Microbicides 2004 Microbicides 200428-31 March 2004, Hilton London MetropoleThe conference42 million men, women and children worldwide were living with HIV by the end of December 2002 (source: UNAIDS), including five million newly-infected during that year alone. Another 45 million people will become infected between 2002 and 2010, unless the current transmission rates can be vastly reduced. Of the 42 million, 29.4 million live in sub-Saharan Africa and 58% of them are women. Not only are women more susceptible to HIV infection, many are powerless to insist on the use of condoms or other methods of protecting themselves. In this context, and with the knowledge that an effective HIV vaccine is unlikely to be available for several years, the need for an effective topical microbicide grows ever more urgent. 2004 should prove to be a landmark year in the field of microbicide development as the first Phase III trials of novel products are due to start – the next step along the road to making a microbicide available to the millions worldwide in desperate need of protection.The aims of the Microbicides 2004 conference are to:Report novel or innovative work in the microbicides fieldProvide updates on recent microbicides research, divided into three tracks: basic science, clinical science, and behavioural science (including public health and the microbicide marketplace)Provide a forum for the discussion of new developments in microbicide research including ethical, clinical, behavioural and methodological issuesPresent opportunities for knowledge-sharing between microbicide researchers, public-health workers and advocacy organisations.There will be an opening ceremony on the evening of Sunday 28 March at which politicians, policy makers and the international media are expected. The conference will run for a full three days, each of which will contain:Scientific overviews and presentations with plenary sessions, invited lecturers and presentations of original researchWorkshops to review issues unique to microbicides such as trial design and outcome measures, and ethical issues in the clinical trials of microbicidesPoster sessions. Focus on LondonFollowing the successful Microbicides conferences in Washington in 2000 and Antwerp in 2002, March 2004 sees the focus move to London.The venue is the Hilton Metropole Hotel, two minutes by taxi from Paddington station and the Heathrow Express, with a journey time from the airport of 15 minutes. The hotel is in walking distance of Hyde Park and London’s main shopping streets, and close to Imperial College. Accommodation will be available at the venue and other hotels in the vicinity.London in March offers a variety of diversions for out-of-conference relaxation, including sight-seeing and shopping; the arts and the theatre; and pubs, clubs and restaurants to suit every taste. Conference staff will be on hand to help delegates plan their spare time.To book your place or find out more information, e-mail info@microbicides2004.org.uk or telephone the Event Office on +44 (0) 20 7720 4411
Oral: invited speaker Oral: Track A Oral: Track B Oral: Track C Poster: Track A Poster: Track B Poster: Track C Abstract only Authors

02284 MICROBICIDE FEASIBILITY STUDY, MWANZA, TANZANIA: PRIORITISING & RESPONDING TO COMMUNITY CONCERNS

Shagi Charles*
Vallely A#, Kasindi S*, Chiduo B~, Desmond N~, Allen C>, Ross D#
*African Medical Research Foundation, Mwanza, Tanzania; # London School of Hygiene & Tropical Medicine, UK; ~National Institute for Medical Research, Mwanza, Tanzania; > Medical Research Council, Social & Public Health Sciences Unit, UK and the MRC/DFID UK Microbicides Development Programme.

OBJECTIVES: To explore strategies for effective community liaison & participation in the context of a feasibility study for a phase III clinical trial of vaginal microbicides in a high-risk occupational study population in Mwanza City, Northern Tanzania.

STUDY POPULATION: 2,400 women working as mamalishe (in makeshift eating places selling food cooked outdoors), or in bars, guesthouses, video halls, vilabu (shops selling locally brewed beer), hotels, restaurants and disco halls (“facilities”) in Mwanza City.

METHODS: A community-based sexual & reproductive health service has been established in 10 city wards. Field staff conduct mobilisation activities at facility level. Participants are enrolled and followed-up at mobile clinics conducted at guesthouses and hotels. Wards were divided into geographical clusters of facilities with 20-30 women per cluster. Cluster and ward-level representatives were elected in a process facilitated by the project’s Community Liaison Officer. Criteria for the selection of representatives were developed by the community e.g. ability to maintain confidentiality, willingness to attend meetings and to represent others. Orientation workshops and community meetings have explored project-related concerns using tools adapted from participatory learning and action (PLA) and related techniques e.g. Venn diagrams, matrices, pair-wise ranking. Development of a city-level Community Liaison Board comprising ward representatives is on-going.

RESULTS: 32 facility clusters each with one elected representative have been identified in four study wards up to end-Sep 03. Mamalishe and vilabu found in pre-existing geographical clusters (e.g. market places) share concerns and experiences that differ from women working in other facilities. Key clinic-related concerns included waiting times, incentives and speculum examination.

CONCLUSIONS: The Mwanza feasibility study was designed around a high-risk occupational cohort in which traditional community development concepts such as general community mobilisation, representation, liaison and participation are difficult to apply. Representation was tackled by using clusters of facilities as core units in a community defined by eligibility to join a study cohort. Adopting community development approaches that made use of participatory methodologies was key to developing meaningful dialogue.

Shagi Charles
c/o AMREF Mwanza, PO Box 1482, Mwanza, Tanzania
(Telephone) +255 28 2500 220 (Fax) +255 28 2500 742 (E-mail) shagic@amrefmza.org