Social and ethical challenges to HIV and tuberculosis health care: expanding the discourse on integration via roundtable discussion at the 6th South African AIDS Conference (External Grant)
Funding program: CIHR, Knowledge Dissemination Event (KTE) Grant
Co-Principal Investigators: Liviana Calzavara, University of Toronto, and Amrita Daftary, ICAP, Columbia University
Collaborator: Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R. Mandela School of Medicine, University of KwaZulu Natal
The 6th South African AIDS Conference (SA AIDS) was held in Durban, South Africa on 18-21 June 2013. The conference attracted well over 3000 researchers, professional and lay health care workers, policymakers, activists and persons living with HIV. The conference theme was ‘Building on Successes: Integrating Systems’, with a special emphasis on tackling the dual epidemic of HIV and tuberculosis (TB) co-infection through “Getting to Zero – zero new HIV and TB infections, zero discrimination & stigma and zero AIDS related deaths”.
Under a CIHR KTE grant, we hosted a symposium at SA AIDS to call attention to the social and ethical challenges of HIV-TB co-infection, particularly in light of the global shift to integrate HIV and TB health care services within high-burden settings. We aimed to broaden scientific discourse around co-infection beyond prevailing clinical and operational spheres, to encompass a wider sociomedical perspective. Our panel was accordingly diverse and interdisciplinary to stimulate knowledge transfer and exchange around the integration of HIV and TB health care, stemming from operational research, evidence-based practice and theoretical debate. Panelists included Dr. Francesca Conradie (Right to Care, Sizwe Tropical Diseases Hospital), Dr. Liesl Page-Shipp (The Aurum Institute), Thabile Lihle Dlamini (AIDS Foundation of South Africa), Dr. Jennifer Zelnick (Touro College Graduate School of Social Work), and Dr. Amrita Daftary (ICAP, Columbia University); panelist presentations and relevant publications of interest may be accessed below. The symposium was moderated by Dr. Nesri Padayatchi (CAPRISA). Over 120 delegates attended, and the interactive discussion gave voice to local and international experiences, including those arising from health care policy, program planning, treatment advocacy, providers and community members.
The event facilitated networking between Canadian and international researchers, helped build capacity to address social and ethical challenges related to HIV-TB health care practice, and complemented ongoing biomedical efforts to mitigate the burden and impact of HIV-TB co-infection.
Panelists’ publications of relevance
Linkage to care and treatment for TB and HIV among people newly diagnosed with TB or HIV-associated TB at a large, inner city South African hospital. Voss De Lima Y, Evans D, Page-Shipp L, Barnard A, Sanne I, Menezes CN, Van Rie A. PLoS One. 2013;8(1):e49140. doi: 10.1371/journal.pone.0049140. Epub 2013 Jan 16. PMID: 23341869 [PubMed - indexed for MEDLINE] Free PMC Article
Health-care workers' perspectives on workplace safety, infection control, and drug-resistant tuberculosis in a high-burden HIV setting. Zelnick JR, Gibbs A, Loveday M, Padayatchi N, O'Donnell MR. J Public Health Policy. 2013 Aug;34(3):388-402. doi: 10.1057/jphp.2013.20. Epub 2013 May 30. PMID: 23719292 [PubMed - in process]
Integrating patients' perspectives into integrated tuberculosis-human immunodeficiency virus health care. Daftary A, Padayatchi N. Int J Tuberc Lung Dis. 2013 Apr;17(4):546-51. doi: 10.5588/ijtld.12.0714. Epub 2013 Feb 11. PMID: 23407149 [PubMed - indexed for MEDLINE]
Social constraints to TB/HIV healthcare: accounts from coinfected patients in South Africa. Daftary A, Padayatchi N. AIDS Care. 2012;24(12):1480-6. doi: 10.1080/09540121.2012.672719. Epub 2012 Apr 24. PMID: 22530855 [PubMed - indexed for MEDLINE]
HIV and tuberculosis: the construction and management of double stigma. Daftary A. Soc Sci Med. 2012 May;74(10):1512-9. doi: 10.1016/j.socscimed.2012.01.027. Epub 2012 Mar 7. PMID: 22444460 [PubMed - indexed for MEDLINE]
Natural killer cell activation distinguishes Mycobacterium tuberculosis-mediated immune reconstitution syndrome from chronic HIV and HIV/MTB coinfection. Conradie F, Foulkes AS, Ive P, Yin X, Roussos K, Glencross DK, Lawrie D, Stevens W, Montaner LJ, Sanne I, Azzoni L. J Acquir Immune Defic Syndr. 2011 Nov 1;58(3):309-18. doi: 10.1097/QAI.0b013e31822e0d15. PMID: 21826013 [PubMed - indexed for MEDLINE]