GOVERNMENT SEEKS DONOR FUNDING FOR NEW PANTY CONDOMS

Many at times, we are stuck with no condom as the body agitates towards the ultimate point. Thus we give in to Sexually Transmitted Infections, unwanted pregnancies and so forth. The good news is that panty condoms could save the rush hour of the day.

Speaking at 27th Science café held at Health Journalists Network in Uganda premises in Ntinda, Dr. Moses Muwonge, Director of Samasha Medical Foundation (SMF) demonstrated about the new innovation, panty condom as a prevention mechanism against Hepatitis B &C, HIV and other infections. Vastha Kibirige, National Condom Coordinator at Ministry of Health and Timothy Damulira from UHMG were also present.

 A panty condom is a V like or G-string, embedded with a softly wrapped condom on the middle part. It’s made of a polythene material and is non rubber.The middle part has an opening where the penis penetrates through the embedded condom to the virginal.The condom sleeps well on the virginal walls living room for only penetration.Hence there is no need of using your hands to dress the condom.

As a matter of fact, the embedded condom is used once and thereafter it’s pelt off from the middle part and wrapped in tissue for disposal in a suitable place like a latrine. The G-string can be kept to put on another condom, as provided for in the panty condom package or can be fashionably kept as an accessory. The G-strings are designed in all sizes and colors but it’s positioned for the corporate lady.

The panty condom comes with an extra  condom..
The panty condom comes with an extra condom.

Fortunately the panty condom is convenient in rush hours, acts as a bargaining tool for a woman in case the man has no condom. Panty condom helps in dual protection against infections/diseases and prevents conception.However besides intercourse; it doesn’t give room for fore play especially the western jazz.

Dr. Mwonge affirms that the condom will be on the market by October this year because it’s still under a London acceptability study of six months, which is done by Uganda National Council Study. “Also there is need for donor funding for the project so that we can equitably give out free panty condoms for social marketing, administer an average price for commercial.”

Kibirige says annually Uganda receives 240million condoms of men and atleast one percent of that for females. “We depend on donors like Global Fund, UNFPA for condoms. Otherwise we don’t have money for condom programming and promotions because we are updating an implementation plan on the National Strategy on condoms.”

“The public should be able to pay for the sustainability of the condom because in 2017,public sector condoms are highly used at 79% and of these 30% are wasted according to the Total Market Approach Report 2016”, Kibirige says.

According to the Total Market Approach Report 2017, the condom market is growing with 28 brands as of 2016 from 19 brands in 2011.

SMF is at the forefront of marketing and distributing the panty condom. The condom was an initiative and innovation, identified by Path under a collaborative effort and project.Panty condoms are manufactured in Colombia and registered in Germany.

 

PrEP and Microbicides:

 

 

 

Facilitator

 

Esther Nakkazi

 

 

CaféTitle/ Topic PrEP and Microbicides: ARV-based prevention technologies in the wake of the CROI results and the implications for HIV prevention worldwide.

 

 

Location Kampala, Uganda

 

CaféObjectives

 

 

·         Toprovidea platformfor engagementbetweenkeyjournalists andbiomedical HIV preventionscientists, programimplementers, advocates,policymakersetc.inUganda

·         Toprovidejournalists updatesonlatestdevelopments in researchonmicrobicidesandother newor emergingbiomedical HIVpreventionoptions

 

·         Help journaliststogeneratestoryandfeaturesideason microbicidesandothernew oremergingbiomedicalHIV preventionoptions, critiquetheir work andengageinthought provokingdebate

·         Tolay thegroundworkforongoingdialogue amongstjournalists onscientific relatedtopicsandfindings, especiallyrelatedtoHIV issues

 

·         Toprovidenetworkingopportunities amongjournalists themselves,andbetweenjournalistandadvocates, policymakers, researchersandimplementers.

“Media ScienceCafés” present aplatformfor uniquepublic engagementonissuesthatmaybeisolated fromthe general public, includingjournalists. Thesecafésare conducted inaninformal settingoversoftdrinks, tea andsnacksthat allowsforcasual interaction. Themaximum numberof participants is usually 25toallowfor greater andmorein-depthinteractionandabsorptionof the topics discussed. Targeted keyresources –preferablyarespectedscientist and/or implementer, policymaker,[potential]clientwhoismedia  savvy,keyadvocateshouldbeavailable toensurethatexpert opinions are shared.

 

 

Participants

 

Like the inaugural event, the second science café, which was held on March 4, 2015 brought together journalists from the print, broadcast and online platforms.

Several journalists who attended the first café were present as well as new young journalists who are starting to get their feet into health/science reporting.

Many showed enthusiasm in learning and knowing more about the different HIV prevention technologies, especially microbicides and PrEP and the debate that will follow.

Proximity plays a key role to the enthusiasm displayed by the journalists. One of the research studies, the Partners Demonstration Study is being conducted in Uganda and Kenya.

 

 

Partners Partners Demonstration Project (Specifically focusing on Pre-Exposure Prophylaxis for HIV prevention and civil society advocacy to develop PrEP guidelines in Uganda) and University Johns Hopkins University Collaboration (MUJHU), focusing on the Microbicide vaginal ring.

 

 

Highlights,keyquestions/Themes

 

 

 

 

 

 

 

 

 

 

 

 

 

Themes

 

Pre-Exposure Prophylaxis:  What is it in light of the Partners Demo results that were released recently?

 

DrNuluBulya from the Infectious Diseases Institute/Partners Demonstration Project took the journalists though this topic, discussing the current status of the research, what has come out of it and the way forward.

DrNulu started her discussion with the definition of PrEP, explaining that it involves the use of antiretroviral medicines to reduce the risk of HIV infection in an HIV negative person, especially those in discordant relationships.

She explained that the Partners Demo Study was undertaken as a result of findings from a 2012 study that found Truvada, an antiretroviral drug was effective in reducing the risk of HIV acquisition by a negative partner.

“When the clinical trial was carried out, it demonstrated that if used consistently, Truvada was 75% against HIV infection,” said DrNulu.

It also sought to demonstrate how PrEP, away from clinical trials could be used in a real world setting.

 

In Uganda, the number of people getting infected with HIV continues to grow, while many are living in discordant relationships.

The study sought to establish if people in discordant relationships would accept to use the intervention of ART for the positive partner and PrEP for the negative partner in order to reduce the risk of infection for the negative partner.

“So far the results we have is that PrEP can reduce the risk of infection by 90 per cent,” said DrNulu.

The PrEP study was started in 2013, with first enrolment in November. It has enrolled 1013 people at two sites in Kasangati and Kabwohe Clinical Research Center in Uganda and . There are two other sites in Kenya– Kisumu and Thika.

 

Civil society perspective on PrEP

Charles Brown, also from the Partners’ PrEP demonstration study gave a civil society perspective, focusing more on advocacy for the establishment of guidelines/policies that ensures that health workers are able to administer PrEP.

“From the recent CROI 2015, we now have more than enough data that PrEP works. What we want is for the government to come up with guidelines that can be used by health workers both in the public and private facilities to prescribe PrEP,” said Mr Brown.

At the moment, many discordant couples and other key risk groups are missing out on the opportunity to access services because the country does not have these guidelines or policies in place.

 

He also urged the media to play a leading role in pushing the government to put in place such policies.

 

  The Vaginal Ring

 

Dr Dr. ClemensiaNakabiito, Makerere University Johns Hopkins University Collaboration (MUJHU

 

DrNakabiito discussed the potential of the vaginal ring, which she said will be a life-changing HIV prevention technology for women if found to be effective at the end of the study.

The dapivirine ring was developed by the International Partnership for Microbicides (IPM) and the active ingredient in it is an antiretroviral (ARV) drug called dapivirine.

The ring is designed in a way that a woman can insert and remove it on her own without a health worker being present.

Explaining to journalists how it works, DrNakabiito said once placed inside the vagina, the ring slowly releases dapivirine during the four weeks when a woman is wearing it.

According to DrNakabiito, the vaginal ring study is targeting women who are at high risk of contracting HIV.

Uganda has been previously involved in other HIV prevention studies that specifically target women. One example is the trial involving the use of a microbicide gel. However, the trial was discontinued because the women using the gel with the active ingredient under study and those using the placebo were getting infected equally.

The Daprivirin ring study started in 2013 and the site at the Makerere University-Johns Hopkins University Research Collaboration (MUJHU) was the first to enroll women.

The study is being conducted in Uganda, South Africa, Zimbabwe and Malawi. In total, there are 15 sites across these countries where the trials are being conducted.

A similar study is being conducted at a trial site in Masaka, although the design is different.

DrNakabiito said so far the data from the study shows the ring is safe. As a result, MUJHU was stopped from enrolling more participants.

“After analyzing the available statistics, we found that the 2629 women we had enrolled were enough to give us an end point of effectiveness. So far the safety is okay,” said DrNakabiito.

Before enrolment on the study, community sensitization was carried out to inform the women of its intentions and why having an effective method to prevent women from getting HIV/Aids is important. 

After the community sensitization, more information is usually given at the site, where screening is done to ensure those enrolled are from the intended high-risk group of women.

In this case, a high-risk person is defined as someone who has had sex at least once in the last three months, without a condom or a person who has multiple partners.

One of the biggest challenges involving such large scale and long-term trials is adherence and the ability to remain in the trial to its conclusive stage. “Once a person makes a commitment to take part in the study, they are encouraged to continue with the process to its completion” explained DrNakabiito.

 

Key questions from journalists

Can we say the vaginal ring is on track as far as protecting women against HIV is concerned?

·         We are closing the follow-up of the participants. By July we will have stopped following up all the participants and then the data will be analyzed.

·         We expect results in the last quarter of this year or first quarter of next year

·         So far it is safe but we have to combine results of the ring study in SA and Masaka sites.

·         At the moment we continue to give the women the ring to wear for one month before returning to the centre. Some get the one with the product under trial and others continue to get the placebo.

·         When they return every month, we test them for HIV and pregnancy because we don’t want them to become pregnant when they are on the ring.

 

·         When they become pregnant, we discontinue the product.

 

So will the ring be recommended only after we have the final results? How is this information important at this stage?

  • Of course for the community, the information is important. It would meant that women adhered to the ring and when the results turn out to be effective, all those who have been in the trial but taking the pacebo will be given the actual product.
  • The message for most of the population in the research is adherence, which has been a challenge because if you don’t take the product as prescribed, there is no way you are going to find out if it works or not.
  • We shall also combine it with other preventive technologies.

 

  • In Africa what measures can we put in place to ensure adherence
  • For every trial we do, we are now attaching a behavioral study to understand the community. -May be we are giving them something they do not want. May be we are not understanding the community. So we have a behavioral science trial within the trial.
  • We ask the women what difficulties they found in using the ring.
  • Male involvement is still a challenge. Many women feel if they put on the ring, the men will feel it during sexual intercourse.
  • We tell them we are trying to find something for them because they don’t have control of using things like the male condom.
  • We also want men to understand that if women find something to prevent HIV, it is also going to benefit them.

 

In these studies, do you offer incentives for the women to be able to participate?

  • We compensate their time and give them transport reimbursement.
  • During the consent signing, we explain to them what will happen and how long and how much of their time may be required. At each visit they may spend almost a whole day.

 

Do you think the long study period also contributes to the lack of adherence?

  • During the VOICE study, we found the non-adherence started at the beginning and not the end. Even for this study, some women would come and tell us they decided to pull out the ring because they had issues. There are several factors that affect adherence which we must address.

 

Explain what the vaginal ring looks like and what it contains.

  • Vaginal rings are flexible products that can be inserted inside the vagina and provide sustained delivery of drugs over a period of time.

·         The active ingredient in the ring is an antiretroviral (ARV) drug called dapivirine.

 

Why did you target people in discordant relationships?

  • The HIV negative partner in a discordant relationship is at a high risk especially if their partner has not initiated ARVs or has not used ARVs for 6 months. So if we are able to identify them before the transmission occurs, the negative partner will benefit and may be protected from contracting HIV.

 

How does PrEP work and when does someone start taking it?

  • For the study, we are using PrEP during a time when the HIV infected partner in a discordant relationship has not initiated ARVs and from the time they initiate ARVs, we allow them to use ARVs for at least six months and during this period the viral load will go down and the immunity will be suppressed.
  • During this period which may take six months or longer, some people may decline to take the medication because of stigma or other factors so we want to give them support.

 

How has been the adherence of PrEp by the participants?

  • Before we enrolled the participants, we took them through intensive counseling to understand the benefits of the study. While some eventually opt out, our retention rate has been about 85 per cent. Others are usually lost to follow up while some may have changed location. Adherence is important and we want people to police themselves.
  •  

Can PrEP be taken like family planning?

  • It cannot be taken as an emergency pill. When used by everybody, it may be prone to abuse and resistance just like we have seen with many other drugs. That is why we are pushing for guidelines so that it is only health workers who can administer it.

 

Does PrEP have side effects?

  • It has minor side effects. People who have used it usually report abdominal symptoms like diarrhea. The side effects are minor compared to the benefit a person gets by consuming the drugs.

 

 

 

 

 

 

 

 

 

Other issues arising

 

 

To ensure that journalists do not misrepresent issues arising from the discussion, especially about the vaginal ring, DrClemensiaNakabiito wondered if would be possible for her to look at the articles before publication.

However, Esther Nakkazi assured her that the journalists would be trusted to be able to write accurate stories as they have always done so. She also encouraged all those journalists to seek any clarifications on things they did not understand with the presenters.

The contact details of the presenters were shared with the journalists

Resources/materials used

 

  • Fact sheet from the International Partnership for Microbicides: The Dapivirine Ring for HIV Prevention in Women
  • Pre-Exposure Prophylaxis for HIV Prevention in Uganda 

 

Stories linked to café http://www.theeastafrican.co.ke/news/HIV-study–Vaginal-ring-shows-promise-/-/2558/2711322/-/87ih9w/-/index.html

 

http://www.independent.co.ug/features/features/10157-arvs-for-hiv-negative-people

 

 

 

 

STRAIGHT TALK SEEKS NATIONAL CONCERN AGAINST ILLICIT DRINKING AMONG YOUTH

Straight Talk Foundation (STF) steps up the game on advocating for the regulation of illicit Alcohol among the youth. Red Card campaign has strives to register success in teacher training, peer education, engagement with district and national level advocacy and provision of information on the dangers of underage alcohol consumption.

Underage alcohol consumption exposes one to reckless antisocial behavior like drug abuse, having multiple sex partners that drive to easy spread of diseases.

This year, STF aims at pursuing high national level advocacy on the enactment of the use of national Identity cards to minimize the sale of alcohol to minors, banning of alcohol sachets, regulation of illicit alcohol, sensitization of opinion leaders about liquor regulations so as to improve them in control of non-compliance.

 

Susan Ajok, Executive Director STF confirms that a shared responsibility against the issue of underage drinking, with individuals, families, governments, law enforcers, educators and other partners can address alcohol abuse by young people.

A recent pilot study conducted by STF was carried out in November 2016 in Gulu, Kabale, Soroti and Kampala targeting 100 children. According to Richard Imarit, Research and Evaluation Manager STF, it reported that 50% had consumed illicit alcohol that include kasese, Eguli, Waraji and 17% of them were underage consumers. Of these, 25% were male and 9% were female.

As a matter of fact, some of the facilitating factors for underage drinking included easy accessibility, cheap cost, mobility of the packaging(it’s easy to move with)preference and taste.

However this is highly attributed to breakdown of family structures. “We need to look out for ways to build social psychological competencies of the youth”, Ajok confirms.

Results from the study had various impacts on different subjects for instance deepens their poverty levels, incites gender based violence where 5 in 10 women are beaters, sexual based violence and peer pressure

As a way forward to curb down on underage drinking, Ajok advised, “Parents ought to administer right norms at home. Through an integrated approach, illicit alcohol can be regulated by working with a cross section of leaders, and inspection of property should be prioritized at school with periodic checks to eliminate alcohol smuggle,” Ajok advised.

Also focus on behavior change by learning from different experiences and testimonies of the former victims.

Straight Talk Foundation organized the 26th media café at their premises in Kamwokya last Wednesday.

MEDICAL MALE CIRCUMCISION

 

Facilitator

 

 

Esther Nakkazi

 

Location

 

 

 

Kampala, Uganda

 

 

Café topic

 

 

Medical Male circumcision as an HIV prevention tool. How much progress have we made?

 

 

 

Café Objectives

·         Toprovidea platformfor engagementbetweenkeyjournalists andbiomedical HIV preventionscientists, programimplementers, advocates,policymakersetc.inUganda

·         Toprovidejournalists updatesonlatestdevelopments in researchon newor emergingbiomedical HIVpreventionoptions

 

·         Help journaliststogeneratestoryandfeaturesideason the new andemergingbiomedicalHIV preventionoptions, critiquetheir work andengageinthought provokingdebate

·         Tolay thegroundworkforongoingdialogue amongstjournalists onscientific relatedtopicsandfindings, especiallyrelatedtoHIV issues

 

·         Toprovidenetworkingopportunities amongjournalists themselves,andbetweenjournalistandadvocates, policymakers, researchersandimplementers.

·         “Media ScienceCafés” present aplatformfor uniquepublic engagementonissuesthatmaybeisolated fromthe general public, includingjournalists. Thesecafésare conducted inaninformal settingoversoftdrinks, tea andsnacksthat allowsforcasual interaction.

·         Themaximum numberof participants is usually 25toallowfor greater andmorein-depthinteractionandabsorptionof the topics discussed. Targeted keyresources –preferablyarespectedscientist and/or implementer, policymaker,[potential]clientwhoismedia  savvy,keyadvocateshouldbeavailable toensurethatexpert opinions are shared.

 

 

Participation

 

·         This was the third Science Café being held by the Health Journalists Network In Uganda. It brings together journalists from the print, broadcast and online platforms.

·         Several journalists who attended the previous cafés were present as well as new journalists keen on understanding and covering health/HIV/Aids issues.

·         The participation was very lively as journalists sought to understand the perception of men, women and young adults towards issues of medical male circumcision. The fears, misconceptions and facts about the intervention etc…

 

 

Partners

 

Aids Control Program/Medical Male Circumcision Program, Ministry of Health, Uganda Network of Aids Service Organizations, Aids Information Center.

   
 

Highlights,keyquestions/Themes

 

Themes

Key issue: What is Safe Male Circumcision? How much progress has Uganda made in implementing the program? What are the current challenges to implementation of the program?

DrBarbara Nanteza, the National Safe Circumcision coordinator at the Ministry of health gave the main presentation, taking journalists through the voluntary circumcision program since the government launched it.

DrNanteza started her discussion by clarifying previous press reports indicating that men who had undergone circumcision were getting infected with tetanus, which would later turn fatal.

Dismissing the allegations as baseless, DrNanteza said records at the Ministry of Health show of the 2 million men so far circumcised under the government’s free program, only 5 deaths related to the procedure have been reported.

On the contrast she said within the same period, a total of 1128 people have died of tetanus, and majority are women. This means that there is no correlation between men being circumcised and an increased risk for tetanus infection.

“We have a lot of background tetanus in our community—among children, women and men,” she said.

She explained that there were still many myths surrounding circumcision, which was affecting the program.

“Our president does not like circumcision so any negative publicity is bad. Let us work together to make the program a success,” she said.

Outlining the progress so far made with the safe male circumcision campaign, DrNanteza said the numbers have been growing from 60,000 to a current 2 million within a period of three years.

She explained that of the 14 HIV endemic countries in Africa, Uganda is considered a success story in ensuring more men get circumcised because it was given a bigger target of circumcising up to 4.2 million men in a five-year period ending 2015.

Kenya, for instance, she says was given a target to circumcise only 800,000 men within the same period.

She explained that the government has put in place the infrastructure—including buildings and the human resources, while money for the actual delivery of the program comes from the US President’s Emergency Plan for Aids Relief (Pepfar).

However, because of the negative publicity that has surrounded the safe male circumcision program in the past few months, Pepfar will this coming financial year give money to carry out circumcision on only 300,000 men compared 750,000 in the past year.

“There is no money so unless we hype our circumcision campaign through the media we are on the downward trend. We also need to have the political will—to ensure the politicians also put money in the program otherwise it is currently being funded solely by donors,” she explained.

 

New methods of circumcision

Although the government started the program using the surgical method, it has recently introduced a non-surgical method, using a device called PrePex.

According to DrNanteza, clients have a choice to decide which method they want to use after they have gone through extensive counseling.

 “PrePex is the best method so far because it does not involve any blood. The health worker makes you wear the ring for 5-7 days. During this period, the foreskin gradually falls off on its own and the person returns to the health facility to have the ring removed,” she said.

Besides the PrePex for adult males, DrNanteza revealed that another similar, non-surgical circumcision method is being tested for children using a device called a glamco clamp.

A Gomco clamp is a metal device with a bell-shaped end. During circumcision, the baby’s foreskin is stretched over the bell and the clamp is tightened over his skin. The skin cuts away and the clamp is removed a few minutes later.

The pilot project, funded by the Bill and Melinda Gates Foundation, is being undertaken in Rakai district in central Uganda. At least 200 infants between the age of 1and 59 days have already been circumcised, with an additional 300 expected to undergo the procedure by the end of July.

 

Civil society perspective

Marion Natukunda from the AIDS Information Centre and Sylvia Nakasi from the Uganda Network of Aids Service Organisation said funding for the free circumcision program from government remains almost non-existent because it has not been made a priority.

“The president is anti-circumcision. So if we do not have the political will from the top, we cannot get the funds needed for the program to succeed,” explained Sylvia Nakasi, the policy and advocacy officer at UNASO.

 

 

 

Key questions from participating journalists

 

 

 

 

 

Do you have campaigns with educational institutions such as universities and schools?

  • I know Implementing Partners (IPs) who do that but like I have told you, my job is to supervise these people who have the money. They go out to look for people to circumcise. So it is according to their working mode. They can choose to go to schools or other educational institutions.
  • We go where we think we can best get these people.
  • Initially, we wanted to circumcise men who are between the ages of 15 and 45. Then we found out that it was the younger people—15 and below who are coming for the services.
  • So now we have lowered the age and can now do circumcision for boys who are 10 and above.
  • Some people even want us to go lower to start from the age of five, but we are saying we are doing circumcision for HIV prevention so we need to target those who are sexually active, or about to become active.
  • However, because we are looking for numbers and we are not getting them through the older men, we are now looking at the young people as well, even though our priority is still the older men.

 

What strategies have you come up with to ensure people do not perceive circumcision in a negative light?

  • The first tetanus case linked to circumcision happened in July 2013. Three other cases came up in August and September 3 came in August and September 2014. I had to do research by going to a hospital in Busia where one of the tetanus cases came from. I looked at the tetanus patients at the hospital from 2009 to 2014.
  •  There were about 25 cases, and out of those, none was circumcised. The majority had been knocked by bodaboda and sustained lower extremity injuries. And because they had not got tetanus shot before, they became infected.
  • So we have done research, written to all circumcision IPs on what they should do. I am coming up with a strategy and I will soon go to media houses to tell people how dangerous tetanus is. I hope after the campaign, when we start circumcising again we shall not get these negative stories about tetanus being caused by circumcision.

 

Do you have sensitization messages in local languages?

  • We started the sensitization program in the central region and soon we shall go to the north. I think they are translating them into the various local languages. We have billboards and the IPs who work in the different areas have materials and radio spots in the local languages. We have 12 languages so far.

 

What kind of feedback do you get from people who are circumcised?

It has now become a choice. For adolescents, it is stylish to be circumcised and it is the girls who are pushing them to do so.

For those 35 and above, the wives usually object to the men being circumcised for fear that they would become promiscuous. The women think that because it reduces the risk of HIV by 60 per cent, men will go ahead and have multiple sexual partners.

We are now involving the women to tell them that if their spouses go for circumcision, they should not get angry.

 

 

When do you plan to begin the non-surgical circumcision program for babies and is it different from PrePex?

  • PrePrex is something we are using among men who are 18 and above. Soon we may go even below. It has different sizes—A, BCDE. Recently, Ugandans need size FG and H for some parts of the country.
  • When you come for PrePex, we first explain to you how it works. We have a sizing plate, which we put around the neck of the penis to establish the size of PrePex an individual needs.
  • The PrePex stays in place for 5-7 days. Because the skin upwards stops having supply of blood, it becomes dead and black.
  • It takes 5 minutes to place the ring and 3 minutes to remove it.
  • People’s skin dry at different rates. We set 5-7 days for it to dry and heal. However, we advise men who have undergone the cut to abstain from sex for about six weeks.

 

 

Resources/materials used

 

 

 

National Safe Male Circumcision Policy  produced by the Ministry of Health.

 

Stories linked to café

 

 

 

http://www.monitor.co.ug/News/National/Men-shun-circumcision-as-youth-dash-for-the-knife/-/688334/2713478/-/tmr2b4z/-/index.html

 

http://www.theeastafrican.co.ke/news/Uganda-tests-new-method-of-circumcision-for-infants-/-/2558/2718764/-/jbgg7c/-/index.htm

 

 

http://www.newvision.co.ug/mobile/Detail.aspx?NewsID=668472&CatID=1

 

 

 

 

 

 

 

 

 

 

 

HIV prevention and research updates

 

Facilitator

 

 

Esther Nakkazi (Health Journalists Network In Uganda)

 

Location

 

 

 

Kampala, Uganda

 

 

Café topic

 

 

HIV prevention and research updates

First café of 2017 and Participation  

·         This is the first Science Café held by the Health Journalists Network In Uganda in partnership with AVAC for 2017.

·         Science cafes bring together journalists from the print, broadcast and online platforms.

·         The participation was very lively as journalists sought to understand prevention/research related interventions with regards to HIV.

 

 

 

Café Objectives

 

·         Toprovidea platformfor engagementbetweenkeyjournalists andbiomedical HIV preventionscientists, programimplementers, advocates,policymakersetc.inUganda

·         Toprovidejournalists updatesonlatestdevelopments in researchon newor emergingbiomedical HIVpreventionoptions

 

·         Help journaliststogeneratestoryandfeaturesideason the new andemergingbiomedicalHIV preventionoptions, critiquetheir work andengageinthought provokingdebate

·         Tolay thegroundworkforongoingdialogue amongstjournalists onscientific relatedtopicsandfindings, especiallyrelatedtoHIV issues.

 

·         Toprovidenetworkingopportunities amongjournalists themselves,andbetweenjournalistandadvocates, policymakers, researchersandimplementers.

 

 

·         Media ScienceCafés” present aplatformfor uniquepublic engagementonissuesthatmaybeisolated fromthe general public, includingjournalists. Thesecafésare conducted inaninformal settingoversoftdrinks, tea andsnacksthat allowsforcasual interaction.

·         Themaximum numberof participants is usually 25toallowfor greater andmorein-depthinteractionandabsorptionof the topics discussed. Targeted keyresources –preferablyarespectedscientist and/or implementer, policymaker,[potential]clientwhoismedia  savvy and keyadvocates.

 

 

Partners

 

Makerere University School of Public Health, Infectious Diseases Institute and UNASO

   
 

Highlights,keyquestions/Themes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Presentations and Resouce Persons:

Dr Noah Kiwanuka, Dr Timothy Muwonge, Charles Brown, Sylvia Nakasi, Moses Supercharger.

Also present were Angelo Kaggwa and Kay Marshal from AVAC, Ida Jooste and ChaachaMwita from Internews, who came to observe how the science cafes are conducted.

Ida and Chaacha will also be working with journalists under Hejnu to offer training and help improve the skills of the journalists.

 

Themes

Key issue: HIV prevention and update on research interventions. 

 

Dr Noah Kiwanuka (Makerere University School of Public)

DrKiwanuka opened the café by giving journalists a basic history of HIV, giving a background of how the disease is spread and the different interventions that can help prevent it.

He noted that while majority of the people contract HIV sexually, it could also be transmitted from mother to child, or by sharing infected sharp instruments such as needles.

However, he said that for the virus to be spread from one person to another, the infected person must have enough virus in the body to transmit it.

And because the forms of transmission are known, there are several interventions that are already being undertaken to help prevent its spread.

He then went ahead to explain some of the interventions/research that have been undertaken/ is ongoing in the area of HIV prevention. 

As a starting point, DrKiwanuka said people who are infected with HIV should know their status so that they do not spread the virus. On the other hand, those who are not infected also need to know their status so that they keep safe.

In this case, he says HIV counseling and testing becomes one of the key means to prevention.

According to DrKiwanuka, when people do not test, it becomes hard to know whether they are infected or not as it takes between eight and 10 years before a person shows signs of HIV/Aids after acquiring the virus.

Testing, he said should also be accompanied by counseling to enable those who are found to be positive cope with living a positive life, as it is a life-long status.

DrKiwanuka said another reason why counseling is important is because it helps in fighting stigma that is associated with being HIV positive.

“HIV is still a stigmatizing disease,” he said.

Treatment as prevention is crucial because if up to 90 per cent of the population get tested, those that turnout to be positive can be put on treatment immediately. This therefore reduces the amount of virus in the body and subsequently the risk of passing it to a sexual partner.

“Being on treatment has another important component of improving the overall health and life of the person, compared to one who is not on treatment,” noted DrKiwanuka.

Over and above, he explained that the advantage of treatment or taking ARVs helps in the general reduction of the burden of infection to the general population.

For young people, giving them information about HIV and ways to prevent it, including delaying sex is one way they can also reduce their chances of contracting HIV.

DrKiwanuka explained that there are a number of biomedical interventions that are being developed such as the use of vaccines.

There are two types of vaccines in this case: the preventive vaccines—that can be given those who do not have the virus yet and the therapeutic vaccines that can be given to a person who is already infected to help block the virus in the body from spreading and thereby reducing the chances of passing it from one person to another.

Much of the research at the moment, according to DrKiwanuka is on preventive vaccines.

He noted that interventions such as voluntary medical male circumcision and the use of PrEP should be promoted as research conducted on their safety and efficacy have proved that they are crucial in the HIV prevention program.

 

Dr Timothy Muwonge (Infectious Diseases Institute)

DrMuwonge’s discussion focused largely on pre-exposure prophylaxis (PrEP), which he said is one of the important HIV prevention interventions.

He explained that prophylaxis is medication used to prevent or reduce the risk of infection from a disease.

In the case of HIV, Truvada is the medication used as PrEP.

Studies on PrEP have been conducted in several African countries including Uganda, showing high levels of efficacy and safety among those who adhere to the treatment.

According to DrMuwonge, the key issue at hand now should be how to translate these research findings into practice.

Already, he said guidelines on the use of PrEP have been put in place. What remains is to roll it out.

 

The plan, at the moment is to have it rolled out in a phased manner.

DrMuwonge said as a start, through funding from PEPFAR, six sites have been identified in specific locations where PrEP will first be rolled out. The initial target is to benefit 3,417 individuals who are at high risk of contracting the HIV virus such as people in discordant relationships, female sex workers, people who inject drugs, migrant workers and men who have sex with men.

DrMuwonge emphasized that PrEP is not a substitute for other HIV preventive interventions such as the use of condoms, but rather an additional safety measure. He noted that with an estimated 83,000 new infections still occurring in Uganda, every year, it is important to embrace a wide range of prevention interventions. Another advantage of PrEP, according to DrMuwonge is that it plays a significant role in circumstances where women have a low bargaining power when it comes to negotiating for safe sex.

“PrEP comes in as one of the options that women can get,” he said.

 

Charles Brown, civil society advocate

 

Charles Brown explained that the civil society have been working with the Ministry of Health to develop the guidelines for PrEP. These guidelines he says outline what is required to rollout PrEP, including whom health workers should prescribe it to.

The test and treat program, he noted should also be expanded to reach more people.

“As advocates, we want to see a rollout of the test and treat program because we think it has not been exploited,” said Mr Brown.

Besides the test and treat program, viral load monitoring should also be expanded to ensure people can monitor their health.

He said prevention emphasis should also be put on key populations.

“There is a lot of HIV among key populations but they also interact with the rest of the population. These are the drivers of HIV,” he said.

 

Moses Supercharger, advocate

In his discussion, Supercharger, an advocate and person living with HIV said drug resistance is becoming a big challenge in addressing HIV prevention.

As a person on second line medication, he said many people who fail on first line were not being enrolled on second line or third line drugs because of funding challenges, as the drugs for third line are very costly.

For instance, it costs the government Shs 50,000 per person per month to be on first line medication, compared to Shs250,000 per person per month for those on second line and Shs850,000 for those on third line.

Supercharger said poor adherence to medication is the main reason people are developing resistance. This, in turn is driven by factors such as poverty.

He however said there is poor education about drug resistance in Uganda and many people may be failing on drugs without exactly knowing about it.

He said the government should pay more attention to the growing threat of drug resistance because it will also fuel new infections.

 

 

 

 

 

 

Stories linked to café

 

 

http://www.chimpreports.com/uganda-to-test-new-hivaids-prevention-vaccine/

 

Radio stories:

1-Sanyu FM (Aired 7/06/2017)—Uganda to rollout PrEP as experts call for implementation guidelines –By Damba Rogers

2-Prime Radio (aired 7/06/2017)—HIV prevention advocates warn on presidential Fast track initiative By Ben Musanje

3-Bukedde Radion–Ministry to rollout self-testing kits –By BenonNsubuga

4-Capital Radio—CSOs call for the establishment of more testing facilities—By DeoArinitwe

5-Voice of Africa Radio—People with HIV urge government on 3rd line treatment-By Muhammed Wamala

6-Radio One—Activists urge government to develop policy on third line therapy—By Leah Kahunde

7-Bilal FM—Luganda news on PrEP –By Halima Nalusiba

8-Mama FM-Luganda news—By Regina Nassanga

9-91.9 FM-Luganda news—Activists speak out on drug resistance—By Ronnie Mayanja

 

 

 

 

 

 

 

 

 

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