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Community Engagement Award

The HIV Prevention Trials Network (HPTN) 2017 annual meeting brought together researchers from its clinical trials involved in HIV prevention in countries across the world. Zambart, is part of a consortium of international researchers currently conducting the world’s largest HIV prevention trial in 21 communities in Zambia and South Africa.

The Zambart Community Engagement (CE) team on the HPTN 071(PopART) Trial won the Best Community Engagement Award for outstanding performance in mobilising the biggest community randomised HIV prevention study in the world. During the course of the four year study, Zambart’s CE team has developed novel strategies to engage, sustain, and work together with other study groups to increase participants for the trial, including ancillary studies nested with the main trial.

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Zambart Commemorates National HIV testing, Counselling, and Treatment Day Activities

On August 15, 2017 Zambart joined other health stakeholders and participated in the annual HIV Testing, Counselling and Treatment (HTCT) Day event spearheaded by the Ministry of Health (MoH). National HTCT Day (previously National VCT Day) is held to raise public awareness on HIV prevention and treatment.  During this year’s event, the President of Zambia Edgar Lungu announced the government shift to routine HIV testing and treatment in all health facilities in the country.

Zambart’s objective of participating in this event was to support HIV prevention and treatment, and showcase some of the organisation’s innovative activities aimed at enhancing uptake of HIV testing and treatment.

Across all its research sites on the Copperbelt, Central, Lusaka, and Southern provinces, Zambart field teams mobilised and conducted various community engagement and sensitisation activities in different zones, and participated in the district-level commemorations held under the theme: “HIV Test and Treat: Towards Ending AIDS”. The activities were also aimed to increase awareness about HTCT Day.

Zambart conducted satellite outreach activities in the communities prior to HTCT Day. The activities included offering free HIV Counselling and Testing, linkage to care, screening for Tuberculosis  and Sexually Transmitted Infections, distribution of lubricants, condoms and  information and education materials, and providing HIV health talks and counselling to adolescents in Youth Friendly Corners in Zambart supported clinics.

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PopART Study Staff Reflections, Challenges, and Experiences

Reflections on 2017 PopART Study all-staff training & retreat

During the last PopART study all-staff training the various teams had an opportunity to share their personal experiences and reflects about the trial. The field teams, on whom the successful implementation of the study relies heavily, had some great feedback about PopART. Equally the supervisors and technical leaders who support the field teams and enable them to boldly carry out their work had a few things to say.

Here are just a few examples of some of the PopART staff reflections from the field and head office alike:

“When you change a life, you change a life forever,” – Steve Belemu, Zambart Community Engagement Team

“The HPTN 071 is an extraordinary study, and we did it, each and every one of you.” – Dr Helen Ayles, PopART Site Principal Investigator: Z Director of Research- Zambart

“PopART has been an amazing study. It has successfully managed to mobilise efforts of different people, organisations and communities towards the dream of achieving an HIV free Zambia. Yes, it is possible to get rid of HIV if we replicate PopART at country level.” – Dr Musonda Simwinga, Zambart Community Engagement Lead & Social Scientist

“I first became involved in HIV research in 1985. The lab I was in was among those conducting the initial trials of AZT, which became the first drug approved for treatment of individuals infected with HIV. Three decades later, PopART is demonstrating the efficacy of treatment as prevention at the population level. It’s gratifying to be a part of the PopART team and the remarkable advances that have been made in HIV treatment.” – Barry Kosloff, Head of Zambart Laboratories

“One day we went in the field and enrolled a female participant whose husband had died some years before. She wanted to know her HIV status. The research assistant consenting the woman and I was called to collect the sample. After the test was done, she was found to be reactive and we linked her to care. She then asked if I could also test her daughter who was not looking too healthy and she also tested reactive. We linked her to care too. From that time to date, this family is like my family to me. I feel happy when I pass by their home and see how happy they are and getting on with their life.” (PopART CHiP)

“I tested a man in a household that I had been visiting in my zone, he tested HIV positive but it was very difficult to link him to care. When he fell very ill, that is when he started the treatment and he is now doing fine. And after that, his mother disclosed that she was also taking care of a child who lost its mother at a very young age. I probed more and asked if I could test the child. The test was positive and I managed to link the child to care. The child looks good and feels good now. She doesn’t get sick like before. This makes me happy and am proud of myself at least I have saved a life.” (CHiP)

In other bizarre experiences shared by the PopART intervention team staff: A female CHiP reflected how a client insisted to the PopART team visiting his household that he was born naturally circumcised and attempted to show them. And in another instance, a client attempted to remove all his clothes off to show the CHiP team during a household visit a skin rash that had spread all over his body.  Some of the CHiPs narrated how at the beginning of the study they would sometimes be mistaken for political cadres. Another CHiP recalled a field encounter when instead of conducting HCT they found themselves as first responders to an expectant woman’s call for help and helped to conduct a home delivery, after which they assisted the woman to the health facility for onward care.

“In year one we tested the wife in absence of the husband and the results were negative. Shortly afterward, the husband came and the wife asked the husband to also test but with a warning that if her results came out positive that would be the end of their marriage. Later, the wife left the house to go to the market and the husband asked to be tested in the absence of the wife and he tested HIV positive.

In year two, we went back to the household and tested the wife again. She tested positive. But she could not understand how she could be positive when her husband was negative (the husband had told her that he tested negative when in actual fact he was positive). The wife refused to start treatment fearing the husband who thought she was negative. The husband-had refused to start treatment for fear of being divorced by the wife who he believes was negative.”-  (CHiP)

“In annual round two, I went to a household where I tested a seven (7) year old girl and she was reactive. Unfortunately, she was not linked to care because her father’s family said that she was too young to be HIV positive, and the girl’s mother’s relatives insisted her mother died of witchcraft and not HIV. In annual round three, I learned that they had not yet linked her to care because of the misunderstanding and beliefs from the two families. This matter was reported to the supervisor and the youth counsellor but to no avail. Eventually the girl got very ill and that is when they cousin decided to take her to the clinic. The file was opened for the girl. As I.mm writing, the girl’s condition has improved.”(CHiP)

“A 13 year old client told me that he was denied condoms, so he only picks the used condoms, washes them and then use them. The CHiP advised him not to pick used condoms because they are contaminated. He was counselled on abstinence ad tested for HIV and condoms were given to him.”- (CHiP)

In delivering the house-to-house PopART HIV prevention package in the various study communities, the field teams comprised of Community HIV Care Providers (CHiPs); Research  Assistants; Research Nurses; Community Mobilisers; worked in collaboration with community leaders and health facilities. Over the course of the four years of study implementation, PopART staff forged great friendships and further strengthened the nearly 3 decade old partnership Zambart has had with the communities.

Thanks to everyone for their support, dedication, and teamwork that continues to make Zambart a solid community-focused local research organization working to improve health for all Zambians.

 

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PopART Study holds final all-study training and retreat

On August 8-11, about 700 staff members on the HPTN 071 (PopART) trial in Zambia, gathered in the small resort fishing town of Siavonga, south of the capital Lusaka, for their last annual refresher training and retreat before the end of study intervention activities later in December 2017.   Organizers brought together all the study staff from the 12 PopART sites, including central Zambart office in one place. This was a huge undertaking by the study leadership and Zambart management.

The PopART trial is the world’s largest community randomized HIV prevention study involving an estimated 1.2 million people in 21 large population communities in two Southern African countries: Zambia and South Africa. Since 2013, international and Zambian researchers have been measuring the impact of combined HIV prevention intervention methods including universal testing and treatment and door-to-door HIV Counselling and Testing, and active referral.

 DSCF5668The training included team building sessions. Team leaders and managers mentored Community HIV Care Providers (CHiPs) in delivery of the final study messages to prepare communities for the end of the study, data collection, orientation in HIV Self-testing, and reviewed enrolment of households participating in the study. Population Cohort (PC) and Phylogenetics scientists and technologists reviewed the upcoming final round of PC activities and Xpert Tuberculosis (TB) testing including other laboratory based activities and protocol training. The r Social Science team reviewed stigma tools for the qualitative cohort and activities conducted under the PopART Story of the Trial.

Zambart Chief Executive Officer Dr Alwyn Mwinga commended the PopART study team in Zambia for their dedication to delivering a complex study such as PopART, through the work that they do.

We have achieved what we set out to do. This study must be written up and put in history books because it is such an interesting research,

she said during the formal opening of the training.

DSC01886Site Principal Investigator Dr Helen Ayles said that the PopART trial was an extraordinary study and was by far the biggest study on HIV prevention ever done. She thanked all the study staff for their hard work and dedication,

You have been amazing, and I want to thank you for such a job well done. This is something that can be rolled out at national scale.

Dr Ayles, explained to the study team the forthcoming end of study intervention activities on 31st December, 2017.

“This has always been a study and we have always had a limited life span. You have managed to reach more young people, and more individuals who had previously not tested for HIV,”

she said, and unveiled plans for continued lower level PopART intervention related activities. These included the on-going Community ART, HIV Self-Testing and measuring the prevalence of TB in PopART.

It is going to be different, but there will still be research activities going on in our sites after the PopART intervention end, for example we will also do more work with adolescents and in social science,”

Dr Ayles said.

 DSC03304Trainers used the opportunity of having everyone together to reflect on the various challenges, experiences and lessons learned by the different study teams during the course of the trial. This generated a deep introspective discussion and brought out poignant aspects of the trial.  This was colorfully depicted through the building of the gigantic PopART study reflection tree. This was a hands-on and exciting time for all study staff. The study teams received awards in various categories and concluded the training on a high note in select sporting activities such as soccer, volley ball and boat cruises on Lake Kariba.