Zambian Government Welcomes HPTN 071 (PopART) Adolescent HIV Prevention Study Findings

Apr 27, 2018

By Olga Manda

As the HIV epidemic continues to take its toll on Zambia, a recent HIV prevention study on young people has found most Zambian adolescents are HIV negative, but more needs to be done to keep them negative by increasing their access to treatment and prevention programs. This gives hope to researchers, policy makers and government representatives that the tide can be reversed against new HIV infections.

Researchers from the HPTN 071 PopART for Youth (P-ART-Y) study in Lusaka recently announced study findings that demonstrate more youth-oriented treatment services are needed to strengthen retention of HIV positive adolescents and youth in care. The study researchers said adequate resource allocation is required for school-based comprehensive sexual education because schools are a primary source of HIV information for young people. Legal barriers hindering adolescents from receiving HIV testing services and other sexual and reproductive health services need to be addressed, in addition to creating more youth safe spaces within the communities.

P-ART-Y researchers made these findings public, along with other lessons learned during the study intervention, at a national level dissemination event that brought together senior government health officials and representatives from various health agencies, local and international researchers, policy makers, implementing partners in HIV treatment and prevention, action groups, and youth representatives.

Abel Kabalo, MBChB, director of health promotions, environment and social determinants, Ministry of Health, Zambia, formally addressed the gathering by delivering prepared remarks from Zambian Minister of Health Chitalu Chilufya, MBChB, MPH. Dr. Kabalo said P-ART-Y was in line with the government’s strategic direction to focus on adolescent and youth in HIV treatment and prevention. He went on to say that through the country’s 2014-2016 National HIV/AIDS Strategic Plan, the Zambian government has identified young people as key in the fight against HIV and will prioritize its interventions towards them.

Dr. Kabalo applauded the research and said key vulnerable populations must be involved to win the fight against new HIV infections saying, “Adolescents are a key tool in winning the battle against HIV, and the findings of this research feed into the government plan for HIV prevention.” Dr. Kabalo also noted the government will make decisions based on evidence that show impact so valuable resources are not wasted. “PopART is unique in design and implementation, and the government is delighted to work with local researchers and will continue to support them,” he said.

Health is about the communities that we serve. We must take our services to the communities to prevent disease. - Abel Kabalo, MBChB, director of health promotions, environment and social determinants, Ministry of Health, Zambia.

Dr. Kabalo closed his remarks by stating Zambia has made strides in combating new HIV infections with robust HIV targets and strategies. He also said the president’s declaration on routine HIV testing – the government’s change of HIV treatment guidelines to include universal testing and adopting of viral load testing to monitor treatment – is a demonstration of the government’s will to achieve the 90-90-90 UNAIDS treatment strategy to end AIDS by 2020. “We’re changing treatment guidelines and viral load testing to monitor HIV, and we are improving funding to fight HIV through the introduction of the new national health insurance bill,” said Dr. Kabalo.

P-ART-Y was a two-country ancillary study nested within the on-going HPTN 071 (PopART) study, and funded by the UK Department for International Development (DFID) through Evidence for HIV Prevention in Southern Africa (EHPSA). The research was conducted by a consortium of Zambian and other international researchers in close collaboration with the Ministry of Health in 21 high-density communities in Zambia and South Africa. Of these communities, 12 were in Zambia, spread across seven districts in four provinces (Copperbelt, Central, Lusaka, and Southern Provinces).

Summary of Findings

The objective of P-ART-Y study was to evaluate the acceptability and uptake of a community level combination HIV prevention package that included universal test and treat among adolescents and young people aged 10 to 24 years in both countries, with a focus on the 15 to 19-year-old group. The study also compared the knowledge of HIV status in the standard of care communities.

“We tested a huge number of adolescents in one setting, over 150,000 young people in Zambia alone,” said Mwate Joseph Chaila, MBChB, P-ART-Y study manager, “This is first step to reaching an AIDS free generation.” He added that the study also significantly closed the gap in the second 90 (i.e., 90% of diagnosed people on antiretroviral treatment), which set Zambia on the correct path to the 2020 UNAIDS goal.

HPTN 071 (PopART) is evaluating the impact of a combination prevention strategy in 21 large communities reaching nearly one million individuals in Zambia and South Africa to reduce HIV incidence. The study, anchored in universal household HIV testing and linkage to immediate antiretroviral treatment initiation, will provide answers to questions regarding how best to combine HIV prevention interventions in different populations and settings for maximum impact while also assessing cost-effectiveness. Future dissemination events will take place at the district level and include all study sites. Manuscripts are currently being developed and abstracts were accepted for presentation at the 22nd International AIDS Conference (AIDS 2018) taking place this July in Amsterdam, Netherlands. Final study results are expected in early 2019.

Olga Manga, is a former communications manager at ZAMBART Clinical Research Site in Lusaka, Zambia.