The role of “conventional” STIs in enhancing and facilitating HIV infection. This led to the development of the pioneering syndromic approach to STI management which resulted in a 25-40 percent decrease in STIs in the general population. This approach has been successfully disseminated to countries such as Uganda, Cambodia, Thailand, and India.

Early identification and confirmation shows that there is indeed a heterosexually transmitted epidemic of HIV in Africa. This led to the understanding that focused prevention programmes for sex workers and their clients to reduce HIV transmission in these groups and the general community is critical. One of the significant findings was the identification of highly HIV-exposed female sex workers who are resistant to HIV infection and the subsequent understanding of acquired immunity to HIV. The protective effect of male circumcision for HIV acquisition in men through a randomized controlled trial conducted in the Nyanza region of Kenya. This led to the scale-up of the national Voluntary Male Medical Circumcision programme in Kenya and other parts of Africa, prioritizing traditionally non-circumcising counties and communities.

The high risk and vulnerability of adolescent and young girls who are part of the social and sexual network at “hotspots” or places, where men congregate to find sexual partners. This has led to pilot projects with young sex workers in hotspots to reach a population that is normally left out of programming. Development of a global code for ethical research in partnership with various partners under the TRUST project funded by the European Union. The code has been accepted and followed by several global institutions and universities.