Brian Kanyemba, Desmond Tutu HIV Centre, Cape Town, South Africa said that phase II study of rectal microbicide (MTN017) has also started at their site which is the only site in Africa. 7 out of 24 study participants have been enrolled so far.
Condoms... and lubes!
Jim Pickett, Chair of International Rectal Microbicide Advocates (IRMA) said in a press conference at AIDS 2014 (via web-link): Project ARM (Africa for Rectal Microbicides) was started by the IRMA few years ago to make sure that as the HIV prevention field moves ahead for research and development of rectal microbicides, these products [when eventually made available] are safe, accessible, and affordable to the people who need them [in African context]. There was a realization that we need to do some specific work in Africa in context that there are many countries where anal sex is illegal, people can be prosecuted and there is lot of [anal sex related] stigma and discrimination too."
"Project ARM was born out of the growing need to create a research and advocacy agenda for rectal microbicides in Africa. Project ARM shows us what are the priorities in terms of research, advocacy and community mobilization around rectal microbicides in African context. One of the priorities that came out of Project ARM discussions was lube access. The reason was that people who practice anal sex cannot access lubricants."
"We have to recognize that it is not just MSM and transgender people who have anal sex but also men and women in heterosexual relationships. If that route of HIV transmission is not looked at then HIV rates are bound to rise in those practicing anal sex."
Jim briefed about "Global Lube Access Mobilization - GLAM". He said "Having safer lubes will not be enough unless policies and programmes start addressing access to lubes. This is how GLAM came into being. If we provide condoms to people and not provide lubes then it is a big problem because then people use whatever they can find and at times they use lubricants or products that are not condom compatible. Lack of condom compatible lubricants in Africa was acute. With no lubes people often resort to body lotions, cooking oil, pre-cum, creams or other things that are not necessarily condom compatible."
IRMA grants announced
Jim Pickett announced in this press conference that few grants have been awarded to some projects to advocate for national and local-level access to safe, affordable, condom-compatible lubricant in Africa to improve the impact of HIV prevention services. These projects are based in African countries such as Cameroon, Ghana, Kenya, Nigeria, Tanzania among others. This is the second year for IRMA to support projects in Africa. This year the grants are supported by amfAR, AVAC - Global Advocacy for HIV Prevention, COC Netherlands, and IRMA.
PrEP and WHO Guidance for key populations
Deirdre Grant from AVAC -- Global Advocacy for HIV Prevention said that "WHO Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations" which were released at AIDS 2014, are first set of guidelines for key affected populations that not only addressed the common areas which affected them all, but also addressed population specific ones. Deirdre informed that these guidelines were for five key population groups which were: MSM, injecting drug users, sex workers, transgender people and people in prisons.
PrEP is recommended as an additional HIV prevention choice within comprehensive HIV prevention package for MSM in these guidelines. On use of PrEP by transgender people, Deirdre said that there needs to be more evidence before strong recommendation can be made for its use among this key population. Deirdre called for heightened advocacy around PrEP and noted that WHO guidance helps with agencies and funders but does not directly help people who want to access services. Lots of other issues such as barriers, investment needs, dearth of smart programming, lack of implementation science, etc must be addressed alongside rolling out the guidance.
Dr Seema Sahay, Deputy Director, National AIDS Research Institute (NARI), Indian Council of Medical Research (ICMR), who is a noted social scientist said: "We are focussing on how to reach 'hidden' MSM especially adolescent MSM as this population is also surfacing right now. This is one problem we will like to have some advocacy and challenge we face. We conducted a small qualitative study and realized that knowledge about PrEP is very low. 2/39 MSM had heard of that. There should be some education programme and advocacy for PrEP as message about PrEP has not reached majority of MSM."
Vijay Nair, who demonstrated leadership years ago in India to organize HIV positive MSM as a network called NIPASHA+. Currently he is involved with India HIV/AIDS Alliance. Vijay expressed concerns if new HIV prevention technologies will ever reach those MSM who are in need.
Discussions about these new HIV prevention technologies are often limited to global conferences or meetings with little ground work taking place in our countries. He expressed concern why it has taken over two decades to do female condom programming after US FDA approved it in 1993? PrEP was approved by US FDA in July 2012 but still there is no clear sense how PrEP will reach MSM in need. He agreed with Dr Seema Sahay's observation that there are 'hidden' MSM in India who are not part of (or perhaps do not want to be part of) targetted interventions for MSM, and PrEP could be an option for them.
Bobby Ramakant, Citizen News Service -- CNS
- Shared under Creative Commons (CC) Attribution License
Condoms... and lubes!
Jim Pickett, Chair of International Rectal Microbicide Advocates (IRMA) said in a press conference at AIDS 2014 (via web-link): Project ARM (Africa for Rectal Microbicides) was started by the IRMA few years ago to make sure that as the HIV prevention field moves ahead for research and development of rectal microbicides, these products [when eventually made available] are safe, accessible, and affordable to the people who need them [in African context]. There was a realization that we need to do some specific work in Africa in context that there are many countries where anal sex is illegal, people can be prosecuted and there is lot of [anal sex related] stigma and discrimination too."
"Project ARM was born out of the growing need to create a research and advocacy agenda for rectal microbicides in Africa. Project ARM shows us what are the priorities in terms of research, advocacy and community mobilization around rectal microbicides in African context. One of the priorities that came out of Project ARM discussions was lube access. The reason was that people who practice anal sex cannot access lubricants."
"We have to recognize that it is not just MSM and transgender people who have anal sex but also men and women in heterosexual relationships. If that route of HIV transmission is not looked at then HIV rates are bound to rise in those practicing anal sex."
IRMA grants announced
Jim Pickett announced in this press conference that few grants have been awarded to some projects to advocate for national and local-level access to safe, affordable, condom-compatible lubricant in Africa to improve the impact of HIV prevention services. These projects are based in African countries such as Cameroon, Ghana, Kenya, Nigeria, Tanzania among others. This is the second year for IRMA to support projects in Africa. This year the grants are supported by amfAR, AVAC - Global Advocacy for HIV Prevention, COC Netherlands, and IRMA.
PrEP and WHO Guidance for key populations
Deirdre Grant from AVAC -- Global Advocacy for HIV Prevention said that "WHO Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations" which were released at AIDS 2014, are first set of guidelines for key affected populations that not only addressed the common areas which affected them all, but also addressed population specific ones. Deirdre informed that these guidelines were for five key population groups which were: MSM, injecting drug users, sex workers, transgender people and people in prisons.
PrEP is recommended as an additional HIV prevention choice within comprehensive HIV prevention package for MSM in these guidelines. On use of PrEP by transgender people, Deirdre said that there needs to be more evidence before strong recommendation can be made for its use among this key population. Deirdre called for heightened advocacy around PrEP and noted that WHO guidance helps with agencies and funders but does not directly help people who want to access services. Lots of other issues such as barriers, investment needs, dearth of smart programming, lack of implementation science, etc must be addressed alongside rolling out the guidance.
Dr Seema Sahay, Deputy Director, National AIDS Research Institute (NARI), Indian Council of Medical Research (ICMR), who is a noted social scientist said: "We are focussing on how to reach 'hidden' MSM especially adolescent MSM as this population is also surfacing right now. This is one problem we will like to have some advocacy and challenge we face. We conducted a small qualitative study and realized that knowledge about PrEP is very low. 2/39 MSM had heard of that. There should be some education programme and advocacy for PrEP as message about PrEP has not reached majority of MSM."
Vijay Nair, who demonstrated leadership years ago in India to organize HIV positive MSM as a network called NIPASHA+. Currently he is involved with India HIV/AIDS Alliance. Vijay expressed concerns if new HIV prevention technologies will ever reach those MSM who are in need.
Discussions about these new HIV prevention technologies are often limited to global conferences or meetings with little ground work taking place in our countries. He expressed concern why it has taken over two decades to do female condom programming after US FDA approved it in 1993? PrEP was approved by US FDA in July 2012 but still there is no clear sense how PrEP will reach MSM in need. He agreed with Dr Seema Sahay's observation that there are 'hidden' MSM in India who are not part of (or perhaps do not want to be part of) targetted interventions for MSM, and PrEP could be an option for them.
Bobby Ramakant, Citizen News Service -- CNS
- Shared under Creative Commons (CC) Attribution License
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