AVAC Report 2019: One-pager

Each year, the AVAC Report frames the most pressing advocacy issues facing the HIV response. At the threshold of 2020, it’s clear that global goals for HIV prevention will miss the mark by a long shot. Now what?

This is a one-pager summarizing AVAC’s priorities for 2020. To download the full Report or see all its graphics, visit report.avac.org.

AVAC’s “3D” View of the World: 2019 and beyond

This infographic lays out AVAC’s top-line recommendations from AVAC Report 2019: Now What? The recommendations fall into three categories: deliver — prevention programs whose impact is well-measured and -defined; demonstrate — next-generation engagement for next-generation trials; develop — new targets for the post-2020 world.

Visualizing Multisectoral Prevention: The DREAMS program theory of change

This is PEPFAR’s own visualization of how its AGYW programs can effect change. It’s notable for the definition of a care package that touches on the individual and her community, and for the way it defines a range of outcomes. There isn’t anything comparable for PEPFAR’s Key Population Investment Fund, which is infusing resources into a range of countries. Some of that funding is going for ART; for primary prevention, a theory of change linked to incidence is a must. AVAC is working with allies in KPIF countries to make this demand.

Excerpted from AVAC Report 2019: Now What?

AVAC Report 2019: Now What?

Each year, the AVAC Report frames the most pressing advocacy issues facing the HIV response. At the threshold of 2020, it’s clear that global goals for HIV prevention will miss the mark by a long shot. Though important progress has been made, the crisis UNAIDS called out in 2016 persists today with new infections around 1.7 million annually, a far cry from the 2020 target of fewer than 500,000. So, we asked ourselves, Now What?, and answered with cross-cutting analysis and an advocacy agenda to match.

For more from the report, including a link to all its graphics, visit report.avac.org. A one-pager of AVAC’s 2020 priorities is also available.

An Activist’s Guide to Influencing and Monitoring KPIF Rollout

Two-page guide for advocates and activists working on the engagement of key population-led groups in the implementation planning of PEPFAR’s Key Population Investment Fund (KPIF). Includes information on the fund, KPIF countries, lead agencies in each country, activist demands and to-do list.

One Timeline, Two Stories, One Message: Putting trials and targets together

One problem with HIV prevention agendas is that they either live in an eternal present or in a far-off future. It’s “work with what we’ve got, which is condoms and VMMC and a little bit of PrEP”, or it’s “nothing can change without an AIDS vaccine”. The future depends on using what’s available, better and more widely, without ever losing sight of what’s in the pipeline.

As the figures below show, in the very same timeframe that the world will miss its critical target for incidence reduction and scale-up of primary prevention, several trials will release results that could change the future. 2020 will be a time of hope and reckoning. But only if the two stories start to be told as one.

Contraception and HIV Prevention: A clear picture of women’s needs

Women face many choices about HIV prevention and contraception. Funders and governments need to move to integrated programs that provide a variety of services in one place.

Peers are Primary: Towards a systematic approach to lay cadres

Across Treatment U=U and prevention programs, peer navigators, mentor mothers and lay counselors are recognized as essential to good services. Yet many countries don’t have clear schemas for quantifying the number of individuals needed, budgeting for their remuneration and defining the roles and responsibilities that lead to impact. Activists are working to ensure clarity by demanding from governments, funders and implementers.

Towards a Demand Creation Cascade

Many countries report low initiation and continuation of PrEP. This doesn’t mean people don’t want the product. They might not want the program that’s offering it; or they might not be being reached. A “demand-creation cascade” such as the one proposed here for PrEP is one way to evaluate the program and the product. It would measure how many people received the full suite of demand-side activities the program hopes to deliver at a given stage. The precise set of steps would depend on the service-delivery design and strategy in question.

Phases of Informed-Choice PrEP Counseling

This flow chart emerged from socio-behavioral research, including surveys and in-depth interviews with Kenyan and South African women. The research team set out with the goal of adapting the informed-choice approach used in family planning programs for use in PrEP, a prime example of fields learning from each other. The result is very clinic-centered; AVAC has added the column at the far right to reflect additional elements. However, it is a step towards much-needed exploration of how to make informed choice a reality in HIV prevention today.