Journalists Told Drop in HIV Prevalence Won't Last Without Renewed Emphasis on Prevention
Peace Corps Volunteer Brian Awsumb presented on the volunteerinitiated
Zebras for Life—Test for Life program which uses national football players
to encourage men and out-of-school youth to test for HIV.
Dr. Samba Nyirenda, a physician in the TB/HIV Research program at BOTUSA,
talked about the dangerous links between HIV and tuberculosis
Journalists at the workshop took a tour of several HIV/AIDS projects in
Selebi Phikwe, including the Positive Living Helper Cells Support Group. The
group members do house-to-house community mobilization for behavior change
and runs a "buddy program" which pairs PLWAs to support each other with
issues of acceptance, stigma, disclosure and
Peace Corps Volunteer Sarah Cahillane introduces journalists to the Peer Mother Programme in Selibe Phikwe which encourages women to participate in the PMTCT program.
SELEBI PHIKWE - The modest declines in HIV prevalence among the Batswana likely won't last and Botswana could experience sudden increases in new infections unless a comprehensive approach to prevention is taken seriously.
This was the message delivered to journalists and members of the Selebi Phikwe District Multi-Sectoral AIDS Committee during a Sept. 25-26 seminar entitled "New Directions in HIV/AIDS," which brought together some of the leading researchers in Botswana.
"There has to be a renewed emphasis on prevention," said Philip Drouin, the Deputy Chief of Mission at the U.S. Embassy who opened the two-day seminar. "Not just the ABCs (Abstinence, Be Faithful, Condomize) of prevention, but a comprehensive approach which considers all options, including the biomedical ones."
BOTUSA, the U.S. Embassy and the Media Institute for Southern Africa (MISA) organized the seminar featuring the latest interventions and research in critical areas like HIV/AIDS and TB prevention, treatment and capacity building. The goal of the seminar was to highlight the latest successes in HIV research and programs in Botswana, raise public awareness and encourage dialogue at the district level among media, leaders and all HIV/AIDS stakeholders.
Drouin quoted the 2006 Sentinel Surveillance showing a decline in HIV prevalence among pregnant women, especially the younger age groups from 15-24 years. While the decline is good, it may take years to understand. The U.S. government is sponsoring a public health evaluation in 2008 to investigate the causes.
Meanwhile, researchers believe there is a chance HIV prevalence could increase in coming years due to factors like "disinhibition" among Batswana on ARV treatment. That is, people who are benefiting from ARV drugs may think they are completely protected when in fact they are only partially protected. There is evidence that complacent attitudes among some gay men in the U.S. who were on anti-retroviral treatment may have contributed to an increase in HIV infections there.
"This misunderstanding or gamble may result in casual risky sexual behavior, which in turn could result in new infections," Drouin said.
Journalists and district leaders should keep abreast of the latest programs and research around HIV/AIDS and TB in order to inform their stakeholders and keep new infections from occurring. "That brings us back to why we are here today, to hear about the latest interventions," he said.
The workshop, which featured a range of speakers from BOTUSA, U.S. Peace Corps, MISA and ACHAP (African Comprehensive HIV/AIDS Partnerships), soon will be taken to other districts like Francistown, Serowe, Kasane and Ghanzi.
"These districts and yours (Selebi Phikwe) provide HIV services to tens-of-thousands of people living with HIV/AIDS and represent the regions of the country with some of the highest HIV prevalence rates - yet these districts are also the ones often left out of the conversation and debate surrounding HIV/AIDS issues," Drouin said. "All too often, the conversation remains at the central level in Gaborone, never making it to the ones who stand to benefit most." The workshop also highlighted the work of international partners like the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), ACHAP and the United Nations to build capacity for the continued scaling up of Botswana's good work. As for PEPFAR, the United States has already committed $76 million in fiscal year 2007 to support Botswana's initiatives.
"We hope this sharing of best practices is interesting for journalists to share with their readers, and inspirational for DMSAC members preparing for their planning sessions," Drouin said. "Let us re-dedicate ourselves to making a difference. Working together, everything is possible."
Highlights from "New Directions in HIV/AIDS" Seminar
Mrs. Prisca Tembo, a behavior change specialist at BOTUSA, presented on new directions in HIV prevention. Her topic covered the new Life Skills Curriculum being rolled out in Standard 1 to Form 5 classrooms, and a U.S.-sponsored assessment of commercial sex workers in Botswana. Mrs. Tembo also discussed male circumcision and the research which has shown more than a 50 percent reduction in HIV in circumcised men versus those who are uncircumcised.
Dr. Ian Lovemore Chirwa, a study physician at BOTUSA, briefed the participants on a new clinical trial called TDF2, which is a study to determine if a once-daily pill can actually prevent HIV transmission. The need for additional prevention options is the biggest motivator behind the trial, Chirwa said, and the hope that this new method could be used safely by both men and women.
Prevention of Mother-To-Child Transmission Dr. William Jimbo of BOTUSA presented on the latest initiatives and successes in Botswana's Prevention of Mother-to-Child Transmission (PMTCT) program. In 2006, 97 percent of pregnant women were tested for HIV. Botswana has reduced the rate of HIV transmission from mother to child to less than 4 percent. This represents the first time that a developing country with a high prevalence of HIV has lowered transmission rates to those in Western countries.
Dr. Samba Nyirenda, a physician in the TB/HIV Research program at BOTUSA, talked about the dangerous links between HIV and tuberculosis. Botswana has one of the highest rates of TB in the world. Unlike HIV, she said, tuberculosis can be cured, and it can be prevented in people living with HIV. BOTUSA is currently conducting a 2000-person clinical trial aimed at determining the efficacy of continuous isoniazid TB preventative therapy (IPT) among people living with HIV/AIDS as compared with the standard 6 month regimen.