Annie Holmes at STOPAIDS meeting


20 May 2016
Annie Holmes

With more than 60 organisational members, STOPAIDS exists to unite UK voices on the global response to HIV. It presents an important platform to engage with those who can use STRIVE research in programmes, policies and funding.

STOPAIDS’ May 2016 members’ meeting focused on Re-prioritising Prevention. Along with an update from the Director Mike Podmore and the STOPAIDS team, the event featured six presentations (available on the STOPAIDS site):

  • Malcom McNeil, DFID: Overview of DFID’s research work on prevention and prevention technologies
  • Matteo Cassolato, IHAA: General overview on combination prevention
  • Cheryl Overs, IDS: Sex work and PrEP
  • Rebekah Webb, AVAC: Microbicides and vaccines
  • Charlie Gamble, Tackle Africa: Education/peer support
  • Annie Holmes, STRIVE: Structural approaches – intervening upstream

Points to Ponder 

The field has prioritised “combination prevention” since the 1980s. What’s needed now, in what Matteo Cassolato described as a “prevention crisis”, are intervention packages that are:

  • tailored to high-risk populations in local contexts
  • designed by or with those most affected
  • guided by insights from social science
  • explained adequately, in order to overcome the perception, by multilateral decision makers for instance, that such interventions are “too difficult”

Malcolm McNeil emphasised the importance of the structural drivers of HIV, including stigma, and expressed some pride in DFID’s championing of research in this field. At the international AIDS conference, IAS 2016, he predicted, there will be a great deal of talk about PrEP but not enough about structural drivers.

For Rebekah Webb, the quest for microbicides as a form of female-controlled prevention has been catalytic rather than biomedical. “It’s not just about putting pills into people’s mouths.”

Cheryl Overs challenged the meeting to consider the health needs of sex workers “above the waist”, versus the assumption that PrEP is the ideal prevention method. Most gay-male dating profiles in the UK, she pointed out, mention “on PrEP” as shorthand for “no condoms”. What does this mean for the health of female sex workers, when PrEP offers no protection against STIs or pregnancy? Any discussion of structural drivers, she emphasised, should begin with the proven impact of decriminalising sex work.

To convey STRIVE’s work in five minutes, Annie Holmes summarised the three over-arching narratives emerging from the consortium’s work: 

  1. Structural measures are necessary to enable if biomedical technologies are to prevent and treat HIV successfully at population level.
  2. Upstream structural measures to prevent HIV also achieve effective and cost-effective multi-sectoral development outcomes.
  3. Special structural measures are required to reach vulnerable populations including adolescent girls in sub-Saharan Africa.

Image credit: STOPAIDS