Carolyne A. Akello, FHI 360
Christopher Akolo, FHI 360
Timothy Mastro, FHI 360

This post was first published on FHI 360 R&E Search for Evidence.

Sub-Saharan Africa is home to 25.3 million (67%) of the global total of 37.7 million people living with HIV infection (UNAIDS 2021). To control the epidemic in Africa, it is essential that solutions for Africa be generated and implemented in Africa. The INTEREST Conference –now in its sixteenth year– is an excellent example of international cooperation intended to advance the fight against HIV in Africa by cultivating African scientists and stimulating innovative solutions on the continent.

In 2007, a group of scientists, led by Elly Katabira (Uganda) and Joep Lange (The Netherlands), launched the INTEREST Conference (International Conference on HIV Treatment, Pathogenesis and Prevention Research in Resource-Limited Settings) in Kampala, Uganda, to focus attention on the need for research and evidence to fight the HIV epidemic and address the shortage of HIV research capacity in Africa. INTEREST started off as an intimate gathering of about 200 scientists from Africa and other countries with a focus on stimulating African scientists to present their work, highlighting gaps in knowledge and application, and an explicit emphasis on mentoring. This year, during May 10-13, the conference was held again on the shores of Lake Victoria in Kampala as a hybrid meeting. A total of 439 in-person attendees and 143 virtual attendees, representing 45 countries, participated in this year’s conference. INTEREST was held virtually in 2020 and 2021. For many, the conference this year was their first in-person conference in more than two years and the enthusiasm was palpable!

The four-day agenda was packed and dynamic. In view of the intervening COVID-19 pandemic, the conference agenda addressed several aspects of COVID-19, especially on how this new epidemic impacted HIV prevention, care and treatment programs. In most countries in Africa, the same health care workers and facilities that manage persons living with HIV (PLWH) took on the additional burdens of fighting COVID-19. On the opening day, there were three Memorial Lectures in honor of Dr. James Hakim (Zimbabwe), a long-term INTEREST leader whom we lost to COVID-19 in January 2021. The memorial lectures by Dr. Adeeba Kamarulzaman (Malaysia), Dr. Sikhulile Moyo (Botswana) and Dr. Salim Abdool Karim (South Africa), covered the emerging science on COVID-19 variants, the impact of COVID-19 on the HIV cascade and how HIV research and training programs adapted to the COVID-19 response.

Also on the opening day was a COVID-19-themed debate, chaired by Dr. Peter Kilmarx (United States), that was a crowd favorite at INTEREST. The debate statement was “Unvaccinated people should be denied access to public spaces to prevent COVID-19 transmission within the African context.” Audience members were able to vote for or against the statement before and after the debate, which was lively, heated and humorous. Dr. Nelson Sewankambo (Uganda) gave an impassioned plea in favor of the statement, while Dr. Francois Venter (South Africa), vigorously rejected the statement on moral, humanitarian, and biological grounds. Those against the statement won the day. Before the debate, 70% of the audience were opposed to the statement with little change an hour later, when 72% voted against.

One of the highlights of INTEREST 2022 was the opportunity to provide updates on new HIV interventions, including the use of long-acting antiretrovirals for HIV treatment and pre-exposure prophylaxis (PrEP). Dr. Linda-Gail Bekker (South Africa) and Dr. Sinead Delany-Moretlwe (South Africa) shared updates from recent and ongoing HIV prevention studies and newer technologies, including the rollout of these new game-changing interventions. The talks covered real-life applications of these technologies, especially within African settings.

Seizing the moment during INTEREST 2022, the MOSAIC Project implemented by FHI 360 in Uganda was unveiled by Carolyne Akello, the project director, in a well-attended breakfast meeting that sparked great excitement and enthusiasm about expansion of PrEP choices in Uganda. Representatives from the Ugandan Ministry of Health and USAID were among the key stakeholders. MOSAIC’s key objectives are to accelerate the introduction and scale-up of new biomedical HIV prevention products and expedite their availability, acceptance, uptake and impact in PEPFAR programs to prevent HIV infection in Africa, with a focus on adolescent girls and young women.

In his presentation, titled “Achieving Epidemic Control among Key Populations in Africa,” FHI 360’s Dr. Chris Akolo shared a science-to-program highlight on HIV control and what it means to key populations (KP) in Africa. Dr. Akolo highlighted some of the strategies that are being used to expand access to relevant services for KP and concluded by discussing a few of the strategies that require more focus to move closer to achieving epidemic control among KP in Africa:

• Better understanding of the various KP groups, their contributions to the epidemic, and how their needs could be better met
• The need to prevent new infections using all the proven interventions, including PrEP, and other new prevention technologies
• Ensuring early identification and prompt linkage to treatment of HIV positive KP through the various differentiated service delivery (DSD) models that have proven to be effective, including those that are KP-led, expanding access to viral load testing, including at community level
• Creating an enabling environment for better service access such as removing discriminatory laws, as well as preventing and responding to violence
• Greater commitment from governments to sustain funding, improve relevant policies and guidelines, and develop systems and capacity to monitor and track HIV outbreaks

Another outstanding presentation that received this year’s Joep Lange Award for the best oral abstract at INTEREST 2022 was by Patriciah Jeckonia from LVCT Health (Kenya). She presented results from a study about integrating PrEP services into family planning (FP) services in Kenya. Overall, oral PrEP uptake was low due to several challenges such related to context, facility/staff dynamics and client circumstances. The key recommendation was training staff on PrEP-FP integration, routine coaching and supervision by facility leadership and constant supply of reinforcements. The study was implemented under the Collaboration for HIV Prevention Options to Control the Epidemic (CHOICE) project led by LVCT Health, in collaboration with FHI 360 and the Nairobi Metropolitan Services (NMS) Directorate of Health Services.

The 16^th INTEREST Conference ended with reflections from the conference chairs, Dr. Kwasi Torpey (Ghana), Dr. Elly Katabira (Uganda), Dr. Sabrina Bakeera-Kitaka (Uganda) and Dr. Andrew Kambugu (Uganda) on the way forward for the fight against HIV and COVID-19 and the critical role of African scientists in finding solutions to control these two pandemics. Dr. Katabira has been a constant throughout the 15-year history of INTEREST and received the heartfelt thanks and appreciation from the INTEREST family for his leadership and inspiration.

There was universal agreement that in-person meetings make an essential contribution to learning, information sharing and capacity building. The International Conference Committee selected Maputo, Mozambique as the setting for INTEREST 2023!

Featured Image: Timothy Mastro/FHI 360