Sustaining community involvement in HIV prevention research:Experiences from the UVRI-IAVI HIV Vaccine Program

UVRI-IAVIHIV Vaccine Programme

Sustaining community involvement in HIV prevention research:

Experiences from the UVRI-IAVI HIV Vaccine Program

William KidegaUVRI-IAVI HIV Vaccine Program


Presentation Layout

- Introduction - About UVRI-IAVI- Why community engagement?- Community engagement activities- Lessons learnt- Conclusion


Introduction

• Despite the known prevention options (ABC strategy), new infections still occur.

• Annual HIV incidence in Uganda reached 132,500 new cases in 2005. This includes 25,000 mother-to-child transmissions.

• Uganda has a population of 28 million people, with an HIV prevalence of about 6.4% and 0.7% adults and children respectively.

270,000 people eligible for treatment in 2007, but only 140,000 (52%) accessing it. Women infected more than men across the age

spectrum from birth to age 45-49 years. (Source: NSP 2007/8-20011/12)


Introduction cont….

• Because of the above, the importance of sustaining community involvement in HIV prevention research cannot be understated.

• Amidst all the existing prevention options, an effective, affordable, accessible HIV vaccine may be the best hope to eradicate the epidemic.

• The Uganda Virus Research Institute-International AIDS Vaccine Initiative (UVRI-IAVI) HIV Vaccine Program works closely with communities at grassroots and national levels in order to engage a wide range of stakeholders.



About UVRI-IAVI HIV Vaccine Program

IAVI MOU with GOU 2001

Mission: To support the conduct of HIV vaccine trials, and also create a conducive environment by working with communities, policy makers and other partners.

• Based at the Uganda Virus Research Institute.

• Two HIV vaccine trials conducted so far (2003 & 2006), third expected to begin in 2009.

• Large number of upstream research activities that will eventually feed into the HIV vaccine R & D process (e.g Bill & Melinda Gates foundation-central lab standardizing assays, epidemiological and feasibility studies).

• Strategic partnerships and outreach at local and national levels.


Why community engagement?

• To elicit understanding and support for HIV vaccine research and development

• To eventually recruit informed participants into trials

• To prepare communities for speedy access to an HIV vaccine once developed


Support to clinical trials and studies

Paving way for vaccine trials through:• Community outreach and community advisory board

(CAB) activities• Collaborations with other HIV prevention researchers• Social science research• Building capacity around services informed by

assessments, e.g. family planning• Working to ensure that communities hosting HIV

vaccine research have access to adequate voluntary counselling & testing, and healthcare services


Community information seminars


Community Advisory Board


Peer Leaders


Support to fishing communities


Healthcare and VCT strengthening


Supportive environment

“Not all can participate as study volunteers, but can provide support in different ways…”

• Policy makers, Government Ministries• Civil society e.g the AIDS Information Centre• Media• Healthcare professionals• Gender Advisory Committee to address inadequate female

participation in HIV Vaccine Trials

Note: The 1st HIV vaccine trial conducted by IAVI in Uganda (2003-2005) enrolled 1 female for every 5.25 males; the 2nd trial (2006-2007) enrolled 1 female for every 1.7 males)


www.iavi.or.ug

IEC Materials and Tools


World AIDS Vaccine Awareness Day


Lessons Learnt

• The continuous engagement of different stakeholders has provided sustained commitment and support.

• Sustained outreach to policy makers has ensured continued support for HIV prevention research.

• The complicated concepts related to HIV Vaccine research require correct messaging.

• Vaccine development timelines are long-term, thus important to manage community expectations.


To create a Vaccine: Takes years, sometimes Decades

Most licensed vaccines took at least several decades to develop, the world still awaits other vaccines

Infectious agent (disease) Agent linked to disease

Vaccine licensed in U.S.

Years elapsed

Bordetella pertussis (Whooping cough) 1906 1948 42

Poliovirus (polio) 1908 1955 47

Measles virus (measles) 1953 1963 10

Hepatitis B virus (hepatitis) 1965 1981 16

Heamophilus influenza (meningitis) 1889 1981 92

Salmonella Typhi (typhoid fever) 1884 1989 105

Vericella zoster (chickenpox) 1953 1995 42

Rotavirus (diarrheal disease) 1973 2006 33

Human papillomavirus (cervical cancer) 1981 2006 25

HIV (AIDS) 1983 - 25+

Human cytomegalovirus (birth defects, mononucleosis)

1960 - 48+

Mycobacterium tuberculosis (TB) 1982 * (not so effective vs adult TB

126+

Plasmodium spp (malaria) 1880 - 128+


Conclusion

• Strategic and sustained community engagement is vital in eliciting support and enhancing ownership of HIV prevention research activities.

• Research teams should work with communities as allies from the outset.


Imagine a vaccine against HIV ………..

…………Now imagine you could make it happen


Acknowledgements

The UVRI-IAVI HIV Vaccine Program would like to thank The International AIDS Vaccine Initiative

for their generous support


Government of Uganda

Health & Medicine

Sustaining community involvement in HIV prevention research:Experiences from the UVRI-IAVI HIV Vaccine Program