Tagged: 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.

  • AIDSWatch 2014: Science and advocacy coming together

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

    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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  • 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.

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

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

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

    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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  • 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.

  • Family Planning and HIV: New Evidence That Integration Works

    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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