July 24, 2018

Creating Demand and OPTIONS for HIV Prevention

Written by Allison Bozniak

The global OPTIONS Consortium shares insights and celebrates the impact made in creating demand for HIV prevention in advance of AIDS 2018 in Amsterdam.

Ruth Nahurira holding up a dapivirine vaginal ring

Photo credit: Leanne Gray/FHI 360

Ruth Nahurira held up a dapivirine vaginal ring as she spoke about her own experience with a dapivirine ring trial in Uganda. She learned about the HIV prevention method from the community health workers who came to her village to educate the women about female controlled HIV prevention.

“In Uganda, men have the power and women are not able to ask for men to wear a condom. I like this method because I don’t have to ask for permission to protect myself. If you don’t have any control over your life, then you can’t have dreams… I’m so happy I had the opportunity to join the study. It has make me a healthy woman and healthy women make a healthy nation.”

Ms. Nahurira’s comments were delivered July 21 at the Insight to Impact: Driving Demand Creation for HIV Prevention pre-conference at AIDS 2018 in Amsterdam. Hosted by the OPTIONS Consortium, in collaboration with Jhpiego, PATH, POWER, Prevention Market Manager, and WHO, the pre-conference presentations and discussions showcased world-class solutions and approaches to driving demand for preventative HIV behaviors, products and services.

The Optimizing Prevention Technology Introduction on Schedule (OPTIONS) is a global consortium of nine organizations working to expedite and sustain access to antiretroviral-based HIV prevention products.. The five-year initiative established in 2015, is one of five interlinked projects funded by the U.S. Agency for International Development (USAID), in partnership with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), It is led by FHI 360, Wits Reproductive Health and HIV Institute (Wits RHI) and AVAC.

“We don’t necessarily have to create demand for a certain protection product, but for protection and prevention in general, “ said Mitchell Warren, Executive Director of AVAC. He described how pregnancy prevention messaging worked better than HIV messaging to promote condom use. STD protection is just a side benefit. “Know your audience, listen to your audience and empower them. Invest as much or more in delivering your product/intervention as you did in developing it. The bottom line is that it’s never just the product, it’s the program. It’s the programs that we design, implement and fund that actually make the impact.”

For HIV prevention methods to have a significant health impact, there is a strong need to learn more abut the attitudes, knowledge, social norms and beliefs of the target audiences so that the right motivating messages are used.

“We concentrate so much of our efforts on the innovations – but we don’t invest as much in the implementation to get the innovations out there,” said Sarah Masyuko who implements PrEP HIV prevention programs for Kenya’s Ministry of Health. “Social and cultural barriers persist, and we need to overcome those in order for innovations to get adopted. In Kenya we are bringing stakeholders together because we’re all working toward the same goal. We can share insights like market intelligence and together engage the private sector.”

Ms. Masyuko shared a video of three women who are using PrEP. While they had different situations and reasons for taking PrEP, the underlying focus on motivations was a powerful take-away message.

The pre-conference also showcased innovations from the winners of the Demand Creation Challenge – a competition designed to highlight innovative, high-impact communications-based approaches to HIV prevention. Along with seven honorable mentions, the three primary winners were:

Best Demonstrated Impact – “Make the Cut,” a voluntary medical male circumcision (VMMC) campaign delivered by Grassroot Soccer. Through the power of soccer, Grassroot Soccer (GRS) educates, inspires, and mobilizes adolescents to live healthier lives and become change agents for their communities. GRS’s 3A approach is guided by a sport-based behavior change methodology that utilizes trained young adult mentors (“Caring Coaches”) to deliver interactive curricula that build youth sexual and reproductive health (SRH) and life skills ASSETS, facilitate ACCESS to health and social services, and support ADHERENCE to biomedical treatment and positive protective behaviors.

Best Breakthrough Creative – “Zathu,” a campaign that promotes gender equity and HIV prevention by Girl Effect. Through its initial research, Girl Effect was able to create holistic behavior change messaging that helps youth in Malawi to tackle sensitive issues through the power of friendship. For example, by informing girls and giving them confidence, they will better understand why their well-being is important, seek help, and be more likely to visit a clinic. By reaching mass audiences and combating the social norms that lead to further spread of HIV/AIDS, Zathu amplifies the work of DREAMS partners by driving demand to health services through a variety of channels.

Best Use of Communication Channels – “MTV Shuga,” an HIV and sexual and reproductive health (SRH) integration campaign by the MTV Staying Alive Foundation. MTV Shuga: Down South is the fifth installment of the popular African TV drama series. Its messages and reach address the substantial need for sexual and reproductive health (SRH) behavioral change communication among young people. This season was set in South Africa, which is home to 7.1 million people living with HIV, among whom almost a million do not know their status. Although the country has the world’s largest HIV epidemic, only 5 percent of South African schools were providing comprehensive sexuality education to young people in 2016. MTV Shuga uses behavior change communication to educate on HIV prevention measures, HIV testing, and SRH by fusing sexual health messages with gripping storylines.