Cleopatra Sheilla Makura

Cleopatra Sheilla Makura is a youth advocate who has volunteered at SAYWHAT for the past three years as a peer educator providing information, counseling and referrals to peers in tertiary institutions. She also served as the SAYWHAT National Coordinating Chairperson, engaging parliamentarians and other key stakeholders for students’ sexual and reproductive health and rights. Additionally, Cleopatra served as a PrEP champion advocating for its acceptance in communities. She strongly believes in meaningful engagement and participation of young people in tertiary institutions to bring out positive change including the prevention of new HIV infections and ending AIDS. Cleopatra attained her degree in psychology in 2018 at the University of Zimbabwe.

Why I Want to Advocate for HIV Prevention in 2019, and What I Plan to Do
There are tools to prevent HIV such as PrEP and more are potentially on the horizon, such as the dapivirine ring. This gives me more power to advocate for HIV prevention. I want to influence my government to strengthen health services for HIV prevention, especially among young people. Specifically, my project aims to include PrEP in Zimbabwe’s university clinics as part of the minimum HIV/SRH package of services. I will also mobilize demand for PrEP on campus and engage students around ongoing research in Zimbabwe.

My Work as a Fellow

Mercy Mutonyi

Mercy is a Project Manager for the BHESP Global Fund/Kenya Redcross project for female sex workers. She is actively engaged in the national key population, PrEP and adolescent girls and young women’s technical working groups. She is a young advocate with over seven years of experience in HIV prevention programming, working with female sex workers and vulnerable young women in Kenya. She was a co-investigator and lead PrEP ambassador in the IPCP-Kenya PrEP demonstration pilot and was also the project manager of DREAMS Innovation Challenge at BHESP. Mercy participated in the development of PrEP and HIV self-testing guidelines in Kenya.

Fellowship Focus
Mercy influenced the implementation of ethical assisted partner notification services (APNS) among sex workers as part of Kenya’s shift to index testing. She identified barriers to APNS for sex workers and ensured that the new national assisted partner notification/index testing guidelines included them. She also influenced PEPFAR to provide guidance on index testing that respects human rights—something that is now part of implementation monitoring. She amplified the voices of young women and sex workers in HIV prevention research and implementation and in the decriminalization of sex work.

In Their Own Words
The protection of the human rights and the safety of sex workers should be a top priority as the community of female sex workers at different levels participate in index HIV testing. HIV prevention is not about numbers and targets–sex workers’ rights and dignity should be upheld.

Advocacy

Media

Shakirah Namwanje

Shakirah is Programs Officer at UNASO. She is a survivor of child sexual abuse and a young woman living with HIV. She is an advocate for positive living and HIV prevention, and works tirelessly to see to it that “my HIV ends with me”. Shakirah leads peer education and counseling of young people through experience sharing, music, dance and drama. She is also an activist for the end of sexual abuse in Uganda, especially against girls and young women, and uses radio and talk shows to tell her story to inspire more girls to speak up about their challenges and seek help.

Fellowship Focus
Shakirah supported young people in Uganda to engage with and influence ongoing HIV prevention research in Uganda; she strengthened PrEP and microbicides awareness and created demand for PrEP among young people. She also pushed for policies that protect against gender-based violence and that support HIV and sexual and reproductive health integration. She established an inter-university coalition to provide a platform for student leaders to discuss HIV related issues in eleven universities across the country.

In Their Own Words
For me, to give a young person out there any chance to a better life is important and is the source of my strength to advocate for HIV prevention.

Media

Materials

Lomcebo Dlamini

Lomcebo Dlamini is a human rights and gender equality activist with a legal background and experience advocating at community, national and international levels for the rights of the most vulnerable and marginalized.

As a Fellow, Lomcebo is advocating for PrEP and PEP access for adolescent girls and young women within the context of integrated, comprehensive SRH and HIV services. Specifically, she will lead a youth-focused CSO contingent in advocacy for national guidelines for youth-friendly integration of services and an accompanying communications strategy. Lomcebo will also monitor and help to mitigate COVID-19’s effect on AGYW and people living with HIV by reporting to Eswatini’s Ministry of Health.

In Their Own Words
My recent work with adolescents and young people has strengthened my resolve that research, as well as national and international policy, do not remain abstract for affected populations such as AGYW. Knowledge is empowering and essential for Eswatini to attain its ambitious prevention targets.

Elizabeth Atieno Onyango

Updated January 2024

Elizabeth is a feminist and human rights defender from Mombasa where she works as the Programs Officer for COSWA (Coast Sex Workers Alliance) KENYA, advocating for HIV and SRHR services for sex workers. She is a young people’s representative for AIDS2024, on the Conference Planning Committee and cochair of the Global Village.

Impact

Liz formed Hidaya, an advocacy network of sex workers who use drugs to advocate for harm reduction. She was a lead in the Global Fund writing process and ensured this population was prioritized for services in the concept note. She also co-founded a social media program—Thursdays with Liz and Lee—to decriminalize sex work.

Media

Outreach

Thuthukile Mbatha

Advocacy Accomplishments for the Year

Thuthu advocated for PrEP implementation among higher education institutions throughout South Africa, while mobilizing students to become PrEP advocates themselves. With Thuthu’s support, students from the University of KwaZulu Natal, Durban University of Technology, Mangosuthu University of Technology, Witswatersand, University of Johannesburg and Rosebank College started programmes in their respective campuses to create sustainable PrEP awareness. Thuthu also guest-edited an entire issue of Treatment Action Campaign and Section 27’s joint publication Spotlight where she shined a light on young women’s reproductive health.

In Her Own Words

I never knew how important advocates are from the invention of HIV prevention products until they get into the hands of end users. Also, the students’ eagerness to be part of my advocacy project was very heart warming. They came up with different strategies to try to reach other students to share the information with them. They led by example, initiating on PrEP so that they can share their experiences with other students through the peer education programme. That was one of many highlights for me.

Materials

Combination Prevention

Expanded combination prevention to bring the epidemic to a conclusive end

Press Release

HIV Vaccine Research Must Continue Following Disappointing Result from Mosaico Trial

Renewed Commitment to Expanding Access to All Existing HIV Prevention Options Must be a Global Priority

Kay Marshall, +1 (347) 249-6375, kaymarshall@mac.com

January 18, 2023 — Today, Janssen Pharmaceutical Companies of Johnson & Johnson and partners announced that the Mosaico study, a large-scale HIV vaccine efficacy study also known as HVTN 706/HPX3002, was stopped early for non-efficacy. The study took place in several countries in North and South America and Europe to test the safety and efficacy of the adenovirus26-based vaccine regimen among 3,900 cis-gender men and transgender individuals who have sex with cis-gender men and/or transgender individuals. An independent data and safety monitoring board, at a scheduled review of the trial data, found the regimen to be safe, but that it did not meet the pre-defined criteria for efficacy and recommended that the study be stopped and trial participants informed.

The Mosaico study used a similar version of the vaccine regimen in its companion study, the Imbokodo trial, which was stopped in August 2021 as it also did not significantly reduce the overall risk of HIV acquisition among over 2,600 cis-gender women in five sub-Saharan African countries.

“We always hope that efficacy trials will show positive results that lead to new prevention options,” said Mitchell Warren, Executive Director of AVAC. “It is disappointing that this particular vaccine candidate did not work, but Mosaico was an important, well-designed and well-conducted trial, especially in the midst of the COVID-19 pandemic and the roll-out of oral PrEP. The trial demonstrated that it is not only possible to design and conduct an HIV vaccine trial in the current environment, but that it is essential to do it.”

“The hard truth is the science of HIV vaccine development is extremely challenging,” Warren added, “but this is not the time to dial back support for ongoing research. Far from it – HIV remains a global threat, and a safe, efficacious and accessible HIV vaccine is still needed to provide a durable end to the pandemic. At the same time, we now have more proven HIV prevention options than ever before, but they are not reaching everyone who needs and wants them. Even as researchers continue the necessary work of accelerating HIV vaccine research, the broader HIV response must act as if we may never have a vaccine and prioritize the roll out of existing prevention options and research for additional ones. Ending this pandemic requires simultaneous action on multiple fronts of research, development and delivery.”

HIV vaccine research is complex and difficult. It is imperative that researchers work together and glean as much information as possible from the research process and from each study. Mosaico and the ongoing PrEPVacc efficacy study will both provide important information to help refine future vaccine research; various antibody studies are providing key information to inform both antibody-based prevention and vaccine development; and basic science research and early phase human studies are providing still more clues to what is needed to develop a safe and effective HIV vaccine.

“While this outcome is a disappointment, it must be seen as a result of the necessary effort to find, and keep the hope alive for, an HIV vaccine. This is, therefore, not an end, but one more addition to the knowledge it will take to find an HIV vaccine. We salute the nearly 4,000 Mosaico trial participants and the communities that were part of this important study. They join hundreds of thousands of previous HIV vaccine trial participants who have selflessly helped in this important global health endeavor,” said Ntando Yola, from the Desmond Tutu Health Foundation and Advocacy for Prevention of HIV in Africa (APHA) in South Africa. “As advocates we stand with communities across the globe who want to see an end to HIV. Working through the Coalition to Accelerate and Support Prevention Research (CASPR), we will continue to work with researchers, funders and policy makers to ensure that community voices, concerns and needs are at the forefront of ethically conducted, participatory HIV prevention research.”

“AVAC congratulates the trial teams at sites across the globe for their work on a superbly run study,” said Stacey Hannah, AVAC’s Director of Research Engagement and CASPR Project Director. “We applaud Janssen for working in collaboration with the HIV prevention community, for their leadership in HIV vaccine research and for their longstanding commitment to robust stakeholder engagement through the Good Participatory Practices (GPP) Guidelines that must be continued to maintain trust in vaccines and in research, irrespective of trial results. In fact, this commitment to GPP helps ensure all of us navigate disappointing results.”

“We’re proud to have worked with the Mosaico trial team to ensure advocate and community voices were heard in the design of the trial, especially around integrating oral PrEP into the design,” added Hannah. “While it is very disappointing that this vaccine will not move forward, this trial was a success in its innovative design and conduct, and provides important lessons for HIV prevention efficacy trials in the years to come.”

The Mosaico study evaluated whether an adenovirus26-based vaccine with a Clade C and mosaic gp140 vaccine regimen could safely and effectively reduce the rate of new HIV infections among cis-gender men and transgender individuals having sex with cis-gender men and/or transgender individuals in Argentina, Brazil, Italy, Mexico, Peru, Poland, Spain, and the United States. Participants received a total of four vaccines over twelve months of either a prime-boost vaccine regimen of a mosaic viral-vectored vaccine, Adeno26.Mos4.HIV (Ad26 prime) together with an aluminum phosphate-adjuvanted Clade C and Mosaic gp140 HIV bivalent vaccine (boost) or a placebo.

“As the HIV prevention field – researchers, funders, policymakers, advocates and communities – has done for decades, we will take the lessons learned from Mosaico and move forward in the quest for an end to HIV and improved health equity in communities across the globe,” said Warren.

A World AIDS Day with Equity at the Center

We are excited to release a new edition of our PxPulse podcast New Products are Needed and a New Paradigm is Essential: A new era in prevention?

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Tomorrow will be the 34th anniversary of World AIDS Day. It comes as countries around the world are approving diverse new options for PrEP, and the uptake of oral PrEP is reaching new heights. For the first time, the HIV response can offer the choice of multiple biomedical options—some long acting, some user controlled, some daily—that protect against HIV. At this critical juncture, global conversations are underway that could leverage this new era of choice and fundamentally reimagine how the world delivers prevention, not just for HIV but as a new paradigm for global health equity and impact. At AVAC, we have been talking about the unprecedented opportunity to dramatically reduce the number of new infections, and to lay the foundation to overcome systemic inequities in global health.

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This podcast explores these questions in depth and features PEPFAR Ambassador Dr. John Nkengasong; Kenneth Mwehonge, Executive Director of HEPS-Uganda and former AVAC Advocacy Fellow; and Lilian Benjamin Mwakyosi, the Executive Director of DARE in Tanzania and former AVAC Advocacy Fellow. Listen to the full podcast here, and listen to this snippet of Amb. Nkengasong in his appeal for an aggressive strategy to scale up combination prevention, including injectable cabotegravir for PrEP.

As we reflect on so many 2022 milestones—the 7th replenishment of the Global Fund, new leadership and a new strategic direction at PEPFAR, the launch of the Pandemic Fund, the launch of the Global HIV Prevention Coalition 2025 Roadmap, the introduction of the dapivirine vaginal ring and injectable cabotegravir for PrEP—we call on our global community to join us in marking this a turning point toward reaching equity and impact in HIV prevention.

This World AIDS Day:

These actions to advance HIV prevention, and end the epidemic by 2030, represent a model that can and should be adapted to any intervention, any product, and to any public health threat. These actions are the recipe to finally arrive at a world without AIDS and to realize equity in global health.

HPTN 071 (PopART)