The Manicaland HIV Prevention Project team was represented at the 22nd International AIDS Conference in Amsterdam (23-27 July 2018) – where more than 15,000 researchers, activists, and policy makers gathered – by Robin Schaefer. He presented two posters on longitudinal analyses of perceptions about risks of HIV infection in the Manicaland Study. HIV prevention interventions, programmes, and messages commonly aim at increasing perceptions about HIV infection risks, but the importance of risk perception for engaging in HIV prevention behaviour is poorly understood due to a lack of longitudinal studies. These studies by the Manicaland Project represent the first scientifically robust evidence that self-perceived risks about HIV infection can be accurate – i.e. correspond to actual HIV infection risks – and that changes in risk perception over time predict changes in condom use behaviour. However, this work also shows significant gaps in risk perception, even among those reporting behaviours associated with increased risks of HIV infection, and that only small proportions of change in condom use can be attributed to changes in risk perception. This underscores the broad range of factors that influence HIV prevention behaviour and the need for a comprehensive approach to HIV prevention. A further poster presented collaborative work with the London School of Hygiene and Tropical Medicine on HIV prevention cascades. The poster outlined the consultations that were held over the course of two years to develop a unifying framework on HIV prevention cascades that builds on a core prevention cascade of motivation, access, and effective use, with further extensions allowing for more complex characterisation of HIV prevention use in a priority population. 

The Manicaland Centre was well represented at the 13th AIDSImpact Conference that was held in  Cape Town, South Africa, on 13 - 15 November 2017. AIDSImpact is an international behavioral and psychosocial science conference that addresses issues related to HIV prevention, treatment and care, focusing on communities and countries hardest hit by the HIV epidemic. 

Constance Nyamukapa (pictured) reported on findings from a new study, which found female sex workers to have greater uptake of HIV treatment services compared to peers who do not engage in  sex work. 

Robin Schaefer presented a couple of posters on the HIV prevention cascade. One poster critiques existing cascades and develops and assesses a new set of generic user-centric formulations for use in population surveys. In another poster, Schaefer presented an overarching explanatory framework  to interpret HIV prevention cascades and to guide interventions.

Morten Skovdal presented a paper drawing on qualitative research, which observed how improved access to antiretroviral therapy made it possible for our participants to live, care for others, and perform their social responsibilities, such as being a parent or a spouse, which in turn sparked engagement with HIV services. Morten also presented a paper reporting on the accounts of relatives of kin who have succumbed to HIV. The relatives vocalized the perceived behavior of some of the hardest to reach men in the HIV response, illuminating how dimensions of masculine norms may contribute to HIV positive men’s reduced life expectancy.

The conference was also attended by Louisa Moorhouse.