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May 2018


Dear Reader,
Welcome to the ECHO Update. It has been a busy year so far for the study: the fifth DSMB review was held in March; South African ECHO sites initiated on-site PrEP provision; and the sites held civil society and community dialogues. Read more about these exciting developments below.

Study Progress

ECHO Study holds final Investigators' Meeting

The ECHO Study team at the 2018 Investigators’ Meeting in Johannesburg. Photo credit: ECHO Communications

The 4th ECHO Investigators’ Meeting took place from 24 – 25 April 2018 in Johannesburg. In attendance were the ECHO management team, site principal investigators, community liaison officers, research nurses, coordinators and members of the operations team. Discussions included an update on overall achievements to date, maintaining participant retention in the trial, and preparing for study close out and results dissemination, as well as ensuring the trial meets the established performance standards. Study results are expected in 2019.
ECHO Study get PrEPd
ECHO staff at most of the sites in South Africa are offering oral pre-exposure prophylaxis (PrEP) to study participants as part of the HIV prevention package provided on site. Earlier this year, site staff were trained to provide PrEP in accordance with national and local guidelines,and approval was sought from study ethics committees. After the training, each site was required to complete a PrEP activation checklist to ensure that they were well prepared to begin PrEP provision.

Photo credit: Wits RHI
ECHO Study to continue following go-ahead from DSMB
The ECHO Study’s independent Data and Safety Monitoring Board (DSMB) met in March 2018 to review study data, safety, the conduct of the study and its anticipated timeline over the next year. The DSMB members commended the study for meeting its high performance standards thus far and recommended that the study continue to its conclusion. Results are expected in 2019.
 
Site Profile

 

Setshaba Research Centre (SRC)


Setshaba Research Centre study team. Photo credit: Enough Mbatsane, SRC

The Setshaba Research Centre (SRC) is an established clinical trial centre, situated in Soshanguve, South Africa. The organisation primarily focuses on conducting HIV prevention, TB and other clinical research trials, with a strong emphasis on data quality. The SRC, supported by its team of experienced and dedicated staff, strives to be a centre of excellence and actively contributes to the education and upliftment of the Soshanguve community.
 

How many participants did you enrol for the ECHO Study?

SRC recruited participants from January 2016 to August 2017, in which time we were able to enrol 810 participants on to the study.

What lesson have you learned during the study so far?

The history of contraception has evolved so much throughout the years, but it is difficult to accept change, especially if the methods used by women have been working for them. Women tend to be comfortable with a known product. However, after receiving counselling about the three products available on the study and other methods available in clinics, they were receptive to the methods on the study and in turn comfortable with being randomised to any of the methods.

To find out more about SRC's experience with ECHO, click here.

We would like to thank Enough Mbatsane, Study Coordinator, and the entire Setshaba Research Centre team for their dedication to this important study and their contributions to this article.

Good Participatory Practices (GPP)


ECHO holds civil society forums and community dialogues on HC-HIV


Delegates in Pretoria at the first of a series of civil society forums on HC and HIV

A high-profile study from the beginning, the ECHO Study has maintained strong performance metrics and received successful DSMB reviews. The World Health Organization’s new Medical Eligibility Criteria (MEC) guidance regarding hormonal contraceptive (HC) use for women at risk of HIV, published in March 2017, has reignited global debates about women’s use of DMPA, method mix, emphasis on dual protection and access to different HIV interventions, including condoms and PrEP. The global discussions on HC and HIV risk acquisition acknowledge that there is a compelling need to ensure that women receive full information about the risks and benefits of different methods and have access to a range of contraceptive methods.

In response to the ongoing need for open discussion and as part of the ECHO Study’s commitment to GPP, the GPP core team is convening a series of civil society forums and community dialogues in partnership with the 12 ECHO sites, ECHO’s Global Community Advisory Group (GCAG) and GCAG members from AVAC and the International Community of Women with HIV (ICW), two groups that convene a civil society network of women committed to these issues.

Delegates to these meetings include Community Advisory Board (CAB) members and advocates and health care providers working in HIV prevention and sexual and reproductive health and rights. ECHO Study site teams and GPP team members are also participating in the meetings.

The forums and dialogues not only focus on specific study-related topics, such as study updates and the timing of data release, but also provide a platform for discussing a wider array of issues, such as what governments should or could do in response to the ECHO results, depending on various possible scenarios.
Photo credit: ECHO Communications

Delegates engage during discussions at the first civil society forum, held in Pretoria, South Africa, on 15 March 2018. The forum was convened by Yvette Raphael, AVAC Fellow and member of ECHO’s Global Community Advisory Group (GCAG), and was attended by Community Advisory Board (CAB) members, advocates, health care providers, ECHO GPP team members and ECHO study site teams from the Aurum Institute, the Madibeng Research Centre, the Setshaba Research Centre and the Wits Reproductive Health and HIV Institute (Wits RHI).
Photo credit: ECHO Communications

Delegates participate in discussions at the community dialogue held in Johannesburg, South Africa, on 16 March 2018. The dialogue was convened by the Wits RHI ECHO Study site team and was attended by GCAG member Yvette Raphael, CAB members, community members, advocates and health care providers.

Photo credit: Modesta Chileshe, UNC Kamwala

Delegates listen to a speaker during a discussion at the civil society forum held in Lusaka, Zambia, on 22 March 2018. The forum was convened by the UNC Kamwala site and was attended by Engwase Mwale, Executive Director of NGO CC and ECHO GCAG member, CAB members, community members, advocates and health care providers. 

Photo credit: Rose Masilo, Madibeng Centre for Research

Delegates engage during discussions at the community dialogue in Madibeng, South Africa, on 19 April 2018. The dialogue was convened by the Madibeng Centre for Research ECHO Study site team.
 
Delegates participate in discussions at the community dialogue held in Soshanguve, South Africa, on 20 April 2018. The dialogue was convened by the Setshaba Research Centre ECHO Study site team and was attended by GCAG member Lebogang Motsumi, CAB members, community members, advocates and health care providers.

Photo credit: ECHO Communications.
FLAS/ICAP hosts retention event

The FLAS/ICAP ECHO Study team hosted a retention event to thank participants for their involvement in the study and encourage them to complete all their study visits.
Ms Zelda Nhlabatsi, FLAS Executive Director and ECHO Site Principal Investigator, speaks with participants during the retention event in Manzini, Swaziland.

Photo credit: Samkelo Dladla, FLAS/ICAP
SRC distributes condoms during STI/Condom Week 2018

During the 2018 STI/Condom Week (7-14 February 2018), Setshaba Research Centre (SRC) staff members were out and about speaking to community members about sexually transmitted infections (STIs) and the importance of using condoms for the prevention of HIV and other STIs.
SRC team members speak with community members about STIs and distribute condoms in Soshanguve, South Africa.

Photo credit: Mercy Ndlovu, SRC
Community Education and Engagement Working Group meet

The ECHO Study’s Community Education and Engagement Working Group (CEWG) met on 23 April 2018 in Johannesburg, South Africa, to discuss challenges, lessons learned, and Good Participatory Practice plans for the final year of ECHO. The team also heard feedback on the community dialogues and civil society forums. Finally, retention achievements, challenges and solutions were discussed.

Photo credit: ECHO Communications

Upcoming Events

2327 July – 22nd International AIDS Conference (AIDS 2018)
21–23 October – HIV Research for Prevention (HIVR4P 2018)
24–27 October – 4th Southern African HIV Clinicians Society Conference
12–15 November – 2018 International Conference on Family Planning

Thank you for reading this edition of the ECHO Update.


A special thanks goes to the site staff at FLAS/ICAPMadibeng Centre for Research, Setshaba Research Centre, Wits RHI and UNC Kamwala for their contributions to this issue.

We encourage you to give us feedback and share requests for stories and information you would like to see featured in future editions.

Don’t forget to visit our website at http://echo-consortium.com for more information about the ECHO Study.

ECHO Study team






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