In the wake of World AIDS Day, we reflect on the recent AIDS conference, which convened over 11,000 researchers, policymakers, industry leaders, funders, and civil society representatives united in the fight against HIV and AIDS. IPPF participated with a delegation comprising representatives from its Member Associations and staff, collectively representing 16 countries.  This conference, the largest global gathering on HIV & AIDS, offered a crucial opportunity to explore the latest scientific developments, particularly in bio-medical prevention tools such as the long-acting PrEP injectable and dual prevention pills. Beyond science, the event also provided a platform to examine the wider political and social contexts that continue to impact the global fight against the pandemic.    A grim reality: the numbers speak  Despite decades of progress, the goal of ending HIV by 2030 remains challenging, as underscored by a few sobering statistics:  Someone dies from AIDS-related illnesses every minute  In 2023 alone, 630,000 people died from AIDS-related illnesses  There are still 1.3 million new cases of HIV annually  The fastest-growing rates of HIV are in the MENA region, Latin America, Central Asia, and Eastern Europe  The country with the highest rate of new cases worldwide is Eswatini  These figures serve as a stark reminder of the ongoing impact of HIV on global populations. 

On World AIDS Day, we commemorate the remarkable achievements of IPPF Member Associations in their unwavering commitment to combating the HIV epidemic. Their tireless efforts have significantly expanded access to prevention, sexual and reproductive health services, and rights, transforming the lives of countless individuals worldwide. One of the key achievements of IPPF Member Associations has been their ability to expand access to essential sexual and reproductive health services through innovative approaches to HIV prevention, testing, and treatment. By establishing comprehensive service delivery networks and building the capacity of healthcare providers, they have ensured that individuals can access the care they need, regardless of their geographic location or socioeconomic status.   Kazakhstan is facing an urgent public health challenge as the number of HIV infections continues to rise. Over the past decade, the number of people living with HIV has doubled, now surpassing 31,000 individuals. The primary driver of this surge is sexual transmission, which accounts for an alarming 74% of cases. One of the most pressing issues is the high rate of undetected HIV infections. This gap poses significant challenges to implementing effective prevention and control measures. Although testing and treatment services are readily available, deep-rooted societal stigma keeps many from accessing them—particularly young people and key populations who are most vulnerable. Addressing this crisis means confronting the stigma head-on. Reducing the shame and fear surrounding HIV testing is crucial to fostering a culture where individuals feel safe and empowered to seek diagnosis and treatment. By promoting awareness, open conversation, and a supportive environment, we can help break down barriers to care and encourage people to take charge of their health. Only through collective effort can Kazakhstan turn the tide on HIV and prevent its further spread.   Fighting the HIV Pandemic: KMPA's Pioneering Efforts The Kazakhstan Association on Sexual and Reproductive Health (KMPA) is at the forefront of the battle against HIV. In collaboration with the AIDS Center of Astana City, Chevron Munaigaz Inc., and the International Center for AIDS Care and Treatment Programs (ICAP) as well as NGOs working with key population in Astana and youth friendly centers, since August 2023, KMPA has launched two groundbreaking initiatives:

On World AIDS Day, we commemorate the remarkable achievements of IPPF Member Associations in their unwavering commitment to combating the HIV epidemic. Their tireless efforts have significantly expanded access to prevention, sexual and reproductive health services, and rights, transforming the lives of countless individuals worldwide. One of the key achievements of IPPF Member Associations has been their ability to expand access to essential sexual and reproductive health services through innovative approaches to HIV prevention, testing, and treatment. By establishing comprehensive service delivery networks and building the capacity of healthcare providers, they have ensured that individuals can access the care they need, regardless of their geographic location or socioeconomic status.   At the Family Planning Association of Malawi (FPAM), we are not only service providers; we're challenging the status quo. By putting clients at the center of our work and championing innovative solutions, we are fighting for a future where everyone, regardless of their background, has access to the sexual and reproductive health services they deserve. FPAM is committed to delivering evidence-based HIV prevention interventions, including the latest technologies like CAB-LA, an injectable, long-acting form of PrEP. By identifying and engaging with communities and collaborating with organizations, we aim to increase access to these life-saving services and ultimately reducing HIV transmissions. Strengthening Communities, Preventing HIV: Our Commitment  To ensure the successful implementation of these new HIV prevention interventions, at FPAM we have adopted a multifaceted approach. We have identified and prioritized high-risk communities, including men who have sex with men, trans communities, sex worker communities, and young women. By working closely with community-led organizations, we are reaching marginalized populations and addressing their needs. FPAM is committed to fostering strong partnerships to improve access to sexual and reproductive health services, including HIV prevention. By collaborating with government agencies, community-based organizations, and other stakeholders, we are confident in our ability to make a significant impact on HIV prevention and improve the health and well-being of our communities. We have partnered with the Ministry of Health through the Department of HIV, STI and Viral Hepatitis (DHA) to strengthen the capacity of healthcare providers and ensure the availability of essential services. Through joint efforts, we have conducted training sessions with out staff on PrEP, developed guidelines, and implemented quality assurance measures. We have also collaborated with the National AIDS Commission (NAC) on the navigation of prevention programs, especially with the key population whose HIV prevalence is high. By listening to the needs of our communities, we can tailor our interventions to their specific circumstances. Community engagement is at the heart of our approach. We work closely with community-based organizations to reach marginalized populations, address stigma, and promote behavior change. FPAM is working with Men of Tomorrow (MOTO), which works with men. This will be a way of reaching out to Men with PrEP information and services. FPAM will work with Youth Clubs and Community Based Organisations (CBOs) for demand creation and client linkage for PrEP services. FPAM intends to engage the Reproductive Health Directorate to discuss strategies for delivering CAB-LA to breastfeeding and pregnant women. This population has highest knowledge gap on PrEP according to the dialogue sessions that were conducted. By building strong partnerships and leveraging our collective expertise, we are making significant strides in the fight against HIV. Together, we can create a healthier future for all.

On World AIDS Day, we commemorate the remarkable achievements of IPPF Member Associations in their unwavering commitment to combating the HIV epidemic. Their tireless efforts have significantly expanded access to prevention, sexual and reproductive health services, and rights, transforming the lives of countless individuals worldwide. One of the key achievements of IPPF Member Associations has been their ability to expand access to essential sexual and reproductive health services through innovative approaches to HIV prevention, testing, and treatment. By establishing comprehensive service delivery networks and building the capacity of healthcare providers, they have ensured that individuals can access the care they need, regardless of their geographic location or socioeconomic status.   Eswatini has made significant strides in advancing sexual and reproductive health and rights (SRHR). The recent introduction of the dapivirine vaginal ring (DVR) and the potential availability of CAB-LA mark a pivotal moment in the country's HIV prevention efforts. The Dapivirine Vaginal Ring (DVR): A Discreet and Effective Solution The DVR, a discreet and user-friendly monthly ring, has revolutionized HIV prevention. By eliminating the need for daily pill-taking, it has significantly improved adherence rates and reduced the stigma associated with HIV prevention. This groundbreaking innovation has empowered individuals to take control of their sexual health and make informed decisions. The adoption of the dapivirine vaginal ring in Eswatini marked a pivotal step in HIV prevention efforts as the ring offered a discreet and effective alternative to traditional methods. It has offered individuals more options to safeguard their health, expanding accessibility and flexibility in HIV prevention strategies. One of the key contributions that came with the Dapivirine vaginal ring is its monthly application, which has eliminated the need for daily adherence associated with oral PrEP. This simple innovative prevention method has brought in a huge contribution to the Kingdom’s HIV prevention efforts as it has reduced the strict time adherence, enhancing the overall effectiveness of the intervention. In rural areas, the discreet nature of the dapivirine vaginal ring plays a significant role in mitigating the stigma surrounding HIV prevention. Unlike oral medication that may be visible to partners and family members. This discrete form of prevention will encourage more individuals to consider and utilize PrEP without fear of judgement or discrimination.

Eswatini (27 August 2024) - IPPF’s Member Association in Eswatini, the Family Life Association of Eswatini (FLAS), is soon to roll out the first women-controlled HIV prevention product, the dapivirine vaginal ring (DVR). FLAS will be among the first organisations to offer the DVR outside implementation or pilot studies anywhere in the world. Made of flexible silicone, the ring is inserted into the vagina by a woman and slowly releases the antiretroviral drug dapivirine in the vagina over a one-month period, helping to reduce a woman’s risk of acquiring HIV. In 2023, in sub-Saharan Africa, women and girls accounted for 62% of all new HIV infections and every week, 3,100 adolescent girls and young women aged 15–24 years became infected with HIV. Therefore, there continues to be an urgent need for HIV prevention methods that females can use to protect themselves. The DVR is a product women can control themselves and use without the knowledge or consent of their partners, unlike condoms, which men often refuse to use. The DVR is inserted into the vagina and left for a one-month period, where it can then be replaced each month for continued protection. Unlike daily oral PrEP, the DVR does not rely on remembering to take a pill each day and is also discreet as it stays inside the vagina throughout the month. The DVR does not prevent pregnancy or other sexually transmitted infections (STIs), so women choosing to use the ring may want to consider combining it with condoms and methods of contraception. The availability of the DVR is an exciting step in supporting women’s autonomy and choice in HIV prevention. This need for women-controlled HIV prevention products has long been advocated for, with the African Women Prevention Community Accountability Board launching the HIV Prevention Choice Manifesto in early 2023. The Choice Manifesto prioritises the principle of choice to ensure that women and girls have the right to choose which HIV prevention methods work for them. Currently the ring is available at selected facilities through implementation studies across six countries in East and Southern Africa; South Africa, Kenya, Zimbabwe, Lesotho, Eswatini, and Uganda.  Diantha Pillay, Associate Director for Product Access for IPM South Africa NPC (an affiliate of the Population Council), said:  “It is encouraging to see the efforts made by FLAS and IPPF to support the choice agenda for HIV prevention for women and make effective HIV prevention methods, like the DVR, more widely accessible in a real-world setting. We hope this can pave the way for introduction of future pipeline products that speak to the needs of women.” The Population Council is currently developing a longer duration DVR that women would use for three months versus one month to significantly lower annual product costs and offer women a more convenient option to protect themselves. Thabo Lizwe Masuku, Programs Manager for FLAS, said: “Women have been telling us for a long time that  there is a need for a variety of methods for HIV prevention, since they are highly exposed. For women and girls to truly have choice about what works for them as they navigate different stages and circumstances of their lives, policy makers, donors, governments and implementers must ensure the mix of HIV prevention methods are available, accessible, and affordable. Access to the ring through our clinics in Eswatini now gives women choice and options to protect themselves against HIV.” IPPF is committed to ensuring that choice in HIV prevention is a reality for women and girls and aims to roll out the dapivirine vaginal rings at as many Member Associations as possible, as well as offer other HIV-prevention choices, as we work alongside our partners towards a future free of HIV in Africa and beyond. For more information and to speak to staff in Eswatini, please email [email protected]   Notes: The dapivirine vaginal ring has been recommended by the WHO since January 2021. (25) In clinical trials, the  ring was shown to reduce HIV infection by 35% in The Ring Study (26,27) and 27% in the ASPIRE Study. (28,29) Recent open-label studies show greater adherence to the ring, and modelling data suggest that HIV risk could be reduced by about 50%. (30) The dapivirine ring has received regulatory approval from the European Medicines Agency (EMA), as well as from local medicines regulators in Namibia, South Africa, Kenya, Zimbabwe, Uganda, Zambia, Malawi, Rwanda, Eswatini, Lesotho, Botswana and is currently under regulatory review in a number of other countries Our Member Associations (MAs) that provide clinical services are required to provide comprehensive SRH services through our Integrated Package of Essential Services (IPES) which include services for sexual health and well-being, contraception, abortion care, sexually transmitted infections (STIs)/reproductive tract infections (RTIs), HIV, obstetrics and gynaecology, fertility support, and sexual and gender-based violence. IPPF’s new five-year strategy, Come Together, focuses on expanding choice. In support of this, we recently launched a special programme to expand our HIV prevention options, which aims to integrate the newest HIV prevention methods – the vaginal ring and injectable PrEP - into our comprehensive sexual and reproductive health services.  IPPF’s IMAP Statement on Biomedical HIV Prevention can be found here. About the Family Life Association of Eswatini (FLAS)  For over 30 years, the Family Life Association of Eswatini (FLAS) has provided sexual and reproductive health (SRH) services to the people of Eswatini (formally Swaziland). While family planning, antenatal, post-natal and post-abortion care form a key part of FLAS services, there’s a significant focus on HIV and AIDS programmes. Eswatini has some of the highest HIV and AIDS prevalence rates in the world. As a result, the prevention and management of HIV and AIDS, the provision of voluntary counselling and testing (VCT), and the prevention of mother to child transmission (PMTCT) are central to FLAS’s work. FLAS has 15 service points, including three permanent clinics and three mobile facilities, staffed by a permanent team of 40 staff backed by 230 volunteers, 180 Youth Action Movement members and 29 peer educators. About the International Planned Parenthood Federation (IPPF) IPPF is a global healthcare provider and a leading advocate of sexual and reproductive health and rights (SRHR) for all. Led by a courageous and determined group of women, IPPF was founded in 1952 at the Third International Planned Parenthood Conference. Today, we are a movement of 150 Member Associations and Collaborative Partners with a presence in over 146 countries.Our work is wide-ranging, including comprehensive sex education, provision of contraceptives, safe abortion, and maternal care and responding to humanitarian crises.  We pride ourselves on being local through our members and global through our network. At the heart of our mission is the provision of – and advocacy in support of – integrated healthcare to anyone who needs it regardless of race, gender, sex, income, and crucially no matter how remote. Our services are available to all, and reach the most marginalised groups in societies, including key and priority populations, youth, and people with disabilities. Most of our MAs have special programs to engage youth (10-24) inside and outside of school settings. Because our clinics offer comprehensive services, attending our clinics is non-stigmatizing and does not label people as having a particular disease or membership to a particular group. This model of services that are integrated and open to all, embedded in indigenous, locally owned organisations, is ideal for ensuring that the most vulnerable and marginalised groups can access the HIV prevention services they need. About the Population Council The Population Council is a leading research organization dedicated to building an equitable and sustainable world that enhances the health and well-being of current and future generations. The Council transforms global thinking on critical health and development issues through social science, public health, and biomedical research. We generate ideas, produce evidence, and design solutions to improve the lives of underserved populations around the world.  

Recognizing the significant global impact of sexually transmitted infections (STIs), this statement affirms IPPF’s commitment to people-centred STI care as a critical aspect of comprehensive sexual and reproductive health and well-being. A holistic approach to sexual and reproductive health and rights acknowledges that true sexual and reproductive well-being extends beyond the prevention and treatment of diseases. It emphasizes the importance of promoting healthy, satisfying sexual and reproductive experiences. This includes advocating for personcentred care, encouraging self-care strategies, and supporting the development of innovative healthcare delivery models tailored to meet the diverse needs of individuals in various circumstances and contexts, particularly reaching those who are often excluded and marginalized. This statement updates the latest information on STIs. It provides practical recommendations for IPPF Member Associations on how to develop a comprehensive, people-centred approach to STI care, emphasizing integrated services, adherence to guidelines, rights-based care, community engagement, advocacy, and a positive perspective on sexual health and well-being.

Lesotho, a country situated in Southern Africa and landlocked by the Republic of South Africa, has an estimated total population of 2.1 million people. The small country is still heavily affected by HIV and AIDS, with high prevalence rates of 24.3% among women aged 15-49, and 14.2% among men in the same age bracket. The Lesotho government, in partnership with various non-governmental organizations, continues to address these alarming rates, including among adolescents and youth. One of the government’s key partners in the country is IPPF’s Member Association in Lesotho, Lesotho Planned Parenthood Association (LPPA). One of LPPA’s strategy aimed at increasing HIV linkage and retention in care and treatment among adolescents and young people living with HIV, is through an initiative known as the ‘Red-Carpet model’. The initiative, started in May 2023, is being piloted in LPPA’s youth clinic located in the capital city, Maseru. The ‘Red-Carpet model’ is aimed at providing adolescents and young people with a VIP experience as they access quality youth-friendly services at the facility. The model fast tracks services and reduces barriers for adolescents to access and utilize integrated HIV/SRH services. We had a chat with Ms. Mamojela Koneshe, LPPA’s Executive Director, who sheds more light on this initiative. How exactly does the ‘Red-Carpet’ model work? The model serves all adolescents and young people who visit the clinic, regardless of if they are first time or returning clients. For the new clients, they first report to the reception area upon arrival at the clinic. They are then referred to the waiting area where an LPPA Youth Ambassador gives them information about the model, how it works and its benefits. Youth Ambassadors are young people seconded to LPPA clinics by one of our partner organizations - Elizabeth Glaser Paediatric AIDS Foundation (EGPAF). Their duties include ensuring that adolescents in the clinic are linked to appropriate HIV prevention methods and treatment. They also hold scheduled peer support groups, and in collaboration with the Youth Nurse, link vulnerable youth to various organisations depending on their needs –for example linking sexual and gender-based violence survivors to shelters. The Youth Ambassadors also ensure that red carpet model is well implemented. While at the waiting area, the Youth Ambassador gives the adolescent or young client access to free wi-fi, which enables them to access the internet. After this, the client is enrolled in the model and given a VIP card. When their turn arrives, the Youth Ambassador escorts them to the relevant consultation or counselling room depending on the service they need. The expected time spent in the facility by the young person is 45minutes. This is the maximum time expected to be spent by young people while accessing services and was informed by the various services that young people access in our facility. Telephone follow-up interviews are then done with the clients on a weekly basis. On their return visit, upon arrival at the facility, adolescents report to the reception where they present the VIP card they were given at their first visit. They are then referred to the waiting area where once again, the Youth Ambassador gives them a free wi-fi voucher and links them to the appropriate service. Similarly, the expected time spent in the facility is 45minutes. Why is the provision of free internet to adolescents and youth at the clinic important? This is because it enables young people to access a vast amount of health information online. By connecting to the internet, they search for health-related information. It also gives them access to educational resources that can help them make informed decisions about their health. Going online also helps them to connect with their peers within established peer support groups. In addition, most of our clients are students at colleges, universities, and other learning institutions, so facilitating their free internet access helps them to continue studying and researching while waiting for services. They like this since they don’t have to use their own internet bundles, which can be quite expensive for them.

Background IPPF offers a comprehensive approach to sexual and reproductive health and rights through its Integrated Package of Essential Services (IPES) which is offered at affiliate service delivery points. The IPES includes HIV testing, HIV prevention, HIV care and treatment, services for sexually transmitted infections and reproductive tract infections, contraception, abortion care, obstetrics and gynaecology, fertility support, and support for sexual and gender-based violence Purpose The purpose of our HIV Theory of Change is to clarify the goals and vision of IPPF’s HIV programme and to articulate the different pathways and strategies IPPF uses to contribute towards its HIV goals and vision. This Theory of Change endeavours to represent a conceptual model that is complex and non-linear in the format of a readable diagram. Therefore, this Theory of Change diagram is a simplified representation of a complex process which cannot be fully captured in this format. Our Theory of Change describes causal pathways for how the work in our HIV programme contributes to the ultimate goals and vision. The purpose of this conceptual model is not to provide a detailed description of the components of our HIV services, as these are described in the 2020 ‘IPPF Comprehensive HIV Services Package’ and the IPPF 2022 ‘Client-centred-clinical guidelines for sexual and reproductive health care’. Reading the diagram Our Theory of Change diagram is read from left to right, representing movement in time from the world we currently live in (left side) towards the future we would like to see, which is represented by our vision (right side). There are 7 pathways (page 1), each with a set of strategies (shown on pages 4 and 5 as close-ups of the diagram), whose work contributes towards achieving our HIV goals and vision. The 7 pathways are divided into cross-cutting pathways (community engagement, evidence and learning, capacity strengthening and sharing, strategic partnership building) and core pathways (advocacy, empowerment, comprehensive service delivery). The cross-cutting pathways are iterative and intersecting, contributing to each other and collectively contributing to the 3 core pathways. The core pathways represent the 3 main areas of our HIV programme, which, like all elements of the diagram, also interact with each other synergistically. The strategies of all 7 pathways working together contribute towards a set of outcomes. The outcomes interacting together contribute towards our goals, which in turn interact with each other, and contribute towards our ultimate vision.

Located in the bustling heart of Iloilo City is the RAJAH Community Centre, a dynamic hub with a meaningful mission. RAJAH stands for "Raising Awareness for Junior Advocates on HIV." Established in 2019 by the Family Planning Organization of the Philippines (FPOP), this centre provides a safe space for HIV testing and support services, free from stigma.  The centre provides counselling and a range of supportive initiatives tailored to its diverse community. What sets this centre apart from other HIV diagnostic and treatment facilities is its unique operational model, primarily driven by volunteers. Many of these volunteers are part of the LGBTIQ+ communities they serve.  Mona Liza S. Diones, the Chapter Program Manager of FPOP Iloilo, noted that a significant number of potential clients still hesitate due to fears associated with visiting a treatment facility. “At RAJAH, we're working to change this perception by providing essential services that promote comfort and eliminate prejudice.”  The centre is a crucial service point that complements existing facilities run by local government units. In partnership with the Department of Health, it provides continuous HIV services, including telemedicine, mobile clinics, and the distribution of essential items such as PrEP (Pre-Exposure Prophylaxis) and condoms. PrEP is an oral pill that reduces the risk of contracting HIV from sex by about 99% when taken correctly. Onsite HIV testing is available for individuals aged 15 and above, following the guidelines of the HIV and AIDS Policy Act in the Philippines, which allows those between 15 to 18 to access testing without parental or guardian consent.  As of January 2023, the Philippines recorded 110,736 cases of HIV. The number of people with HIV is projected to rise by 200%, from 158,400 in 2022 to 364,000 by 2030.