Day 2

DAY TWO:
INT. WORKSHOP ON HIV & ADOLESCENCE 2019

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SKILLS BUILDING SESSION
The day started with interactive skills building sessions, conceived and delivered by youth and adult experts. Audrey Nosenga, Tinashe Rufurwadzo, and Seifu Ibrahim delivered a workshop on Aiming High for Meaningful Youth Leadership and Engagement, they encouraged organisations to hold themselves accountable and shared practical ‘how to’ tips. Lubna Bhayanni and Eddy Rudram delivered on Funding: Where is the Money: Top Tips for Raising Funds utilising a case study to solve a problem and developing a proposal to fund it. Fletcher Chiu and Wipaporn Natalie Songtaweesin covered Using Data to Inform Programming on how data collection tools need to be targeted, specific and adolescent-friendly; Rick Evans, Saidy Brown, and Loyce Maturu built skills on Communications for Advocacy focusing on understanding your audience and using variety of platforms. During their session Youth-driven design: techniques for generating and testing innovations for scale Rebecca Hope, Michael Roberts, and Brenda Bakobye encouraged participants to come up with innovative solutions to big problems.

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Session 4: Biomedical Interventions and Clinical Management
The session opened with the keynote presentation Towards HIV Eradication: HIV Prevention Research in Adolescents by Nyaradzo Mavis Mgodi, University of Zimbabwe College of Health Sciences Clinical Trials Research Centre. Dr. Mgodi shared her experience of be an orphan and encouraged young people to saying ‘HIV status doesn’t matter – you can be who you want to be!’ Dr. Mgodi focused her presentation on catching HIV at different points in the virus cycle through PreP, Dapivirine ring, long acting injectable, and antibodies for prevention. Lastly she stressed that novel drug delivery systems need to consider adolescents!

 Session 4 continued with a presentation on Managing Adolescent HIV in a Changing World by Wipaporn Natalie Songtaweesin of Chulalongkorn University. Natalie focused on ART management, outcomes, and co-morbidities, highlighting that ART coverage and viral load suppression is lower among ALHIV. Natalie’s take home message concentrated on the importance of a targeted approach for adolescents. Specifically, it is crucial to counsel on the drivers of non-adherence rather than simply the consequences, along with ensuring strong peer support and clear transitioning protocols (including pregnant adolescents). In all we must understand the adolescent development trajectory, re-engagement in care, along with creating and maintaining an open door policy to services.

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Oral Abstracts
We heard two oral abstracts with the following key messages:

View all the abstracts online

The Future of HIV Treatment – Long Acting Antiretrovirals
The session focused on Long acting antiretrovirals from the perspectives of the developers; clinicians; users and health system. Key messages included:

  • Alex Rinehart from ViiV Healthcare introduced 2 studies looking at long acting ART injectables for prevention (PreP - HPTN 083 & 084) and treatment (ATLAS and FLAIR), stating evidence that >93% of clients on LA ART maintained undetectable viral load to week 48; it’s as safe as oral ART; and that >90% who switched preferred injection; and new evidence from ATLAS that 2M injection is as effective as 1M injection.
  • Dr. Sheetal Kassim raised implications for adolescents, especially how injectables fit into the unpredictable lives of adolescents. She also stressed adherence with LA ART - that a daily pill is a constant reminder while a once monthly may be more easily forgotten.
  • Damaris Nyamweya shared her experience that taking bitter, hard to swallow drugs in school and in public with a shaking bottle of pills draws attention.
  • Nandita Sugandi MD made critical step-by-step points on how health systems need to adjust to accommodate new ARVs. It’s complex! There has been so many ARV changes there’s a bit of transition fatigue. Considerations for LA: 1) eligibility criteria; 2) HCW training; 3) Infrastructure (e.g. RPV needs refrigeration); and 4) accessibility. She highlighted the need for differentiated service delivery for adolescents and the need for adolescents’ voices to be heard to facilitate implementation.

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Session 5: INTERVENTION AND SERVICE DELIVERY APPROACHES
The key note presentation High Impact Implementation and Service Delivery Approaches across the HIV Prevention and Treatment Cascade for Adolescentswas presented by Nadia A. Sam-Agudu, MD, Institute of Human Virology, Nigeria. She focused on both the prevention and treatment and care continuums, stressing the need for retention in both. Evidence for effective prevention and testing interventions included: PITC, index testing, risk screening, self-testing, alternate service venues, peer engagement, mHealth, and age lowering of consent policies. Evidence for retention and adherence included adolescent friendly-services, caregiver support, peer support, psycho-social support, and knowledge of HIV. She emphasised that adolescent friendly services should be those which are equitable, accessible, acceptable, appropriate, and effective.

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Oral Abstracts
We heard five oral abstracts with the following key messages:

Differentiated services for adolescents came up several times during the discussion. Highlighting the importance of knowing your target population and their health determinants!

View all the abstracts online

 

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Session 6: Communications and Behaviour Change: Interpersonal to Mass Media
Georgina Caswell, Frontline AIDS, South Africa presented the keynote presentation Preaching but Failing? Communications for Change. Ms. Caswell challenged us to be cognizant of the way we communicate with young people, reminding us that adolescents reject traditional media and that scare tactics do not work, abstinence only campaigns do not work, and that saying no is not an incentive. She highlighted what communication works for adolescents: pictures, gaming, text messages, and peer power – but that there must be good evaluation and learning from these interventions. She also highlighted the importance of context and working with caregivers. “It’s not all about the digital – the human touch is important.

Oral Abstracts
We heard two oral abstracts with the following key messages:

View all the abstracts online

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MARKETPLACE: INNOVATION TO SCALE, SHARING SPACE FOR RESEARCH AND IMPLEMENTATION
The market place gave organisations the opportunity to display their work to share resources, other documentation and ideas. Tables showcased creativity with some opting for videos and pamphlets and others going for a more DIY approach of vibrant hand drawn posters. Viva! 

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