Susan Kasedde is the author of this guest blog. She is regional advisor with UNAIDS Regional Support Team for Eastern and Southern Africa.
On Thursday evening I moderated a very interesting satellite session with the title ‘Knowledge Translation and HIV Incidence Measurement’. At this session, countries reported on the results of the “Modes of HIV Transmission” studies they carried out last year with the support of UNAIDS and the World Bank. The purpose of these studies was to better understand the nature of the national epidemics in these countries and examine the adequacy, gaps and misalignment in their current prevention responses and resource allocation for prevention.
It was particularly interesting to hear from the country representatives on how the results of the Modes of Transmission studies have impacted on policy and strategy development at the national level and on the overall national discourse around HIV prevention. For instance, in Kenya, the studies’ results have helped defined the country’s national HIV prevention strategy and review options for cost effectiveness of HIV programmes. In Lesotho, they have prompted the development of a national behaviour change communication strategy ,while Uganda has defined a new prevention policy and guidelines and has declared 2010 the ‘year of couple testing’ based on findings from the study that most infections occur in long term, stable relationships which were previously perceived to be low risk.
All these countries used these studies to better understand where new infections are likely to occur and are using their findings to better target prevention interventions.
Experience in five countries in Eastern and Southern Africa confirmed that there is limited understanding of the epidemic in populations at higher risk for HIV infection – i.e. men who have sex with men, sex workers and injecting drug users – due to limited availability of data on population sizes and sexual behaviour patterns in these groups. This makes it difficult for effective prevention programmes and services to be made available for these populations .The response from countries has however been very positive as many preceded to fill these data gaps immediately by investing more technical and financial resources in gathering data around these populations.
The countries have disseminated the findings of the Modes of Transmission studies with partners and civil society at national and sub-national level ensuring the widest possible engagement in dialogues around the epidemic, the prevention response, the implication for improving prevention responses and appropriation of responsibility for this improved response by partners at all levels.
The final presentation on measurement of HIV incidence was a welcome response to the gap in knowledge that was identified during and leading up to the studies in these countries. The presentation highlighted the available tools for measurement of HIV incidence – cohort studies, mathematical models and laboratory assays – and offers useful reference for decision makers seeking to make better use of HIV incidence to monitor trends in infection and the impact of HIV prevention.