I must begin by sharing with you that this was my first ICASA meeting ever. I have no experience to compare it with other can my expectations and experience attending other conferences on HIV/AIDS and other conferences in general, in Africa. Prior to arriving in Dakar, I was impressed by the conference organization. Before arriving in Dakar, my interaction with the ICASA organizers was smooth especially given that I speak no French.
However, on the first full day of the conference (the opening ceremony was the night before), December 4, I arrived early to check-in and pick up my conference goodies (bag and guides). That’s when the problems began. They had run out of bags!! It was 9:30AM on the first official day of the conference, I had pre-registered almost 3 months earlier, and there was no bag or abstract book for me. It turned out I was not alone. There were a few of my colleagues hanging around who had arrived earlier that morning who were also without bags or abstract books. The best we had were little foldable presentation sheets with the session names, but with no information about the topics being presented and who was presenting. As a result, I attended a session titled “Community-based involvement in prevention”, but the first two presentations were on “building stronger African civil society participation in policy advocacy in Africa” and “Primary caregivers – the critical but hidden hands in HIV/AIDS care”. After the first two presentations, I discovered that the session title didn’t exactly fit the presentations and not what I had expected to hear. If I had the bigger book with the presentations actually listed at this time, I would have been able to better select the sessions of interest to me. After this session, I went back again to the check-in desk in search of the book that listed the presentations in addition to the session titles.
It turned out that the ladies at the check-in desk were hording the bags and books. It was the oddest thing. While I was standing around waiting for the bags to come (in a hour as I had been assured), I would see some people go up to check-in and come out with bags. I would go back only to be told there were no bags. Apparently depending on whom you spoke to (the ladies attended to different people according to the last names) you could get nothing, just a bag, or everything! And also, depending on how you smiled or asked. I am not sure. I checked-in about 9:30AM, got a bag about 1PM, and finally managed to get an abstract book, or rather presentation book listing the presentations in each session, at about 6PM. The book didn’t have the abstracts as we thought. Technology has taken over, so we got the abstracts in CDs, but if you wanted it in hardcopy for convenience, they were on sale for approximately $10 (5000 CFA). And this was only beginning on the second day as we discovered when we saw the stands open up on December 5.
Despite this little frustration, the conference was a good one for me although I have a few comments regarding my impressions, good and bad.
For one thing, there was a large representation of the disabled HIV/AIDS community at the conference. I have not been to an AIDS conference in a few years, but it was interesting and good to see this group so visible and well represented and participating, at the conference – in wheelchairs, blind, etc. There were also a number of interesting sessions on the topic. One I found particularly interesting which is related is the relationship between mental health and a person’s HIV/AIDS status.
From what I was able to tell, most of the abstract submissions were accepted as poster presentations, with certain groups either being invited or organizing special panels to talk about their research orally. A number of the oral sessions were sponsored by groups such as Amref, Fogarty, Global Fund, etc. A couple were on actual scientific research but more on reports from interventions, but there were some really interesting results from scientific research being conducted by institutions in the West. Unfortunately, this is where most of the high quality research was presented. It struck me that African groups conducting high quality research might not choose ICASA as a forum to share their results and may want to attend more pres
tigious conferences which larger media coverage to disseminate their findings. I don’t recall ICASA being mentioned on CNN the week of the conference. The problem with this is that most of these conferences are held in countries that most Africans have difficulty traveling to easily due to travel restrictions, as well as the major issue of most of these countries, including the US, not permitting HIV positive people entry into these countries. So the African audience is very limited at these ‘prestigious’ conferences, when they might be the ones to benefit most from the results being presented there and should be the ones hearing the information for several reasons including the fact that their communities provide the subjects which are being studied.
For my group, we were attending ICASA not to present any findings from our research, but rather to be challenged by what other researchers in Nigeria and Africa were doing. Unfortunately we came out feeling very good about our study methodology and progress, even though we know that there are a number of areas we can improve on. This does not say much for the research presented at ICASA, especially research from Nigeria. There were only one or two notable oral sessions on studies conducted in Nigeria. At one of these sessions, there were to be three presentations from Nigeria in that session titled “Determinants of the HIV Epidemic: where do we need to focus?”, however, only one showed up. A researcher at UCH presented on the “sexual practice among people living with HIV at the UCH, Ibadan, Nigeria” after they begun to receive ART. When he was challenged as to the point of the study, given that we all know that when someone is weak it can prove difficult to be sexually active and treatment that leads to feeling stronger could lead to increased sexual activity, the same with malaria or any other weakening illness, he could not defend the study. The study also found a slight increase in the use of condoms by the study subjects, but there were free condoms at the treatment center, so if people took condoms when they came for treatment, then it only seemed logical that they could see an increase and a very slight increase in use of condoms. A useful follow-up question in this study could have been for the researchers to find out where the respondents reporting increase in use of condoms where getting their condoms. Were they going out to purchase condoms or just using them when they happened to get a few free ones at the hospital?
All other Nigeria presentations were poster presentations, of which more that half did not show up. At least they were not there when I did my rounds and I made sure to circle all Nigeria studies in the book before I went looking for the specific poster numbers. Some put up their studies and were not there to talk about them, while for most, the studies where not put up at home. There are a few pictures of some studies that were there. I won’t really comment on them, but I personally thought the topics were already over studied and provided nothing new, or that certain high government officials shouldn’t be presenting very simple poster presentations. That’s just me though.
Back to the research sessions from the West, it was interesting to me that the audience was largely western. There were very few Africans in these sessions, which could be explained by the fact that a majority are still studying condom use and sexual behavior, and are not interested or aware of other more complex issues such as “how and why does infection with different subtypes impact on the neurological diseases associated with HIV-1 and HIV-2?” Even a great presentation by the APIN/Harvard group on the different types of HIV and their subtypes, only very few Africans were in the room. And I have to admit, this session was one of the most intriguing sessions to me and one I thought people could learn a lot from especially in understanding why sometimes ‘AIDS dey show for face’ and sometimes ‘AIDS no dey show for face’, or why you could have unprotected sex once, and become infected, or why in some cases people can get away with having unprotected sex on so many occasions. It could all come down to the HIV type or sub-type infecting the person’s partner and how easily it could be transmitted or develop to AIDS.
Although I didn’t feel like Nigeria represented very well at the conference and some of the organizing could be better, I did enjoy the conference and took away a great experience from it. Learning can come in different ways, and I did learn that we could challenge ourselves more in Nigeria to study HIV/AIDS topics that move away from condom use, sexual behavior, awareness, knowledge and maybe try to find out more why someone thinks they are not at risk of becoming infected, but in the same breath believes that HIV can be transmitted by mosquito bites and touching PLWHA. One poster actually presented this and when I asked her how it was possible – did these people not take public transportation or live in an area where there were mosquitoes, I risked being a sarcastic audience member and I politely acted like it was a joke.
Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead