Factors associated with North–South research collaboration focusing on HIV/AIDS: lessons from ClinicalTrials.gov
Authors: Wao Hesborn , Wang Yan , Wao Melvin A. , Were Juliana A. 
Published: August 2021

Abstract
Background
A North–South (N–S) research collaboration is one way through which research capacity of developing countries can be strengthened. Whereas N–S collaboration in HIV/AIDS area may result in research capacity strengthening of Southern partners, it is not clear what factors are associated with this type of collaboration. The study aims to characterize N–S research collaboration focusing on HIV/AIDS and to determine factors associated with such N–S research collaborations.

Methods
Clinical trial data on HIV/AIDS-related studies conducted between 2000 and 2019 were obtained from ClinicalTrials.gov. Using these data, we characterized N–S collaborative studies focusing on HIV/AIDS and summarized them using frequencies and percentages. To determine factors associated with these studies, we used logistic regression and reported results as adjusted odds ratios with Wald 95% confidence intervals.

Results and discussion
Of the 4,832 HIV/AIDS-related studies retrieved from the registry, less than one-quarter (n = 1133, 23%) involved a Southern institution, with 77% of these studies classified as N–S collaborations. Majority of these studies have single PI (50%), are conducted at single location (39%); have large sample sizes (41%); are federally-funded (32%) or receive funding from other sources (32%); are intervention studies (64%); and involve a mixture of male and female participants (58%) and adult participants (54%). Single PIs (as opposed to multiple PIs) were more likely to be from the North than South institution (odds ratio = 5.59, 95%CI: 4.16 – 11.57). Trend analyses showed that N–S research collaborations produced HIV/AIDS-related studies at a faster rate than S–S research collaborations. N–S collaborations involving female or children produced HIV/AIDS-related studies between 2000 and 2019 at a significantly faster rate than S–S collaborations involving females and children during the same period. Holding other factors constant, N–S collaborative research focusing on HIV/AIDS are associated with: multiple PIs as opposed to single PI, multiple institutions as opposed to a single institution, multiple locations as opposed to a single location, large number of participants as opposed to small sample sizes, and public funding as opposed to industry funding. Almost half of these studies had a Northern PI only, about one-third had a Southern PI only, and much fewer had PIs from both North and South. However, these studies were less likely to receive funding from other sources than industry funding.

Conclusions
HIV/AIDS-related research is increasingly becoming a more collaborative global research involving more N–S collaborations than S–S collaborations. Factors associated with N–S collaborative studies focusing on HIV/AIDS include multiple PIs, institutions, and locations; large sample sizes; publicly funded; and involve vulnerable populations such as women and children. Whereas almost half of these studies have a Northern PI only, about one-third have a Southern PI only, and much fewer have PIs from both North and South. Our results inform future design and implementation of N–S research collaborations in this area. Suggestions for improvement of ClinicalTrials.gov registry are provided.