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Table 2 Challenges with performing an HIV cure trial in Guinea-Bissau and strategies to overcome these

From: HIV-2 as a model to identify a functional HIV cure

Challenges for HIV cure trials Strategies to manage challenges
Reluctance to accept high volume blood samples if not sick Consent for 10 ml EDTA can usually be obtained
Keeping the cold chain Samples can be transported in cooler to National Health Laboratory and placed in − 80 °C freezer or on dried ice
Cell recovery Standards for transport of viable PBMCs in place to be analysed elsewhere [18]
Ethical concerns for vulnerable HIV population with limited health literacy [161] Audio-visual teaching materials can be produced to inform patients relevantly for informed consent
Taboo/stigma of HIV Staff trained in enrolling and following patients on trials without breaching confidentiality and keeping HIV a secret to other family members in the house
Loss-to-follow-up [98, 162] Strategies to reduce loss-to-follow-up, including staff trained in mobile phone contact and home visits in place [163]
Considerable adherence challenges, difficult to achieve long-term viral rebound-free treatment [164] Within the framework of a clinical trial, adherence and follow-up can be improved [126]