AIDS Impact 2017
Without youth-friendly services, the battle for adolescent sexual and reproductive health will be lost. Early findings from three of EHPSA’s adolescent research studies, presented at the AIDS Impact Conference in Cape Town (November 13-15, 2017), reflected on this conundrum in different ways.
The Girl Power study in Malawi presented findings from focus group discussions, where young people compared the clinics in the experimental arm of the study to standard care. Four major differences emerged...
While it is generally agreed that the HIV response has failed adolescents, there has been relatively little attention paid to the some two million HIV-positive adolescents in sub-Saharan Africa who have been truly “left behind”.
The Mzantsi Wakho study, which is partly funded by EHPSA, has spent the past three years trying to understand the lives and needs of positive adolescents in South Africa’s Eastern Cape province. Researchers interviewed 1,060 HIV-positive adolescents receiving care in 53 health facilities - visiting them in 150 schools and homes. This is the largest cohort of positive adolescents to be studied worldwide, and findings presented on Tuesday at the AIDS Impact Conference in Cape Town should go some way towards filling a serious evidence gap.
The opening session of the 13th International AIDS Impact Conference in Cape Town (13-15 November 2017) laid bare the challenges ahead for the global HIV community. On the one hand, the campaign to scale up HIV treatment has been successful and, according to UNAIDS South African country director Mbulawa Mugabe, 18 million people are accessing the drugs. We are well on our way to meeting the agreed 90-90-90 treatment targets.
On the other hand, new HIV infections are unacceptably high, particularly among adolescents in eastern and southern Africa. There are two thousand new HIV infections a week among South African girls and young women: two thousand reasons to do things better.
Did you know you can create really professional-looking icons, figures and infographics in PowerPoint? I discovered this for the first time during the EHPSA Communications workshop that we hosted for RRIF researchers in Johannesburg in early November 2017.
Now that EHPSA researchers are in the final stages of their studies they require a range of skills to disseminate and communicate their findings to appropriate audiences. The workshop was also attended by colleagues from the UNAIDS Regional Support Team for Eastern and Southern Africa who had the opportunity to network with researchers and learn new skills.
Zambia and the 90s
An EHPSA-funded study, P-ART-Y*, is providing insights into the challenges and progress towards achieving the ‘three 90s’ targets for adolescents in Zambia.
A session at IAS 2017 in Paris was devoted to interim findings from the large PopART study (HPTN 071) in which P-ART-Y is nested. After two years of this multi-pronged intervention it was estimated that 87% of Zambians now know their HIV status –the country is well on its way to achieving the first 90.
At a Tuesday session at IAS 2017, Jpiego’s Daniel Were presented Kenya’s approach to a national scaled-up programme that is based on the latest epidemiological data. The evidence shows that young people count for 46% of Kenya’s new infections and key populations experience a disproportionate burden of HIV, with 29.3% of sex workers and 18% of MSM 18% being infected.
IAS 2017, July 23-26
At the opening session of the 9th IAS Conference on HIV Science in Paris, IAS Chair Prof Linda-Gail Bekker compared the global environment with that of the previous conference, commenting that since 2015 it seems that “the world has turned upside down”. Not least of which, the period has seen a decline in global funding for HIV, and important donors are proposing substantive cuts to research and treatment. This threatens to erode former gains. But, says Bekker, these setbacks can lead to new partnerships and “creativity can grow out of chaos”.
A spanner in the works?
“PrEP is here and in our toolbox today,” said an upbeat Prof Linda Gail Bekker, IAS Chair and Deputy Director of the Desmond Tutu HIV Centre. Wednesday’s plenary session at the 8th SA AIDS Conference was devoted to the “nuts and bolts of HIV prevention”. Leading scientists discussed advances in biomedical research including pre-exposure prophylaxis (PrEP), vaccine development, steps towards a functional cure and the latest thinking on HIV transmission dynamics, drug resistance and barriers to elimination.
The opening session of the 8th SA AIDS Conference, “The Long Walk to Prevention”, set the scene by inviting youth voices to frame the major challenges ahead for HIV in the region. The conference began in darkness with the voice of 22-year-old Saidy Brown reading a personal poem to HIV. “Because of you,” she said, “there goes all my happy days”.
In a carefully scripted drama, a group of young people took us through all the parameters of youth HIV risk: poverty, gender-based violence, stigma against young key populations, the generation divide... They made a convincing plea to be involved as active partners in big decision-making, complaining that HIV organisations are filled with old people whose top-down programmes have failed to work, “Stop starting new campaigns, “they said. “This year ‘She Conquers’, next year ‘He Conquers’, the following year ‘They Conquer!”
It has long been recognised that new models of HIV care are essential if we are to reach the 90-90-90 treatment targets. In a preconference session to the 8th SA AIDS Conference, FHI360 presented their experience of differentiated models of care in Nigeria and six countries in eastern and southern Africa. Innovations include a range of strategies across the 90-90-90 cascade, such as multi-month scripting, spaced clinic visits, decentralised care, ART clubs and ART refills in community, targeted services for adolescents and key populations, task shifting and many others.