A synergistic model of engagement: the ECHO Global Community Advisory Group and HC-HIV Advocacy Working Group

BACKGROUND: In 2019, the Evidence for Contraceptive Options in HIV Outcomes (ECHO) study found no substantial difference in risk of HIV infection among women using one of three safe and effective contraceptive methods (DMPA-IM, LNG implant, copper IUD). The trial used a range of advisory mechanisms that aligned to global standards in stakeholder engagement, including an ECHO-specific Global Community Advisory Group (GCAG).
METHODS: The HC-HIV Advocacy Working Group includes highly visible women leaders from diverse geographies who advocate on the global, national and local stage; their advocacy paved the way for the formation of the ECHO GCAG. The GCAG included a subset of advocates from the Working Group that advised and communicated regularly with the ECHO Consortium around key trial issues-particularly community engagement.
RESULTS: The strength of the GCAG/HC-HIV Advocacy Working Group model was the high degree of synergy between the two groups. The GCAG workshopped issues with the Group, and together ensured the voices of women were well-represented in the study. Following the trial, the Group provided a space for GCAG members to continue advocacy efforts - including communicating the implications of the trial results to their communities, pushing for integrated sexual and reproductive health services in national Task Forces, and monitoring WHO and Ministry commitments. This demonstrates how the model can advance advocacy from research to policy and implementation.
CONCLUSIONS: The model is now driving discussions around engagement for future HIV prevention clinical trials. A study looking at a new daily oral PrEP using F/TAF, planned in communities similar to the ECHO study, highlighted the model as part of their stakeholder consultations. Advocates engaged in the study include members of the GCAG, and study sponsors are utilizing existing advocacy networks to inform the engagement strategy. Similar to the ECHO study, the F/TAF trial has global implications for women. It remains to be seen if the study will replicate or adapt facets of the model; however, it is clear that there is much that can be learned from the relationship between the Working Group and GCAG and how it can support engagement and implementation.