The increased pressure on public health systems to respond to the COVID-19 pandemic affects all routine health care, including the provision of essential HIV services. People living with HIV require regular access to treatment, but crowded public health facilities carry increased risk of exposure to COVID-19. Routine treatment sites also may be harder to reach because of stay-at-home orders, curfews and public transportation shutdowns. To maintain gains in HIV epidemic control, we must ensure that people needing antiretroviral therapy (ART) continue to receive medication uninterrupted.
Tagged: HIV
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Although we cannot truly compare COVID-19 with HIV, there are similarities worth exploring. As the COVID-19 epidemiological data pours in, we have learned that communities of color are at heightened risk for hospitalization and death. With the reality that the economic fallout affects minority communities more than anyone else, it is clear the odds are against us yet again. We have seen this story play out throughout the course of the HIV epidemic, with LGBTQ, black and Latinx communities enduring the brunt of the disease’s burden. These health disparities are the result of structural inequities that our nation has not yet found the resolve to address. So, just as we did in the early days of HIV, we must arm ourselves with knowledge and a community-driven purpose to protect ourselves and those around us from COVID-19.
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The global health community is concerned that tuberculosis (TB) continues to disproportionately kill people living with HIV, despite the availability of TB preventive therapy. According to the World Health Organization’s Global Tuberculosis Report 2019, deaths attributed to TB among people living with HIV account for 17 percent of all TB deaths, even though people living with HIV account for only 8.6 percent of overall TB cases.
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Total Quality Leadership and Accountability: Reaching the last mile in HIV epidemic control
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At recent global health meetings that assessed progress made against the HIV epidemic, presentation after presentation confirmed that the world is inching closer to epidemic control. The excitement at these gatherings was palpable. It would be the first time in human history that such a public health milestone would be achieved without either a cure or a vaccine.
As technical experts attending these meetings, we were struck by the critical importance of logistical and operational interventions, alongside biomedical ones, to reach the last mile. Yet, unlike the private sector, public health systems in low- and middle-income countries often remain underfunded and understaffed. This environment can make project management very challenging.
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The Determined, Resilient, Empowered, AIDS-free, Mentored and Safe women (DREAMS) partnership aspires to reduce HIV infections among adolescent girls and young women in 10 sub-Saharan African countries. These countries alone accounted for more than half of the HIV infections that occurred among adolescent girls and young women globally in 2015.
DREAMS reaches beyond the health sector to address the direct and indirect factors that increase girls’ HIV risk, such as poverty, gender inequality, sexual violence and inadequate education. Interventions can include paying school fees, providing bicycles to girls who would otherwise walk long distances to school, supplying sanitary napkins for menstrual hygiene management and offering mentoring to help girls avoid early pregnancy, gender-based violence and discrimination. DREAMS is supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare.
Two young women who participate in DREAMS projects attended FHI 360’s 2018 Gender 360 Summit and discussed how DREAMS is making a difference in their lives. Here are their stories.
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A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.
The USAID– and PEPFAR-supported LINKAGES project is excited to announce the arrival of a new supplement in the Journal of the International AIDS Society (JIAS) titled Optimizing the Impact of Key Population Programming Across the HIV Cascade.A collaboration among LINKAGES, USAID, CDC, amfAR, and JIAS, this supplement contributes new evidence and data-driven strategies for improving programming with men who have sex with men, sex workers, transgender people and people who inject drugs. It contains 14 original articles that represent a range of multidisciplinary efforts from diverse geographies to advance key population science and practice across the HIV prevention, care and treatment cascade.
As HIV services are scaled up in pursuit of 90-90-90 targets, investments to address the epidemic among key populations must be central to these efforts. Global data indicate that gains made among key populations lag substantially behind those made in the general population. This supplement aims to accelerate progress toward controlling the epidemic by bringing visibility to new evidence and approaches that can make key population programming smarter and more effective.
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A version of this post originally appeared on the LINKAGES blog. Reprinted with permission.
“We will only achieve HIV/AIDS epidemic control if we reach the UNAIDS 90-90-90 targets for all ages, genders, and at-risk groups, including key populations.”
– Ambassador Deborah L. Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy, June 2018
In 2013, UNAIDS set out to establish new global targets for HIV testing, care and treatment. Stakeholder consultations were conducted at country and regional levels around the world, ultimately resulting in the creation of the ambitious 90-90-90 targets to help bring an end to the AIDS epidemic:
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The focus of the global effort to end the HIV/AIDS epidemic, now 37 years on, is epidemic control, which the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) defines as limiting the annual number of new HIV infections in a country to less than the number of deaths among people living with HIV.
Sub-Saharan Africa, home to 26 million (70 percent) of the global total of 36.9 million people living with HIV, is where the battle must be won. To succeed and sustain the gains achieved in the past 15 years, countries in Africa will need to assume greater responsibility for managing their epidemics.
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Big breakthroughs in HIV science, such as antiretroviral therapy and the “universal test and treat” policy, create hope and galvanize efforts to bring the epidemic to an end. Yet, no matter how promising the strategy, we know from experience that it is not easy to incorporate the latest approaches into poorly resourced, over-stretched health systems. Nor is it reasonable to expect that health systems can absorb the increased volume of patients that seems to go hand in hand with innovations.
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A version of this post originally appeared on FHI 360’s R&E Search for Evidence blog.
Known around the world, Prof. Peter Lamptey is a global health champion in any light. Many of you may know him from his early involvement in the global HIV response or from his fight to raise public awareness of noncommunicable diseases (NCDs). I first heard Prof. Lamptey speak about the role of laboratory science in the NCD response at a conference plenary hosted by the African Society for Laboratory Medicine, my former employer. A compelling talk for sure, but notably his plenary was also my first significant introduction to FHI 360’s research.