Health

  • December 11, 2013

    New strategies reach men who have sex with men with HIV prevention and care services in Ghana

    Written by
    Kim Green, Chief of Party, Ghana, FHI 360

    In Ghana, men who have sex with men often fail to access critical HIV information and services due to deep-rooted fear of social stigma. The Ghana Men’s Study, conducted in 2011,1 revealed a high level of HIV prevalence among men who have sex with men in five sites in Ghana (17.5 percent), with the highest rates in the Greater Accra and Ashanti regions: 34.4 percent and 13.6 percent respectively. This study also found that less than half of the men who have sex with men population surveyed had been reached with HIV prevention services.

    Since 2010 year, the Strengthening HIV/AIDS Response Partnership with Evidenced-Based Results (SHARPER) project, funded by the U.S. Agency for International Development and implemented by FHI 360, has worked to reduce HIV transmission among men who have sex with men and other most-at-risk groups. The project operates in 30 districts with high HIV prevalence, with the goal of reaching 178,000 individuals with health behavior messages and improved access to health services by June 2014.

    Before 2012, SHARPER relied on peer education alone to reach this key population. We found, however, that less than 10 percent of the men in this group referred by peer educators for HIV testing were positive. Clearly, new strategies were needed to identify those most at risk of HIV and link them with prevention and care services.

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  • December 10, 2013

    Realizing the full potential of microbicides for women’s HIV prevention

    Written by
    Robyn Dayton, Senior Technical Officer in Research Utilization, FHI 360
    Kathleen Shears, Science Writer, FHI 360
    Michele Lanham, Research Associate in Social and Behavioral Health Sciences, FHI 360
    Rose Wilcher, Technical Advisor in Research Utilization, FHI 360

    The need for better HIV prevention options for women has driven the search for a microbicide, a product that could be used to reduce the risk of HIV infection. Microbicides hold promise as a new method that women can control — or at least initiate —to protect themselves from HIV.

    Progress in clinical trials suggests that an effective microbicide, which could be inserted in the vagina or rectum, may be within reach. But as we prepare for the eventual introduction of a microbicide, we must recognize that women will still face gender-related barriers to its use.

    With support from the U.S. Agency for International Development, FHI 360 conducted two gender analyses — one in Kenya and another one with Sonke Gender Justice in South Africa — to identify these barriers and ways to address them. We reviewed microbicide studies, analyzed HIV and gender policies and population-level data, and interviewed key stakeholders. Results of the analysis were presented today at the International Conference on AIDS and Sexually Transmitted Infections in Africa. Notably, many of the barriers identified are not exclusive to microbicide use; they also apply to other areas of women’s sexual and reproductive health and can be addressed now.

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  • December 9, 2013

    Fighting HIV/AIDS while strengthening the national health system: A winning combination in Zambia

    Written by
    Michael Welsh, PhD, Country Director, Zambia, FHI 360

    What will it take to get to zero? The search for answers to this question will be a major focus of this week’s International Conference on AIDS and Sexually Transmitted Infections in Africa, the largest gathering of its kind on the continent. In Zambia, while we are still a long way off from zero, we have made monumental progress in the fight against HIV and AIDS.

    Since May 2009, the Zambia Prevention, Care and Treatment Partnership (ZPCT II) project, with support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), has both strengthened and expanded access to quality HIV/AIDS services in Zambia. In close partnership with the Government of Zambia, the project operates in six provinces (Central, Copperbelt, Northwestern, Luapula, Northern and Muchinga), supporting services in 60 percent of the nation’s districts and nearly 50 percent of the government health centers in the supported provinces.

    ZPCT II provides a comprehensive package of HIV/AIDS services that is improving the health and well-being of millions of people living in Zambia. Services include HIV testing and counseling, prevention of mother-to-child transmission (PMTCT) of HIV, clinical care, male circumcision and antiretroviral therapy, which are supported by strengthened laboratory and pharmaceutical systems. Nearly 40 percent of Zambians receiving antiretroviral therapy access these services at ZPCT II-supported sites. Over 2.9 million people have received counseling and testing services, and 70,000 men have been circumcised through the project. Over 870,000 pregnant women have received PMTCT services in ZPCT II-supported health facilities, which has greatly assisted the Government’s push to eliminate mother-to-child transmission.

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  • December 8, 2013

    Toward an AIDS-Free Generation

    Written by
    Joy Cunningham, Technical Advisor, FHI 360
    Kate Plourde, Technical Officer, FHI 360

    Today’s generation of young people has never known a world without HIV. Yet, according to a new report released by UNICEF, Children and AIDS: Sixth Stocktaking Report 2013, the promise is in reach of a world where no child is born with HIV and all children remain uninfected through adolescence. In the 33 years since the first HIV diagnosis, we have both seen the devastating impact of the disease and made impressive progress in HIV prevention and care.
    The introduction of lifesaving antiretroviral (ARV) drugs has reduced mother-to-child transmission of HIV and increased life expectancy among perinatally infected infants. The rate of HIV infection among children is rapidly decreasing; since 2009, new HIV infections among children younger than 15 years of age have declined by 35 percent. Despite the enormous progress, much more must be done, especially for adolescents, before we are able to achieve an AIDS-free generation.

    According to the report, an estimated 2.1 million adolescents were living with HIV at the end of 2012. Although the overall number of global AIDS-related deaths for all ages declined by 30 percent between 2005 and 2012, AIDS-related deaths among adolescents increased by 50 percent during the same time period. Girls are disproportionately affected. In 2012, an estimated two-thirds of all new HIV infections among adolescents ages 15–19 occurred among girls. In Gabon, Sierra Leone and South Africa, girls accounted for more than 80 percent of all new infections among adolescents. Adolescent key affected populations — injecting drug users, men who have sex with men and individuals who trade or sell sex — are also extremely vulnerable. In Asia and the Pacific, more than 95 percent of new HIV infections occur among this population. This group of adolescents faces particular barriers to accessing services because of social stigma, violence and laws that criminalize risky behaviors.

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  • December 2, 2013

    New resource for people working with adolescents living with HIV: Positive Connections

    Written by
    Kate Plourde, Technical Officer, FHI 360
    positive-connections-coverWhy adolescents?

    In 2012, young people ages 15 to 24 accounted for an estimated 40 percent of new nonpediatric HIV infections worldwide [UNAIDS World AIDS Day Report 2012]. Furthermore, perinatal HIV transmission is a major cause for HIV infection, and given the success of pediatric antiretroviral therapy (ART), many more infants born with HIV are growing up into adolescents and young adults living with HIV.

    While care and treatment programs for people living with HIV (PLHIV) can be found in every country, there is a gap in provision of ongoing, supportive counseling for adolescents living with HIV (ALHIV). Adolescence is often when young people begin having sex, which increases chances that adolescents living with HIV might pass the infection to partners who are HIV negative. Another concern is that girls living with HIV may become pregnant; if they do not know about or have access to services for preventing mother-to-child transmission, they can pass the infection to their babies. Given that adolescents are a large sub-group of those living with HIV, there is a need for tailored interventions and support systems that address adolescents’ unique vulnerabilities.

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  • December 2, 2013

    A world without AIDS? A promising approach is bringing Vietnam closer

    Written by
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360
    Caroline Francis, Deputy Country Director, Vietnam, FHI 360

    For those of us who work in the field of HIV, words like “eradication” or “elimination” are not commonly used. Yet, new evidence and tools suggest that getting to zero might just be possible if we look at HIV through a fresh lens and focus our limited resources in strategic ways. As World AIDS Day nears, an example in Vietnam shows one promising approach.

    Vietnam is at a tipping point. The country is working hard to scale up methadone maintenance treatment for injecting drug users and to provide antiretroviral (ARV) treatment for those living with HIV. External resources, however, are declining and every dollar (or Vietnamese dong (VND)) makes a difference. The cascade of HIV care — an approach that links prevention outreach, testing and treatment services across a continuum of care — helps identify the key opportunities to improve services to stop the spread of HIV. This tool has come to Vietnam at a critical time. Vietnam’s HIV epidemic is still in a concentrated phase, with the highest seroprevalence among populations at higher risk. These include injecting drug users, female sex workers and men who have sex with men.

    Using the cascade — in every facility, commune, district and province — helps Vietnam monitor HIV service system performance and focus its remaining human, financial and programmatic resources on the ultimate aim of the HIV response: viral suppression. The cascade approach identifies “leaks” in the system to target resources on interventions that diagnose people with HIV, initiate ARV treatment quickly and sustain those individuals with continued care. Knowing where the drop-offs are most pronounced can assist decision makers and service providers in implementing system improvements and service enhancements that make the greatest impact on individuals, communities and Vietnamese society.

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  • November 26, 2013

    AIDS by the Numbers

    The Joint United Nations Programme on HIV/AIDS (UNAIDS) has released their 2013 report, AIDS by the Numbers, which contains its latest data on the state of the epidemic globally and the progress made over the last decade. The report shows the world is coming closer to ending the AIDS epidemic but that significant challenges remain in getting to zero.

    In 2012, an estimated:
    • 35.3 million [32.2 million – 38.8 million] people globally were living with HIV
    • 2.3 million [1.9 million – 2.7 million] people became newly infected with HIV
    • 1.6 million [1.4 million – 1.9 million] people died from AIDS-related illnesses

    AIDS by the Numbers presents a wealth of data on a range of topics, such as HIV infections, access to treatment and AIDS-related deaths, along with regional statistics on HIV.

    Learn more about AIDS by the Numbers.

    Follow @UNAIDS to join the conversation.

  • November 26, 2013

    Reducing violence against women and girls in Papua New Guinea

    Written by
    Mirriam Dogimab, Gender Equality Expert, FHI 360

    Yesterday was the International Day for the Elimination of Violence Against Women. In Papua New Guinea, where I work for FHI 360, violence is a serious, widespread problem that affects many women and girls on a daily basis. While exact figures are difficult to obtain, recent estimates show that violence occurs in more than two-thirds of families living in the country.

    FHI 360 is tackling this pervasive problem through a new project. The Komuniti Lukautim Ol Meri Project (KLOM), funded by Australian Aid, supports women and girls who are survivors of violence in Papua New Guinea by providing community services focused on prevention, response and empowerment. The project, which is managed by FHI 360, is being implemented in ten communities in the Sandaun and Western Highlands provinces. Each community has two “mobilizers” who play a pivotal role in helping women and girls who survive violence. For example, when two primary school girls were gang-raped coming home from school in April, the girls’ families reported the incident to the two community mobilizers, who then accompanied the girls to town for medical and legal assistance. FHI 360 works closely with these mobilizers, as well as two provincial hospitals, a faith-based organization and a community-based organization.

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  • November 22, 2013

    Beyond ICFP 2013: Let’s keep the focus on youth

    Written by
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360
    Joy Cunningham, Technical Advisor, Global Health, Population and Nutrition , FHI 360
    Kate Plourde, Technical Officer, Global Health, Population and Nutrition , FHI 360

    A version of this post originally appeared on The Huffington Post. Reposted with permission.

    This year’s International Conference on Family Planning (ICFP) saw the largest youth delegation in its history. Approximately 300 young people between the ages of 18 and 25 attended, doubling the number who participated in 2011. These young family planning activists moderated panels, delivered plenary presentations and assisted in launching ground-breaking publications, such as the United Nations Population Fund’s State of World Population 2013 report on adolescent pregnancy and the International HIV/AIDS Alliance’s paper on young people living with and affected by HIV. Young people’s needs were a major focus of conference presentations, events and press coverage. Government officials publically recognized the importance of young people and encouraged their active participation as emerging leaders in the field of family planning and reproductive health.

    The attention to the unique needs of this population could not be more timely. Every day, 20,000 girls under the age of 18 in developing countries give birth. That is roughly 833 girls every hour, or 14 girls each minute. Of the 7.3 million girls who give birth each year, two million are under the age of 15 (UNFPA). Adolescent mothers face devastating social, educational, economic and health outcomes. Girls who become pregnant confront discrimination within their communities and are often forced to drop out of school or get married. Pregnancy during adolescence increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, malnutrition and mental health disorders. Complications from pregnancy and childbirth are the leading cause of death for 15- to 19-year-old girls (UNFPA). Furthermore, adolescent mothers are more likely to have a lower income and have more children at shorter intervals throughout their lifetime.

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  • November 14, 2013

    Family Planning and HIV: New Evidence That Integration Works

    Written by
    Ward Cates, Distinguished Scientist and President Emeritus, FHI 360
    Rose Wilcher, Technical Advisor, Research Utilization, FHI 360

    A version of this post originally appeared on The Huffington Post. Reposted with permission.

    An AIDS-free generation. Eliminating pediatric HIV infections and keeping mothers alive. Providing 120 million more women with more convenient choices of effective contraceptives to avoid unintended pregnancies.

    At this week’s International Conference on Family Planning (ICFP), we are examining the latest evidence on integrating family planning and HIV service delivery. It shows that stronger linkages between family planning and HIV programs are critical to helping us realize these ambitious goals for global health.

    A small but growing number of HIV prevention, care and treatment programs offer women a range of contraceptives, along with counseling about family planning and safe pregnancy. The aim of these programs is to save lives by supporting the fertility choices of women living with HIV.

    For women with HIV who want to have children, preconception planning, good prenatal care and emergency obstetric care are crucial to ensure safe pregnancies and healthy outcomes. Closely spaced pregnancies are more likely to lead to adverse outcomes — such as low birth weight, premature birth, infant death and maternal death — and HIV infection compounds that risk. Compared to HIV-negative women, women living with HIV are almost twice as likely to die in childbirth.

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