Tagged: HIV

  • December 18, 2014

    Can women living with HIV and taking antiretroviral therapy use hormonal contraceptive methods?

    Written by
    Chelsea Polis, Senior Research Associate, Guttmacher Institute
    Kavita Nanda, Senior Medical Scientist, Contraceptive Technology Innovation Department, FHI 360

    Extraordinary gains have been made in the last decade toward increasing access to antiretroviral therapy (ART) for HIV. With an eye toward ending the AIDS epidemic by 2030, UNAIDS recently released bold targets related to HIV diagnosis and treatment. By the year 2020, their aim is to have 90 percent of all people living with HIV aware of their status, 90 percent of people diagnosed with HIV receiving sustained ART and 90 percent of people on ART achieving viral suppression. As we move closer to these laudable public health goals, we must also consider how expansion of ART may affect and be affected by other health issues, such as prevention of unintended pregnancy among women living with HIV.

    An increasingly important issue is whether certain ART regimens are expected to have drug interactions when used with certain hormonal contraceptive methods. In theory, an interaction could affect the efficacy of either medication or cause side effects or toxicity. If contraceptive efficacy decreases, the chances of contraceptive failure, unintended pregnancy and the accompanying consequences increase. A decrease in ART efficacy could lead to treatment failure, viral resistance and greater likelihood of subsequent HIV transmission. Increases in side effects or toxicity can affect quality of life and medication adherence. Yet, despite the importance of this issue, relatively few studies (particularly those with clinical outcomes such as ovulation, pregnancy or treatment failure) have been conducted.

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  • December 10, 2014

    Inextricable links: HIV and human rights

    Written by
    Kevin Osborne, Project Director, LINKAGES, FHI 360

    The AIDS epidemic has been characterized by the stigma and discrimination of people who are all too often already on the margins of society.

    This marginalization has made it more difficult for millions of people on every continent to access much-needed HIV prevention, treatment, care and support services. As we recognize International Human Rights Day on Dec. 10, we cannot lose sight of the inextricable link between HIV and human rights, which should be the cornerstone of our response to and understanding of this epidemic.

    And there is, perhaps, reason for cautious optimism. Despite some policy gains and increased global attention, HIV continues to disproportionately affect “key populations” — men who have sex with men, sex workers, people who inject drugs and transgender people. UNAIDS estimates that 40 to 50 percent of new adult HIV infections worldwide occur among key populations and their partners.

    Read the remainder of the blog here.

  • December 1, 2014

    Bringing heart and mind to the fight against HIV

    Written by
    Elizabeth Tolley, Senior Scientist, FHI 360
    Dr. Timothy Mastro, Director, Global Health, Population and Nutrition, FHI 360

    The rapid spread of the Ebola virus through human-to-human contact — compelled by the urge to embrace a family member with symptoms of infection, to transport a neighbor to the nearest clinic, to nurse the infected or bury the dead despite the lack of basic protective gear — reminds us of the complex relationship between health and human behavior.

    Like Ebola, HIV was once an emergent infectious disease. Although HIV may take years rather than days to kill its victims, similarities exist between HIV and Ebola in the conditions that facilitate their spread and the challenges to containing both diseases. Highly stigmatized, those who fear infection may avoid being tested or disclosing to loved ones; those diagnosed may face limited treatment options provided by harried health care workers within overburdened health care systems.

    Now in its fourth decade, the fight against HIV has seen tremendous breakthroughs in medical technology. A spectrum of antiretroviral (ARV) treatment options now exists and is available around the globe. Clinical studies have proven that taking a daily oral ARV-based pill can reduce a healthy person’s chance of getting the infection — and, other types of ARV prevention products (i.e., gels, rings and injections) are on the horizon. Increased testing through provider-initiated strategies has increased access to both treatment and prevention technologies. There is even some thought that we will have a cure for HIV one day.

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  • July 24, 2014

    Research on key populations leads Botswana to smarter HIV prevention

    Written by
    Mike Merrigan, Regional Technical Advisor, FHI 360
    Kerry Aradhya, Science Writer, FHI 360

    At approximately 18 percent, the prevalence of HIV in Botswana’s general population is one of the highest in the world. As a result, national HIV prevention efforts have focused more intensively on the general population than on other populations. Little is known about key populations, such as female sex workers and men who have sex with men, whose behaviors are both stigmatized and illegal in Botswana.

    In 2012, the Botswana Ministry of Health used an integrated behavioral and biological surveillance survey to estimate population sizes and prevalence of HIV and sexually transmitted infections (STIs) among female sex workers and men who have sex with men. The study was historic. For the first time, it showed the HIV and STI burden among these two key populations and raised awareness about how they might have contributed to the generalized HIV epidemic.

    The survey, carried out with technical assistance from FHI 360 through the Preventive Technologies Agreement (funded by the U.S. Agency for International Development), uncovered a population of more than 4,000 female sex workers in the three districts where the survey was conducted. Among these female sex workers, HIV prevalence was 61.9 percent, and the prevalence of gonorrhea and chlamydia were both higher than 10 percent. The female sex workers had a mean of more than seven partners per week, and condom failure, which includes condom breakage and being paid or forced not to use condoms, was common.

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  • July 23, 2014

    Improving HIV testing in targeted populations in India

    Written by
    Bitra George, Country Director, India, FHI 360

    At the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia, staff from FHI 360’s India office will present a poster on a study that shows improved HIV testing among clients of female sex workers. The study contributes to evidence about what works to strengthen HIV prevention.

    Why focus research on the clients of female sex workers?

    Recent studies from India suggest that the purchase of sex from female sex workers is most predominant in higher HIV-prevalence states, such as Andhra Pradesh, Maharashtra and Tamil Nadu. In India, there is a growing recognition of the importance of considering clients when looking to stop HIV transmission, and a number of prevention efforts under the national program have targeted these clients, most of whom are men.

    Conducting surveys among clients of sex workers is challenging, because clients do not like to be identified. There is also little evidence that establishes clients’ risk of contracting HIV in India. To bridge this gap and to provide invaluable information on HIV trends and risk behavior, FHI 360 designed and managed the largest integrated biological and behavioral assessment (IBBA) for most-at-risk populations in India.

    Collecting evidence to inform HIV programming

    Conducted in 2006 and 2009, this cross-sectional survey interviewed approximately 10,000 clients of sex workers as part of Avahan (the India AIDS initiative). This program, funded by the Bill & Melinda Gates Foundation, gathered evidence to inform future HIV prevention programs in India. The IBBA survey was implemented by the institutes of the Indian Council of Medical Research, and technical support was provided by FHI 360.

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  • July 1, 2014

    A bold plan for ending HIV and AIDS in New York State

    Written by
    Dr. Timothy Mastro, Director, Global Health, Population and Nutrition, FHI 360

    Dr. Timothy MastroFor more than thirty years, health care providers, program implementers, policymakers and academic researchers have strived to meet a goal that once seemed impossible: a world without AIDS.

    The fourth decade has brought hope, based on extraordinary progress in learning how to combine HIV treatment and prevention. However, much work remains to be done, including in the United States where, according to the U.S. Centers for Disease Control and Prevention, the groups most seriously affected are gay, bisexual and other men who have sex with men, and, in particular, young African-American men who have sex with men.

    On June 29, 2014, Governor Andrew Cuomo of New York announced an initiative designed to achieve an AIDS-free generation in his state by 2020. Governor Cuomo’s three-pronged plan focuses on improved testing, preventing the spread of the virus and providing better treatment for those living with HIV.

    At FHI 360, we applaud Governor Cuomo’s bold plan to end the HIV epidemic in New York State. We currently have the scientifically proven prevention and treatment tools to stop HIV transmission. Now, we need to commit to using these tools for all populations in order to end the epidemic in New York, the United States and globally.

    We are encouraged to see Governor Cuomo take a brave stand against HIV and hope that others will join him. Together, we believe we can make a world without AIDS a reality.

  • May 21, 2014

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

    Written by
    Kate Plourde, Technical Officer, FHI 360
    A version of this post originally appeared on Interagency Youth Working Group’s Half the World Blog. Reposted with permission.
    Why 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.

    Positive Connections

    To shed light on the specific health and social support needs of ALHIV, FHI 360 — on behalf of USAID’s Interagency Youth Working Group — developed a resource called Positive Connections: Leading Information and Support Groups for Adolescents Living with HIV. This unique guide provides facilitators with background information about the needs of ALHIV, tips for starting an adult-led information and support group, 14 sessions to follow in a group setting and guidance on tracking a program’s progress.

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  • May 14, 2014

    Experts from FHI 360 address the intersection of NCDs and HIV

    On April 15, 2014, FHI 360 and its partners hosted a one-day symposium to discuss challenges and opportunities faced by the noncommunicable diseases (NCD) and HIV/AIDS global communities. Our co-host was the London School of Hygiene & Tropical Medicine (LSHTM) Centre for Global Non-Communicable Diseases. Other collaborators were the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the University College London (UCL) Grand Challenge of Global Health. FHI 360 experts who spoke include:

    • Peter Lamptey, MD, DrPH, MPH, Distinguished Scientist and President Emeritus
    • Timothy Mastro, MD, DTM&H, Director, Global Health, Population and Nutrition
    • Tricia Petruney, MA, Senior Technical Officer
    • Kwasi Torpey, MD, PhD, MPH, Technical Director, Strengthening Integrated Delivery of HIV/AIDS Services, Nigeria

    View the presentations from the symposium to hear our experts’ and partners’ perspectives on how these different disease communities can work together for more common, efficient and cost-effective strategies in the prevention and control of NCDs and HIV.

  • May 2, 2014

    AIDSWatch 2014: Science and advocacy coming together

    An Interview with
    Cornelius Baker, Technical Advisor, HIV and AIDS and Community Health, FHI 360

    What is AIDSWatch?

    AIDSWatch is an annual event in DC. Hundreds of people come from across the United States to educate members of Congress and other senior government officials about the impact of HIV in their communities and lives and to discuss strategies for ending the HIV epidemic. Public health officials, policy advocates, leaders from community-based organizations and people living with HIV seek to gain vital support for lifesaving programs and services.

    The event includes a briefing on key policy issues and HIV-related programs, scheduled visits with members of Congress and the Positive Leadership awards reception. Participants learn about the budget and appropriations process, critical programs serving people with HIV — such as the Ryan White CARE Act and the Affordable Care Act — and effective HIV prevention strategies. The event includes a “telling your story” session to help participants communicate their experience to policymakers and networking sessions to share resources.

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  • March 18, 2014

    Gender, economics, and ART adherence: What’s the connection?

    Written by
    Dominick Shattuck, PhD, Technical Director and Scientist, Social and Behavioral Health Sciences, FHI 360

    In a rural village in central Africa, my colleagues and I stood over a registration book for antenatal care clients with the goal of identifying clinic-level data that could be extracted for a project evaluation. As we made our way through the book, the left sides of the pages were filled with names of women, dates and HIV test results — it was clear that almost all of the women who tested HIV positive received some form of antiretroviral therapy (ART). As my eyes ran to the right across spaces for follow-up records, however, the fields became increasingly emptier, and our team began to discuss the various barriers to services, even a highly effective service like prevention of mother-to-child transmission (PMTCT).

    Access and adherence to the greater continuum of HIV care is influenced by several factors, including community-level gender norms and related behaviors. For example, HIV-positive men may avoid HIV testing and may spend a significant amount of their income attempting to address symptoms of their illness rather than confirming their HIV status. Often, these behaviors are driven by fear that knowledge of a positive HIV test result could compromise their leadership at home and cause family instability. Research has also identified instances when men undermine their wives’ access and adherence to ART, even taking their wives’ medication for themselves. Interestingly, despite such challenges, women are more likely to access and adhere to HIV-related treatment and care than men.

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