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.  

By Mallah Tabot and Sylvia Ekponimo In May 2024, The International Planned Parenthood Federation’s International Medical Advisory Panel (IMAP) released a statement on person-centered care for STIs. The statement  offers the most recent updates on sexually transmitted infections (STIs) and shares practical guidance for IPPF Member Associations (MAs) on “how to develop a comprehensive, person-centered approach for STI care” with emphasis on the importance of integrated services, adherence with guidelines, rights-based care, community involvement, advocacy, and a positive outlook on sexual health and well-being. As with other IMAP statements, this publication is very timely considering the global STI trends which are unfortunately on the rise, with more than 1 million curable STIs acquired every day and many countries continuing to report an increase number of cases. Despite the deployment of interventions for the prevention, treatment, and management of STIs including HIV at global and regional levels, as well as the introduction of biomedical prevention technologies such as vaccines and pre-exposure prophylaxis (PrEP) for HIV prevention, the situation remains bleak. In 2020, global data indicated an estimated 374 million new STI cases per year, with 26% of the new cases coming from Africa. For HIV prevention, PrEP services are expanding significantly in Africa, with 22 countries offering it to adolescent girls and young women, sex workers, gay and other men who have sex with men, transgender individuals, people who inject drugs, and/or prisoners. While its benefits have been widely documented, with the latest research revealing that PrEP reduces the risk of getting HIV from sex by 99%, it however does not prevent against other STIs or pregnancy.     Strategies and planning frameworks for the integration of HIV and other STIs in the face of this global surge exist. However, the elements required for intentional implementation may be missing especially in low resource settings which in turn limits our collective ability to overturn this trend and improve efficiency within our health systems. Currently, most PrEP interventions are implemented within HIV programmes with significant focus on priority population groups. While this is plausible as these populations are at-risk and most-often underserved, pertinent questions however remain, which we must continually reflect upon and consider – Have we fully harnessed valuable opportunities to integrate and link STI service delivery to other services including HIV? How can we ensure that current STI interventions truly contribute to reverse the trends of STI prevalence in Africa? Is the expansion in access to PrEP services in Africa an opportunity to do so? With the rollout of multiple PrEP methods that protect against HIV without condom use, are we fully integrating services?     A systematic review of some studies on STI prevalence amongst PrEP users highlights the need for active integration of HIV and STI services especially for key populations. Therefore, a critical interrogation into current implementation strategies for STI management vis-a-vis PrEP programming is essential. With this in mind, it is of the essence for MAs and other partners to take heed of the robust and actionable recommendations in this IMAP statement, and reevaluate their STI/HIV integration strategies. From standard operating procedures that ensure that clients are systematically offered testing for HIV and STIs, no matter the reason they are attending the clinic, to provider training on integrated services, or checklists to ensure these tests are offered and conducted, we must ensure that strategies are tailored to overturn the current STI prevalence while sustaining efforts in HIV prevention through PrEP.

The Japan Trust Fund (JTF) represents a visionary partnership that began in 2000 between the Government of Japan and IPPF. Together, we invest in programmes that prioritize health equity, gender equality, and human security for all. Traditionally a driving force behind IPPF's efforts to support the integrated HIV prevention programmes of our Member Associations in Africa and Asia, JTF has adjusted to reflect changing global health priorities. We attach importance to universal access to sexual and reproductive health and rights - an essential contributor to universal health coverage and the global development goals.     These projects have transformed the lives of people most vulnerable to HIV and high risk of maternal and child mortality. Equally, it ensures that as a donor, the GOJ’s response to HIV remains people-centred and contributes to human security.      

This programme addresses critical challenges faced by young women around sexual health and sexuality. It has produced a range of advocacy, education and informational materials to support research, awareness-raising, advocacy and service delivery.    Girls Decide is about the sexual and reproductive health and rights of girls and young women. Around the world, girls aged 10 to 19 account for 23% of all disease associated with pregnancy and childbirth. An estimated 2.5 million have unsafe abortions every year. Worldwide, young women account for 60% of the 5.5 million young people living with HIV and/or AIDS. Girls Decide has produced a range of advocacy, education and informational materials to support work to improve sexual health and rights for girls and young women. These include a series of films on sexual and reproductive health decisions faced by 6 young women in 6 different countries. The films won the prestigious International Video and Communications Award (IVCA). When girls and young women have access to critical lifesaving services and information, and when they are able to make meaningful choices about their life path, they are empowered. Their quality of life improves, as does the well-being of their families and the communities in which they live. Their collective ability to achieve internationally agreed development goals is strengthened. Almost all IPPF Member Associations provide services to young people and 1 in every 3 clients is a young person below the age of 25. All young women and girls are rights-holders and are entitled to sexual and reproductive rights. As a matter of principle, the IPPF Secretariat and Member Associations stand by girls by respecting and fulfilling their right to high quality services; they stand up for girls by supporting them in making their own decisions related to sexuality and pregnancy; they stand for sexual and reproductive rights by addressing the challenges faced by young women and girls at local, national and international levels.

The People Living with PLHIV Stigma Index documents how people have experienced HIV-related stigma and how they have been able to challenge and overcome stigma and discrimination relating to HIV. People living with HIV receive training in quantitative data collection, and implement the survey using a standard questionnaire which covers the following 10 areas: Experiences of stigma and discrimination and their causes Access to work and services Internal stigma Rights, laws and policies Effecting change HIV testing Disclosure and confidentiality Treatment Having children Problems and challenges for people living with HIV The People Living with HIV Stigma Index puts the principle of the greater involvement of people living with HIV and AIDS (GIPA) into practice, the research is driven by people living with HIV and their networks and provides them with evidence and opportunity to address challenges in their communities and catalyze change. The findings are instrumental in increasing collective understandings of stigma and discrimination, and detecting changes and trends over time. The evidence has shaped future programmatic interventions by revealing areas of need and gaps in existing programming. The People Living with HIV Stigma Index is a powerful advocacy tool which will influence policy and support the collective goal of governments, NGOs and activists to reduce stigma and discrimination related to HIV.   The People Living with HIV Stigma Index has been rolled out in more than 40 countries, where it has been a catalyst for fostering change. Each country is different, from the number of people interviewed to the composition of responses from different group (such as men who have sex with men, sex workers, injecting drug users and other key populations).  The People Living with HIV Stigma Index was developed and pioneered by a partnership between the International Planned Parenthood Federation (IPPF) and the Global Network of People Living with HIV(GNP+), the International Community of Women Living with HIV (ICW) and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Integra is a 5-year research initiative in Kenya, Malawi and Swaziland. It aims to reduce HIV infection, HIV-related stigma and unintended pregnancy. IPPF implements the Integra Initiative with support from the Bill and Melinda Gates Foundation and in collaboration with the London School of Hygiene and Tropical Medicine and the Population Council.  

IPPF collaborates with UNAIDS and The PACT to implement ACT!2030 (formerly ACT!2015), a youth-led social action initiative which engages young people in 12 countries with advocacy and accountability around the Sustainable Development Goals (SDGs) and other SRHR agreements/frameworks. ACT!2030 was initiated in 2013 as a way to increase youth participation in the negotiations leading up to the adoption of the post-2015 development agenda, and for two years focused on establishing alliances of youth-led and youth-serving organisations in 12 countries across the world. The project is currently in Phase 4, which runs until the end of 2017, and aims to establish youth-led, data-driven accountability mechanisms to ensure youth engagement with the implementation of the SDGs and build an evidence base for advocacy. Ultimately, Phase 4 of ACT!2030 seeks to identify, assess and address key policy barriers to young people’s sexual and reproductive data by using existing data, supplemented by youth-collected data, to advocate and lobby for policy change. This phase involves four main activities: indicator advocacy (persuading decision makers to adopt youth-friendly SRHR and HIV indicators, including on things like comprehensive sexuality education (CSE) and access to youth-friendly services, into national/global reporting mechanisms); evidence gathering (creating national databases on quality of and access to youth-friendly services and CSE); communications (transforming this data and evidence into communications pieces that can be used to advocacy and lobby at national and international level); and global exchange (facilitating global visibility to share advocacy and engagement learnings and increase youth-led accountability in global and regional processes). ACT!2030 is implemented by national alliances of youth organisations in 12 countries: Algeria, Bulgaria, India, Jamaica, Kenya, Mexico, Nigeria, Philippines, South Africa, Uganda, Zambia and Zimbabwe.  

20-year-old Hayathe Ayeva is the President of the Youth Action Movement (YAM) of the Togolese Association for Family Welfare (ATBEF) -the Member Association of the International Planned Parenthood Federation (IPPF) in the country. A college student who is passionate about communication and writing, Hayathe has won several public speaking competitions. She identifies herself as ‘a proud social activist, woman defender of Human Rights, committed to the Sexual and Reproductive Health of adolescents and young people’. Hayathe is passionate about leadership, and has held various leadership roles in her community since the age of 10. Before joining the YAM at the age of 12 years, she was a member of several associations including the Light Club of Plan International Togo, the German Club, the theatre group and the UNESCO Club at her school, where she was also the founding president of the Anti-AIDS Club. As part of YAM’s activities, Hayathe works with her peers to support ATBEF's advocacy work on Sexual and Reproductive Health and Rights (SRHR) issues, especially among the youth. According to Hayathe, the main health SRHR challenges facing young people in Togo include prohibitive traditions that consider sexuality issues as taboo, the lack of spaces dedicated to youth activities, long distances to youth-friendly service centers, and difficult access to SRHR information including family planning. To address some of these challenges, ATBEF supports young people by availing their premises for YAM  activities. In these youth-friendly centers, they can access various documents and services. Hayathe is very active in ATBEF's activities. "I have participated in several ATBEF campaigns and projects where I have raised SRHR awareness targeting young people on social media platforms through my pages. I was also involved in the development of the novel mobile application ‘InfoAdoJeune’, a platform that helps young people access credible information on Sexual and Reproductive Health during the COVID-19 period. Hayathe is also part of the implementation team for the project on "Effective youth involvement in the mid-term review, implementation, monitoring and evaluation of TOGO's 2017-2022 National Budgeted Action Plan for Reproductive Health/Family Planning (PANB)”. As a young female leader and SRHR champion, Hayathe faces various challenges, more so those related to social and financial support. "To address these challenges, I try to increase everyone's understanding of the value of my involvement.  For activities that require costs, I try to manage with my own money and those of my relatives because I am committed to serving my community without expecting anything in return.” Despite women's involvement in all sectors around the world, Hayathe notes several obstacles to women's access to leadership positions. “They include society’s view that tends to place men above women -and the resultant women's lack of self-confidence, forced marriages and early pregnancies, family and marital responsibilities that impede them from fully pursuing their ambitions.“ To overcome these obstacles, Hayathe believes that "governments must promote gender equality and appoint more women to positions of responsibility. This will ensure they are represented at all levels and in organizational structures. More honor should be accorded to women in order to encourage others to cultivate the culture of excellence.” Hayathe's primary motivation for women's leadership is to uplift the voice of voiceless youth, to reach out to vulnerable and marginalized populations, and to share quality sexual and reproductive health information. "I am proud of the positive impact of my actions on young people in my community, which I note through their encouragement and suggestions,” she concludes. Read this article in French here. Hayathe on social networks: Facebook: Hayathe AYEVA Facebook page (personal blog): Hayathe AYEVA Twitter: @AHayathe

Hayathe AYEVA a 20 ans. C’est une étudiante togolaise très engagée dans la vie associative. Passionnée de communication et d'écriture, elle a été lauréate de plusieurs concours d'art oratoire. Activiste sociale, femme défenseur des Droits Humains, engagée pour  la Santé Sexuelle et Reproductive des adolescents et jeunes, elle préside le Mouvement d’Action des Jeunes (MAJ) de l’Association Togolaise pour le Bien-Être Familial (ATBEF), Association Membre de la Fédération Internationale pour le Planning Familial (IPPF) dans le pays. Hayathe occupe des rôles de leader communautaire depuis l'âge de 10 ans. Avant de rejoindre le MAJ à l'âge de 12 ans, elle a été membre de plusieurs associations dont le Club Lumière de Plan International TOGO, le Club Allemand, le groupe théâtral et le Club UNESCO de son école et même présidente fondatrice du Club Anti SIDA. Dans le cadre des activités du MAJ, Hayathe travaille d’arrache-pied avec ses pairs à appuyer les actions de sensibilisation de l’ATBEF sur les questions de Santé et Droits Sexuels et Reproductifs (SDSR). Selon Hayathe « les principaux défis sanitaires liés à la SDSR au Togo sont essentiellement le poids de la tradition, qui engendre des tabous liés à la sexualité, le manque d'espaces dédiés aux activités des jeunes, l’éloignement des centres de services pour jeunes, la difficulté d’accès aux informations liées à la santé reproductive (SR) et la planification familiale (PF) ». L'ATBEF appuie les actions des jeunes du MAJ en mettant à leur disposition leurs locaux et de la documentation pour certaines de leurs activités. Hayathe est personnellement très active dans les activités de l’ATBEF. « J'ai été associée à plusieurs campagnes et projets de l’ATBEF pour lesquels j’ai fait des sensibilisations sur les réseaux sociaux à travers mes comptes et pages personnels. Nous avons développé avec les jeunes du MAJ, en collaboration avec l'ATBEF, une application mobile nommée ‘InfoAdoJeune’, qui aide les jeunes à accéder à des informations crédibles sur la Santé Sexuelle et Reproductive pendant cette période de COVID-19 ». Hayathe fait également partie de l'équipe de mise en œuvre du projet portant sur « l'implication effective des jeunes dans la revue à mi-parcours, la mise en œuvre, le suivi et l'évaluation du Plan d’Action National Budgétisé (PANB) en Santé Reproductive/Planification Familiale 2017 -2022 du Togo. En sa qualité de femme leader, Hayathe se retrouve malheureusement confrontée à des défis sociaux et financiers. « Pour relever ces défis, j'essaie de faire mieux comprendre à tout le monde le bien fondé de mon engagement. Pour les activités qui requièrent des coûts, j’essaie de gérer avec mes moyens personnels et ceux de mes proches car je me suis engagée à servir ma communauté sans rien attendre en retour » Malgré l’engagement des femmes dans tous les secteurs d’activités dans le monde, Hayath note plusieurs obstacles à l'accès des femmes à des postes de direction : « le regard de la société ayant tendance à  mettre l’homme au dessus de la femme, le manque de confiance en soi des femmes en lien avec la sous-estimation dont elles font l’objet, les mariages forcés et grossesses précoces, la vie familiale et conjugale ne permettant pas aux jeunes femmes de pouvoir assouvir pleinement leurs ambitions. » Pour parer à ces obstacles, elle estime que « les gouvernements doivent prôner l'égalité de genre en nommant plus de femmes à des postes de responsabilité, afin qu’elles soient représentées à tous les niveaux hiérarchiques et à tous les niveaux dans le secteur privé. Attribuer davantage de distinctions honorifiques aux femmes afin de les stimuler à cultiver l'excellence. La principale motivation de Hayathe est de porter la voix des jeunes sans voix, de côtoyer des populations vulnérables et marginalisées afin de partager des informations de qualité sur la santé sexuelle et reproductive: « Je suis fière des impacts positifs de mes actions sur les jeunes de ma communauté que je note par les encouragements et suggestions que je reçois de leur part». Lisez cet article en anglais ici. Hayath sur les reseaux sociaux : Compte Facebook :  Hayathe AYEVA Page Facebook (blog personnel) : Hayathe AYEVA Compte twitter: @AHayathe

A Federação Internacional Para o Planeamento Familiar (IPPF) acolhe as notícias sobre a descriminalização das relações entre pessoas do mesmo sexo em Angola.  A IPPF reconhece e congratula os activistas, defensores e organizações que ajudaram a tornar possível esta alteração histórica na lei. Na Quinta-feira, 10 de Fevereiro, entrou em vigor o novo código penal de Angola, o qual descriminaliza as relações entre pessoas do mesmo sexo. Também introduz protecções relativas à orientação sexual em algumas das cláusulas não-discriminatórias de Angola, e menciona a orientação sexual nas cláusulas do discurso do código penal. Os Angolanos de todas as orientações sexuais podem finalmente viver com maior liberdade e desfrutar do mesmo direito constitucional relativo ao amor e à autonomia corporal. Estas alterações representam a primeira reformulação das leis da era colonial desde que Angola conquistou a independência em 1975, abolindo cláusulas dessa era que estavam em vigor desde que o código penal introduziu a proibição em 1886. A Directora do Escritório Regional de África da IPPF, Marie-Evelyne Petrus-Barry declarou: “As notícias que chegam de Angola dão nova vida e esperança renovada não apenas para a comunidade LGBTI em Angola, mas para África como um todo. As leis anti-LGBTI da era colonial são uma mancha na nossa consciência colectiva, e esta decisão assinala uma nova era de inclusividade, esperança e amor. Ninguém deve ser tratado como criminoso por escolher quem amar, e esperamos que esta alteração legislativa inspire outros países que tenham um vestígio colonial semelhante a reverem as suas próprias leis.” O primeiro passo para alterar o código penal foi dado em 2019 quando o Parlamento aprovou as alterações propostas. No entanto, apenas em Novembro de 2020 é que estas foram ratificadas pelo Presidente João Lourenço, com um prazo de 90 dias até à sua entrada em vigor na última semana. O novo código penal aboliu a linguagem de “vício contra natura”, a qual era percebida como uma proibição às relações com pessoas do mesmo sexo. A nova lei inclui vários artigos que protegem contra a discriminação com base na orientação sexual, em relação ao trabalho ou locais públicos e eventos, e inclui a pena de prisão até dois anos por discriminação baseada na orientação sexual. Após a descriminalização em Angola, o número de países onde a homossexualidade é descriminalizada é agora 72. Esta é uma base sólida para o que aí vem, para permitir um mundo onde todas as pessoas possam tomar decisões sobre a sua sexualidade e bem-estar, livres de discriminação, uma luta na qual a IPPF será uma participante activa. Leia esta declaração em inglês.