Day Two of AIDS 2016: Women and girls, new prevention research, stigma and discrimination
“What a Girl Wants” was the title of a Tuesday Special Session at AIDS 2016, and understanding what HIV prevention tools and information girls and young women want and need, and how to provide them, is a continuing theme at the conference. Throughout AIDS 2016 we are reminded -- and are reminding the world -- of the enormous impact of HIV on adolescent girls and young women, especially in sub-Saharan Africa.
AIDS 2016 symposia sessions on the impact of HIV on adolescent girls and young women, and how to reverse it, featured The United States President's Emergency Plan for AIDS Relief (PEPFAR) leader Ambassador Deborah Birx, humanitarian and former South African Frist Lady Graça Machel, actor and activist Charlize Theron, Global Fund chief Mark Dybul, UNAIDS Executive Director Michel Sidibé and other towering figures in the fight to achieve female health and empower girls and women to stay safe from HIV. The sessions gave voice to a growing global consensus that prioritizing the needs of girls and young women is essential to saving lives and ending AIDS.
Maintaining the spotlight on HIV in times of political upheaval, budget shortfalls, and new epidemics such as Ebola was another Tuesday conference theme, with sessions and media events offering strategies for keeping HIV treatment and prevention moving forward in the face of earthquakes, armed conflicts, the refugee crisis, and a decline in donor funding that advocates called “unprecedented in the history of the AIDS response.”
Justice Edwin Cameron of the Constitutional Court of South Africa, the first senior South African official to state publicly that he was living with HIV, received a standing ovation when he gave the lecture named for pioneering AIDS researcher and advocate Dr. Jonathan Mann at Tuesday’s plenary session. Cameron, whose stirring talk included a frank acknowledgement of the impact of HIV stigma on his own life, paid tribute to South Africa’s Treatment Action Campaign (TAC), praised the national effort that has made antiretroviral treatment (ART) accessible to more than 3.1 million South Africans, and brought the house down when he invited sex workers, transgender people, and lesbians and gay men from Africa and the Caribbean to take the stage and share the Jonathan Mann honour with him.
One of the most encouraging elements of AIDS 2016 is the strength of research presented here on progress in HIV prevention. Incoming IAS President Linda-Gail Bekker christened AIDS 2016 as “the dawn of the global PrEP era,” and encouraged delegates to move science into practice for people at risk for HIV, especially key populations. Final results from the Partners Demonstration showed the near elimination of HIV transmission among serodiscordant couples with PrEP and ART, while a number of other studies offered new insights on PrEP uptake, acceptability and adherence.
Participants at AIDS 2016 also heard results from HVTN 100, a South African study of a modified version of the RV144 regimen, the only HIV vaccine regimen to show efficacy to date. HVTN 100 adapted the RV144 regimen to make it specific to the southern Africa’s Clade C HIV subtype, changed the adjuvant to elicit a more powerful immune response, and added a booster to prolong protection. The successful study provided the green light for a larger efficacy trial of the improved regimen, which, if successful, could lead to a licensed HIV vaccine in South Africa and the world’s first preventive HIV vaccine.
90-90-90 provides a useful framework and an ambitious set of targets for measuring progress towards achieving HIV diagnosis, referral to treatment and viral suppression – the three pillars of efforts to slow and ultimately stop the epidemic. In the session “Measuring Progress Towards 90-90-90,” presenters contrasted efforts and progress towards the goal across South Africa, Botswana, Namibia, and Zimbabwe. While each setting presents different opportunities and challenges, one striking similarity across the countries appears to be the comparative challenge of engaging men and adolescents in testing. More detailed reports on this and many other sessions from Tuesday, and throughout the conference week, are available on the AIDS 2016 Rapporteur Summary page.
Finally, the detrimental impact on the HIV response of laws that criminalize homosexuality, and punish sex workers, drug users and people living with HIV, has long been decried by health workers and advocates. But the appearance on the AIDS 2016 stage of high-ranking political figures working to repeal these laws may represent a turning point in the effort to make these regressive statutes a part of history. Strategizing in an AIDS 2016 Symposium on Tuesday on building the political will to overturn such laws was U.S. Congressperson Barbara Lee, Justice Zak Yacoob of South Africa’s Constitutional Court, and former Presidents Festus Mogae of Botswana, Joyce Banda of Malawi, and Ruth Dreifuss of Switzerland. We hope their words in Durban will echo through the corridors of power worldwide.
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