Africans Call for Voluntary Medical Male Circumcision

Energy was high at the “Call to Action for Voluntary Medical Male Circumcision” session convened by AVAC, Champions for an HIV-Free Generation, PEPFAR, UNAIDS and the WHO. Leaders from across Africa emphasized the potential for VMMC to dramatically reduce infections and save significant treatment and care costs.

Former Tanzanian President Benjamin Mkapa said, “Scaling up this intervention is an urgent priority. Although it means an upfront investment, the results are significant long-term cost savings.” Former Ugandan Vice President Specioza Wandira stressed the need to involve women in every step of VMMC rollout and scale-up: “Women, in their role as sisters, mothers, wives and partners also play a pivotal role in supporting men to make this decision.” Zimbabwean parliamentarian Blessing Chebundo told the moving tale of his decision to get circumcised along with 43 other Zimbabwean lawmakers: “At first I was scared, but later I found out it was almost painless. Every man should consider getting circumcised.” Zambian Chief, Jonathan Mumena XI, the leader of the Kaonde ethnic group which does not practice traditional male circumcision, challenged other leaders to ensure that traditional practices don’t get in the way of saving lives. “What is a culture without a people?,” he asked. AVAC’s Angelo Kaggwa also gave his experience of getting circumcised in Kisumu, Kenya. He challenged the participants to join a coalition of Africans advocating for the accelerated scale-up of VMMC as part of combination HIV prevention. The event also highlighted a new publication by AVAC, UNASO (Uganda), Sonke Gender Justice Network (South Africa) and NEPHAK (Kenya) that is a “Call to Action” on VMMC. Notable African leaders including former Zambian President Kenneth Kaunda and former Botswana President Festus Mogae were among the packed room of participants.

PowerPoint presentations from the session are available on the AIDS 2012 website. Learn more about the importance of VMMC as an HIV prevention tool at and For more information on and to join a coalition of Africans advocating for VMMC scale-up visit

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The Role of Vaccines in Ending the Pandemic

AVAC and a broad array of AIDS vaccine partners convened an interactive session made up of a panel and Q&A session with researchers, funders and local advocates to discuss the latest in AIDS vaccine research and explore how AIDS vaccine research remains a critical and integral part of ending the epidemic. Chaired by Margaret McCluskey of USAID and moderated by Mitchell Warren of AVAC, panelists included Rainer Engelhardt, Public Health Agency of Canada; Glenda Gray, Perinatal HIV Research Unit; Kevin Moody, GNP+; Chidi Nweneka, African AIDS Vaccine Partnership; Punnee Pitisuttithum, Mahidol University; Nina Russell, Bill and Melinda Gates Foundation; and Bill Snow, Global HIV Vaccine Enterprise.

The lively question and answer session touched on many issues including the impact that new strategies like PrEP or a microbicide could have on trial design. As additional prevention strategies are introduced, trial population incidence should fall. This could mean larger trial sizes. Panelists agreed that this will be an issue that needs close attention in the years to come. Bill Snow noted that if trials must be larger because the prevention is more effective and incidence is declining, that is something to be celebrated. One audience member who described his ongoing work with treatment literacy and community education said the question he is asked most often is, “When will we have an AIDS vaccine?” Nina Russell gave a best-case scenario answer based on the timeline for trials designed to follow up on the Thai RV144 result. A coalition dubbed the Pox-Protein Public Private Partnership, or P5, has a South African trial planned of ALVAC plus a protein boost, similar to the regimen tested in RV144. The P5 is comprised of the Gates Foundation, the US Military HIV Research Program, the HIV Vaccine Trials Network, Sanofi and Novartis. Russell said that if this research confirms the Thai RV144 trial, the candidate could potentially move toward licensure by 2022.

Mitchell Warren reminded the audience that history has shown that AIDS vaccine advocacy cannot predict with any certainty when we will finally have a vaccine available for use. Rather researchers, advocates and funders must all work to ensure none of the steps in the timeline take any longer than absolutely necessary.

PrEP for Women — What’s the Plan?

Just days before the start of the International AIDS Conference, the US Food and Drug Administration announced its approval of TDF/FTC for pre-exposure prophylaxis (PrEP). This development has raised hopes, questions and concerns on many fronts. A session in the Global Village at AIDS 2012, “How can ARVs as prevention work for HIV-negative women?”, looked specifically at women’s views on this potential new prevention tool. Over 30 participants, most of whom were women, discussed current and future options for using ARVs for prevention in HIV-negative women. The session was co-facilitated by Lisa Diane White of SisterLove (and a PxROAR member) and Manju Chatani-Gada of AVAC.

The animated dialogue started with a presentation on HPTN 064, also known as ISIS, a US government-funded study designed to estimate the overall new HIV infection rate for women at risk in the US. Through focus groups and in-depth interviews, this research identified a number of barriers to HIV prevention and risk factors affecting these women. The discussion then shifted to one potential new prevention tool for women—daily oral TDF/FTC as PrEP. After a review of the data and current regulatory developments, the audience discussed what PrEP might mean for US women. Participants raised many questions including who would pay, how much PrEP would cost, what types of programs would offer PrEP to HIV-negative women and what kinds of testing would be required.

Similar questions apply internationally. Look out for more opportunities to join the US and international-based conversations led by AVAC and its partners.

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