AIDS 2016 – a focus on progress and challenges

Members of the ALPHA Network have returned from AIDS 2016, which saw more than 15,00 global leaders, scientists, advocates, and frontline health workers gather in Durban for the 21st International AIDS Conference.

More than 17 million people living with HIV are on treatment, and both new HIV infections and AIDS-related deaths are falling. The conference focused on the work that needs to be done to achieve the global goal of ending AIDS by 2030.

The conference included addresses from high-profile speakers including; Chris Beyrer, AIDS 2016 International Chair and President of the International AIDS Society, Olive Shisana, AIDS 2016 Local Chair and President and CEO of Evidence Based Solutions,  Cyril Ramaphosa, Deputy President of South Africa, Michel Sidibé, Executive Director of UNAIDS, Nkhensani Mavasa, Chairperson of South Africa’s Treatment Action Campaign, Charlize Theron, Founder of the Charlize Theron Africa Outreach Project and United Nations Messenger of Peace, Bill Gates, HRH Prince Harry and Sir Elton John.

21st International AIDS Conference (AIDS 2016), Durban, South Africa. Monday 18th July 2016, VENUE : Durban ICC Main Hall Opening Ceremony Speakers : Ms Olive Shisana and Chris Beyrer Photo©International AIDS Society/Abhi Indrarajan

Durban ICC Main Hall Opening Ceremony Speakers : Ms Olive Shisana and Chris Beyrer

21st International AIDS Conference (AIDS 2016), Durban, South Africa. Monday 18th July 2016, VENUE : Durban ICC Main Hall Opening Ceremony Speaker : Charlize Theron Photo©International AIDS Society/Abhi Indrarajan

ICC Main Hall Opening Ceremony Speaker : Charlize Theron

Accelerating the Decline of the Burden and Incidence of HIV in Sub-Saharan Africa (WESS01) Special Session. Bill Gates speaks, 20 July, 2016.

Special Session (THSS01) Ending AIDS with the Voices of the Youth: How Stigma and Discrimination Affect Key Populations, 21 July, 2016 Sir Elton John and Prince Harry

The event featured 2,500 scientific abstracts and presentations including project results from the network throughout the week. During their well-attended symposium, the network presented new mortality results described as “the good, the bad and the ugly”.   The good– confirmation of how ART has succeeded in bringing down AIDS mortality and the resulting gains in life expectancy that have already been observed in their communities; the bad– identifying the parts of the HIV treatment cascade where excess deaths are still occurring; the ugly– the puzzling new differences between the epidemic impacts on men and women that are now emerging.

They also discussed how the methods developed by the partner studies of the ALPHA network could be applied in communities that are less intensively studied. As well as the demographic and HIV surveillance data, which are the basis of our mortality analyses, they presented the results of national policy analyses and facility surveys looking at how the policies were implemented in the health centres serving its communities.  The results of its qualitative “bottlenecks” studies also provided fresh insights on the experiences of community members navigating the HIV treatment cascade.

Slides, posters and webcasts can be downloaded below and the network would like to thank everyone who came to their symposium and presentation sessions.

Photo 18-07-2016, 16 07 45Photo 19-07-2016, 11 36 57Photo 19-07-2016, 12 25 29Photo 21-07-2016, 13 18 23Photo 20-07-2016, 13 06 36

Symposium: HIV Mortality Trends in Africa in the Treatment Era: New Evidence from the ALPHA Network of Community-based HIV Surveillance Studies

Co-chair’s introduction: the ALPHA network: What makes ALPHA data on HIV mortality unique?
The good news – expansion of policies and services and the rapidly shrinking burden of HIV mortality
The bad news – residual mortality on the HIV care continuum and insights on the experiences of people who died of HIV
The ugly news – widening gender disparities in ART access and benefits: warnings for test and treat programs?
Breaking news – opportunities and challenges going beyond the study populations, linking research and routine service data
A critical evaluation of the evidence presented from the UNAIDS perspective

Tuesday 19 July

Poster exhibition

Population-wide adult mortality following expansion of ART in the Rakai district (Uganda) (TUPEE526) Doreen Nabukalu, Rakai, Uganda

The rapidly shrinking burden of HIV on adult mortality in KwaZulu-Natal, South Africa (TUPEC132).Georges Reniers, LSHTM

Eddies, backflows and stagnancy: qualitative research findings on the HIV treatment cascade (TUPED273). Morten Skovdal, Manicaland

Factors associated with acquisition of HIV during 2005-2014 in 7 ALPHA network cohorts (TUPEC141). Emma Slaymaker, LSHTM

Oral Abstract Session Track D– Shame-Less: Stigma Interventions That Work Presentation: Changing forms of HIV stigma along the HIV care and treatment cascade: findings from a multisite qualitative study in eastern and southern Africa (TUAD0405). Joyce Wamoyi, Kisesa, Tanzania

Wednesday 20 July

Poster exhibition

HIV policy implementation in S.Africa: evidence from policy reviews and facility surveys (WEPED453). Natsayi Chimbindi, Africa Centre, S.Africa

Healthcare providers go beyond their call of duty in an ART programme in rural KwaZulu-Natal (WEPEE490). Natsayi Chimbindi, Africa Centre

Opportunities and challenges for ‘test-and-treat’ in E. and S. Africa: (WEPED431). Constance Nyamukapa, Manicaland. Zimbabwe

HIV testing models and their implications for patient engagement with HIV care (WEPED375). Alison Wringe, LSHTM

How ambivalences in the provider-patient relationship mediate access to care (WEPED430). Fredrick Odongo, Kisumu KEMRI, Kenya

EWhat is the truth? A comparison of HIV results from VCT rapid test and standard ELISA (WEPEC144). Emanuel Mwendo, Kisesa, Tanzania

When ‘bad’ patients transform into ‘good’ patients. (WEPED333). Mosa Moshabela, University of KwaZulu-Natal, S.Africa

Understanding couple dynamics and engagement with HIV care services: (WEPED314). Joyce Wamoyi, Kisesa, NIMR, Tanzania

Oral Poster discussion – Translating Tradition in the AIDS Response Presentation: Promise or Peril? The nature of medical pluralism along the cascade of care for HIV/AIDS in eastern and southern Africa (WEPDD0101). Mosa Moshabela, University of KwaZulu-Natal, South Africa

Oral Poster discussion– Filling the Gaps in PMTCT/B+ Programmes Presentation: Counselled to compliance: experiences of Option B+ for the prevention of mother to child transmission in four health and demographic surveillance sites in sub-Saharan Africa (WEPDE0102). Estelle McLean, LSHTM

Oral Abstract  – It’s All in the Family Presentation: Partner communication and support around HIV and how this relates to health-seeking behaviour: a qualitative study amongst HIV-positive individuals and couples in Karonga, Malawi (WEAD0104). Jenny Renju, LSHTM and webcast.

Thursday 21 July

Poster exhibition

A qualitative exploration of barriers to “test and treat” for HIV, in Rakai fishing communities (THPEE593). Robert Ssekubugu, Rakai, Uganda

What influences patients’ presentation stage for HIV services in Uganda? (THPEE481). Dominic Bukenya Yiga, MRC/UVRI, Uganda

Oral Abstract– Barriers Must Fall: Community-Led Delivery Presentation: A comparative study of policy and practice influencing progression through HIV care (THAD0104). Fredrick Otieno, Kisumu, Kenya