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Improve Lube Access in Africa with the New GLAM Toolkit

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GLAM - Global Lube Access Mobilisation - is an initiative of IRMA's Project ARM to improve access to safe, condom-compatible lube in Africa. Learn more about this work here: …

GLAM - Global Lube Access Mobilisation - is an initiative of IRMA's Project ARM to improve access to safe, condom-compatible lube in Africa. Learn more about this work here: http://irma-rectalmicrobicides.blogspot.com/p/project-arm-africa-for-rectal.html. This presentation officially launched a Toolkit designed to help advocates in Africa work on lube access issues.

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  • 1. Improve Lube Access in Africa with the New GLAM ToolkitAVAC Partner’s Forum – Johannesburg – 6 Dec ‘12
  • 2. Today • Introductions • Who is IRMA, what does she do? • Project ARM, GLAM background • GLAM Toolkit • Lube safety research • Discussion
  • 3. The arc of the moral universe is long, but it bends toward justice.
  • 4. 1100+ advocates, Mission: support scientists, funders, development of policymakers from 6 safe, effective, acceptable,–and continents S. America/Latin accessible America and Nigeria rectal microbicides for all chapters them that needAIDS Foundation of Chicago is the IRMA secretariat 4
  • 5. Advocacy priorities o Increase and diversify funding o Increase research activities o RM research, expand pipeline o Lubricant safety, lubricant access o Increase knowledge o Heterosexual anal sex o Anal sex behaviours and practices in general
  • 6. Highly active moderated listserv Focused projects in Website Africa, S. • Tons of resources AmericaMaterials Blog, Facebook,• Fact sheets, reports Twitter video Global teleconferences • Recorded, materials posted 6
  • 7. @rectalmicro rectalmicrobicides.org irma-rectalmicrobicides. facebook.com/ blogspot.com InternationalRectal MicrobicideAdvocates 7
  • 8. 8
  • 9. Africa needs a rectalmicrobicide researchand advocacystrategy specific tothe continent 9
  • 10. at ICASA 2011• Birthing Project ARM – Working/strategy meeting before ICASA 2011 – Addis, Ababa, Ethiopia December 2 – 3, 2011 – 45 individuals: Africans/allies 10
  • 11. at ICASA 201145 individualsInvited and scholarship recipients– Cameroon, Canada, Ethiopia, Kenya, Malawi, Nigeria, RSA, Rwanda, Uganda, UK, USA, Zambia– Competitive scholarship program supported additional 16 Africans to attend • 145 Africans submitted scholarship applications • Represented: gay/MSM, female, trans, openly HIV+, researchers, advocates, NGOs 11
  • 12. 12
  • 13. Goals• Project ARM’s activities will lead to expanded African rectal microbicide education and advocacy. 13
  • 14. Goals• Project ARM’s activities will support the planning and implementation of rectal microbicide clinical trials in Africa in an environment that are as safe as possible. 14
  • 15. Goals• Project ARM’s activities will support the eventual rollout of safe, effective, acceptable and accessible rectal microbicides for African men, women, and transgender individuals. 15
  • 16. 7 Research and Advocacy priority actions 1. GLAM – “And Lube!” 2. KAB – AI, anal health perspectives and practices 3. Communication education materials 4. Acceptability study, studies 5. Mapping sex education 6. Document best practices in anal health, RM advocacy 7. Awareness raising and education 16
  • 17. www.rectalmicrobicides.org/ProjectARMreport2012.pdf
  • 18. 18
  • 19. Visit http://tinyurl.com/AndLube
  • 20. Visit http://tinyurl.com/AndLube
  • 21. The GLAM Toolkit Visit http://tinyurl.com/AndLube 21
  • 22. What is in the GLAM Toolkit? • Facts on Lube Access and Safety • Review of African National Strategic Plans • Lube Procurement National Case Studies • Findings from Survey on Lube Distribution and Access • Advocacy Steps for Improving Access to Safe, Condom-Compatible Lubricant 22
  • 23. What is in the GLAM Toolkit?Lube Access and Safety Info• Many people use some type of lubricant during anal and vaginal intercourse.• Some lubricants (water- and silicone-based) are safe to use with condoms; others (petroleum- based products) are not safe to use with condoms.• Using condom-compatible lube reduces the risk of condoms breaking or slipping. 23
  • 24. What is in the GLAM Toolkit?Lube Access and Safety Info• Condom-compatible lubes are inaccessible to most people around the world, esp. Africa.• Promotion and distribution of condoms and safe condom-compatible lube should go hand in hand.• However, more research is needed on the safety of lubricants to determine which products are safest. 24
  • 25. • Some studies tested lubes in a lab to see if they killed HIV in vitro or enhanced HIV-1 replication in vitro.• Some tested lubes on rectal tissue in mice to see if toxic, irritating, caused damage.• Some used human tissue (vaginal or rectal) and tested lubes in vitro to see if toxic, irritating or caused damage to the tissue. Lube Studies 25
  • 26. • Only one study has tested the effect of lubes on rectal tissue in humans.• Another study looked at the link between self-reported lube use during anal intercourse and testing positive for some rectal STIs. Lube Studies 26
  • 27. Osmolarity Many water-based lubes are hyperosmolar 27
  • 28. Osmolarity Osmolarity is a measure of the concentration of the soluble components—or solutes— present in a solution. Can be iso, hypo, or hyper 28
  • 29. Osmolarity Iso-osmolar products have same osmolarity as normal cells 29
  • 30. Osmolarity Hypo-osmolar products tend to make cells swell up with water, can lead to cells bursting 30
  • 31. Osmolarity ***Hyperosmolar products have a higher concentration of solutes than normal human cells. When in contact with rectal/vaginal cells, “suck” away water from inside cells, making them shrink in size 31
  • 32. BASED ON CURRENT EVIDENCE:•Unclear whether any particular type orbrand of lube might increase, decrease,have no effect on acquiring HIV and/orrectal STIs•Using male or female condomsconsistently and correctly still consideredbest way to prevent acquiring HIV and STIsduring anal and vaginal intercourse IRMA Steering Committee, and Lube Safety Working Group 32
  • 33. BASED ON CURRENT EVIDENCE: •Condom-compatible lubes associated with decreased risk of condoms breaking, slipping •Not possible at this time to recommend for/against using lubes if having AI without condoms •Lube use on its own not proven method of HIV or STI prevention IRMA Steering Committee, and Lube Safety Working Group 33
  • 34. Lube Fact Sheet, Lube QA oSafety of lubricants for rectal use: A fact sheet for HIV educators and advocates oSafety of lubricants for rectal use: Questions & Answers for HIV educators and advocates 34
  • 35. ACTION ON LUBE ACCESS /SAFETY: •IRMA Lube Safety Working Group •CDC Lube Safety Working Group •WHO/UNFPA/FHI360 Guidance (draft, process began April ‘11) •Population Services International •Manufacturers •U.S. Food and Drug Admin (FDA) •PEPFAR Lube Safety Working Group 35
  • 36. IRMA Steering Committee, and Lube Safety Working Group 36
  • 37. Discussion:How do wenuance theissues ofaccess andsafety?
  • 38. What is in the GLAM Toolkit? Review of African National Strategic Plans • 43 countries reviewed, 7 incorporated lube • Burundi, Djibouti, Gabon Namibia, Nigeria, Rwanda, RSA 38
  • 39. What is in the GLAM Toolkit?Lube Procurement Case Studies• Collected at AIDS 2012, MSM Zone• Zimbabwe, Burundi, Uganda, Kenya• Challenges and successes of lube procurement and distribution for GMT (gay men, MSM, trans) in African contexts• Highlight creative efforts• Issues related to lube related stigma, customs, taxes, sustainability 39
  • 40. Discussion:Share yourown casestudies
  • 41. GLAM Request for Proposals • Micro-grants • 3 to 5 projects • Lube access advocacy in Africa utilizing the Toolkit • Deadline Tuesday January 25, 2013 41
  • 42. GLAM Request for Proposals • Funding recs to be announced in Feb ‘13 • Projects begin March • Approx. 6 months • Open to AVAC/amfAR partners, Project ARM members 42
  • 43. 43
  • 44. Thank YOU 44
  • 45. Discussion 45

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