Community Engagement is Essential for Successful Combination Prevention

The 17th International Conference on AIDS and STIs in Africa is now fully underway in Cape Town, South Africa. With a theme focused on targeting zero new infections, much remains to be done to stem the global HIV epidemic. Two sessions on Sunday, Dec. 8 focused on eliminating new infections among HIV-exposed infants while keeping their mothers healthy.

The first session looked at integrating service delivery models for pregnant and breastfeeding mothers and their babies. Malawi, Swaziland, and Uganda shared a variety of lessons learned related to their successes in integrating antiretroviral therapy (ART) into maternal, neonatal and child health (MNCH) services.

Malawi in particular noted the essential importance of social and behavior change communication (SBCC) needed both before and during implementation through the introduction of Option B+. The role of male involvement in community engagement as an essential element was also highlighted in Malawi. Swaziland shared impressive results of increasing ART uptake by pregnant women from 45% in 2010 to 75% in 2013 with equally impressive increases in the numbers of children on treatment after integrating ART into MNCH services. Community engagement was highlighted repeatedly in each of the above countries as a critical component of success. Uganda echoed the need to work through community-level structures to create strong linkages between communities and the facilities that serve them particularly with the roll out of Option B+.

The second session stressed that leadership is required to eliminate new infections among babies born to HIV-infected mothers. Each speaker further underscored the essential role of working closely with communities. As Annie Lennox, UNAIDS Goodwill Ambassador, noted, “HIV is an illustration of all human behavior…with the disparity in gender playing out in disturbing ways [at the community level].” Michel Sibide, Executive Director of UNAIDS, further highlighted his belief that community engagement is essential to eliminate new infections. Carol Nawina Nyirenda, a women living with HIV from Zambia, agreed by saying we “must let communities lead.”

Each speaker reiterated the critical role communities play in the HIV response. Capacity strengthening efforts, which support communities, are absolutely essential. HC3, through its work over the coming years, intends to focus on just that and is committed to supporting communities and the health facilities surrounding them in providing access to quality services for all women, their partners, and HIV-exposed infants. Without community ownership and true engagement, we will never be able to reverse the spread of HIV.