Welcome to P-Values, AVAC’s
bulletin highlighting advocacy work by our
partners and many other stakeholders around the
world. “P-value” is a statistical term for
the probability that a trial result is a real
finding and not the result of chance. As the
world faces new challenges and opportunities in
prevention research, the global advocacy
community isn’t leaving anything to chance.
P-Values tracks HIV work on
country-and community-level engagement in
trials, preparing for results and
implementation of new findings. Here’s what
you need to know now.
Modeling the End of the
Epidemic
“We need to use modeling to communicate what
the possibilities are and what’s been gained
from investments to date.” This was the
consensus of a small group of advocates,
activists, public health leaders and modelers
gathered on September 9 by AVAC and amfAR to
take a closer look at the state of
epidemiological modeling as it relates to the
goal of ending the AIDS epidemic. There is
scientific evidence for a range of potent
prevention strategies including treatment
as prevention, male
circumcision in the immediate term and, in
the future, microbicides,
PrEP and vaccines.
But decision makers face real challenges about
determining priorities and budgets. Models
can’t provide the answers, but they can give
a sense of the benefits and trade-offs for
different scenarios. On October 3, Tim Hallett,
a modeler and epidemiologist from Imperial
College London, met in Nairobi with AVAC and a
small group of East African advocates including
several of our Fellows,
to discuss how advocates can be what Hallett
calls “informed consumers” of HIV models.
In the coming weeks and months, AVAC and its
allies will be working to help frame the
questions and modeling the needs critical to
ending AIDS. Watch this space.
Ensuring Gender Sensitivity in the
Rollout of Medical Male Circumcision in South
Africa
Leader
Kanyiki, an AVAC
Fellow, has been working with allies in
South Africa since the beginning of this year
to ensure civil society input into the National
Implementation Guidelines for Medical Male
Circumcision. This document, to be released on
December 1, will guide South African policy and
strategy for this powerful prevention tool.
Kanyiki held meetings with policy makers, the
Department of Health (DOH), the South African
National AIDS Council (SANAC) and civil society
as part of contributing to the drafting
process, with a particular focus on gender
sensitivity. Through the work of Kanyiki and
allies, the final document states, “The
involvement of women, both as sexual partners
and mothers, will be promoted to the greatest
extent possible. Men who wish to be circumcised
will be encouraged to discuss the decision with
their sexual partner.” While the inclusion of
gender sensitivity language in significant,
monitoring its implementation as South
Africa’s medical male circumcision rollout
moves forward is critical.
Advocating for Increased HIV
Prevention Funding in Uganda
AVAC
Fellow, Sylvia
Nakasi, recently published a letter, “Uganda
must move fast on HIV”, in The New
Vision, a leading newspaper in Uganda. Her
letter reflected on the
recent announcement that Rwanda would
consider implementing immediate antiretroviral
treatment for all serodiscordant couples on the
basis of effective data on treatment as
prevention from the HPTN
052 trial. Nakasi called on Uganda to take
similar steps, citing modeling data that
suggests putting more resources into prevention
now decreases how much will be needed to spend
for treatment in the future. “As a country we
need to move faster and also learn from our
neighbors next door and speed up the process
from research results to policy.” Given that
Uganda sees 350 new HIV infections every day,
prevention is a clear priority.
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issues of P-Values
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