Tagged: HIV

  • 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.

    Continue reading

  • 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.

    Continue reading

  • 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.

    Continue reading

  • 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.

    Continue reading

  • 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.

    Continue reading

  • 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.

    Continue reading

  • January 2, 2014

    AVAC Report 2013: Research and Reality

    AVAC, a global advocacy organization for HIV prevention, recently released AVAC Report 2013: Research and Reality. The report urges the biomedical HIV prevention field to address gaps between the promising data from recent clinical trials and the complicated reality of implementing new options. The need for a renewed focus on the research agenda for women’s HIV prevention is also emphasized.

    The report calls on funders and researchers to learn from the lessons offered by recent HIV prevention trials with better problem solving, more critical thinking and coordinated action around large-scale human trials; faster rollout of proven options; and ongoing research for new advances in HIV prevention methods that women and men will want to use.

    FHI 360 plays a pivotal role in HIV prevention research. Data from FHI 360 research informed some of the report’s findings, such as those on treatment as prevention, male circumcision and microbicides. Ward Cates, MD, MPH, President Emeritus and Distinguished Scientist with FHI 360 along with other leaders in the field, was recognized for the contributions he made to the report.

    Research and Reality offers four key recommendations:

    • Launch complex trials to answer complex questions
    • Map rollout beyond pilot projects
    • Invest in innovative approaches to virologic suppression
    • Align programs, models and funding to stay on track to end AIDS

    Learn more about the AVAC Report 2013: Research and Reality.

  • 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.

    Continue reading