Later this month, leading scientists and cutting-edge thinkers will gather at the International AIDS Society’s 9th IAS Conference on HIV Science in Paris to discuss the latest scientific discoveries in HIV prevention, care and treatment. These discoveries hold the potential to accelerate progress toward the global 90-90-90 targets set forth by the Joint United Nations Programme on HIV/AIDS (UNAIDS). And, they are especially important for key populations — including men who have sex with men, sex workers, transgender people and people who inject drugs — who shoulder a disproportionate burden of HIV. UNAIDS estimates that 45 percent of all new HIV infections among adults worldwide occur among these key populations and their sex partners. Reaching these groups with new technologies and approaches is essential to ending the epidemic.
Every year, the International AIDS Society (IAS) holds the largest open scientific conference on HIV and AIDS-related issues. This year’s conference, IAS 2017, will take place in July in Paris. FHI 360 is a media partner with IAS 2017, and in the lead-up to this year’s conference, we are coordinating Facebook Live conversations with experts who will be speaking there.
One U.S. expert who will present at the conference is Dr. Anthony Fauci, Director of the U.S. National Institute of Allergy and Infectious Diseases. Dr. Fauci was recently in Washington, DC, to speak at the annual meeting of the HIV Prevention Trials Network. After his plenary talk, Dr. Fauci sat down with FHI 360’s Dr. Otto Chabikuli, Director of Global Health, Population and Nutrition, for a Facebook Live chat on the science of HIV. Dr. Fauci talked about his experience working in HIV research for more than 35 years, addressing issues such as what a cure for HIV might look like, the multiple ways to prevent HIV infection, treatment as prevention, and the projects that his team is currently working on.
The full version of this post originally appeared on R&E Search for Evidence. Reposted with permission.
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is a remarkable success story built on the effective use of data. The achievements of this landmark initiative have played a central role in getting us to the point where we can finally talk about controlling the HIV epidemic and creating an AIDS-free generation.
Through 2016, US$70 billion has been invested in this unprecedented disease control effort. The accomplishments to date have been extraordinary and unimaginable just a few years ago: In 2016 alone, 74 million people were tested for HIV infection; since the start of PEPFAR, 2 million babies were born HIV-free due to women receiving prevention of mother-to-child HIV transmission (PMTCT) treatment; 12 million voluntary medical male circumcisions have been performed; and PEPFAR accounted for 12 million of the 18 million people globally receiving life-extending antiretroviral therapy (ART).
An Interview with
Mary Mittochi, Project Director, DREAMS: Malawi Communities Investing in Education for Child Health and Safety, FHI 360
In this Q&A, Mary Mittochi, the project director for DREAMS: Malawi Communities Investing in Education for Child Health and Safety, discusses how this new project will reduce the acquisition of HIV by adolescent girls and boys. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) named FHI 360 as one of the winners of the DREAMS Innovation Challenge. The DREAMS partnership, led by PEPFAR with support from the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare, is helping adolescent girls and young women become Determined, Resilient, Empowered, AIDS-free, Mentored and Safe.
As one of the 56 DREAMS Innovation Challenge winners, how will FHI 360 help adolescent girls and young women become Determined, Resilient, Empowered, AIDS-free, Mentored and Safe?
FHI 360’s DREAMS: Malawi Communities Investing in Education for Child Health and Safety project will focus on integrated, community-led efforts designed to ensure that education, health and economic drivers for staying in school and completing secondary education are simultaneously addressed and strengthened. Over time, this will reduce the incidence of HIV in adolescent girls and boys. By keeping girls in school and connecting them to a comprehensive range of services and supports, we aim to equip them and their communities with the knowledge and agency they need to make more informed choices about their health and their future.
Adolescent girls and young women continue to be at unacceptably high risk for HIV infection. UNAIDS estimates that 7,500 girls and young women, 10 to 24 years of age, become infected with HIV every week, with the highest rates in southern and eastern Africa. Girls and young women account for 71 percent of new HIV infections among adolescents in sub-Saharan Africa, highlighting the gender disparity in this age group. Despite active prevention efforts, recent clinical trials in southern Africa have measured new HIV infection rates of 4 to 6 percent per year among young women. It is imperative that we implement aggressive measures to decrease new HIV infections among girls and young women.
Our current HIV prevention package of HIV testing, behavioral risk reduction, management of sexually transmitted infections and condom use is inadequate because young women often lack the ability to control their risk. The evidence is clear that the source of HIV infection for most girls and young women in southern Africa is older men. For young women, a complex mix of economic dependency, limited educational opportunity, gender inequality, unequal power dynamics and social norms leads to a lack of choice of how and with whom to have sex.
A version of this post originally appeared on Huffington Post. Reposted with permission.
As FHI 360 and the global health community prepare to travel the “Road to Durban” to the 21st International AIDS Conference (AIDS 2016), it is poignant to reflect on how far we have come since the AIDS 2000 meeting held in Durban, South Africa. I recommend taking the time to read a recent message from the conference organizers titled, The Return to Durban: A Critical Moment in History.
After reading the piece, I was reminded of what a critical role the entire development community, including organizations like FHI 360, has played in the global response to HIV. I am inspired every day to witness how the broad global response has rallied around the concept of building on the available evidence and advancing integrated development solutions — which is why we continue to make real and sustainable progress in battling HIV.
As part of FHI 360’s deliberate approach to advancing integrated development solutions, we will be hosting a summit June 13, 2016, in Washington, DC, titled, Greater than the Sum of its Parts: The Power of Integration. The event will be a space for innovative thinking, learning and dialogue that will focus on the “how” to achieve the Sustainable Development Goals. The discussions will include global development leaders and practitioners, policymakers, donor organizations and other change-makers.
World AIDS Day 2015 comes at a watershed moment in the fight for the health of people living with HIV and for the health of all the citizens of this planet. The two are intimately related: HIV has, for the last three decades, defined the landscape of ambitious, collaborative and innovative responses that marry science, rights, community-based responses and structural change. Ultimately, these responses can be leveraged to improve health everywhere, but only if we continue to make real progress in battling HIV.
In recent years, collaborations between research teams and thousands of volunteers in clinical trials have yielded insights into how to use HIV prevention and treatment options to end the epidemic. These insights have led to the Joint United Nations Programme on HIV/AIDS (UNAIDS) “Fast-Track” approach to ending the epidemic, which sets ambitious targets for a range of interventions, including 27 million voluntary medical male circumcisions by year 2020, three million people on daily oral pre-exposure prophylaxis (PrEP) annually, major reductions in violence against women, improvements of human rights and, of course, the 90-90-90 targets for 2020: 90 percent of all people living with HIV will know their HIV status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (ART) and 90 percent of all people receiving ART will have viral suppression.
The world has gotten this far because of massive investments in the HIV response. To actually end the epidemic, though, it is imperative that we resist complacency, cutbacks in funding and a sense that, on any level, our work is done.
Over the last 15 years, the Millennium Development Goals guided the global response to development. Health, including controlling HIV, figured prominently in these goals. In September, the members of the United Nations adopted the Sustainable Development Goals (SDGs), which will guide policy and funding for ending poverty everywhere over the next 15 years. Health is one of 17 goals. To meet it, funders, implementers and country governments will need to be smarter with investments in HIV/AIDS. This means working side by side with people living with and most affected by HIV to develop rights-based approaches and efficient and community-supported service delivery models. And, it means thinking beyond any single health issue and toward integrated approaches that both fight HIV and contribute to ending poverty, hunger and inequality.
I have three long-haired boys, and wherever we go in Cambodia, people are confused, certain they are girls. We are constantly asked, “Why?” The answer is simple: They like having long hair. My boys’ push against traditional gender expressions is perhaps acceptable only because Cambodians have come to expect odd behavior from foreigners.
Yet, it is a different matter for a Cambodian transgender individual with long hair. Transgender individuals in this setting face many acute challenges, and their unconventional appearance is only one of them.
Transgender individuals in Cambodia carry a high burden of HIV. According to a study conducted by FHI 360 in select urban centers of the country, transgender individuals have an HIV prevalence of 4.15 percent (compared to 0.6 percent for the general population). Despite this striking percentage, they have historically been left out of HIV prevention and care programs. When they were included, they were incorrectly targeted as men who have sex with men. This means that there were no distinct behavior change communications or services for this group.
Final results from two research studies presented at IAS 2015 yesterday demonstrated clear scientific evidence on the benefits of early initiation of antiretroviral therapy (ART). Building on early results of HPTN 052 released in May 2011 that then showed a 96 percent reduction in HIV transmission, the study results presented yesterday provide conclusive evidence that ART should be provided to all HIV-positive people as soon as they are diagnosed for the benefit of both themselves and their sexual partners.
Jens Lundgren of the University of Copenhagen presented the initial results of the Strategic Timing of AntiRetroviral Treatment (START) study, a randomized trial looking at whether starting ART in people with CD4+ cell counts above 500 cells/mm3, rather than waiting for CD4+ cell counts to drop below 350 cells/mm3, reduces the occurrence of serious morbidity and mortality. START was recently unblinded by the international Data & Safety Monitoring Board (DSMB) 18 months early due to data that showed very clear benefits of immediate treatment versus delayed treatment. Previous studies and guidance from the World Health Organization (WHO) suggested that ART should not be given to patients unless they had symptomatic HIV and/or CD4+ counts that were below 350 cells/mm3. The interim results from START show that ART is safe and effective for all HIV-infected persons regardless of CD4+ count.