70% HIV Incidence Reduction Seen with Digital Tools & Community Health in Kenya & Uganda
A new study offers a significant boost to the global fight against HIV, demonstrating a 70% reduction in new infections in rural communities in Kenya and Uganda. The findings, presented today, , at the 33rd Conference on Retroviruses and Opportunistic Infections (CROI 2026) in Denver, highlight the power of integrating digital tools with existing healthcare infrastructure and community-based services.
The research, funded by the National Institutes of Health (NIH), focused on a tailored approach to HIV prevention and treatment delivered by community health workers and clinicians. This strategy addressed a critical gap in healthcare access, particularly in rural areas where reaching and retaining individuals needing HIV care can be challenging. Despite the availability of safe and highly effective medications, an estimated 30,000 people in the United States and 1.3 million people worldwide acquire HIV each year.
The study involved 16 remote, rural communities – eight in Kenya and eight in Uganda. Researchers paired communities with similar characteristics and randomly assigned one from each pair to receive a comprehensive intervention, while the other continued with standard HIV prevention and care. The intervention, implemented over a two-year period beginning in 2023, targeted adults aged 15 years and older.
The three-part intervention was designed to be practical and sustainable within existing systems. First, trained community health workers conducted home visits to offer HIV testing to all adults. Those who tested positive were referred to local health centers for treatment, while those who tested negative but were at risk were connected to HIV prevention services. Second, healthcare providers at local health centers received training to deliver personalized HIV prevention and care, tailored to the individual needs and preferences of their patients. Finally, a key component involved the enhanced use of a ministry of health-compatible app on handheld devices. This app linked community health workers with clinicians, medical records, and services at health centers, streamlining follow-up care and facilitating community-based delivery of preventative medications.
After two years, the results were striking. Among approximately 42,000 people in the intervention communities, only seven newly acquired HIV, compared to 22 in the control communities. This translates to a 70% reduction in HIV incidence. Importantly, this positive effect was observed consistently across different age groups, sexes, and in both countries.
To understand the mechanisms driving this significant decrease, researchers examined the uptake of biomedical HIV prevention methods – pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). They found that the intervention strategy led to a four-fold increase in the use of PrEP or PEP, with 1.67% of adults in the intervention communities utilizing these methods compared to 0.41% in the control communities. This increase was consistent across demographics.
The study also revealed high levels of HIV treatment and viral suppression in both the intervention and control groups. This suggests that the reduction in HIV incidence was largely driven by increased prevention uptake in a context where effective treatment was already widely available. “The findings from this innovative study underscore the critical value of conducting implementation research that tests HIV prevention and treatment strategies in real world settings,” said Jeffrey K. Taubenberger, MD, PhD, acting director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID).
Perhaps equally encouraging, the intervention proved to be readily implementable. Researchers reported that most community health workers, healthcare providers, and study participants found the intervention easy to use, even though many of the community health workers had limited prior experience with smartphones or delivering HIV services. This suggests the model is scalable and adaptable to other resource-limited settings.
The success of this trial offers a promising model for reducing HIV incidence not only in sub-Saharan Africa but also in other countries, including the United States. By leveraging existing healthcare infrastructure, empowering community health workers, and utilizing readily available technologies, this approach demonstrates that significant progress can be made in the fight against HIV, even in challenging environments. The study, conducted by the longstanding Sustainable East Africa Research in Community Health (SEARCH) consortium, builds upon years of research aimed at ending the HIV epidemic and improving overall community health.
This news release was published by the National Institutes of Health on .