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Mapping Pathways Reveals Importance of Localised Strategies for Using ARVs to Prevent HIV/AIDS

Background

Clinical trial data show great promise for antiretroviral (ARV) drug based strategies to fight HIV. However, the science is rapidly evolving and real-world implementation is complex, shaped by local political and social circumstances.

Goals

To provide a resource for policymakers and communities, RAND Europe was a partner in Mapping Pathways, a multinational project led by the AIDS Foundation of Chicago to develop and nurture a research-driven, community-led global understanding of the emerging evidence base around the adoption of ARV-based prevention strategies to end the HIV/AIDS epidemic.

Mapping Pathways was the first study of its kind to synthesise evidence and views about ARV-based prevention strategies in diverse global contexts.

The project included a thorough review of the social, economic and clinical impact of four treatment regimes. Research, community engagement and policy work took place in three countries, the United States, India and South Africa.

Key Findings

Key insights on ARV-based prevention:

Structural factors such as cost and access are as important as individual behaviours
Policymakers and communities need more information to develop successful local strategies
Local context shapes perception: the same scientific data will be viewed and interpreted differently by stakeholders in different countries and groups

As Archbishop Desmond Tutu says in the report's foreword, all science is local. Strategies must be successful at a local level before they can have a global impact.

The next step is to work directly with communities to map locally driven but globally informed pathways to effective decisions about ARV-based prevention strategies.

Mapping Pathways infographic from RB9719

Resources

Mapping Pathways: Developing evidence-based, people-centred strategies for the use of antiretrovirals as prevention — June 19, 2013

Research Team and Project Partners

RAND Europe

Molly Morgan Jones
Joanna Chataway

Partners

Desmond Tutu HIV Foundation (South Africa)
Naz India
AIDS Foundation of Chicago
AIDS United (United States)

Baird's CMC provided communications support.

Mapping Pathways Provides Basis for Workshops in US to Generate Local HIV Prevention Strategies

Knowledge Exchange Workshops to be held in San Francisco, Atlanta and Washington D.C. will bring the Mapping Pathways project leaders together with stakeholders to consider recent developments in ARV-based HIV prevention strategies. Future scenarios and potential tailored strategies will be devised and planned using stakeholders' knowledge alongside the project results.

RAND Health Research on HIV/AIDS in Africa

HIV/AIDS continues to be a major health crisis in sub-Saharan Africa, where more than two-thirds of the world's HIV-infected population resides. In addition to studying condom use and antiretroviral therapy (ART), RAND researchers examine a variety of medical, social, and economic factors that affect the health outcomes and quality of life for Africans with HIV/AIDS.

Molly Morgan Jones Presents at AIDS 2012 Conference

Mapping Pathways, a multinational research project in which RAND Europe is a partner, participated in the AIDS 2012 conference 22-27 July in Washington, DC, and Senior Analyst Molly Morgan Jones was a presenter at one of the sessions. Her talk described how Mapping Pathways is exploring strategies in the use of antiretroviral (ARV)-based HIV prevention.

Mapping Pathways Project Reaches International Audience at ICASA 2011

Molly Morgan Jones, research leader for the Mapping Pathways project, visited Addis Ababa to present findings at the biennial International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) 2011. The conference was attended by more than 10,000 delegates from around the world, and many expressed an interest in having their countries serve as additional Mapping Pathways case-study sites. The project provided one of the few presentations on antiretroviral-based prevention.