If It Works, We Should Use It

This was originally published on the What’sUpHIV blog that provided live coverage during HIV R4P 2014.

While numbers and slogans are important in themselves, focus should also be given to interventions that are making positive impact,” that’s how Mitchell Warren, Executive Director of AVAC, opened the 2014 HIV R4P Advocates’ Pre-Conference Workshop.

In his talk, titled, HIV Prevention: Research, reality & context, Warren observed that, “method mix is needed by the community members and not the policy maker.” And so it is critical for civil society to push for access to the full range of biomedical interventions which research has proven efficacious, like PrEP (Pre-exposure prophylaxis) and VMMC (voluntary medical male circumcision). Such interventions have to be embraced by policy makers in Africa, if the quest to end the AIDS epidemic by 2030 is going to be achieved.

Warren summed up by saying that, “It is therefore incumbent upon us to ensure that all our efforts are aimed at rolling out interventions that would save more people from contracting HIV in our communities.” I couldn’t agree more.

New Px Wire: The state of the prevention union

The new issue of Px Wire, AVAC’s quarterly newsletter on HIV prevention research and implementation, is now available.

Click here to download.

This issue goes to press as global stakeholders in the HIV prevention field are preparing for the HIV Research for Prevention (R4P) conference in Cape Town. HIV R4P is the first-ever meeting to bring together researchers, implementers, policy makers and advocates from across biomedical prevention, including vaccines, microbicides, PrEP, voluntary medical male circumcision, cure and ART in HIV-positive people.

In this issue of Px Wire, we offer a selective “state of the union” update on various areas of the prevention field—highlighting key developments, messages and areas of work that warrant particular joint attention in Cape Town and beyond.

Our centerspread looks at the targets UNAIDS announced at AIDS 2014 in Melbourne—“90- 90-90” targets calling for 90 percent of people with HIV to know their status, get initiated on ART and achieve virologic suppression. Goals such as 90-90-90 help focus the field, and treatment is crucial in ending the epidemic—but this view is incomplete. The field must have the same attention and clear objectives in preventing HIV.

The full issue of Px Wire, as well as our archive of old issues and information on ordering print copies, can be found at www.avac.org/pxwire.

Post AIDS 2014 Webinars: Experts, issues, answers—and more!

The special set of post-AIDS 2014 webinars concluded on Wednesday, October 8. As part of the ongoing Research & Reality series, these webinars gave advocates a chance to talk to leaders from various fields about issues including cure and prevention research, new global targets and more—all of which were raised at the recent International AIDS Conference.

See below for information on and links to slides and recordings from each of the AIDS 2014 webinars. And stay tuned for updates on future installments in the Research & Reality series.

UNAIDS, Targets and Civil Society
In Melbourne, UNAIDS launched a new initiative known as “90-90-90”, which lays out new targets for testing, treatment and virologic suppression. Where did these targets come from, what do they mean—and where does prevention fit in? Chris Collins, Chief of the Community Mobilization Division at UNAIDS addressed these questions and more.
October 8 — Animation: Flash, Audio: MP3, Slides: PDF

Data and Uncertainty: Understanding updates on hormonal contraceptives and HIV
AIDS 2014 featured analyses of data on the potential relationship between hormonal contraceptives and risk of HIV infection. Researchers Charles Morrison (FHI 360) and Kristin Wall (Emory University), and Mary Lyn Gaffield from the WHO discussed the newest findings and guidance.
October 1 — Animation: Flash, Audio: MP3, Slides: PDF

Results of the iPrEx open-label extension (iPrEx OLE): PrEP uptake, sexual practices and HIV incidence
Get details on the iPrEx OLE study from principal investigator Robert Grant, who presented the data at AIDS 2014. The first open-label PrEP study to publish results, these data from iPrEx OLE begin to answer a number of questions on PrEP use in the “real world”.
September 24 — Animation: Flash, Audio: MP3, Slides: PDF

Latest developments in VMMC research and implementation
AIDS 2014 brought more updates on voluntary medical male circumcision (VMMC) including new data on risk behaviors in circumcised men, the impact of cash transfers as part of VMMC programming and more. Kenyan researcher and implementer Kawango Agot reviewed the latest findings.
September 17, 2014; — Slides: PDF

State of the Art HIV Cure: Where are we now and where are we going?
The field of cure research is evolving and expanding, with various proposed trials that require informed engagement from many stakeholders. Get an update, discuss research and hear questions answered by plenary speaker Jintanat Ananworanich.
September 3, 2014 — Animation: Flash, Audio: MP3, Slides: PDF

As always, questions or comments are most welcome! 

Progress in VMMC Scale-up in Priority Countries

This map shows progress made through 2013 towards the target of circumcising 80% of eligible men in 14 priority countries. It is particularly useful as a tool for advocates to show how their country’s VMMC program compares to others in East and Southern Africa.

AVAC Fellow Khanyisa Dunjwa advocates for safe male circumcision

AVAC Fellow Khanyisa Dunjwa continues to work with different stakeholders at the provincial and national levels in South Africa to get their heads around making traditional circumcision safe.

This press release describes her work with the South African National AIDS Council’s Civil Society Forum (SANAC-CSF) and the position paper they put forth.

She has also published a couple of mythbusting pieces on voluntary medical male circumcision, arguing for its importance as part of an effective HIV prevention strategy. See this piece in news24 and Business Day, two South African publications.

Voluntary Medical Male Circumcision: What Gets Counted

This table from Px Wire January-March 2014 Volume 7, No.1 examines why the global systems for tracking voluntary medical male circumcision are lagging behind the actual progress being made.

Too Little Too Slow: Results from from civil society monitoring of male circumcision for HIV prevention in Uganda

A jointly-authored report by Ugandan civil society groups taking stock of progress and challenges in Uganda’s voluntary medical male circumcision program as of 2012. Makes recommendations for future action, and highlights examples of best practices in the country.

A New Way to Protect Against HIV? Understanding the Results of Male Circumcision Studies

A 2007 document discussing the results of three large efficacy trials of voluntary medical male circumcision (VMMC) as an HIV prevention strategy. It proposes key priorities for additional research and preparing for implementation.

Voluntary Medical Male Circumcision (VMMC) Device Evaluations Map and Table

One-page resource on non-surgical device evaluation in Africa as of late 2013. 

Frequently Asked Questions on Non-Surgical Devices for Voluntary Medical Male Circumcision for HIV Prevention

Basic information on non-surgical devices with a focus on the implications of WHO prequalification and next steps for product introduction.