As the HIV epidemic continues to take its toll on Zambia, a new HIV prevention study on young people has found that most Zambian adolescents are HIV negative, but more needs to be done to keep them negative by increasing their access to treatment and prevention programmes. This gives hope to researchers, policy makers and government actors that the tide can be reversed against new HIV infections.
Results released by researchers of the PopART for Youth Study (P-ART-Y) in Lusaka on March 15, 2018 indicated that 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 towards 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.
Health is about the communities that we serve. We must take our services to the communities to prevent disease.- Dr Abel Kabalo, Director of Health Promotions, Environment and Social Determinants, MOH.
P-ART-Y researchers made public these findings and other lessons learned during the study intervention at a national level dissemination event that brought together senior government health officials and representatives of various health agencies, local and international researchers, policy makers, implementing partners in HIV treatment and prevention, action groups and youth representatives.
Zambian Minister of Health Dr Chitalu Chilufya in his formal address presented on his behalf to the gathering by Ministry of Health Director of Health Promotions, Environment and Social Determinants Dr Abel Kabalo, said P-ART-Y was in line with the government strategic direction to focus on adolescent and youth in HIV treatment and prevention. He said through the 2014-2016 National HIV/AIDS Strategic Plan, government has identified young people as key in the fight against HIV and will prioritise its interventions towards them.
Dr Chitalu Chilufya applauded the research and said to win the fight against new HIV infections key vulnerable populations must be involved. “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.”
He said the government will make decisions based on evidence that show impact so that valuable resources are not wasted in combating the AIDS epidemic in Zambia. “This study is no mean achievement. PopART is unique in design and implementation, and the government is delighted to work with local researchers and will continue to support them,” Dr Chilufya said.
Dr Chilufya said Zambia has made strides in combating new HIV infections with robust HIV targets and strategies. He 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 are a demonstration of the government’s will to achieving 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,” he said.
P-ART-Y was a two-country ancillary study nested within the on-going HPTN 071 (PopART) Trial, 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 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 7 districts in 4 provinces (Copperbelt, Central, Lusaka, and Southern Provinces).
The objective of P-ARTY study was to evaluate the acceptability and uptake of a community level combination HIV prevention package that included a universal test and treat among adolescents and young people aged 10 to 24 years in both countries, with a focus on the 15 – 19 year old group. The study also compared the knowledge of HIV status in the standard of care communities.
P-ART-Y study results come just months ahead of the main landmark HPTN 071 (PopART) trial which is measuring the impact of a combined HIV prevention package on community level HIV incidence, and ends in June 2018. The final results of the PopART trial will be available early 2019.
P-ART-Y Study Manager Dr Joseph Mwate said what the study had achieved has never been done before. “We tested a very huge number of adolescents in one setting. Over 150, 000 young people in Zambia alone,” he said.
Dr Mwate said that P-ART-Y achieved the first 90 target, “This is first step to reaching an AIDS free generation,” he said and added that the study also significantly closed the gap in the second 90 HIV which set Zambia on correct path to the 2020 AIDS goal.
The HPTN 071 (PopART) study under which P-ART-Y was nested is the single largest HIV prevention trial to be ever conducted with partners in 3 continents. It is taking place in Zambia and South Africa and represents a population of 1.2 million people.