AVAC | AKULU | Y+

Ruth Akulu deserves applause. She beat thousands of Ugandan applicants for the most coveted global HIV advocacy fellowship and sailed through as Uganda’s only AVAC Fellow 2022/23.

Uganda as a country also needs to be hailed for defeating all other countries that applied for the same AVAC Fellowship to be ranked number one. 

Over 40 countries applied for the most sought-after fellowship but only seven were successful, Uganda beating them all, courtesy of Akulu who presented the most appealing application.

The countries were: Zimbabwe, Tanzania, Malawi, Zambia, Lesotho, Uganda, Kenya and South Africa. While pronouncing their victory, AVAC management remarked: “AVAC is delighted to announce the 2022/23 AVAC Advocacy Fellows—the 12th class of Fellows!” Adding, “Please join us in congratulating these seven talented advocates. 

With this incoming class, the AVAC Fellows program has grown to 85. We hope you will find ways to collaborate with the new Fellows in 2022/23 and beyond.”

What is AVAC? 

The Global Advocacy for HIV Prevention (AVAC) Advocacy Fellow is a program which was launched in 2009 to foster a network of deeply-informed, skilled, and confident advocates to strengthen and expand advocacy for HIV prevention locally, regionally, and globally.

The voices of those who qualify to accelerate ethical research and equitable access, and their oversight demands accountability so that interventions that work reach those who need them most.

Applications are usually every two years to different countries and different advocates apply. If qualified, an advocate is selected to become a Fellow for 18 months.

Akulu attributes her being selected as the AVAC Fellow in Uganda to her hard work, resilience and dedication as an HIV advocate.

Akulu is openly living with HIV and was crowned Miss Y + (young positive) Ambassador against HIV and AIDS 2019/20 and also won the Y + Media Advocate award in 2020.

She has been using her platform as Miss Y+ Ambassador to challenge HIV stigma and discrimination in the country. She has also supported many young people to access HIV prevention services like PrEP, PEP, and ARVs.

She is a youth mentor, an HIV and sexual and reproductive health (SRH) and mental health advocate for young people living with HIV. 

She has been a Community Monitor for the Community Led Monitoring project for the International Community of Women Living with HIV Eastern Africa (ICWEA) since 2020 and is a National Young People and Adolescent Peer Supporters Trainer.

What does her fellowship focus on?

“The focus of my fellowship is to contribute to the reduction of new HIV infections and unintended pregnancies among Adolescent Girls and Young Women (AGYW). I plan to do this by fast-tracking the introduction of the Dual Prevention Pill (DPP) in Uganda,” she stresses.

What is DPP?

According to Akulu, the Dual Prevention Pill (DPP) is a single, co-formulated, daily oral pill containing oral pre-exposure prophylaxis (PrEP), currently being developed to prevent both HIV and the acquisition of unintended pregnancy.

The DPP, which is the pipeline, is one of several multipurpose prevention technologies (MPTs) - a single product designed to address multiple health needs. Akulu stresses the importance of the DPP, saying that in East and South Africa, where the intervention is initially planned for instruction, 65 percent of new HIV infections in adults are amongst women aged 15 and over, yet 16 percent of women of reproductive age have an unmet need for contraception.

“The DPP is currently undergoing a Bioequivalence Study in Kenya, Zimbabwe, and South Africa and we are awaiting the results. These are the very countries that have been prioritized for DPP implementation research and introduction based on an analysis of need, demand, and enabling environments,” she says.

Adding, “Uganda was left out due to the low uptake of PrEP. Perception of low risk for HIV acquisition and HIV stigma has been cited as a reason for limited uptake of and adherence to pre-exposure prophylaxis (PrEP)”

Akulu says that tthrough the Girl Power project, they are laying the groundwork to prepare for its introduction by advocating for increased access to integrated PrEP and Family Planning services.

“PrEP/FP integration is still an area with slow progress yet by contrast, contraceptives compared to PrEP are more widely used and valued among women due to the high perceived, and actual, risk for unintended pregnancy,” she says.

She adds that they have also been advocating for the pharmacy PrEP delivery model as another way to diversify PrEP service delivery and together with MOH and support from other CSOs, they have been pushing for funding for the Model through PEPFAR and Global Fund. 

“I determined to address the social, economic and cultural barriers leading to the overwhelming numbers of unintended pregnancies and HIV in AGYW. It is time for AGYW-aged 10-25 years to take control of their lives through urgent gender-responsive interventions to prevent the two unwanted scenarios,” Akulu says.

Akulu is an Economist by profession and holds a Bachelor’s degree in Economics and Trade Policy from Ndejje University.

She is hosted by the International Community of Women Living with HIV Eastern Africa (ICWEA) and currently implementing the Girl Power Project.