Unlocking the Power of Choice in HIV Prevention

In Harare, Zimbabwe, on the 3rd of December 2023, AfNHi convened the 6th Biomedical HIV Prevention Forum (BHPF) with the support of the BHPF and AfNHi steering committee partners who made the forum a success. The BHPF partners among others included the Advocacy for Prevention of HIV and AIDS (APHA), AIDS Health Foundation (AHF), AVAC,  Frontline AIDS,  Global Network of People Living with HIV (GNP+), HIV Vaccine Trials Network (HVTN), International AIDS Vaccine Initiative (IAVI), International Partnership for Microbicides (IPM), New HIV Vaccines & Microbicides Advocacy Society (NHVMAS), Rwanda NGOs Forum on HIV/AIDS and Health Promotion, Society for AIDS in Africa (SAA), CASPR Partners, WACI Health and partner the Global Fund, CIFF, and USAID.   

• In her impactful address at the BHPF, Tariro Pamela Mapeto, a young leader from Zimbabwe, shed light on the gaps and opportunities for involving the youth in HIV prevention research. Tariro emphasised the need for meaningful inclusion of young people as equal contributors in crafting solutions tailored to their needs. She highlighted the disproportionate impact on adolescent girls and young women in Sub-Saharan Africa, underscoring the urgent need for their active involvement. Despite the challenges, Tariro asserted that young people possess untapped potential for innovative solutions crucial in the global fight against HIV. Her call to action focused on scaling up interventions such as PrEP, U+U, and self-testing while urging the approval and expansion of newer options like long injectable PrEP and DAPIRing. Tariro emphasised the importance of intentionally creating and sustaining platforms for the voices of Adolescent Girls and Young Women in the HIV response, bridging knowledge gaps through youth-centric channels like social media. Finally, she urged the facilitation of effective support groups to provide safe spaces for young people affected by HIV by: fostering interaction, sharing experiences, and empowerment among peers. Tariro’s call to action resonates as a compelling roadmap for bridging the gap between policy and action in the multifaceted realm of HIV prevention. 

The HIV Prevention Choice Manifesto was envisioned and put together by African women, girls, feminists, and advocates for HIV prevention across Southern and Eastern Africa. United in their call for sustained political and financial commitments for HIV prevention choice.  The Choice Manifesto was visualised following extensive dialogues with funders, governments and communities. At the BHPF, a panel of experts delved into the implications of this manifesto, unravelling its significance and envisioning its impact on the future landscape of HIV prevention. 

Moreover, Grace Kumwenda urged the importance of choice in HIV prevention. She presented the HIV prevention pipeline, which includes long-acting injectables, dual protection pills and ongoing advocacy through the Choice Manifesto. Grace emphasised the importance of quickening the process from product approval to hands-on implementation and addressing structural barriers. Advocating for provider training and investing in healthcare professionals is essential for successful implementation. 

The Partner’s Panel on the future of biomedical HIV prevention, featured insights from key representatives. Mary Latka, from USAID, emphasised collaboration with local governments, donors, and academia, and creating an enabling environment for affordable choices. Anna Rammou, of CIFF, highlighted the importance of choice, emphasising CIFF’s commitment to multi-stakeholder agreements and empowering communities to make informed decisions. Financial diversification and accountability were key considerations for CIFF. Dr. Vuyiseka Dubula, of the Global Fund, emphasised the centrality of communities in their strategy for future prevention options. Community representative, Ruth Akulu, stressed the need for sustainability in HIV prevention, addressing challenges such as gender-based violence and empowering communities to make choices. She advocated for broader participation in research across all African countries to ensure demand and supply alignment for effective solutions. 

Key takeaways from the forum; 

Strengthen Youth Involvement: Actively involve young people in shaping HIV services by letting them express their preferences in terms of services, delivery methods, and locations. Their meaningful participation should be a cornerstone in the planning and execution of Biomedical HIV Prevention (BHP) initiatives. 

Let Communities Lead: Empower communities to take charge of programs designed for them. Decision-making processes within BHP should prioritise the voices and needs of the communities being served, ensuring programs are tailored to their unique circumstances. 

Unlock the Power of Choice: Expand the range of available HIV prevention options. It is crucial to ensure that key populations are not excluded, and affordability must be prioritised to guarantee widespread access to these prevention products. 

Enabling Policy Environment: Remove or amend punitive laws that hinder access for key populations. Create policies and legal frameworks that facilitate the distribution and accessibility of BHP products, particularly to those who need them the most. 

Sustainable Financing: Strengthen domestic resource mobilisation efforts to fund biomedical prevention research. Emphasise the importance of sustainable financing, exploring various funding options to ensure the continued development and accessibility of prevention methods. 

Partnership & Collaboration: Promote collaboration among stakeholders and partners. Strengthen domestic resource mobilisation not only for funding but also for fostering collaboration among diverse entities involved in biomedical prevention research and health funding options.