Clancy Broxton USAID Office of HIVAIDS 2202021 FOOTER

Clancy Broxton USAID Office of HIV/AIDS 2/20/2021 FOOTER GOES HERE Photo Credit: Eric Gauss for PSI Zimbabwe STAND BY OUR MEN: PHIA results and the importance of reaching men 1

2/20/2021 Source: PEPFAR Namibia Media Information Session, May 2017 2

2/20/2021 Source: PEPFAR, 2018 3

2/20/2021 Source: PEPFAR, 2018 4

2/20/2021 Source: UNAIDS. Addressing a blind spot in the response to HIV – Reaching out to men and boys, November 2017 5

MALAWI POPULATION-BASED HIV IMPACT ASSESSMENT, 2015– 2016 MPHIA – Progress toward the 90 -90 -90 targets among HIV-positive adults, age 15 -64 *Insert numbers are conditional percentages 2/20/2021 Source: MPHIA First Report, ICAP, November 2017 6

MPHIA – Self-reported HIV testing in the last 12 months 2/20/2021 Source: MPHIA First Report, ICAP, November 2017 7

MPHIA – Viral load suppression prevalence among HIV-positive persons 2/20/2021 Source: MPHIA First Report, ICAP, November 2017 8

Malawi – FY 19 Net New on Treatment Target by Region 2/20/2021 Source: Opening Plenary, PEPFAR Regional Planning Meeting, February 2018 9

ZAMBIA POPULATION-BASED HIV IMPACT ASSESSMENT, 2015– 2016 ZAMPHIA – Progress toward the 90 -90 -90 targets among HIV-positive adults, age 15 -59 *Insert numbers are conditional percentages 2/20/2021 Source: ZAMPHIA First Report, ICAP, November 2017 10

ZAMPHIA – Self-reported HIV testing in the last 12 months 2/20/2021 Source: ZAMPHIA First Report, ICAP, November 2017 11

ZAMPHIA – Viral load suppression prevalence among HIV-positive persons 2/20/2021 Source: ZAMPHIA First Report, ICAP, November 2017 12

ZIMBABWE POPULATION-BASED HIV IMPACT ASSESSMENT, 2015 -2016 ZIMPHIA – Progress toward the 90 -90 -90 targets among HIV-positive adults, age 15 -64 *Insert numbers are conditional percentages 2/20/2021 Source: ZIMPHIA First Report, ICAP, November 2017 13

ZIMPHIA – Self-reported HIV testing in the last 12 months 2/20/2021 Source: ZIMPHIA First Report, ICAP, November 2017 14

ZIMPHIA – Viral load suppression prevalence among HIV-positive persons 2/20/2021 Source: ZIMPHIA First Report, ICAP, November 2017 15

2/20/2021 Source: UNAIDS Data, 2018 and PHIA, 2017 16

2/20/2021 Source: Opening Plenary PEPFAR Regional Planning Meeting, February 2018 17

Engaging Men: Some Observations • Younger men are a population that has been ‘left behind’ in our focus on reducing HIV incidence among young women – The highest unmet need for HIV treatment is in men, with viral load suppression lowest among 25 -34 years – Need to use survey data to drive services towards pockets of men with highest burden • In East and Southern Africa, – Current progress to date shows nearly a 50% decline in incidence has occurred while missing more than 50% of the men – especially healthy young men (with lots of sex partners) – If this is addressed the epidemic can be controlled. 2/20/2021 18

Programmatic Implications • Focus on test and treat strategy for pockets of men with the lowest access to services and highest role in transmitting the virus • Poor diagnosis of HIV-positive men is the most important driver of the differences in service access across the clinical cascade – Need to create demand for HIV testing among key age bands of men • Use regular data collection of intermediate outputs and key outcomes to closely monitor performance – Adjust programming accordingly • Update our messaging: ART is not only for the sick! • Important role of stigma as a barrier to accessing services 2/20/2021 FOOTER GOES HERE 19

Photo Credit: USAID Office of HIV/AIDS Thank you!! The content in this presentation is that of the presenters and does not necessarily reflect the view of the U. S. President's Emergency Plan for AIDS Relief, the U. S. Agency for International Development or the U. S. Government. 2/20/2021 20