Are we FGS and HIV aware?

Community Health Workers’ Knowledge on Female Genital Schistosomiasis (FGS) and HIV risk in Zimbabwe

Charashika P¹, Masiye K , Chisenye O, Mushonga N, Hove M, Gale L, Moore S, Webb K

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Friday, December 8^th, 2023

E3 - Integrated HIV service delivery services with non-health response programs

Oral Abstract FRAE1703

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• Schistosomiasis is caused by parasitic worm that live in freshwater

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• FGS is a condition that can result from untreated schistosomiasis or bilharzia

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• Female Genital Schistosomiasis (FGS) is a widespread and neglected condition that increases the risk of HIV infection in women and girls

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• In sub-Saharan Africa alone, FGS affects an estimated 56 million women and girls

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• FGS = 3X risk of HIV & 2X risk of HPV!!!!

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• FGS is treatable and preventable – this is NOT a ‘’nice to do”

Background – FGS What?

Ref: https://www.unaids.org/sites/default/files/media_asset/female_genital_schistosomiasis_and_hiv_en.pdf

https://frontlineaids.org/our-work-includes/fgs-integration-group/#:~:text=Women%20and%20girls%20with%20FGS,FGS%20is%20treatable%20and%20preventable.

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• FGS remains highly prevalent and under-diagnosed due a low index of suspicion among health-care professionals

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• All individuals with symptoms of STIs and cervical cancer should be screened for FGS alongside cervical cancer screening and STI testing in all health care facilities of endemic countries.

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• What do we know?

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• What do we need to know?

Background (2)

Ref: https://iris.who.int/bitstream/handle/10665/180863/9789241509299_eng.pdf;jsessionid=7A0269BA13CDA23BA502A66BDF194CA7?sequence=1

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• In Zimbabwe, schistosomiasis occurs in 91% of all districts with an overall mean prevalence of 23%

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• Rural-urban migration is common in Zimbabwe, meaning that most adolescent girls and young women will come into contact with infected water sources in their lifetime

Schistosomiasis in Zimbabwe

Evaluate community health care worker (CHW) and adolescent and young people’s awareness of Female Genital Schistosomiasis (FGS) and its relationship to HIV risk, and current access to FGS information resources in two urban cities of Zimbabwe

Objective

Mixed method evaluation

• Electronic Survey: 110 Community Outreach Agents
• Focus Group Discussions: adolescents and young people 16-24 years (n=38)

Methods

Health Care Workers (n=111)

Knowledge of signs or symptoms of FGS

Access to information on FGS

Adolescents and young people (n=38)

FGS knowledge and association with HIV

FGS is not a familiar topic. If you talk about bilharzia, we recall mass drug administration in primary school…but nothing since then.

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FGD participant, 23 years, Chitungwiza

• Co-Designed with Community Health Workers across Southern Africa

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• Evidence-based and aligned to current WHO guidelines

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• Job aid providing information to increase confidence and fidelity of information

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• Free to access, data light, works offline

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• Translated into local languages (Shona & Ndebele)

https://boost.avert.org/

Conclusions

• Limited knowledge on FGS and HIV for among both health care workers and young people

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• Digital tools provide access to health information “in your pocket”

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• Evidence on prevalence of FGS required

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The OPHID TASQC and Youth Boost COAs for their dedication and hard work in the communities they serve

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Zimbabwean Ministry of Health and Child Care, AIDS & TB and Mental Health Units

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MOHCC AIDS & TB Unit, Provincial and District Health Authorities and participating COAs, COACs and CRFs from the OPHID TASQC Program

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President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID to OPHID Target, Accelerate and Sustain Quality Care (TASQC) for HIV Epidemic Control: 72061320CA00005

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Avert for the development of the Boost App https://boost.avert.org/

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BOOSTING Community Health Worker Access to Information

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Increasing confidence and quality of services to support HIV Epidemic Control and comprehensive health in Zimbabwe

Thank you – Tatenda - Siyabonga