A chatbot named Eli that can answer questions about growing up, love, relationships and sexual health, including HIV prevention and treatment, has been launched on the VKontakte social network, adding to the resources for health available to young people in eastern Europe and central Asia.

Created by the United Nations Educational, Scientific and Cultural Organization (UNESCO) Institute for Information Technologies in Education (IITE), Eli answers questions on six topics—psychology, physiology, sex, relationships, family and health. The knowledge base was created by an editorial team in collaboration with health workers and psychologists using materials on, for example, sexual and reproductive health, psychological well-being and HIV prevention, testing and treatment from UNESCO, UNAIDS and other United Nations agencies.

A large proportion of Eli’s knowledge base is on HIV prevention, testing and treatment. In a dialogue with a user, Eli explains why young people who have sex may need to be tested for HIV, what kind of tests are available, where and how they can be done and why it is crucial to start antiretroviral therapy immediately if the test results show that the person is HIV-positive. Eli helps to overcome fears and concerns and motivates its users to seek medical help.

“The use of modern innovative information technologies is an indispensable element of successful HIV education and prevention among young people, and UNESCO remains the leader in this area,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Machine learning technologies were used to create the chatbot. Users can ask Eli a question of their own or choose one of the suggested questions. Artificial intelligence powers the response, taking into account possible connections—for example, when talking about sexually transmitted infections, Eli will give information about symptoms and diagnostic methods and will also tell the user what to do if his or her partner does not want to use protection.

Eli’s language combines expertise and respect for the user and its speech is as gender neutral as possible and free from stigma.

“Eli is an irreplaceable assistant for those who are growing up and discovering new feelings and relationships and who often need truthful information without edification and stereotypes. Eli is another step in implementing UNESCO's global strategy to empower girls and boys to increase their health literacy and to build and maintain healthy, respectful and rewarding relationships,” said Tigran Yepoyan, Head of ICT and Health Education at UNESCO IITE.

In the first week after its launch, more than 4000 people subscribed to the Eli VKontakte group and Eli answered more than 150 000 questions from 10 000 users. People also shared their feedback: “Cool and important topic!” “Eli learns and shares it with us! Go for it, Bot!” “This is very cool guys!”  “I would like to thank the creators of this project. You are doing great!”

Eli is available right now and instructions are available for those who have never used such a service.

Eli will serve as a prototype for the creation of similar chatbots in Russian and in the national languages ​​of Kazakhstan and Kyrgyzstan this year and in the languages of other countries in eastern Europe and central Asia in the future.

Monthly data routinely reported to UNAIDS on disruptions to HIV testing and treatment services have found significant decreases in HIV testing services in nearly all countries with available data.

Since the start of the COVID-19 pandemic, UNAIDS, the World Health Organization and the United Nations Children's Fund have collected data from countries through an online platform (https://hivservicestracking.unaids.org) to identify national, regional and global disruptions of routine HIV services caused by COVID-19.

Fifty-six countries reported at least one month of HIV testing data to the platform between January and July 2020, with 17 supplying enough data to calculate trends over time. To measure the impact of COVID-19 on HIV testing services, a ratio was calculated relative to January—for example, if the number of tests in April was the same as in January, the ratio is 1; if there was a decline, the ratio is less than 1.

Large, sustained decreases in HIV testing services have been seen across all countries except Rwanda, with reduced services reported for most countries starting in April. Five countries, Myanmar, Mozambique, Madagascar, Rwanda and Armenia, have rebounded to pre-COVID-19 testing levels, while in other countries, such as Guyana and Peru, testing remains low.

“There were no such diseases back in the day! AIDS came into being only because of college kids like you messing around,” shouted an old man at a group of students who were speaking to people about HIV prevention at China’s West Lake beauty spot. “Behave yourselves! We don't need to listen to your rubbish!”

In 2020, almost three years later, Zhao Honghui, the group leader and a medical student in his third year at Zhejiang University, still remembers every word, but he knew he didn’t do anything wrong. “I wanted to tell the old man that actually new HIV infections among old people are also increasing,” he said. “And that hatred and denial are never the solution to HIV.”

Recently, Mr Zhao had the opportunity to say what he had wanted to say and speak about all the experiences, good and bad, he had as a HIV prevention volunteer, speaking to a live online audience of more than 71 000 people from across China.

He and five other young HIV volunteers joined an online dialogue on youth and HIV organized by UNAIDS and Tencent, a Chinese technology company, one of a series of youth dialogues organized by the United Nations in China and Tencent to mark International Youth Day and the United Nations’ 75th anniversary that enabled Chinese young people to speak their minds about the Sustainable Development Goals.

In China, according to government statistics, new HIV infections among young people aged 15–24 years have been on the rise over the past few years. By inviting young volunteers to share their stories, the UNAIDS dialogue aimed to raise awareness among young people about the risk of HIV infection, tell them how to protect themselves and other people and encourage more young people to engage in HIV prevention work.

Mei Junyan, a second-year student from the South China University of Technology, shared his experience as a peer educator on sexuality education and HIV prevention. Sun Yinghui, from Zhongshan University, told the audience how her medical research team had looked at COVID-19’s impact on people living with HIV and how to help them address the challenges. “I see hope because the dialogue made me realize that I’m not alone in this battle,” said Ms Sun. “It’s an inspirational dialogue for all of us who are devoted to HIV prevention,” said Mr Mei.

They also had good interactions with the guest speakers. UNAIDS China Goodwill Ambassador Huang Xiaoming, an actor, said it was not easy to be a volunteer. The Director of the Chinese Association of STD and AIDS Prevention and Control, Hao Yang, encouraged all the participants to continue what they are doing. He said peer education is complementary with school education and he encouraged students to do more volunteer work.   

One special guest was Andy Liu (not his real name). He contracted HIV five years ago, when he was 21 years old. Now he has an undetectable viral load after taking and adhering to antiretroviral therapy and has become a volunteer to help other people living with HIV. Unfortunately, however, he felt that had to turn his camera off to hide his identity, as stigma against people living with HIV is still prevalent in China. A touching moment came at the end of the dialogue when Mr Huang told Mr Liu that he hoped that one day he would not be afraid to show his face. He said he believes that day will come soon and he will continue to speak for people living with HIV and to advocate against stigma and discrimination.

Mr Zhao hopes the youth dialogue will become an annual event where young HIV volunteers can exchange ideas. “This dialogue is useful for us to know what other volunteers are doing and to learn from each other. I thank UNAIDS for providing this platform and I hope it can become a regular event,” he said.

Amakobe Sande, the UNAIDS Country Director for China, said that UNAIDS is committed to serving young people, together with the Chinese Government and community-based organization partners. “I hope the young people at today’s dialogue will inspire more people to join our efforts too. Together we can achieve an HIV-free generation. We can end AIDS as a public health threat.”

UNAIDS is saddened by the death of Guillermo Soberon Acevedo on 12 October at the age of 94 years. He leaves behind a long list of accomplishments in his home country, Mexico, in the education and health sectors. He was the architect of modern public health in Mexico and served as the Rector of Mexico’s National University through difficult times, from 1973 to 1981.

Under his leadership as the Minister of Health from 1982 to 1988 he secured the constitutional right to health for all Mexicans and created the National Institute of Respiratory Diseases, which has become today vital for people with the new coronavirus. He also established the National Institute of Public Health and created around 800 health centres and general hospitals.

Dr Soberon led the AIDS response in Mexico in the early 1980s from the Ministry of Health and started public debates on prevention campaigns that included the use of the word “condom”, proudly confronting fundamentalist groups in the country. He is also known for spearheading Mexico’s health response to the 1985 earthquake.

When he led the National Bioethics Commission from 2004 to 2009 his work included the right to health and the role of homophobia in limiting effective health responses.

He was a great friend of UNAIDS. His vision to host the SIDALAC initiative, funded by the World Bank, which became a UNAIDS collaborative regional project as soon as the Joint Programme started to operate, allowed the flourishing of a programme that contributed to strengthening the AIDS response throughout Latin America and the Caribbean. He was also a member of the UNAIDS Human Rights Committee at the beginning of its operation.

The Ashodaya pre-exposure prophylaxis (PrEP) demonstration project for female sex workers in south India has shown how PrEP and HIV prevention programmes can be strengthened and their implementation accelerated beyond pilot projects.

While PrEP has been shown to be highly efficacious, with nearly 100% protection if it is taken as directed, delivering a successful PrEP programme is challenging. HIV prevention efforts among sex workers have traditionally focused on condom use, and while a range of successful programmes have contributed towards the decline in new HIV infections in the Asia–Pacific region, sex workers still experience a disproportionate burden of infection. In 2019, 9% of the estimated 300 000 new HIV infections in the Asia–Pacific region were among sex workers and globally the relative risk of HIV infection is 30 times higher among sex workers than among the general population.

PrEP is a relatively recent addition to the range of HV prevention options available. It involves someone who is HIV-negative taking antiretroviral medicines prior to possible exposure to HIV. Although recommended by the World Health Organization (WHO) for all people at substantial risk of HIV since 2015, PrEP is inaccessible to the majority of key populations, including sex workers, and their partners in the Asia and the Pacific region. There is limited evidence on PrEP use among women, and particularly among female sex workers, in Asia and the Pacific.

The Ashodaya PrEP demonstration project was one of two community-led and community-owned initiatives to provide PrEP to female sex workers supported by the Bill & Melinda Gates Foundation (the other was led by the Durbar Mahila Samanwaya Committee Kolkata). Sex workers in India had been concerned by the fact that, although condom use was high, some sex workers still acquired HIV.

“Our project shows that community-led PrEP delivery can be effectively integrated into the existing HIV prevention and care services for sex workers and result in high retention and adherence. Policymakers need to consult with us, listen to us and trust us as we know what works for us and how to make it work. We have an obligation to make PrEP available as an additional prevention tool in a safe and sustainable way and we are advocating for that,” said Bhagya Lakshmi, Secretary of Ashodaya Samithi.

The PrEP demonstration project, which began in April 2016 and ended in January 2018, reported good results. High levels of continuation on PrEP were reported, with 99% of the 647 participants completing the 16 months of follow-up. For women, it is critical to take PrEP daily to maintain protection. Although adherence was only 70% at month three, this increased to 90% at month six and was 98% in the final month of the project. Self-reported adherence was verified in the blood of a subset of participants at months three and six.

The project not only helped to dispel some common fears about PrEP but showed benefits in bridging the prevention gap. Rather than undermining condom use, it remained stable. Condom use was high for occasional clients, at approximately 98%, but lower for repeat clients (87–96%) and regular partners (63%). There were also no increases in symptomatic sexually transmitted infections and no cases of HIV acquisition during the follow-up period.

Several factors contributed to the success of the Ashodaya PrEP project, including:

• Fully integrating PrEP into an existing range of health services, outreach and community mobilization. This approach recognized that PrEP is not just a medicine or a standalone service but is part of a prevention and health package, including sexual and reproductive health services.
• Communities leading the way: planning, implementation and monitoring. 
• Preparing the community and ensuring ongoing engagement. An intensive process of community preparedness and ongoing engagement allowed sex workers to make informed decisions about participation.
• Addressing excluded groups early. Recognizing that many community members would miss out, the community was proactively informed that not all members would be eligible for PrEP under the demonstration project, given the limited places and scope.
• Prioritizing continued engagement over perfect adherence. Drawing on Ashodaya’s existing network of peer outreach workers allowed for individualized adherence support strategies to best meet the needs of PrEP users, both in terms of scaling up support when dips in adherence were observed and through referrals to Ashodaya’s comprehensive package of health and social services beyond PrEP.

“We cannot stop new HIV infections in Asia and the Pacific if we stick to business as usual,” said Eamonn Murphy, Director, UNAIDS Regional Support Team for Asia and the Pacific. “PrEP answers an unmet need and expands the prevention options for people at substantial risk of HIV. We need to scale up PrEP as an additional effective HIV prevention intervention. The principles of the Ashodaya PrEP demonstration project is a model not only for India but for the entire region. The lessons learned from the project are critical to informing the way forward in the prevention agenda.”

From conceptualization to planning, implementation and monitoring, the Ashodaya PrEP project was a community-led process. In 2018, the pilot project ended and analysis of the results was completed with support from UNAIDS India and WHO. Since then, Ashodaya has trained a cadre of community members as advocates for PrEP in partnership with the All India Network of Sex Workers and with support from AVAC. Ashodaya, with support from UNAIDS, WHO, the Durbar Mahila Samanwaya Committee and the All India Network of Sex Workers, is also continuing to advocate for PrEP with the Indian National AIDS Control Organization (NACO). Ashodaya is also exploring opportunities for community social franchising and marketing of PrEP to further support access. NACO has developed a draft national PrEP policy and guidelines. The community is eagerly waiting for the resumption of PrEP services.

More than a thousand people of faith working in the HIV field recently came together for an online HIV interfaith conference, Resilience & Renewal: Faith in the HIV Response.

“More than ever, it is important that faith communities and leaders are strong voices for people. This means, in a time of COVID-19, recognizing that a call to action on COVID-19 and a call to action on HIV should be complementary and synergistic—they are not in opposition to each other. We will rely on faith partners to be strong and true voices of support for people living with HIV,” said Shannon Hader, UNAIDS Deputy Executive Director, Programme.

During the three-day meeting, the participants identified joint action to address some of the challenges and emerging issues related to the achievement of the 2020 and 2030 HIV targets. All people of faith were invited to sign the online declaration of commitment to the HIV response: Our Promise to Action—Resilience & Renewal: Faith in the HIV Response. 

The conference also saw the launch of the 13 Million Campaign to engage faith leaders, individuals and communities to promote access to health services by the 13 million children, women and men living with HIV who are not yet on antiretroviral therapy.

Winnie Byanyima, the Executive Director of UNAIDS, reminded the participants that the nearly four decades-long HIV response has taught us that global solidarity is essential to overcoming the COVID-19 pandemic. Like HIV, this new pandemic is not just a disease, it has social, economic, ethical and political implications on society and only a multisectoral approach, including the involvement of faith communities, can help the world to overcome it. 

Jessie Milan Jr, the Chief Executive Officer of AIDS United, highlighted the increased vulnerability of marginalized communities to both epidemics. Racial injustices have compounded the suffering. “When our faith in systems and society is shaken, our faith community is needed even more,” he said.

Thabo Makgoba, a South African Archbishop, noted that religious institutions are serving the vulnerable, especially at the national level, and are providing a substantial proportion of services and cooperating actively with government agencies. He proposed that 5% of global funding for HIV be channelled through faith-based initiatives.

Katy Godfrey, from the United States President’s Emergency Plan for AIDS Relief (PEPFAR), shared her experience in providing HIV services to 15.7 million people, in close collaboration with governments and faith communities. She reiterated that services could only be effective if they are underpinned by a learning process that listens to community needs, and works with them, that is responsive to convenient client-centred care and that does not neglect care for the carers.

Good practices by faith groups that ensure the provision of HIV services during COVID-19 were shared. The conference was also an opportunity for faith groups to learn from the science, research and information presented at the 2020 International AIDS Conference. Narratives shared by people engaged in the HIV response spurred discussions and presented opportunities to learn from their experiences and journeys. Songs, prayers and petitions from children challenged the current paucity in the HIV response for children and adolescents.

Representatives of community groups played a major role in the conference.

Nine women with disabilities from Nigeria from the BOLD (Beautiful Outstanding Ladies with Disabilities) Hearts Network participated. Ndifreke Andrew-Essien, the Coordinator of the BOLD Hearts Network, said, “It was wonderful to listen to and see how persons with disabilities living with HIV were building even more resilience and inspiring many. We truly benefitted from the conference. It is our hope that in future our deaf constituents can participate through sign language interpretation.”

“I was particularly impressed by the good practices from Kenya, especially those of linking peers who have achieved viral suppression. The use of celebration as a strategy, rather than punitive, is something which inspired me,” said Aarti Parab, one of six adolescents living with HIV who were facilitated to attend the conference.

A consortium of organizations from several faith traditions and people living with HIV from around the world organized the meeting, which was held from 22 to 24 September, with the support of the UNAIDS/PEPFAR Faith Initiative. 

Community-based organizations in Dar es Salaam, United Republic of Tanzania, with assistance from UNAIDS, are supporting women who use drugs and their families to survive during these difficult times.

“Before the pandemic, life was simple and better. I used to do activities at the beach, such as cleaning fish, helping people load and clean their boats, and they would pay me. I would help my daughter wash her clothes; I would escort her to school and cook food for her. Life was simple,” said Doroth Hassan as she sits in the office of SALVAGE, a sister organization of the Tanzania Network for People who Use Drugs (TaNPUD), in Kigamboni, Dar es Salaam.

Ms Hassan would normally provide for herself and her daughter by doing sex work and other informal jobs, such as the work on the beach. But this has become a challenge since the onset of the COVID-19 pandemic.

“Now life has changed. I live in fear and worry. People who I worked for don’t want to pay, with the excuse that they have no cash because of the coronavirus. Everything changed. Life is tough. Clients disappeared, vanished. And the few who are still coming cheat; they pay less for sex,” said Ms Hassan.

She is not alone in her worry. Most of the women who use drugs in Dar es Salaam survive in the same way as Ms Hassan does, by doing sex work, trading and doing other jobs in the informal sector. They live in camps for people who use drugs or in informal and densely populated settlements.

With support from UNAIDS and other partners, local community-based organizations, including TaNPUD and SALVAGE, have been able to provide some relief to women in the camps and settlements in Dar es Salaam.

“TaNPUD raised awareness and SALVAGE provided buckets, soap and food with other hygiene materials to us and other women in the community. TaNPUD always advocates for our health rights,” said Oliver Kinanda, a person who previously used drugs and is now on opioid substitution therapy.

Ms Kinanda also volunteers at the Medication-Assisted Treatment (MAT) clinic in Temeke, where she lives. Here, she informs people on prevention of tuberculosis (TB) and takes samples from clients for TB screening. With the onset of COVID-19, however, her tasks have shifted.

“As a peer educator I have knowledge of prevention of COVID-19 and provide education and awareness. Together with other people who use drugs I also got help; for example, face masks,” said Ms Kinanda. She has also received information and support from other local community-based organizations, including donations to the community and the clients she works with in the Temeke MAT clinic.

Ms Hassan received the same support.

“TaNPUD is raising a voice on our behalf, and SALVAGE, as the sister organization of TaNPUD, supporting women, has been linking us to care and treatment with other services and providing shelter, food and hygiene support to us,” she said.

The support, distributed with financial and material assistance from UNAIDS, will help to alleviate some of the consequences of the global pandemic, even as the effects of COVID-19 are slowly wearing off in the United Republic of Tanzania.

Happy Assan, the Coordinator of TaNPUD, said this support has so far reached 55 families of women who use drugs in Dar es Salaam.

“The support covered food and hygiene needs. It also provided women with the ability to stay at home instead of going out, for example to do sex work, and to negotiate less risky sex. The support reduced fear and worry about meeting the food needs of families with children,” said Ms Assan.

Many of the women who use drugs are living with or at risk of HIV infection and depend on reliable access to treatment and care, including harm reduction services. Despite the support in the community, some services that the women who use drugs depend on have been halted.

“Harm reduction services have been interrupted; they are less. No condom distribution or other commodities, only needle and syringes distribution. At least now SALVAGE is helping with sanitary items. At hospital there is no other support; HIV treatment only,” explained Ms Hassan.

Ms Hassan and Ms Kinanda both recount facing increased stigma during the pandemic—some derived from unintended consequences of the support, since the face masks they received were a certain colour, making the wearer identifiable in the local community as a person who uses drugs. Stigma and discrimination at hospitals is also reportedly high, adding to the difficulties of accessing services. But most difficult is the financial loss because of the pandemic.

As Ms Kinanda puts it, “No clients, no pay. Financially it is hard because my clients say they have no cash because the coronavirus has affected their jobs. I continue providing awareness and education to the community and my family too. I financially suffer, but what can I do other than continue pushing on?”

Lola Makhmudova (not her real name) grew up in a close-knit family, but her parents were afraid to tell her about her HIV-positive status for a long time, even though they both work in the health sector. She found out about it by chance, after hearing nurses talking in the hospital when she was 10 years old.

“Once, a few years later, when I already knew a lot about HIV infection and treatment, I was in the hospital with one boy, he also had HIV,” Ms Makhmudova said. “But his parents refused to give him antiretroviral therapy for religious reasons. I told them about myself, that therapy helps you to remain healthy, that I feel good and live a full life. I am happy that I managed to convince them. We are still friends with this boy.”

Ms Makhmudova is now 18 years old and has been a peer counsellor and volunteer at the Day Center for HIV Affected Families in Tashkent, Uzbekistan, for several years. She communicates with children and adolescents living with HIV, helps them to accept their diagnosis and explains the need for treatment.

Ms Makhmudova has not yet decided precisely what she will become when she is an adult, but she is sure that she wants to help people. She became one of three young people living with HIV to join the new United Nations Youth Advisory Board in Uzbekistan.

She takes her work on the Board for Youth Affairs seriously. “I was scared at first,” she said. “Everyone there is so grown up and smart. But I decided that I would study, I would learn languages ​​so that I could be heard, and I could influence decisions that concern young people.”

The Board for Youth Affairs includes 15 young people from different regions in Uzbekistan, representing various social groups and interests, including the most disadvantaged and marginalized.

“Uzbekistan has agreed to be a fast-track country for implementing the Global United Nations Youth 2030 Strategy. The United Nations Board for Youth Affairs is part of the initiative. Currently, the board works with partners to ensure that the views of young people are taken into account in the development and implementation of United Nations strategies and programmes as well as the State Youth Policy in the country,” said Charos Maksudova, UNAIDS Country Manager for Uzbekistan.

Guzal Akhmedova (not her real name) is a young woman who has been living with HIV for eight years. She is a second-year student at the University of World Economy and Diplomacy and speaks Uzbek, English and Russian and is learning Chinese.

“I have been working as a peer educator for five years, and it is giving me a lot of opportunities. I’m a delegate of the International AIDS Society. In 2018, I was selected to go to the Netherlands to participate in the conference. And this year, I got a scholarship to take part in the virtual AIDS 2020 conference. My life and my story of living with HIV are unique because I love myself, my illness, my body and everything that I have. This all started when I accepted myself as I am. I suggest my simple motto to everyone: positive mind, positive life!”

Shirin Botirova (not her real name) found out that she was living with HIV five years ago, when she was 15 years old. Like many of her peers, she had to go through all the stages of accepting her HIV status. And this, according to her, was not easy. “After a while, I decided to start a new life without self-stigma. And from that day, my activism began. I started going to a self-help group, studying all the information about HIV.”

She also began studying law to know her rights and how to protect people living with HIV.

Since 2015 Ms Botirova has been actively participating in various trainings for peer counsellors.

“Today, I am a national trainer, and I try to share the knowledge and skills that I have. We conduct training throughout the country, and even in other countries, talk about peer self-help groups and consultations, give general concepts about HIV.”

Ms Botirova is doing everything to ensure that the world accepts people living with HIV without stigma. “I want to contribute to creating a world without stigma and discrimination. I set myself the goal of changing the attitude of people towards us, people who are living with HIV, since this is one of the most urgent tasks in our region. I believe that everything depends on ourselves, and I believe that together we can create a world without borders.”

A virtual event held on the sidelines of the United Nations General Assembly used virtual reality and extended reality technology to connect the young delegates of YOUNGA—a youth forum initiative of the Office of the United Nations Secretary-General—with influential decision-makers and industry leaders. The discussion and the following interactive question-and-answer session on global challenges and how to create solutions for a more inclusive and sustainable world used three-dimensional avatars of each panellist and participant.

On the event’s panel were Tanaka Chirombo, representing the Global Network of Young People Living with HIV, Daniel Nagel, representing Youth Against AIDS, Dilnaz Kamalova, the co-creator of Sequence, an application that helps to monitor a person’s daily intake of medicines, and Praddep Kakkattil, the Director of Innovations at UNAIDS.

Social, technological and scientific innovations, from new medicines and testing tools to innovative community-led approaches, have been a crucial aspect of the HIV response since the beginning. As we are transitioning to a more virtual world, technologies such as applications, video games, social media platforms and new community-led approaches will be important to bridge the gap between people and HIV services, especially for hard-to-reach populations.

Convened by UNAIDS, the event showcased examples of social and technological innovations led by young people, saw a discussion on how to ensure that the voices of young people and innovative approaches led by young people are central in the next global AIDS strategy and sought to identify the critical factors for scaling up proven health innovations for all young people in need.

Community innovations have always been critical to the AIDS response, as they show the resilience and leadership of communities affected by HIV. Mr Chirombo highlighted how local networks of young people living with HIV have played a key role in improving service provision through the roll-out of innovative peer-support services and youth-led monitoring to assess HIV services. “Young people need to get involved and take the lead to see changes on the ground,” he said.

The importance of collaboration between networks of young people to leverage access to political space and resources for innovations was spoken about throughout the event. “We need to overcome silos, listen to each other and be open to new ideas and partnerships,” said Mr Nagel.

“We need to believe in the ideas we are developing and understand that adolescents and youth can make an impact and change the world,” said Ms Kamalova, who is also a Youth Ambassador for the United Nations Children’s Fund.

Mr Kakkattil spoke about how the AIDS response has been driven by innovations since its early years and about the power of activism to demand the scale-up of scientific and social innovations. “The Health Innovation Exchange, founded by the UNAIDS Secretariat, is a good example of how we can make efforts to connect communities, innovators, developers and investors to improve access to health,” he said.

The event, Youth-Led and Youth-Centered Health Innovations to Reduce Inequalities, was moderated by Gareth Jones, the Vice-Chair of the PACT. 

A new project aimed at helping countries to incorporate recency testing into national HIV reporting systems has been launched by UNAIDS in seven countries of eastern Europe and central Asia.  

A recency test is a laboratory-based test that detects whether an HIV infection is recent (less than six months) or not. The incorporation of HIV recency testing in national HIV case reporting systems will help to assess how HIV is being transmitted, describe behaviours that are facilitating HIV transmission and optimize HIV-related data collection and information on risk factors.

Many countries in eastern Europe and central Asia report that despite significant progress in the epidemiological surveillance, prevention and treatment of HIV, a substantial number of new HIV diagnoses are made late. In Armenia, for example, according to national data, almost 66% of all new diagnoses of HIV infection in 2019 were made at the stage when the CD4 count was less than 350 cells/mm³ (in Kyrgyzstan, the percentage was 53%, while in Tajikistan it was 56%).

“The average time from infection to the moment a person enters the health-care system in the region varies from five to seven years,” said Lev Zohrabyan, a UNAIDS Regional Strategic Information Adviser. “All those few years, a person could be putting at risk his or her own health and the health of a partner. Moreover, prevention measures are often based on old data on transmission.”

By determining recent infections among people newly diagnosed as living with HIV, countries can identify the geographic areas and subpopulations where HIV transmission is happening. They can then effectively interrupt HIV transmission by building evidence-informed policies, guiding resources to the right place and measuring the impact of HIV prevention programmes.

“We often understand the situation as it was—what happened five years ago. This test allows us to identify and characterize cases that occurred a maximum of six months ago. Thanks to this system, we may better understand where the latest cases of HIV infection occurred,” said Meerim Sarybaeva, UNAIDS Country Manager for Kyrgyzstan.

After a multicountry study, the testing has been thoroughly evaluated and discussed with national partners with the aim of developing the most effective way of incorporating HIV recency testing into national HIV case reporting systems. The innovative technology has been transferred to national experts through extensive training programmes provided by UNAIDS for epidemiologists and laboratory experts.

This innovative approach is being integrated into routine HIV surveillance in several countries in eastern Europe and central Asia in the framework of the UNAIDS Regional Cooperation Programme (RCP) for Technical Assistance on HIV and Other Infectious Diseases, funded by the Government of the Russian Federation. The RCP aims to strengthen health systems, ensure better epidemiological surveillance of HIV and promote the scale up of HIV prevention programmes among key populations at higher risk in Armenia, Belarus, Kyrgyzstan, Tajikistan and Uzbekistan.