Tagged: HIV

  • Promoting male involvement in Uganda

    Since August 2012, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) has partnered with FHI 360 to engage men in the prevention of mother-to-child transmission (PMTCT) of HIV and other family planning services in Uganda. The project, titled, “Promoting Constructive Male Engagement to Increase Use of PMTCT Services,” encouraged clients to seek HIV/AIDS care and treatment services at eight health facilities in the Kabale District of Uganda.

    Studies have shown that male involvement in PMTCT and other family planning activities can reduce the risks of vertical HIV transmission (mother-to-child) and infant mortality by more than 40 percent. Educating male partners about HIV in general and how it is transmitted is essential to successful, long-term approaches to eliminating HIV/AIDS. A 2008 study by the University of North Carolina at Chapel Hill and South Africa’s University of KwaZulu Natal found that male involvement in PMTCT was linked to more people taking advantage of HIV testing, antiretroviral treatment, condoms, and support for infant feeding choices. What’s more, some women say they need their partner’s support in order to access HIV prevention, care, and treatment services, including PMTCT.

    To encourage male involvement, team members from EGPAF and FHI 360 consulted with leaders in the Kabale district, including district health officials, civic leaders, religious leaders, politicians, and community groups to discuss matters related to gender and HIV and family planning. The community leaders then nominated well-respected men from their community to serve as champions (called “Emanzi” in the local language) and role models for their peers and lead discussions on gender and health issues in their communities.

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  • Efforts to prevent HIV must focus on gender equity

    The latest figures on HIV infections, as reported this week by the Joint United Nations Programme on HIV/AIDS (UNAIDS), revealed an impressive 33 percent reduction in new infections among adults and children since 2001. To continue down the road to success, future efforts must address the gender inequities that contribute to the disproportionate impact of HIV and AIDS on women and girls.

    More than half of the 35 million people living with HIV are women. In sub-Saharan Africa, almost 60 percent of people living with HIV are women. Young women between ages 15 to 24 are at highest risk of and most vulnerable to HIV infection. Closer to home, black women in the United States remain at high risk for HIV infection, and HIV-related illness is now one of the leading causes of death among black women between ages 25 to 34.

    Gender inequity is a key driver of the epidemic, making women more vulnerable to HIV in many ways.

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  • A roadside attraction in Djibouti: Community and condoms at the SafeTStop

    Whether on foot, camel, dhow, containership, tanker, or truck—traders have likely criss-crossed Djibouti and its waters for as long as there has been trade. Today, the Port of Djibouti, one of Africa’s busiest, lies at the nexus of major shipping routes between Asia, Africa, and Europe.

    From Djibouti, most goods travel inland by trailer-truck: some 800 Ethiopian truckers arrive every day. After offloading coffee, cotton, beans and other commodities from Ethiopia, truckers wait 4 to 6 days to reload with imported electronics, spare parts, construction materials, food aid and much else.

    This range of activity makes a small community, virtually unknown outside Djibouti, both important and vulnerable. It’s called PK-12 for “Point Kilometre 12″ in French, the official language. Meaning that it’s 12 km from Djibouti town, the capital and site of the port. PK-12 looks like the mother of all truckstops. Colorful vehicles lie like flattened dominoes as far as the eye can see — thousands of them.

    Understandably, drivers with several days on their hands also ferry back and forth another invisible item. About 25 percent are thought to be HIV-positive. The number of HIV-positive young women and men from the community is not known, and the stigma is too strong for even the boldest to disclose their status.

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  • PrEP use and risk perception: What’s the connection?

    Now that the U.S. Food and Drug Administration has approved the use of the antiretroviral drug combination of tenofovir disoproxil fumarate and emtricitabine (Truvada®) for HIV prevention, its success will depend on user adherence to the daily drug regimen.

    Several trials of Truvada as pre-exposure prophylaxis (PrEP) showed it is most effective when adherence is high. Two trials, VOICE and FEM-PrEP, were unable to determine whether Truvada worked, likely because most participants did not take the study pills daily as directed.

    One explanation for low adherence to PrEP is that study participants might have thought they were not at risk of HIV infection.

    A study from FHI 360’s Preventive Technologies Agreement (PTA) explored this possibility. Our analysis of data from a randomly assigned cohort of 150 participants who received Truvada in the FEM-PrEP trial yielded some intriguing results, presented in a late-breaker poster this week at the International AIDS Society conference (IAS 2013) in Kuala Lumpur, Malaysia.

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  • Patriotism, sacrifice and an HIV vaccine

    Over the past week, scientists and advocates around the world refocused their attention on the search for an HIV vaccine. Fittingly the observance stems from a long ago speech by President Bill Clinton. On May 18, 1997, Mr. Clinton delivered an inspiring commencement address at Morgan State University in Baltimore, Maryland. In the speech, the president challenged the scientific community and the graduating class from one of America’s foremost historically black universities to invest their talents in the discovery of an HIV vaccine. Mr. Clinton also called for a worldwide commitment to develop an “AIDS vaccine within the next decade.” Since that commencement, May 18 has been marked by scientists, advocates and governments as HIV Vaccine Awareness Day.

    In the years following Mr. Clinton’s bold challenge, there have been gains and setbacks in our quest to find an HIV vaccine.

    In 2009, the world applauded when the U.S. Army’s research program and the Thai Ministry of Health announced the first HIV vaccine trial to show efficacy. The trial results showed that the candidate vaccines in the RV144 study worked in 31 percent of the people who were vaccinated. Although this level of efficacy is not sufficient to bring a product to market, it is a promising sign that a vaccine is indeed possible.

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  • ROADS II: Transforming corridors of risk into pathways of prevention and hope

  • FHI 360’s Deputy Country Director for Nigeria, Dr. Robert Chiegil, spoke with Voice of America’s health correspondent Linord Moudou yesterday about reducing the impact of HIV and TB in Nigeria and other African countries. Watch the video below.

  • Getting to zero: National Youth HIV and AIDS Awareness Day

    More than half of the world’s population is under the age of 30 and has never lived in a time without AIDS. Despite the steady progress of our collective scientific and community efforts to end the HIV epidemic, the lives of young people continue to be especially vulnerable. To bring attention to this ongoing crisis and to commit ourselves to achieving an AIDS-free generation, today marks the first National Youth HIV and AIDS Awareness Day.

    According to the U.S. Centers for Disease Control and Prevention (CDC), 50,000 people in the United States are infected with HIV each year. Of those, one in four is between 13 and 24 years old. Further, CDC reports that nearly 60 percent of new infections in youth occur in African Americans, 20 percent in Latinos and about 20 percent in whites. In 2010, CDC estimates that 87 percent of the 12,000 annual infections in youth occurred among gay and bisexual young men. Nearly half of all new infections among American youth occur in African American males.

    In a CDC Vital Signs report released for World AIDS Day 2012, the agency noted that “about 60 percent of youth do not know they are infected and so don’t receive treatment, putting them at risk for sickness and early death. These youth can also unknowingly pass HIV to others.”

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  • Partner reduction to avoid HIV risk is the focus for a new publication

    Promoting Partner Reduction title page

    Having multiple sexual partners, particularly when relationships overlap in time, is a major driver of the HIV epidemic. Overlapping, or concurrent, relationships increase the number of people who are connected in a “sexual network,” and HIV spreads more quickly the larger the sexual network. Although young people report having multiple sexual partners, few HIV prevention programs for youth tackle this topic.

    FHI 360, on behalf of USAID’s Interagency Youth Working Group, recently helped address this gap with a new publication, Promoting Partner Reduction: Helping Young People Understand and Avoid HIV Risks from Multiple Partnerships. The late Dr. Doug Kirby of ETR Associates was a major contributor.

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  • Preventing mother-to-child transmission of HIV in Zambia: Replicating success

    In 2010, around 390,000 children under age 15 became infected with HIV, mainly through mother-to-child transmission. However, with effective interventions, mother-to-child transmission can be virtually eliminated to save the lives of thousands of children every year. One effective, evidence-based intervention is the preventing mother-to-child transmission of HIV (PMTCT) component of FHI 360’s Zambia Prevention, Care and Treatment Partnership (ZPCT). This USAID-funded program, which ran from 2004–2009 —and was renewed through 2014 as ZPCT II— serves as a model for other countries.

    The ZPCT I program increased the percentage of pregnant women in antenatal clinics who accepted HIV tests and received test results from 45 to 99 percent. Among women who tested positive for HIV, the program increased the percentage of women who received a full course of antiretroviral prophylaxis from 29 to 100 percent. Most importantly, observational data from ZPCT sites showed an HIV acquisition rate of 6.5 percent among children ages 0 to 6 weeks where the mother and infant received interventions, compared with 20 percent where no intervention was given to either mother or baby. The fact that this highly effective intervention costs merely US$113–126 per mother makes a compelling case for replicating it in other contexts.

    To support program designers who wish to replicate this program, FHI 360 produced Preventing Mother-to-Child Transmission of HIV: Implementation Starter Kit. This starter kit describes and provides access to all programmatic materials and tools (such as training materials and job aids) used by ZPCT and provides basic guidance on replicating effective programs. We hope that such an effective and low-cost intervention will be reproduced in other country contexts and that it will generate the same life-saving results.