New Px Wire: Where did Durban leave HIV prevention?

The International AIDS Conference closed exactly a month ago today. While it lacked the pageantry of last night’s Olympics closing ceremony—which included a prime minister dressed as a video game character—the Durban wrap-up was a reminder of how important the meeting can be in framing global issues and priorities. AVAC’s new issue of Px Wire offers a look at how the Durban wrap-up catapults us into the future.

Click here to download the new issue.

And don’t miss our centerspread graphic:

  • A scorecard for the conference—how did it deliver?
  • A novel look at how to use today’s tools to break the cycle of heterosexual transmission that was so clearly defined in a major Durban presentation.

Biomedical Prevention in 2016 – At a Glance

A snapshot of prevention strategies underway or under development from 2015-2020. Excerpted from AVAC Report 2016: Big Data, Real People.

Not on Track: The Slow Pace of VMMC Scale-up

More than five years ago, epidemiologists and modelers helped set a target of 20 million VMMCs in 14 key countries in sub-Saharan Africa by 2015. WHO’s official tally is 11.7 million cumulative procedures through the end of 2015. That’s 60 percent of the original target—and will avert 335,000 new HIV infections by 2020. Excerpted from AVAC Report 2016: Big Data, Real People.

Prevention Data Dashboards: A Key Tool for Impact on the Epidemic

Big data tells us far too little about HIV negative people in key populations. This infographic from AVAC Report 2016: Big Data, Real People, proposes the development of a Prevention Data Dashboard that would guide the field toward a deeper understanding of how to reach high-risk populations and keep them HIV negative. The dashboard would create a toolbox of visual data on referral rates, characteristics of high-risk populations, and the uptake and success of different prevention strategies.

Progress in VMMC Projected Through 2015

VMMC is falling short of the target. Global figures for VMMC puts the number of VMMC in 14 key countries at 11.7 million—only 60 percent of the 2015 goal of 20 million. Excerpted from AVAC Report 2016: Big Data, Real People.

New! AVAC Report 2016 Big Data, Real People: The annual state of prevention advocacy

If you’re packing for Durban, we hope you’ll pause right now and add to your bag AVAC’s annual state of the field, Big Data Real People. The full PDF, Executive Summary and graphics are available here.

As always, AVAC Report is our annual advocacy analysis, with an agenda that spans the next 12 months—and beyond. We’ve designed it be a clear, succinct, actionable statement of the strengths and weakness of HIV prevention data today—and we hope you’ll join us in amplifying these messages at next week’s gathering.

Even if you’re not heading to Durban, we hope that this year’s Report will top your packing list for the journey through the next 12 months of advocacy and action.

In the Report, we argue that the state of HIV prevention data collection in 2016 is poor. One part of the solution lies in the adoption of “HIV Prevention Data Dashboards”. This tracking tool could bring the same specificity and accountability to non-ART prevention services that the “treatment cascade” of diagnosis, initiation, retention and virologic suppression does for antiretrovirals for people living with HIV.

The world cannot even pretend that ending AIDS is possible without action on non-ART prevention. We need to roll out what we have, continue R&D on what we still need, as well as scale up ART for all people living with HIV. That’s what the new UNAIDS Prevention Gap report says. That’s what AVAC has said for years. That’s what we hope you’ll say in Durban and over the coming year.

Here’s the Report, a roadmap for the coming year. Please read it, join us on the journey, let us know what you think!

Press Release

Data gaps hinder global efforts to reduce HIV infections, AVAC report warns; improved data collection and reporting needed to meet looming global AIDS targets

Contacts

Mitchell Warren, mitchell@avac.org, +1-914-661-1536
Kay Marshall, kay@avac.org, +1-347-249-6375

In a report issued today, AVAC warned that major gaps in global HIV/AIDS data stand in the way of delivering HIV prevention advances to millions of people who need them most. The report identifies several critical weaknesses of today’s HIV prevention data collection and monitoring systems and offers a concrete roadmap for closing these gaps. The report, Big Data, Real People, was issued ahead of next week’s International AIDS Conference in Durban, South Africa (July 18-22), where advocates will demand action to speed HIV prevention research and delivery.

“In an era in which big data are expected to improve essentially every part of our lives, there’s no excuse for HIV prevention data systems to be so uneven, incomplete and inefficient,” said Mitchell Warren, AVAC’s executive director. “To have any chance of ending the epidemic by 2030, we need to be collecting and accounting for every bit of useful information from every person living with or at risk for HIV.”

The need for improved HIV prevention data systems is particularly pressing given the UNAIDS “fast-track” goal to reduce new annual diagnoses to no more than 500,000 by 2020. Earlier this month, UNAIDS reported that the number of new HIV infections has remained near 2 million per year for the past decade.

Report identifies specific HIV data gaps, recommends solutions

AVAC’s report focuses on four critical data gaps that must be addressed to effectively prioritize, target and measure the impact of efforts to develop and deliver HIV prevention advances.

Specifically, today’s HIV prevention data are:

  • Not sufficiently broken down by age, gender, income status, key population status and other vital categories
  • Missing or incomplete for key populations most in need of prevention, including adolescent girls and young women, men who have sex with men, transgender women, and others
  • Not tied to useful HIV prevention metrics and indicators, so that it is impossible to know whether prevention programs are actually averting infections and improving health
  • Not effectively informing the HIV prevention research agenda

To overcome these weaknesses, the report outlines three critical strategies that should be pursued most urgently:

1. Standardize and systemize data collection and reporting for HIV prevention

Understand, measure and report on the risk level of people testing HIV-negative; create and measure linkages to evidence-based prevention for people at substantial risk; and use a standardized “Prevention Data Dashboard” to continually evaluate progress. Such dashboards would consolidate and arrange available data to illuminate critical prevention gaps and help the global community, governments and funders better conceptualize their HIV prevention programming and evaluation. AVAC’s report provides a model dashboard for decision-makers to adopt.

2. Improve use of data for adolescent girls and young women

Ensure that a growing volume of available data can be applied in a meaningful way. As a first step, funders, implementers and governments need to do a better job of defining and segmenting this population; map who is investing in what and where; put adolescent girls and young women in control of core aspects of the data-collection enterprise; and adopt gender-specific indicators tailored to girls and women.

3. Put research on the “fast-track” and countries at the center

Fit biomedical HIV prevention research into comprehensive prevention plans tied to national targets for incidence reduction. Countries and research institutions must invest time and resources in stakeholder engagement; ensure that research priorities are informed by epidemiological and other quality HIV data; and develop national research plans for meeting the prevention needs of specific, affected populations.

The new report and related resources, including downloadable graphics, are available now at www.avac.org/report2016.

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About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

Introducing Innovation: The Role of Devices in VMMC

One of the greatest opportunities for impact in prevention is to quicken the pace of scale-up for voluntary medical male circumcision (VMMC). VMMC devices are one of the recent innovations in delivery that could assist in reaching coverage goals.

Just this month, the Journal of AIDS (JAIDS) published a special supplement on devices for VMMC. Check out the full supplement here. The collection of articles examine safety, acceptability and operations research on implementation of two devices used to assist male circumcision in adults and adolescents, PrePex and ShangRing. All articles are available as open access.

And for those attending AIDS 2016, be sure to download the VMMC roadmap available as part of the online conference programme—and for details on a number of the sessions and ways to connect via social media at the conference visit: aidsfree.usaid.gov/news-events/aids-2016.

New Px Wire: What to Watch in 2016

There are few, if any, quiet years in HIV prevention research and implementation. 2016 promises to be another year of big deal data, whether it’s findings from clinical trials, funding levels or readouts from PEPFAR’s first year of a geographically focused program plan. We write about this and a lot more to watch for in our new issue of Px Wire.

Click here to download the new issue.

We take a look at the bigger picture in our centerspread. Check it out for the most current version of AVAC’s classic timeline of biomedical HIV prevention research. But don’t get too attached—some of the trials mentioned in the timeline will have updates presented next week at the annual Conference on Retroviruses and Opportunistic Infections. We’ll always have an updated version in our Infographics Gallery—and save the date for a March 1 webinar to discuss the latest data and what’s next?

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.

As always, we welcome your questions and comments at avac@avac.org.

Anatomy of a Target – VMMC

In Px Wire, our quarterly newsletter, we looked at the strengths and limitations of new PEPFAR targets, new UNAIDS targets, new guidelines on ART and PrEP from the WHO and new Sustainable Development Goals.

In this excerpt from our centerspread graphic, we take a closer look at voluntary medical male circumcision.