Mpho Dimene

Rebecca Dirks, FHI 360, US

Sumita Taneja, FHI 360 India Country Office

Bitra George, Country Director, FHI 360/India

Hally Mahler, FHI 360, US

Papa Alioune Gueye, Solthis , Senegal

Cameron Wolf, USAID/DC

John Macom, FHI 360, Cambodia

Teresita Bagasao, EpiC-HIV, Philippines

Richmond Tagoe, Sanford Health-Ghana

Parsa Sanjana, FHI 360, USA

Rafaela Egg, FHI 360 consultant, South Africa

Pamela Donggo, JSI/ USAID RHITES-North, Lango Project (Uganda)

Kenisha Jefferson, FHI 360, Washington DC

Bhawani Prasad Dahal, AFAO/SKPA Program, Bangkok

My name is Phal Sophat FHI360 Cambodia

Chavia Trufani, FHI 360, Indonesia

Mpho Dimene, EpiC Lesotho

Paul Amechi, Heartland Alliance Nigeria

Carey Johnson, Altair Consulting, Boston MA

Pallavi Dani, FIND, India

Hi everyone, Bhagawan from FHI 360 Nepal

Madison Mellish, Palladium, Washington, DC

Kristina Grabbe, Jhpiego, US

Aarti Gor, FHI360, India Country Office

Rachel Eersel, Suriname

Irma Anintya, Indonesia

Irfan Riswan, FHI 360, Indonesia

Emily Headrick, EpiC/FHI360, NC(US)

Sunni Wenson, FHI 360, Zambia

Scholastica Tembo, FHI360, Zambia

Hi - Tim Mastro, CSciO - FHI 360 HQ

Mame Faye USAID Senegal

Kate Douglass, EpiC/FHI360, DC/HQ

Mulenga chilambwe fhi 360 zambia

Rajesh Khanal, EpiC/FHI360 Nepal

Joseph from UNFPA regional office

Tom Boyles Right to Care, South Africa

Pradeep Kumar Thakur, Sr. Technical Advisor, SI, EpiC.

Tom Newton-Lewis, HSS team, FHI360

Siti Sulami, Associate Director, SI, EpiC Indonesia

Chirantani Dey Baroi, Communication Specialist and Consultant for STAPI/FHI360 (ARPA Program)

Please drop any questions for George into the chat.

Mbezele Essomba Thérèse from Cameroon

Lynette Hardy from EpiC Guyana

Endale W Tilahun, PSI Eswatini

alick samona from zambia

Dr. Siberry, can you please talk about any interactions between the COVID vaccines and hormone therapy, ART, or TB drugs? Do PLHIV need to stop taking medications before or after COVID vaccination?

Chris Akolo, FHI 360, Washington, DC

any preference in vaccine type

Hi @Mame. Any COVID vaccine authorized for use can be used in PLHIV.

usually PLHIV with cd4 count less than 200 susceptible to co infection, is their specific recommendation on which type of vaccine for PLHIV?

Hi @Mulenga. PLHIV with CD4<200 should get an additional dose of COVID vaccine to complete their primary series - but any of the authorized/approved COVID vaccines can be used.

Hi, what are the known major barriers for PLHIV in accessing COVID-19 vaccination?

Hi @Chavia--Padmavathi's presentation highlights some of barriers PLHIV encounter when trying to access vaccines

EpiC India summarized their work vaccinating key populations and PLHIV in this success story: https://www.fhi360.org/sites/default/files/media/documents/resource-epic-increasing-vaccination-india-success-story.pdf

Great, thank you @Kenisha :)

EpiC's technical guide for expanding vaccine access among PLHIV and key populations is available here: https://www.fhi360.org/sites/default/files/media/documents/epic-guide-covid-19-vaccination-plhiv.pdf

Thank you @ George

thanks is that available in french?

Not yet, but we do plan to get it translated.

Thanks Rose!

does EpiC have any guidance for PLHIV should not do before and after Varina

Does EpiC have any guidance for PLHIV and KPs should not do before and after Vaccinated?

Is there any evidence that the promotion of COVID vaccination amongst KPs increase the uptake of HIV services in turn?

What mechanism or approach did you use to understand the specific drivers of vaccine hesitancy and incorporate them into ongoing programs? Surveys or reports from peer counselors? Other approaches?

kindly request slides after presentation mdimene@pactworld.org

Hello Phal... as outlined by George the only issue concerns whether or not PLHIV are on corticosteroids. Otherwise there is nothing for PLHIV to do before or after vaccine that differs from the general population... so nothing before, and perhaps treating any small side effects with fever/pain reducers afterward.

Agree with Hally's advice. (Even for people receiving high-dose corticosteroids for treatment of certain opportunistic illnesses, the concern with COVID vaccines is not safety; rather, it's the potential for poorer protective response to the vaccine. These will be uncommon scenarios.)

Given the challenges with CD4 to determine PLHIV for are at elevated risk, is there a way to add covid-19 testing to the advanced disease package for PLHIV maybe based on clinical criteria or should program just prioritize vaccination for all newly diagnosed PLHIV

through experience in Cambodia 🇰🇭 a lot of people's drank alcohol before vaccinations and after vaccinated . what should we tell them about drink alcohol when they had vaccinated ?

I noticed that 4047 PLHIV were vaccinated, but what is the proportional achievement against the Tx cur of the PLHIV for the period January and February?

@Phal, thanks for this question. I think there are two main points: (1) alcohol, even in excess, whether before or after vaccine should NOT be a barrier to getting COVID vaccine. Frankly, there are VERY few legitimate medical/health reasons to not get a COVID vaccine. (2) The program can, of course, take the opportunity of interacting with such clients to counsel them about the many other health benefits of limiting their alcohol intake and support them to work on that.

@Moses I don't see Covid testing being added to the AHD package of care. I assume you are concerned with persistent covid- in reality the only treatment in LRS is ART and everyone with AHD needs that

Mulenga, we started implementation Jan 22 and do not have complete vaccines status on all PLHIV yet. We collect this information as clients come for drug pick to facilities or any of our community drug pick sites

Good afternoon everyone. I am Engr. Bukola ESAN, a Consultant Biomedical Engineer from Nigeria.I am glad to be here

thank you so much for your response the questions

thank you Hadiza

@Tom, I might add that there is no reason for routine COVID testing in people with AHD - should still be driven by symptoms or exposures. I completely support your point about the importance of supporting folks with AHD to take on effective ART ASAP! People with AHD would also benefit from an extra dose of COVID vaccine in their primary series.

any evidence vaccine among TBHIV coinfection?

@Travis - given the overwhelming request ($3.3 Million) vs. action (just $300 thousand, only 10%) - how has OutRight coordinated and partnered with other donors to reach the unmet need?

one of the barriers that we face here in Indonesia is that some health care workers believe that PLHIV requires to achieve some level of control (e.g. CD4 level, viral load) in order to receive COVID-19. Thus, in some occasions, PLHIVs were turned away because they were required to get CD4/viral load tests before getting vaccinated. Is there any other country experiencing the same thing? And how did you overcame this?

Given the limited quantities of vaccines and the fact that many PLHIV are on effective therapy, is there adequate justification to prioritize PLHIV on effective ART above other population groups such as the elderly?

Chavia... it sounds like you need to invest in making sure health care workers have received some training/technical updates on PLHIV and Covid vaccines. There isn't an easy answer other than sensitization and training.

Perhaps COVID-19 vaccination should be part of the standard package of services for all PLHIV, particularly those newly diagnosed.

Hi Rafaela--Padmavathi sent the following note regarding your question: Promotion of COVID vaccination among CBO staff and volunteers put them at reduced risk for COVID there by ensuring continuity of service delivery even during COVID surges

@Siti, I am not aware of dedicated studies of COVID vaccines in people with TB/HIV; I'm also not aware that TB coinfection alters the recommendation to provide COVID vaccine to PLHIV. (In fact, the presence of TB makes it more likely that the person may have lower CD4 or less well controlled HIV.... which would make it even more important to provide COVID). [If I can find something more specific about COVID in TB/HIV, I will share with the organizers after this webinar.]

thanks all presenters very interested presentation