AVAC partners were a dynamic presence at the Microbicides 2012 (M2012) Conference in Sydney, Australia (April 15-18, 2012). HIV prevention advocate Milly Katana—a frequent collaborator and advisor on our 2010 Advocacy Fellowship and WHiPT programs—gave a plenary address, “Making Access a Reality for All Those in Need”. Bonnie Saxon Medeossi of the Witwatersrand Reproductive Health Institute (WRHI) presented “Putting the GPP guidelines to work: Achievements and challenges for the FACTS Consortium.” Through a partnership with AVAC, Bonnie and colleagues at Wits Reproductive Health and HIV Institute (WRHI) have been implementing the Good Participatory Practice (GPP) guidelines as a core part of the FACTS 001 trial of 1% tenofovir gel. This presentation, along with her overview in a GPP symposium led by WRHI and AVAC, resulted in networking and sharing of GPP tools amongst conference attendees. Fellow Alliance Nikuze chaired a session, “Criminalization and its intersection with HIV risk behavior” which also included presentations from 2011 Fellows Brian Kanyemba and Simon K’Ondiek. These presentations just scratch the surface of a busy week which also included the launch of Project ARM report on the African Rectal Microbicides movement in Africa (a project led by IRMA, with AVAC collaboration), presentation of the Omololu Falobi Award to long-time advocate Anna Forbes, media skills-building sessions by the Microbicides Media and Communications Initiative (MMCI), and a vibrant Advocacy Corner in the exhibition all that was brought to life by partners—including past, current (and maybe even future) Fellows—from around the world.
AVAC Partners at M2012
PxROAR
The PxROAR program significantly expanded this month. AVAC launched a PxROAR Europe pilot program with partner organizations WECARe+, The German Sexuality and Health Foundation, NAM, Planeta Salud and the Migrant African MSM Sexual Health Group. AVAC also selected six new members for the US-based contingent of PxROAR bringing our total number of domestic members to 17. Launched in 2009, the PxROAR program provides research literacy and advocacy training, as well as peer-to-peer support for individual and group strategic plans focused on biomedical HIV prevention research. PxROAR members represent communities hard-hit by the epidemic in the US and their projects have ranged from social media outreach to Black MSM to influencing study protocol development. Learn more about the PxROAR program here.
As just one example of the work done by members of this program, AVAC PxROAR member Charles Stephens is leading the effort on a new social marketing campaign, From Where I Stand. This campaign, started as part of Charles’ consulting work with AID Atlanta, seeks to engage young black gay men in Atlanta in affirming their sexual identities and reducing stigma around HIV. The campaign features billboards, a presence on Facebook: www.facebook.com/fromwhereistandatl, and a planned website and mobile app. Charles helps to moderate online forums and face-to-face gatherings for young black gay men, who are able to share their stories and talk about things like getting an HIV test and condom use. In its next phase Charles hopes to incorporate discussion on biomedical HIV prevention, such as PrEP and rectal microbicides. He’s been building his own literacy and engagement with these topics at AID Atlanta and through the ongoing discussions among ROAR members. From Where I Stand may expand to other cities—if you or your agency is interested, contact Charles at [email protected].
Community HIV Cure Workshop
AVAC’s Kevin Fisher was a co-author with colleagues from Project Inform, Treatment Action Group, and AIDS Treatment Activists Coalition, of a report on a March 2012 “Community HIV Cure Workshop.” The meeting, convened by Project Inform, TAG and ATAC, invited scientists to discuss the search for a cure for HIV infection with advocates and activists, and identify advocacy activities to overcome current obstacles.
HIV Prevention Research Advocacy Fellows
In April AVAC released Spotlight, a biannual bulletin chronicling AVAC’s HIV Prevention Research Advocacy Fellowship. Spotlight is an excellent way to learn more about what Fellows do during their fellowship year and beyond.
Highlights from this issue of Spotlight include:
- Advocacy Fellows’ commitment to ending the AIDS epidemic
- Profiles of the 2012 cadre of Advocacy Fellows
- 2011 Advocacy Fellows’ milestones
- Inaugural 2012 Advocacy Fellows and where they are
A number of Fellows and a broad array of coalition partners have been working to influence the Country Operation Plans (CoPs) that guide the President’s Emergency Plan for AIDS Relief (PEPFAR). The US government, including President Barack Obama, has made strong commitments to beginning to end the AIDS epidemic using core elements of combination prevention including ARV treatment, voluntary medical male circumcision, HIV testing and PMTCT. To meet these goals, the COPs need targets that are ambitious and strategic. For more on Country Operating Plans, read the current issue of PxWire. Since PxWire was published, Advocacy Fellows in Zambia, Zimbabwe and Kenya have led efforts to submit letters directly to the US Office of the Global AIDS Coordinator listing key concerns and demands. AVAC, amfAR and Health GAP submitted letters echoing these concerns.
More on the Fellows’ work can be found here.
Click here to download Spotlight on Advocacy Fellows.
Charting the Course of the First Phase II Rectal Microbicide Trial
Last month the Microbicide Trial Network (MTN), in partnership with AVAC and other groups (see below for full list), held community consultations in Chiang Mai and Bangkok on the planned MTN-017 trial of a rectal formulation of 1% tenofovir gel. These consultations were organized in partnership with advocates who have worked with AVAC on implementing Good Participatory Practice guidelines in Thailand. MTN-017 plans to enroll approximately 216 participants, men who have sex with men and transgender women, at trial sites in South Africa, Peru, Thailand and the United States. Results of the Phase II safety trial will be used to guide decisions on future efficacy trials of the gel as an HIV prevention tool for use during anal sex. At the meetings in Chiang Mai and Bangkok, community stakeholders emphasized the importance of gathering data on rectal use of 1% tenofovir gel among transgender women. As a result of this feedback, the trial team decided to amend the protocol to include transgender women as trial participants—an example of GPP in action!
The full group of collaborators included the International Rectal Microbicide Advocates (IRMA), the Thai Ministry of Public Health – US Centers for Disease Control and Prevention Collaboration and the Thai Research Institute for Health Sciences (RIHES) along with MTN and AVAC. MTN-017 consultations were also held in South Africa in October 2011 and are planned for Peru in March 2012. Contact [email protected] to learn more.
Background facts: The rectal formulation of 1% tenofovir gel was developed to address results from an earlier study, RMP-02/MTN-006, which found that while the vaginal formulation of 1% tenofovir gel used in CAPRISA 004, VOICE and FACTS 001 was generally safe to use in the rectum, side effects were problematic to a few study participants. A rectal formulation of the gel was subsequently developed and tested in MTN-007, the results of which will be reported at CROI in March of this year.
Yes We Can End the Epidemic: AVAC Fellows Orientation 2012
AVAC’s HIV Prevention Research Advocacy Fellows gathered for an orientation and wrap-up session in Kampala at the end of January. Fellows from 2010, 2011 and eight new fellows from 2012 together with their host organization supervisors gathered in Kampala, Uganda, to take stock of recent accomplishments, plans for the future and take steps to forge an African movement to end the AIDS epidemic. The three-day meeting included debates and discussions about how to prioritize prevention strategies that are available today, such as treatment as prevention and voluntary medical male circumcision (VMMC), and explorations of the agenda for emerging strategies such as PrEP and microbicides and hoped-for interventions like an effective AIDS vaccine. One highlight was an intensive afternoon session on the potential for influencing the Country Operating Plans that guide the President’s Emergency Plan for AIDS Relief (PEPFAR). These “COPs” can be used to leverage additional resources for the pillars of combination prevention—ARV treatment, VMMC and prevention of pediatric infection. In the coming months, advocates will be participating in intensive country-level campaigns.
HIV Risk and Hormonal Contraceptives: Women weigh in
On January 25, more than 40 women—representing HIV prevention advocates, reproductive health service providers and women living with HIV from across Africa—met in Kampala, Uganda to review and discuss the existing data on hormonal contraceptive use and HIV risk. The meeting was convened by the International Community of Women Living with HIV/AIDS East Africa (ICW-EA) and AVAC. Drs. Nelly Mugo and Edith Nakku-Jaloba, of the Partners in Prevention trial team, gave an overview of recent data. Lydia Mulwanyi-Mukombe, a 2012 AVAC HIV Prevention Research Advocacy Fellow, who will be tracking women’s perceptions of and questions on HIV and hormonal contraceptives as part of her fellowship, led an interactive capacity-building exercise on key terms in reproductive health and family planning. One goal of the meeting was to develop a women’s civil society statement, which was presented at a World Health Organization consultation on hormonal contraceptives and HIV risk held January 31-February 2 in Geneva, Switzerland. Lillian Mworeko, head of ICW-EA, Alliance Nikuze, AVAC Fellow 2010, and AVAC Senior Program Manager Deirdre Grant attended and carried women’s voices forward to the discussion. A statement of the meeting outcome is expected in February, and AVAC will hold an advocates’ call to discuss the developments as they emerge. Details of the call will be released on the AVAC Advocates’ Network—subscribe here.
Background Facts: Data from one recent trial suggested that injectable contraceptive use increased women’s risk of acquiring or transmitting HIV by twofold, compared to women using non-hormonal methods of family planning. There are mixed data on this issue, and while the most recent data are cause for concern, they are not conclusive.
US Government Reaffirms Support for Fight Against HIV/AIDS
In a World AIDS Day speech on December 1st, US President Barack Obama announced that the United States is renewing “its commitment to ending the AIDS pandemic – once and for all” at an event at George Washington University organized by the ONE and (RED) campaigns. In the speech, President Obama pledged $50 million in new funding for domestic HIV treatment and care programs and set a goal of helping six million people receive antiretroviral treatment (ART) by 2013—two million more than the previous US target. At the close of this historic event, AVAC and other coalition partners including amfAR, Health GAP, ACT V and many others were recognized for their work in coalition to build momentum for the campaign to end AIDS. The speech came on the heels of November 2011 remarks by US Secretary of State Hillary Clinton at the National Institutes of Health endorsing combination prevention and treatment as prevention. In 2012, AVAC and other coalition members will be working to ensure that President Obama’s commitments are fully realized and that other donors and developing country governments show equal leadership and willingness to fund ambitious new programs. Stay up-to-date by visiting our website or follow us on Facebook and Twitter.
Project ARM Charts a Course of Action for Rectal Microbicide Research and Anal Health in Africa
The first meeting of Project ARM (Africa for Rectal Microbicides) was held in Addis Ababa, Ethiopia, in December. The two-day ICASA satellite meeting was initiated by IRMA (International Rectal Microbicide Advocates) and organized in partnership with AVAC. Forty delegates, including gay advocates from throughout Africa, met to chart a rectal microbicide advocacy and research agenda for Africa. Participants agreed that expanded research on rectal microbicides, anal sex behaviors and health should be prioritized for transgender women, gay men and other men who have sex with men (MSM) and heterosexual populations in Africa. They also discussed the need for expanded communication and education efforts to raise awareness of issues and developments related to rectal microbicide research and anal health. Rectal microbicides could play a key role in HIV prevention for gay men, transgender women and other MSM. But these are still experimental products, and there are immediate sexual health needs that could be addressed through responsive rights-based programming. One basic need is lubricants, or “lube” that can be used with condoms as part of safer anal sex. The Project ARM participants decided to create the Global Lube Access Mobilization (GLAM) campaign to support increased access and availability of condom-compatible lubes throughout Africa, employing the tagline “And Lube!”. The meeting provided a safe space for gay and other men who have sex with men (MSM) to publically articulate their issues and concerns. It is critical that such spaces flourish throughout the world. Unfortunately, another pre-ICASA conference meeting, Claim, Scale-up and Sustain, organized by AMSHeR (African Men for Sexual Health and Rights) to draw attention to MSM/LGBT and HIV-related issues in Africa, was shut down by local religious leaders. IRMA will release the Project ARM strategy report at the 2012 International Microbicides Conference in April.
AVAC Partner Provides AIDS Briefing to Ohio State Representatives
Julie Patterson, director of capacity building for the AIDS Task Force of Greater Cleveland and an AVAC PxROAR member provided unprecedented HIV/AIDS testimony and education to the Ohio House of Representatives Committee on Health and Aging. She was invited by the Republican Caucus of the House of Representatives. The event, which took place the week after World AIDS Day, allowed Patterson to review HIV disease, prevention, treatment and testing and to provide information on recent breakthroughs in biomedical HIV prevention research, including the HPTN 052 trial which found a significant reduction in transmission within HIV-serodiscordant couples when treatment was initiated earlier (350-550 CD4 cells) versus in accordance to national guidelines. Although the vast majority of HPTN 052 participants came from outside of the US, the trial is of great relevance for the domestic US epidemic, where “treatment as prevention” could be a potent part of a combination prevention package, supported by additional US funds (see first item.) Patterson explained that earlier treatment for HIV positive people is cost-saving, and urged legislators to support expanded ART programs with the goal of optimizing the health and prevention benefits of ART—and saving costs over the long term. For more on HPTN 052, read Patterson’s piece in Ohio’s weekly Gay People’s Chronicle entitled “Treatment as prevention, turning the tide in the AIDS epidemic”.