Dr Marie-Huguette KINGBO (Côte d’Ivoire)�Lead Rapporteur TRACK C

RAPPORTEURS SESSIONS

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TRACK C

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EPIDEMIOLOGY & PREVENTION SCIENCES

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INTRODUCTION

Dr Marie-Huguette Kingbo

Côte d’Ivoire

Lead Rapporteur TRACK C

Dr Grant Murewanhena

Zimbabwe

Rapporteur TRACK C

Ms Rumbi Gumbie

Zimbabwe

Rapporteur TRACK C

Dr Tapfuma Parirenyatwa

Zimbabwe

Rapporteur TRACK C

TRACK C: Number of sessions covered

HIV/AIDS remains a significant global health challenge

• Key populations remain disproportionately affected
• Women (AGYW) make up 63% of new infections (WHO, 2022)
• Women living with HIV have 6 x higher rates of cervical cancer compared to HIV-negative women

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PEDIATRIC HIV/AIDS

• 90% of all new pediatric and children HIV infections occurred in SSA
• The majority of HIV/AIDS related deaths are among children & infants in SSA
• It was reported that there remains a 20% gap in ART between adults & children
• There is a lack of easy access to early infant diagnosis and point-of-care tests for children

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EPIDEMIOLOGY (1/2)

PREVENTION STRATEGIES FOR HIV

• 35,000 new HIV infections among AYP in Mozambique
• 180,000 – 2million condoms are used in Uganda

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NCD & HIV AIDS

• Cardiovascular diseases are prevalent among PLHIV in Zambia (median age 44yrs) with 21% PLHIV over 50yrs. 14.5% prevalence of Hypertension

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EPIDEMIOLOGY (2/2)

ADVANCING INTEGRATED BIOMEDICAL PREVENTION SERVICES

VMMC uptake among adolescents in Zimbabwe - 98.9% acceptability and 81% chose Shang ring over surgery

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THE STEPPED CARE APPROACH: Defragmenting digital SRHR for young people

Help to provide health information & services and provide specialized support

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ADOLESCENTS AND YOUTHS highlighted as a key group for epidemic control

• AGYW a vulnerable group to the triple threat of incident HIV, SGBV and unintended pregnancy
• Tailored, Afrocentric preventive interventions driven by community needs are urgently required to drive control of the triple threat in this population

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PREVENTION SCIENCE (1/2)

Making PrEP delivery work for people: community based interventions

• Studies in Kenya and South Africa highlighted the success and acceptability of PrEP delivery through private pharmacies
• Significant gaps in awareness and knowledge of PrEP, including shang ring and long-acting injectable carbotegravir noted in communities
• Effective PrEP delivery requires precision and differentiated strategies to suit the needs of diverse populations

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PREVENTION SCIENCE (2/2)

“The need for improved access and continuity of services across delivery sites for young people who may experience challenges with consistent and convenient health service access given their lifestyles and mobility remains critical¹.”  

Source: 1 Catherine E. Martin, Laura Ashleigh Cox, Pelisa Nongena, Vusile Butler, Sydney Ncube, Shobna Sawry, Saiqa Mullick. Patterns of HIV Pre-exposure Prophylaxis use Among Adolescent Girls and Young Women Accessing Routine Sexual and Reproductive Health services in South Africa. Journal of Adolescent Health. 73(6) 2023

STIGMA & SOCIAL DISCRIMINATION

The magnitude of HIV and other STIs among key populations in SSA has been difficult to estimate due to significant barriers such as restrictive legislation, stigma and social discrimination

Prevention strategies and interventions

• Shang ring was demonstrated to be a safe option for adolescent boys in Zimbabwe. Governments urged to take up VMMC led by civil society organisations
• Investment in condom programming has yielded fantastic results and should be encouraged
• The fourth 95% will become critical as PLHIV age  

Integration of services

• Integration of NCDs into HIV care is not only about funding but building simple diagnoses into treatment and care
• Educational videos on screens in treatment center waiting rooms encourages care-seeking

Key Populations

• Include gender-affirming services and trans-affirming language (in Africa region) in health services to improve cervical and prostate cancer screening uptake

RECOMMENDATIONS (1/3)

NEW WHO 2023 recommendations

NEW: HIV self-testing may be used to deliver PrEP, including initiation, re-initiation and continuation (conditional recommendation, low-certainty evidence)

NEW: HIV self-testing may be offered as an additional option for testing at facilities (conditional recommendation, low-certainty evidence)

NEW: Caregiver-assisted testing using HIVST: There is insufficient evidence to support caregiver-assisted testing using HIVST kits.

NEW: On-demand dosing is now available for all men and not just MSM - including transwomen who are not taking hormonal therapy

NEW: Hep B is no longer contraindicated for PrEP 

UPDATED: Social network testing approaches may be offered as an additional approach to HIV testing as part of a comprehensive package of care and prevention (conditional recommendation, low-certainty evidence)

Source: IAS Satellite Symposia

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Source: WHO, 2022

RECOMMENDATIONS (2/3)

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• To end AIDS in pediatrics and children by 2030, we need comprehensive- policies, strategies, fundings and services
• Optimizing community involvement to improve how KPs can be treated and represented
• Epidemic control cannot be achieved without involving the KPs as a significant stakeholder
• To end AIDS by 2030, there is a need to maximize the use of digital technology including artificial inteligence

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RECOMMENDATIONS (3/3)

MERCI BEAUCOUP

THANK YOU

TATENDA