"I'd like to see us...reflecting on our successes. It has been proven that testing someone for HIV and, if positive, linking them to services and care as soon as possible has very positive health outcomes."
In the final part ofthis three-part series, Charles Stephens of AIDSUnited, a Mapping Pathwayspartner organisation, speaks about the successes in the HIV preventionlandscape and some of the challenges faced by people in rural areas. Read partone hereand part two here.MP: What are thethings being done well in the HIV prevention landscape?
CS: Models likethe Mapping Pathways project excite me. The process of collecting data from avariety of different experts and stakeholders on the field and using that datato make a strong case is an excellent model. Other interesting models are AVAC’s HIV prevention research advocacy workinggroup, which I’m a part of, and the community education and research advocacywork of the Black AIDS Institute. Mostimportantly, stakeholders and leaders within communities are trained andsupported to go back to their communities with new biomedical HIV preventioninformation to disseminate it within their communities.
One of the things I’d like to see more of is reflecting onour successes and planning how to build on the victories we’ve seen over thelast few years. It has been proven that testing someone for HIV and, ifpositive, linking them to services and care as soon as possible has verypositive health outcomes. Also from the community perspective we have achievedcertain successes like reducing stigma, mobilising communities and providingsupport networks and services. I’m extremely interested in finding out how we canbuild on these successes.
MP: What are some ofthe challenges individuals and communities face in rural areas?
CS: Capacity isone of the main challenges in rural areas. I find that the doctors on theground are often very knowledgeable, passionate and committed, but the problemthat is there just aren’t enough doctors and medical resources.
Transportation is another huge barrier in rural areas.People have a hard time getting to their doctors, as the transportationinfrastructure isn’t always in place. Some people have to travel three or fourhours to get to their physicians.
Addressing these barriers has been a challenge, but therehave been some innovations like telemedicine, where doctors can remotelyprovide medical information and check in with their clients from a differentlocation.
MP: Are there any trial results that came outrecently that you have followed closely? Are there any upcoming trials you areinterested in?
CS: The HPTN 061 study,which looked at 1553 black, American MSM, shared initial results at AIDS 2012 thatreinforced what a lot of us had been seeing on the field. One of the moststartling projections of the study was that unless improvements are seen, morethan half of all young black gay men who are gay or bisexual will be infectedby HIV within the next decade.
Other upcoming trials I will be following with interest arethe HPTN073 study which looks at ways to optimise PrEP adherence in black MSM andthe HPTN 069study, also called NEXT PrEP, which seeks to assess the efficacy of four ARVdrug regimens used as PrEP to prevent transmission of HIV in a population ofat-risk MSM.
[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position. Please look for us on Facebook here www.facebook.com/MappingPathways and you can follow us on Twitter @mappingpathways as well.]
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