA-IeDEA), involves more than 50,000 HIV-positive children and adults taking anti-retroviral therapy (ART).

“During our first five years leading CA-IeDEA, we built the research capacity and technical infrastructure for tackling this enormous project,” said dual principal investigator Kathy Anastos, M.D., professor of medicine, of epidemiology & population health, and of obstetrics & gynecology and women’s health at Einstein and attending physician, general internal medicine at Montefiore. “Over the next five years, we will use our high-quality data to address scientific clinical and healthcare delivery questions that will inform care in Central Africa and beyond.” Dr. Anastos is also co-director of the Global Health Center at Einstein.

CA-IeDEA partners with the governments of five nations—Burundi, Cameroon, Rwanda, and the Democratic Republic of Congo—and will extend the collaboration to the Republic of Congo. Researchers and health workers based in each country regularly collect de-identified data from electronic medical records, which are integrated into an external database for analysis. Over the next five years, the team will increase the number of clinical sites involved in the study from 15 to 20 as CA-IeDEA expands into more rural areas.

CA-IeDEA is a member of the International Epidemiologic Databases to Evaluate AIDS (IeDEA), a global research consortium with seven regional members. The members collaborate with each other and external groups, including the World Health Organization and PEPFAR, to address the evolving questions in HIV/AIDS.

CA-IeDEA researchers will use the data for their own research projects. Dr. Anastos, the chair of IeDEA’s Clinical Outcomes working group, will lead clinical investigations, such as how do blood test results change over the course of treatment or vary by age and gender.

By following how, when and under what circumstances patients enter and leave care, investigators can identify challenges to providing high-quality treatment and services. This field, also known as implementation science, seeks to improve health outcomes by considering changes in the administration of care. Denis Nash, Ph.D., dual principal investigator of CA-IeDEA, will pursue this area of research. Dr. Nash is professor at the CUNY School of Public Health and executive director of CUNY’s Institute for Implementation Science in Population Health. He is also adjunct clinical professor of epidemiology & population health at Einstein.

“The IeDEA project is helping us learn more about the models and approaches to HIV care delivery at scale that result in optimal clinical outcomes, such as long-term retention in care and survival,” said Dr. Nash. “Through IeDEA, we are also learning about the ability of HIV clinical sites to diagnose and manage other chronic conditions, such as hypertension, diabetes, and mental illness. This is very cutting edge work, with relevance to health systems in Central Africa and beyond.”