10 DECEMBER 2021 VOLUME 23 ISSUE 49

Calls for better implementation of HIV/AIDS framework from a political standpoint towards the global eradication of the virus were made on Wednesday at the International Conference on AIDS and STIs in Africa (ICASA), held at the ICC in Durban, KwaZulu-Natal.

Orphaned at the age of six years, Winifred Ikilai lost her dear mother to AIDS in the late 90s when the HIV pandemic ravaged the country. By then, HIV treatment did not exist and was a mystery for many. Only those who could afford millions for the monthly dose survived. But her mother was among the unlucky left only to die in her ancestral home.

Ryan White had been sick throughout the summer and fall of 1984 — plagued by chronic night sweats, diarrhea, stomach cramps, and exhaustion. By the time he turned 13 on December 6 of that year, Ryan couldn’t take it any longer. He told his mother, Jeanne, that he “can’t even get off the school bus without being tired.” Several days later, Ryan ran a fever of 104 degrees, at which point Jeanne rushed him to the local hospital in Kokomo, Indiana. There, doctors concluded that Ryan had antibiotic-resistant pneumonia in both lungs.

Scientists have demonstrated the potential of CRISPR-Cas9 technology to remove the HIV genome from the DNA of infected cells. They have also identified some of the consequences of doing so and begun to investigate how these side-effects may be mitigated. In one study, Dr Michele Lai and colleagues at the University of Pisa demonstrated the capacity of CRISPR-Cas9 to remove HIV genetic material from infected cells but also investigated whether the excised sections of DNA may reintegrate and start replicating again.

Many people living with HIV in rural Africa are not receiving regular treatment due to the long distances they have to travel to get their medication.

He was once called “dead man walking” and now he is the longest surviving person with HIV in Africa. Ntimbwe Mpamba was born with HIV in Kitwe, Zambia in 1982 and while he admits he has been at death’s door many times he is a living reminder of the scientific strides made in treating HIV.

A systematic review of studies of medical conditions in women living with HIV has found large gaps in the data, particularly for women over 50. The studies that do explore this topic showed that women living with HIV are at increased risk of acute cardiac disease, reduced bone mineral density and poorer cognitive function than women in the general population, while their gender increases the risk of kidney disease.

The updated National HIV/AIDS Strategy, announced on World AIDS Day, December 1, offers a road map to the ultimate goal of ending the HIV epidemic in the United States by 2030. It spans 2022 to 2025 and builds on previous strategies; the first such strategy was launched during the Obama administration in 2010.

Cabotegravir (CAB) and rilpivirine (RPV) is the first long-acting injectable antiretroviral therapy (ART) option approved for virologically suppressed adults with HIV-1. In addition, long-acting CAB is a promising agent for HIV preexposure prophylaxis (PrEP). This review focuses on phase 3 clinical trial results and implementation considerations for these long-acting ART and PrEP strategies.

We collected 216 responses from sexually active MSM, transgender women, and gender-nonconforming (GNC) people of color through a web-based survey to understand the facilitators and barriers to research participation in a hypothetical LAI PrEP trial. In adjusted models, these items were found to be significantly associated with research participation likelihood: ever participated in HIV research study; comfort with taking daily pill; comfort with providing urine sample; and concerns over potential side effects of shot.

Here we show that a single subcutaneous administration of GS-CA1 provides long-term protection against repeated rectal SHIV challenges in rhesus macaques. Whereas all control animals became infected after 15 weekly challenges, a single 300 mg/kg dose of GS-CA1 provided 97 percent per-exposure risk reduction for infection for 24 weeks. Pharmacokinetic analysis showed a correlation between GS-CA1 plasma concentration and protection from SHIV challenges, with GS-CA1 levels >2-fold the rhesus plasma protein-adjusted 95 percent effective concentration conferring 100 percent protection in this model. These proof-of-concept data support the development of capsid inhibitors as a novel long-acting PrEP strategy in humans.

Although the concept of treatment as prevention has generated optimism that an AIDS-free generation is within reach, the success of this approach centers upon early diagnosis and linkages to care for people living with HIV. Unfortunately, people continue to present for HIV care at late stages of disease and HIV-related stigma has been recognized as the major impediment to HIV prevention and treatment efforts.

Rapid PrEP intensification to ART allowed to achieve high rates of HIV viral suppression despite significant rates of M184 V mutation harboured in those newly diagnosed with HIV and reporting recent PrEP exposure.

Inflammatory cytokines augment humoral responses by stimulating antibody production and inducing class-switching. In women, genital inflammation (GI) significantly modifies HIV risk. However, the impact of GI on mucosal antibodies remains undefined. We investigated the impact of GI, pre-HIV infection, on antibody isotypes and IgG subclasses in the female genital tract.

Traditional healing plays an important role in healthcare in Eswatini, and innovative collaborations with traditional healers may enable hard-to-reach men to access HIV and tuberculosis diagnostic services. This study explored attitudes towards integration of traditional healers into the provision of HIV self-testing kits and sputum collection containers.

Pre-exposure prophylaxis (PrEP) is recommended by the WHO for HIV prevention among female sex workers (FSWs). A study conducted in 2016–2017 in Côte d’Ivoire showed that if PrEP is acceptable, FSWs also have many uncovered sexual health needs. Based on this evidence, the ANRS 12381 PRINCESSE project was developed in collaboration with a community-based organization. The main objective is to develop, document, and analyze a comprehensive sexual and reproductive healthcare package among FSWs in Côte d’Ivoire.

Retention in HIV pre-exposure prophylaxis (PrEP) care and adherence to PrEP has been suboptimal in some populations, despite evidence that high adherence dramatically enhances PrEP efficacy. A comprehensive PrEP Clinic with a retention specialist and clinical pharmacist could impact patient’s retention and adherence in PrEP care.

Identifying approaches to improve levels of health care provider knowledge in resource-poor settings is critical. We assessed level of provider knowledge for HIV testing and counseling (HTC), prevention of mother-to-child transmission (PMTCT), and voluntary medical male circumcision (VMMC). We also explored the association between HTC, PMTCT, and VMMC provider knowledge and provider and facility characteristics.

The Open Doors project was able to reach large numbers of previously undiagnosed key populations by implementing a targeted managerial and technical intervention, resulting in a significant increase in the HIV positivity rate sustained over 12 months. These results demonstrate that differentiated, data-driven approaches can help close the 95-95-95 gaps among key populations.

Nigeria has low antiretroviral therapy (ART) coverage among HIV-positive pregnant women. In a previous cluster-randomized trial in Nigeria, Baby Shower events resulted in higher HIV testing coverage and linkage of pregnant women to ART; here, we assess outcomes of Baby Shower events in a non-research setting.

As countries move towards the UNAIDS's 95-95-95 targets and with strong evidence that undetectable equals untransmittable, it is increasingly important to assess whether those with HIV who are receiving antiretroviral therapy (ART) achieve viral suppression. We estimated the proportions of children and adolescents and adults with viral suppression at 1, 2, and 3 years after initiating ART.