# Wastewater Sampling: A New Tool to Accelerate Ending the HIV Epidemic

> **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2024 · $761,163

## Abstract

PROJECT SUMMARY
Current estimates are that 57% of persons in the U.S. with HIV are suppressed, leaving 43% unsuppressed,
including about 13% who are undiagnosed and 30% who have been diagnosed but are not currently
suppressed. Identifying persons with unsuppressed HIV to link them to care and antiretroviral treatment (ART)
is critical for improving health and reducing new infections. New epidemiologic tools that identify in real time
communities with high amounts of circulating HIV may enhance efforts to reduce HIV transmission and
substantially contribute to ending the HIV epidemic. During the SARS-CoV-2 (SCV2) pandemic, we and others
used “wastewater environmental virology” to monitor and respond to COVID. It uses viral capture and PCR
detection of viral nucleic acid from wastewater collection sites to detect, quantify, and predict total SCV2
activity in time. We built a robust and mature wastewater sampling program for the Houston region that
includes weekly assessment of 39 wastewater collection sites covering about 4 million residents. Our recent
preliminary data demonstrate that HIV is detected in wastewater. Wastewater testing is unbiased,
comprehensive, real-time, quantitative, and not influenced by access to health care, stigma or denial. We
hypothesize that our pioneering wastewater sampling program can be applied as a powerful new tool to
identify geographic areas with a high active burden of HIV, reflecting substantial numbers of people with
undiagnosed or untreated HIV infection. Resources can then be mobilized to these communities to enhance
HIV outreach, testing, prevention and linkage to care. The specifics aims are: 1) To develop a sensitive,
reproducible, and streamlined wastewater HIV detection pipeline; 2) To develop epidemiologic models
incorporating data from wastewater sampling as a novel and informative parameter along with routine
surveillance data on HIV diagnoses and population data; 3) To characterize and incorporate stakeholder
preferences, priorities, and recommendations for engaging key community stakeholders in the HIV wastewater
sampling program with consideration to the ethical, legal, social, and cultural contexts of individuals living in
target neighborhoods; 4) To determine if delivering proven public health interventions to neighborhoods as
directed by wastewater data can reduce the wastewater viral load and increase HIV diagnoses in those
neighborhoods. This research will enhance the Respond pillar of the End the HIV Epidemic (EHE) strategy. It
will leverage and strengthen partnerships between the researchers and the Houston Health Department, the
regional public health authority overseeing many EHE programs in Houston. The work in Houston, a high
priority EHE region, will result in: (i) the US’s only HIV wastewater sampling program, (ii) epidemiologic models
enhanced with wastewater data that identify unmet testing and treatment needs, (iii) community-informed and
ethically appropriate, real-time public hea...

## Key facts

- **NIH application ID:** 10930110
- **Project number:** 5R01DA059394-02
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Thomas P Giordano
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $761,163
- **Award type:** 5
- **Project period:** 2023-09-15 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10930110

## Citation

> US National Institutes of Health, RePORTER application 10930110, Wastewater Sampling: A New Tool to Accelerate Ending the HIV Epidemic (5R01DA059394-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10930110. Licensed CC0.

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