About

Salim Abdool Karim is a clinical infectious diseases epidemiologist widely recognized for his research contributions in HIV prevention and treatment. He holds the position of CAPRISA Professor for Global Health in the Department of Epidemiology at the Columbia University Mailman School of Public Health. He is also the Director of the Centre for the AIDS Program of Research in South Africa (CAPRISA), Pro Vice-Chancellor (Research) at the University of KwaZulu-Natal in Durban, South Africa, and an Adjunct Professor of Medicine at Weill Medical College of Cornell University. His research spans over two decades, focusing on microbicides for HIV prevention, culminating in the CAPRISA 004 tenofovir gel trial which demonstrated that antiretroviral drugs can prevent sexually transmitted HIV infection and herpes simplex virus type 2 in women. He is a co-inventor on patents used in several HIV vaccine candidates and has conducted clinical research on TB-HIV treatment that has shaped international guidelines. Abdool Karim serves as Chair of the UNAIDS Scientific Expert Panel, Chair of the WHO's HIV and Hepatitis Scientific and Technical Advisory Group, and is a member of the WHO HIV-TB Task Force. He is an elected Fellow of multiple scientific academies, including the World Academy of Sciences, the African Academy of Sciences, and the Royal Society of South Africa, and is a Foreign Associate Member of the US National Academy of Medicine. His work has earned numerous awards, including the TWAS Prize in Medical Sciences and the Science-for-Society Gold Medal from the Academy of Science in South Africa.

Research topics

• Political Science
• Public relations
• Virology
• Medicine
• Nursing
• Immunology
• Biology
• Business

Selected publications

• Acceptability of an annual tenofovir alafenamide implant for HIV prevention in South African women: findings from the CAPRISA 018 Phase I clinical trial

  Journal of the International AIDS Society · 2025-02-01 · 5 citations

  articleOpen access

  INTRODUCTION: Long-acting HIV pre-exposure prophylaxis promises to improve uptake, adherence and persistence challenges experienced with daily oral tablets. We assessed the acceptability of an annual tenofovir alafenamide (TAF) implant in South African women enrolled from 9 July 2020 until 31 May 2022 in a Phase I trial. METHODS: Six women received one TAF implant for 4 weeks (Group 1), after which 30 women were randomized (4:1, TAF to placebo ratio) to receive 1 or 2 TAF or placebo implants for 48 weeks (Group 2), before trial discontinuation. Acceptability assessments were conducted pre- and post-implant removal. Implant attributes (size, quantity, insertion site, palpability, visibility) and physical experiences (insertion/removal procedures, implant site reactions [ISRs]) were rated on a scale of 1 (highly unacceptable) to 6 (highly acceptable), with 4 being the acceptability threshold. The mean (range) of the mean acceptability scores across all pre-removal visits were calculated, including stratification by removal timing (early vs. scheduled). Implant likes and dislikes were also assessed. RESULTS: The median participant age was 26 years. Prior to implant removal, the mean (range) acceptability scores were 5.4 (3.6-6.0) for product attributes and 5.1 (1.7-6.0) for physical experiences. Eleven (31%) participants had early implant removals, occurring on average 19 weeks (range 2-27 weeks) after insertion. The proportion of study visits reporting adherence measure as unacceptable in early versus scheduled removals: ISRs (50% vs. 19%), visibility (30% vs. 15%), palpability (14% vs. 8%), pain (16% vs. 4%) and implant quantity (13% vs. 1%). Pre-removal acceptability scores for ISRs (p = 0.003) and physical experiences (p = 0.05) were significantly associated with early removal. Overall, mean (range) acceptability scores were 5.8 (4.0-6.0) and 5.9 (4.7-6.0) for lifestyle compatibility and likelihood of recommendation, respectively. After removal, 39% of participants found ISRs unacceptable, followed by 22% citing implant visibility. Potential for long-term HIV protection, followed by discreet and convenient use, were most liked, while ISRs were the most disliked aspect. CONCLUSIONS: While implant attributes, physical experiences and insertion/removal procedures were largely acceptable, local ISRs significantly reduced tolerability and acceptability, resulting in higher-than-expected early removals. The potential benefits of an annual TAF implant may be undermined unless tolerability is improved.

  PublisherOA PDFDOI

• Safety, tolerability, and pharmacokinetics of an annual tenofovir alafenamide silicone subdermal implant in South African women: a two-part, randomised, placebo-controlled, double-blind, first-in-human, phase 1 trial

  The Lancet HIV · 2025-07-02 · 6 citations

  articleOpen access
  PublisherOA PDFDOI

• Circulating Short-Chain Fatty Acids: Association with Vaginal Microbiota, Genital Inflammation, and HIV Acquisition

  AIDS Research and Human Retroviruses · 2025-12-01 · 1 citations

  article

  Little is known about the relationships between circulating short-chain fatty acids (SCFAs) and genital microbiota, inflammation, and the risk for HIV infection in women. As circulating SCFAs are potentially modifiable, for example, through dietary fiber or probiotics, we investigated association of circulating SCFA levels with these outcomes. We carried out a nested matched case–control study within a randomized trial of an antiretroviral microbicide to prevent HIV infection to study the association between circulating SCFAs and HIV acquisition (primary outcome for case definition), vaginal microbiota, and genital inflammation. Levels of the SCFAs butyrate, acetate, and propionate were quantified in plasma using mass spectrometry. Vaginal microbiota was assessed using metaproteomics and characterized as Lactobacillus dominant (LD) or low Lactobacillus (LL). Genital inflammation was measured using multiplex immunoassays. Logistic regression models were used to study the association of SCFAs with each outcome. Study population ( N = 99) characteristics were similar between cases (33 who acquired HIV) and controls (66 who did not acquire HIV). We did not observe any associations between any of the circulating SCFAs with HIV acquisition or with LL vaginal microbiota status. However, there was an inverse association between circulating SCFAs and several pro-inflammatory genital cytokines, including interleukin-6 (IL-6), IL-1α, and IL-8. In our study of women with high risk of HIV infection, higher levels of circulating SCFAs were associated with lower levels of various genital inflammatory markers, but not with HIV acquisition or a LL microbiota profile. Future larger studies, including genital SCFA assessment, are needed to confirm these findings.

  PublisherDOI

• Mobilising national and regional assets and non-state actors for pandemic preparedness

  The Lancet · 2025-04-01

  article
  PublisherDOI

• Hyaluronidase-enhanced subcutaneous delivery of bNAbs: a phase 1 randomized controlled clinical trial in HIV-uninfected women

  Nature Communications · 2025-09-01

  articleOpen accessSenior author

  Broadly neutralizing antibodies (bNAbs) offer a promising strategy for HIV prevention. Subcutaneous (SC) administration is more feasible than intravenous delivery but may be limited by prolonged administration times and multiple injections. Here we report a pharmacokinetic (PK) modelling study, an unspecified exploratory analysis that involved 57 HIV-negative African women (median age 25 years; BMI range 18.1–39.3 kg/m²) enrolled in the CAPRISA 012B trial (PACTR202003767867253, total participants n = 76). A predefined sub-analysis directly comparing the 20 mg/kg dose level of ENHANZE™ drug product (EDP) versus no-EDP was conducted in a subset of participants (n = 5 with EDP, n = 5 without). CAP256V2LS and VRC07-523LS—potent HIV-1 bNAbs targeting conserved envelope epitopes—were administered SC with and without EDP. The primary outcome of this sub-analysis was duration of administration. Secondary outcomes included PK and safety. Among the subset of participants (n = 10), EDP significantly reduced median administration time from 49.5 to 10.0 minutes and reduced injections per dose from 3 to 1. CAP256V2LS and VRC07-523LS concentrations at 24 weeks post-dose, were 4.8- and 3.0-fold higher, respectively, with EDP. CAP256V2LS exposure (AUC) increased by 40%, despite a 30% decrease in Cmax. EDP was well tolerated with no safety concerns. These findings support EDP-enhanced SC delivery as a scalable and simplified strategy for long-acting antibody-based HIV prevention. Optimizing HIV preventive therapy administration is key to improved uptake in vulnerable populations. Here, the authors report that subcutaneous administration of broadly neutralizing antibodies formulated with EDP is safe while reducing infusion duration and number of injections in healthy female participants.

  PublisherOA PDFDOI

• Analysis of mpox in Angola conflates distinct timelines

  The Lancet · 2025-10-01

  letterOpen accessSenior author
  PublisherOA PDFDOI

• Impact of Point-of-Care Urine Tenofovir Testing Among Adults after Initiating Antiretroviral Therapy: 24-Week Outcomes of the Randomised Controlled STREAM HIV Trial

  SSRN Electronic Journal · 2025-01-01

  preprintOpen access
  PublisherDOI

• Navigating Virology’s Frontiers in Africa: Global Virus Network 2024 Durban Meeting

  Viruses · 2025-06-05

  articleOpen accessSenior author

  The Global Virus Network (GVN) is a voluntary consortium of virology laboratories and affiliated scientists that seek to prevent and control global viral threats. The meetings of the GVN are characterized by academic, health center, government, and industry participation, sharing information that is designed to further the mutual mission. In September 2024, the meeting in Durban, South Africa, highlighted diseases and investigators from Africa, and paid special attention to pandemic preparedness. Selected highlights from the meeting are presented here, along with a call-to-action in defense of global partnerships for research in the origins of human and animal viruses, the risk to humans from other animal sources, the pathogenesis of given viruses, and their prevention and treatment. Discussions of laboratory discovery science are juxtaposed with development of vaccines, antiviral drugs, immunotherapies, and innovative field strategies for control of viral diseases.

  PublisherOA PDFDOI

• The persistent pool of HIV-1-infected cells is formed episodically during untreated infection.

  UNC Libraries · 2025-09-25

  articleOpen access

  Previous studies have shown that the majority of long-lived cells harboring persistent HIV-1 proviral genomes originates from viruses circulating in the year prior to antiretroviral therapy (ART) initiation, but a smaller proportion originates from viruses circulating much earlier in untreated infection. These observations suggest that discrete biological factors influence the entry and persistence of viruses into the persistent proviral pool, and there may be periods earlier in untreated infection with increased seeding. Therefore, we examined the timing of formation of the long-lived pool of infected cells that persists during ART in seven women (after a median of 5.1 years of suppressive ART) by comparing the phylogenetic distance between unique 3' half genome on-ART proviral sequences and longitudinally sampled pre-ART viral RNA sequences, focusing on the period >1 year prior to ART initiation (i.e., the "early" proviral pool). We constructed models of continuous entry into the persistent proviral pool prior to ART initiation and analyzed the fit of our experimentally derived data to these models. We found that the pattern of persistent proviral pool formation in five of seven participants is incongruent with a model of continuous entry, implying that persistent proviral pool formation can occur episodically during untreated infection. Notably, increased entry into the persistent proviral pool was not universally observed during acute infection, and the timing of enhanced early entry differed across the participants.IMPORTANCECells harboring HIV-1 proviruses that persist on antiretroviral therapy (ART) constitute the main barrier to an HIV-1 cure. Recent work has elucidated that the majority of persisting proviruses harbor HIV-1 variants circulating near the time of ART initiation, whether the proviruses are intact or defective, though a portion forms earlier in untreated infection. We examined the formation of the "early-forming" persistent proviral pool and found that in 5/7 participants, persistent proviral pool formation was episodic, rather than continuous, suggesting that there are host/biological factors that periodically enhance the formation of the persistent proviral pool. Further characterization of these factors will aid in the development of methods to abrogate their effect, thereby reducing the size of the persistent proviral pool.

  PublisherDOI

• Rapid loss of activity but not serum concentration in a passive infusion clinical trial of an HIV neutralizing antibody

  medRxiv · 2025-09-07 · 1 citations

  preprintOpen access

  Monoclonal antibodies (mAbs) are a major class of drugs for treatment and prevention of disease. In early clinical trials, the pharmacokinetics (pK) of mAbs are usually assessed by measuring mAb concentration in serum. However, it is not a given that the mAbs will retain full functionality over time, emphasizing the need for integrated PK and functional assessments. In a re-analysis of data from the CAPRISA 012B trial, a previously published phase 1 study evaluating mAbs CAP256V2LS and VRC07-523LS in HIV-negative women, we report an unexpected disconnect between serum bNAb concentrations and HIV neutralization activity of CAP256V2LS, with implications for ongoing assessment of passive immunization trials.

  PublisherOA PDFDOI

Recent grants

• NIH Grant D43TW000231

  NIH · $16.1M · 2015

• KwaZulu-Natal Clinical Trials Unit

  NIH · $35.9M · 2007–2027

• NIH Grant U01AI048013

  NIH · $4.1M · 2005

• NIH Grant U01AI069469

  NIH · $28.0M · 2014

• NIH Grant U2GPS001350

  NIH · $30.7M · 2014

Frequent coauthors

• Quarraisha Abdool Karim

  University of KwaZulu-Natal

  990 shared

• Carolyn Williamson

  603 shared

• Lynn Morris

  University of KwaZulu-Natal

  482 shared

• Nigel Garrett

  Centre for the AIDS Programme of Research in South Africa

  390 shared

• Penny L. Moore

  379 shared

• Koleka Mlisana

  349 shared

• Jo‐Ann S. Passmore

  National Health Laboratory Service

  298 shared

• Cheryl Baxter

  252 shared

Education

• M.D.

  University of Natal

• M.A.

  University of Natal

• B.A.

  University of Natal

• Ph.D.

  University of Natal

Awards & honors

• TWAS Prize in Medical Sciences (2008)
• Outstanding Senior African Scientist Award from the European…
• Allan Rosenfield Alumni Award for Excellence from Columbia U…
• Science-for-Society Gold Medal Award from the Academy of Sci…
• Fellow, The World Academy of Sciences (TWAS) (2008 - present…