‘OpenWHO’ is WHO’s new interactive, web-based, knowledge-transfer platform offering online courses to improve the response to health emergencies. OpenWHO enables the Organization and its key partners to transfer life-saving knowledge to large numbers of frontline responders. To access click here.
Storytelling is an incredibly powerful tool for social and behaviour change. It inspires people to view a topic in a new way or motivate them to make a positive change in their lives. Traditionally, storytelling has been done through face-to-face conversations. However, increased access to mobile phones and social media has changed the way that people can share and hear stories, as well as expanded the number of people reached by one person’s story.
Please join the Health Communication Capacity Collaborative (HC3) on Wednesday, August 23 from 9:00 – 10:00 am EDT to hear about the experiences of young sexual and reproductive health (SRH) champions who have used storytelling to mobilize others around the topic. Speakers will give tips for making quality and engaging videos and positively interacting with viewers. HC3 will also launch its newly developed FP INFOcus Guide, which provides step-by-step guidance for producing and promoting mobile phone videos that give young people the information they need to make informed contraceptive choices. Representatives from HACEY Health Initiative, a Nigerian non-profit organization, will share their experiences working with HC3 to pilot the FP INFOcus Guide and approach.
Webinar speakers include:
Daysha Veronica Edewi is a writer, director, producer and social media influencer who currently works for BuzzFeed as a Video Producer. At BuzzFeed, Daysha produces viral short-form video content, with a focus on sexual health, race and gender politics and body positivity. Her videos have been featured on the Huffington Post, Bustle and Refinery29, among other media outlets.
Muluba Habanyama is a journalism student at the Sheridan College Institute of Technology and an HIV activist. She was born HIV-positive and lost both of her parents to the virus. Since disclosing her status on YouTube in December 2014, she has been featured in various Canadian publications, as well as the MTV Staying Alive Foundation. She has a passion for education, engaging and empowering youth and has served as the national ambassador for the Canadian Foundation for AIDS Research’s (CANFAR) Kisses for CANFAR project.
Cori Fordham is a Program Officer with the Health Communication Capacity Collaborative, led by the Johns Hopkins Center for Communication Programs, and has over five years’ experience in global health and social and behaviour change. She supports the FP INFOcus project and co-authored the FP INFOcus Guide. Cori is passionate about using creative and innovative strategies to give key populations the tools they need to improve their health and well-being.
Winifred Imoyera is a Program Officer with HACEY Health Initiative, with five years’ experience promoting health in several parts of southern and western Nigeria. Using the FP INFOcus approach, Winifred has developed and shared a series of mobile phone videos aimed at increasing youth’s knowledge of long-acting reversible contraceptives.
David Adewoye is an IT and Communications Manager with HACEY Health Initiative. He has collaborated on several mobile and web-based projects, including HACEY’s FP INFOcus video series, and actively promotes the use of technology in addressing health challenges.
PANCAP facilitated a study tour for seven (7) partners at the Jamaica AIDS Support for Life (JASL) organisation in Kingston, Jamaica on August 8-11. Led by PANCAP Knowledge Coordinator, Dr Shanti Singh-Anthony, the study tour titled the ‘South-to-South Learning Exchange’, aimed to expose the partners to JASL’s model of care delivery including the antiretroviral (ART) delivery model. The activity forms part of the initiatives under the PANCAP Knowledge for Health Project (Official project web page here).
Objectives
The participants from Barbados, Guyana and The Bahamas toured JASL’s facilities and were provided with first-hand information on JASL’s operations. Dr Singh-Anthony explained, ‘the study tour focused on providing participants with a full illustration of the model of care delivery. Participants were provided with information on the factors contributing to the successful delivery of comprehensive HIV prevention, care, treatment and support services by JASL including the provision of ART to key populations’.
The study tour also aimed to illustrate for participants the degree and mechanisms of coordination and collaboration between JASL and the Ministry of Health (Jamaica) in supporting the scale up of HIV prevention, care and treatment services to key populations. In addition, the study tour facilitated knowledge sharing and exchange among participants on 90-90-90 and Treat All.
Outcomes and next steps
Dr Singh-Anthony emphasized that one of the key outcomes of the tour would be the development of country specific action plans to enhance in-country collaboration among National AIDS Programme Managers and Civil Society Organisations. ‘One of our final activities is the preparation of work plans by participants based on the knowledge and best practice steps garnered from JASL’, stated Dr Singh-Anthony, ‘our intention is that the study tour achieves actionable steps that participants can incorporate into their own models of delivery to improve health outcomes for people living with HIV’.
Capturing a best practice
The JASL Model of Care and other key operational activities will be documented and shared with the entire Partnership as well as the study tour experience. The documentation was facilitated by Ms Kathi Fox of the Knowledge for Health Project, Baltimore, Maryland. In addition, all participants will be sharing their experiences in the form of blogs which will be highlighted on the study tour web page on PANCAP.org available here.
Step 1. Click on the ‘Resources’ menu and select ‘Document Library’.
Step 2. Click on the ‘Submit A Document’ button.
Step 3. Use any of your social media accounts to log into the Document Library.
Step 4. The website will connect with the social media account you selected.
Step 5. Sign into your social media account to access the Document Library. This activity WILL NOT be posted on your social media profile.
Step 6. Select ‘Create a new account’ which will be associated with your social media ID.
Step 7. Complete all the fields and click ‘continue’ to proceed.
Step 8. The message below will appear requesting permission to use your social media account to access the PANCAP Document Library. Click ‘allow’. Only basic profile information like your name will be visible.
Step 9. You’re here. Welcome to the PANCAP Document Library. Select ‘Add New PANCAP document’ to start.
Step 10. Complete all necessary fields to provide viewers with as much information about your document as possible. Your document will also be reviewed before it is posted. Details are important for the review.
Step 11. Ensure you enter the ‘document type’ e.g. case study, best practice, guidelines, etc.
Step 12. A brief description of your document is required. Please be as concise as possible.
Step 13. PANCAP can promote your document on the home page. Select the ‘highlight’ option to request this.
Step 14. You can preview how your document will appear on the website by clicking the ‘preview’ button. Use this option to make any changes or correct errors before final submission of the document.
Step 15. Click ‘Submit for review’ to send your document to the PANCAP Coordinating Unit for review. This will take one (1) working day.
Step 16. After approval, your document will appear in the library and will be disseminated to the entire Partnership. Viewers will have the option to view the document on the site or download and save.
To upload a document now, click here.
For clarifications, please contact taustin.consultant@caricom.org
Tuesday, August 8, 2017 (PANCAP Coordinating Unit, CARICOM Secretariat): The Pan Caribbean Partnership against HIV and AIDS (PANCAP), the mechanism that provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, upon the initiative and request from the Office of the Deputy Secretary-General will facilitate an awareness activity on HIV and AIDS titled ‘HIV Edutainment Hangout’. The special initiative will focus on the children of CARICOM employees, ages 10 – 19 and will be held on Wednesday, August 9, 2017 at the CARICOM Secretariat, Georgetown, Guyana.
The event will be hosted by the Office of the Deputy Secretary-General in close collaboration with the PANCAP Coordinating Unit, CARICOM Secretariat. The first of its kind, the activity is meant to reinforce the message from PANCAP to increase HIV and AIDS education among youth in the region.
Director of PANCAP, Mr Dereck Springer, explained ‘we believe that education should begin at home, hence we are educating the children of CARICOM Secretariat employees on HIV and AIDS-related topics with the intention to inspire other institutions and networks within the region to conduct similar activities. PANCAP has been advocating for an increase in HIV education among youth. This was done most notably during our ‘Meeting of Youth Leaders: Sexual and Reproductive Health’ on April 21 and 22, 2017 in Port-of-Spain, Republic of Trinidad and Tobago.
Dr. Manorma Soeknandan, Deputy Secretary-General, CARICOM Secretariat, shared that the response to the initiative has been overwhelming with over 50 participants registering. The event will include a combination of education and entertainment on HIV-related topics including HIV transmission, stigma and discrimination and prevention with an overarching emphasis on how youth can contribute to the end of AIDS.
Role-play, drama and creative writing will be utilised to engage participants in scenarios, which will seek to build their capacity to recognise social situations, which may put them at risk, as well as the ability to recognise and address stigma and discrimination and identify ways in which HIV transmission can be prevented and discuss what they can do to protect themselves from HIV.
‘Youth have an integral role in ending AIDS’, stated Dr. Soeknandan, ‘we hope that this event serves as a catalyst for heightened advocacy and mobilisation of resources for HIV education among Caribbean youth’.
– ENDS –
What is PANCAP?
PANCAP is a Caribbean regional partnership of governments, regional civil society organisations, regional institutions and organisations, bilateral and multilateral agencies and contributing donor partners which was established on 14 February 2001. PANCAP provides a structured and unified approach to the Caribbean’s response to the HIV epidemic, coordinates the response through the Caribbean Regional Strategic Framework on HIV and AIDS to maximise efficient use of resources and increase impact, mobilises resources and build capacity of partners.
Contact:
Timothy Austin
Communications Specialist
PANCAP Coordinating Unit
CARICOM Secretariat
Turkeyen, Greater Georgetown, Guyana
Email: taustin.consultant@caricom.org
Tel: (592) 222-0001-75, Ext. 3409 | Visit www.PANCAP.org
I wish to congratulate the Partnership and to acknowledge the significant progress made towards achieving the 90-90-90 targets, as highlighted in the UNAIDS Report, July 2017.
I thank the Joint United Nations Programme on HIV/AIDS (UNAIDS) for responding to the National AIDS Programme Managers’ (NAPs) request to provide the Caribbean with disaggregated regional data. This information is very useful as it allows us to track progress towards the 90-90-90 targets, and to identify the gaps.
HIV testing has been significantly scaled up with the use of rapid diagnostic technology, greater community involvement and prioritizing key populations testing. These efforts have yielded results as more than two-thirds of people living with HIV in the region know their status.
Over the last six years, the number of persons accessing treatment in the region has more than doubled. More recently, guided by scientific evidence on the benefits of earlier initiation, eight countries in the region have adopted the World Health Organisation’s recommendation of initiating antiretroviral therapy irrespective of CD4 count. This shift has contributed to an increase of 81% of persons who know their HIV status accessing treatment. This increase has played a significant role in reducing AIDS related deaths from 21,000 in 2000 to 9,400 in 2016.
Although less robust, there has been progress in achieving viral suppression. In 2016 about half of the people receiving antiretroviral treatment had access to viral load testing and among these, 67% were virally suppressed.
While we celebrate the progress made, we acknowledge the significant gaps along the 90-90-90 continuum. To achieve these targets, the region has to scale up HIV testing to ensure that the additional 81,000 persons living with the disease receive their diagnosis. There must be greater community engagement and increased use of rapid diagnostic technologies and point of care testing. On the treatment front, it is crucial for the region to increase access to high quality, effective antiretroviral therapy in order to initiate and maintain an additional 92,000 persons living with the disease who are not on treatment.
In this regard, programmes must continue to be evidence driven and more countries must make the shift to Treat All and introduce newer ARV regimen with high potency, high genetic barriers to HIV drug resistance, low toxicity and low cost that will enhance retention and achieve viral suppression. We must continue to build our laboratory systems to support treatment programmes so that all persons receiving treatment will have access to viral load testing.
The Partnership remains committed to achieving 90-90-90 by 2020 and ending AIDS in the region by 2030.
Read the UNAIDS report here.
The NHS in England has announced it will finally give people a drug to dramatically reduce the risk of being infected with HIV, from next month.
The health service had previously fought against paying for Prep and even took the issue to court, unsuccessfully, last year.
The drug will be given to 10,000 people in a £10m trial lasting three years. The Terrence Higgins Trust said it was “crucial” the NHS delivered plans to offer the protection routinely.
Prep (pre-exposure prophylaxis) is a daily pill that disables HIV before it gets a stranglehold in the body. Trials suggest it can cut the risk of being infected by up to 86%. People buying the drug privately has been linked to the first fall in new infections in gay men.
Scotland has already announced it will make Prep available on the NHS to people at risk of HIV. And in Wales, the government is also trialling the drug.
‘Supercharge’
Sexual health clinics in London, Brighton, Manchester, Liverpool and Sheffield are expected to be the first to offer Prep to high-risk people, starting September. The rest of the country will take part by April 2018. Simon Stevens, the chief executive of NHS England, said: “This major new intervention should complement and supercharge the wide-ranging and increasingly successful effort to prevent HIV.
“It’s another milestone in more than three decades’ worth of progress in tackling one of humanity’s major health challenges.” NHS England had fought not to offer the drug, arguing responsibility for paying for it should fall to local authorities, not the NHS. The trial will aim to answer questions about how Prep should be offered on a wide scale across England.
Harry Dodd, 25, is one of about 500 gay men in England who are taking Prep as part of a trial called Proud. He says: “I’ve seen the panic on the face of previous boyfriends when they are awaiting their [HIV test] results – it’s a huge fear, and it affects everything you do. “To be able to have sex without having that fear hanging over you all the time is huge.” Harry says taking Prep has still not become socially acceptable.
“Too many people seem to think it will encourage a hedonistic lifestyle, but for me this is about saving lives,” he says. “People reacted with cynicism when the contraceptive pill for women was first introduced.
“For me, taking Prep has helped me to trust again, have relationships and build bridges, and that shouldn’t be taken away.”
Ian Green, Chief Executive of the Terrence Higgins Trust, said: “the priority must now be to make sure that the trial reaches everyone at risk of HIV, and that it is rolled out speedily across the whole country, by the end of this year at the very latest – spring 2018 is not soon enough.
“To make sure no-one at risk of HIV is left behind, it is crucial that at the end of this trial, a clear process for routinely commissioning Prep on the NHS is agreed.”
Deborah Gold, the Chief Executive at the National Aids Trust, said: “this is a pivotal moment in the fight against HIV. “Prep, if targeted properly at those in need and at high risk of HIV, offers the possibility of transforming the English HIV epidemic.
“We warmly welcome this announcement”.
PARIS — With more powerful anti-HIV drugs, the triple therapy paradigm might be changing, researchers suggested.
Two studies, one conducted in the U.S. and one in Argentina, showed promising efficacy for different two-drug regimens, investigators told at an oral session here at the International AIDS Society meeting on HIV science.
The three-drug paradigm — highly active antiretroviral therapy or HAART — has been the norm since the later 1990s, commented James Hakim, MD of the University of Zimbabwe, who was not part of the research but who co-moderated the session at which the studies were presented.
“There has been a concern” that using fewer than three drugs would be less effective and more likely to allow the development of drug resistance,” Hakim told MedPage Today.
“But increasingly, with more powerful drugs, the observation has been that you could drop the third drug and still have the same level of efficacy with a reduced risk of mutations that would make the drugs ineffective,” he said.
The simpler regimens would have the advantage of lower cost and a smaller range of possible adverse events, Hakim said. As well, “psychologically and practically” many patients would prefer to take fewer drugs if they could get the same results, he said.
The two studies are preliminary, he said, but “so far — this is still early phase — it seems to be working,” he said.
The Argentine study, dubbed ANDES, is a phase IV study that is directly testing a two-drug regimen with ritonavir-boosted darunavir and lamivudine against a triple-drug regimen that adds tenofovir, according to Pedro Cahn, MD of Fundacion Huesped in Buenos Aires.
The primary endpoint is how well patients on each regimen do after 48 weeks of treatment, but Cahn presented an analysis of a secondary endpoint — efficacy outcomes after 24 weeks.
There’s evidence that a simplified regimen is effective at maintaining control of HIV after the virus has been suppressed on triple-drug therapy, Cahn said, but the ANDES trial enrolled 145 patients who had never been treated.
The study has two phases, Cahn said. In the first phase, ending after 24 weeks of therapy, he and colleagues were interested in what proportion of patients in each arm had plasma HIV RNA of fewer than 400 copies per milliliter.
If at least 75% of those in the experimental arm reached that level, he said, the trial would proceed to the next 24 weeks, in which the endpoint would be the proportion achieving undetectable HIV, defined as fewer than 50 copies of HIV RNA per milliliter.
The study was designed to demonstrate non-inferiority at both endpoints, Cahn said.
At 24 weeks, he reported, 95% of those on two drugs and 97% of those on three had reached or exceeded the 400-copy benchmark and the difference showed the two regimens were non-inferior to each other.
In the two-drug arm, 10 patients reported 11 adverse events that were thought to be possibly drug-related, while in the triple-drug arm 16 patients reported 21 events. There were eight serious adverse events, but none was related to the medications, he said.
The American study, ACTG A5353, had a different design: it was a single-arm study of dolutegravir (Tivicay) and lamivudine in 120 treatment-naïve patients, according to Babafemi Taiwo, MD, of Northwestern University Feinberg School of Medicine in Chicago.
The goal was to estimate virologic success of the regimen after 24 weeks of therapy, defined as a plasma viral load of fewer than 50 copies of HIV RNA per milliliter, Taiwo reported.
The study protocol defined virologic failure as a confirmed viral load of more than 400 copies per milliliter at weeks 16 or 20 of therapy or more than 200 copies at or after week 24. Patients were followed for 52 weeks.
The bottom line, Taiwo said, was that 108 (or 90%) of the patients reached the efficacy endpoint, with only three meeting the criteria for virologic failure. The data showed those three patients were not correctly following the drug regimen, he said.
One of the first studies to explore the acceptability, safety and use of pre-exposure prophylaxis (PrEP) in adolescents in an African context has found that PrEP was safe and tolerable, although PrEP usage and adherence did tail off during the twelve months of the programme.
Presenting the findings of the PlusPills project to the 9th International AIDS Society Conference on HIV Science (IAS 2017) in Paris yesterday, Katherine Gill of the Desmond Tutu HIV Foundation said that South African adolescents need access to PrEP with tailored adherence support and more frequent clinic visits. Less frequent dosing schedules, if validated, could be of interest to this population, she suggested.
PlusPills is just one of several demonstration projects on PrEP for adolescents and young women in South Africa that are underway or have recently been completed. Yogan Pillay, the country’s Deputy Director General for Health, told the conference that these findings would be considered together to inform the development of the country’s PrEP programming. South Africa is further ahead with PrEP provision for sex workers and men who have sex with men than it is for adolescents and young women.
Adolescent girls and young women aged 15 to 24 account for 23% of all new HIV infections in sub-Saharan Africa. Females are much more vulnerable to HIV than their male peers. Whereas 0.7% of adolescent boys aged 15 to 19 have HIV in South Africa, the equivalent figure for girls is 5.6%. In the 20 to 24 year age group, 5.1% of men and 17.4% of women have HIV. In some parts of the country, prevalence is even higher.
The primary objective of PlusPills was to evaluate the acceptability, safety and use of a daily regimen of daily Truvada PrEP as part of a comprehensive HIV prevention package. As there are not any data on PrEP in adolescents in an African context, such studies are needed before PrEP can be licensed for use by adolescents, Gill said.
PlusPills recruited a self-selected cohort in need of HIV prevention services. It enrolled 148 HIV-negative adolescents (ages 15 to 19 years) at two sites in Cape Town and Soweto. Of note, while 99 of the participants were female, 49 were male. The median age of study participants was 18, a quarter had completed formal schooling and 90% were living with their family.
Their median age at sexual debut was 14.5. One in five had had a partner who was at least five years older. While three-quarters had used a condom the last time they had sex, only a third always used a condom and 41% tested positive for a sexually transmitted infection (STI) at baseline.
This was a single arm study. In addition to PrEP, the HIV prevention package that all participants received included HIV testing, management of STIs, risk reduction counselling, male and female condoms, post-exposure prophylaxis (PEP), and circumcision counselling and referrals.
Recognising that many young people struggle to adhere to daily pill-taking, the programme also provided extra support using SMS, adherence clubs, and real-time feedback on drug levels.
The study participants were required to take PrEP daily for the first three months of the study but could opt out at the three-month mark. At each study visit after that, they could opt in or out of PrEP.
PrEP was reasonably well tolerated with minimal safety concerns. Sixteen participants (11%) experienced a grade 2 or 3 side-effect, including headaches, nausea and vomiting, abdominal pain, diarrhoea, skin rash and weight loss. Participants who stopped PrEP often complained of side-effects, although Gill said that many participants were starting contraception at the same time and it could be hard to be sure of the exact cause of problems.
The use of PrEP and adherence to daily dosing dropped off over time, something that has been seen in PrEP studies conducted with adolescents in the United States. There was a particular drop off when clinic visits switched from monthly to quarterly, suggesting that adolescents need more regular contact and support. Tenofovir (one of the drugs in Truvada) was detectable in blood in 57% of participants at week 12, 38% at week 24 and 38% at the end of the study. Young women had similar levels of adherence to young men.
Participants continued to be diagnosed with STIs throughout the study. For example at the week 12 visit, there were 29 herpes diagnoses, 21 chlamydia and 8 cases of gonorrhoea.
One study participant acquired HIV during the study – a 19-year-old woman who had opted out of PrEP 24 weeks before diagnosis. While the study was not powered to demonstrate the efficacy of PrEP in adolescents, this population could be expected to have an HIV infection rate of around 7% a year and the STI data indicate that the participants continued to take sexual risks. It, therefore, appears that PrEP as part of a comprehensive prevention package did provide some protection in this population.
While the home is a fundamental institution for educating young people, particularly teenagers, of the devastating effects of HIV and AIDS and other sexually transmitted infections (STIs), schools also play an equally important role since it is believed that in addition to the family, schools are the primary places responsible for the development of young people.
For this reason, health education should be seen as a significant step towards preventing the spread of HIV and other STIs, and therefore should be universally integrated into all educational systems.
To embark on this venture, an excellent first approach is to ask students what they already know about STIs. This would allow educators to identify any inaccurate information young people may have and provide an opportunity for introducing age appropriate education.
