10 March 2017 VOLUME 18 ISSUE 10

Seen at the heart of fighting the HIV/AIDS epidemic....To end this pandemic, women are advancing research on the front lines as scientists in laboratories and clinics, as leaders of large, international clinical trial efforts,....as participants in clinical trials, [and] volunteering to help us better understand and fight the disease, one person at a time.

At Harvard Medical School, research associate Navid Madani has spent years working with Iranian scientists on HIV/AIDS research. The collaboration builds expertise in Iran,...while Iranians share their knowledge on matters like needle exchange programs and methadone treatment centers. After the initial ban was announced, Madani and her team had to rethink how to bring students and scientists to the U.S....[Madani said] “The administration is throwing a lot of marbles for us to walk around instead of paying attention to serious security issues.”

At CROI 2017, Morenike Ukpong-Folayan spoke with Mark Hubbard and Stacey Hannah about community concerns regarding medical research. The Good Participatory Practice (GPP) guidelines were developed...to serve as a "comprehensive, structured and strategic...scaffold" to be adapted to specific research.....Groups in South Africa are trying to incorporate these guidelines into ethics reviews of clinical trials....It is important that GPP not simply become a list of checkboxes to be ticked off, but a guide to meaningful engagement.

We are now at another fork in the road for the AIDS pandemic. President Trump’s first budget proposal imperils the progress made over 13 years of PEPFAR and the Global Fund [and]....could cut foreign assistance spending by as much as 37 percent — meaning fewer people on HIV treatment, more preventable deaths, and greater instability around the world....Vice President Pence, President Trump, and Secretary of State Tillerson have publicly voiced their support for PEPFAR and the Global Fund.

Secretary of State Rex Tillerson's...formal appeal of the OMB's initial budget proposal seeks to restore some of the huge cuts proposed by the White House for State Department and foreign assistance funding....The bottom line is that funding for diplomacy and development will be the subject of a series of negotiations and likely fall somewhere between what the White House and Congress each want. Tillerson's challenge is to navigate between those two power centers and do as much as he can to defend the programs he believes in.

On Friday, Utah's House Judiciary Committee voted to expand the state's definition of nonconsensual sex to include when a person with HIV who knows his or her status does not disclose it prior to sexual conduct. The bill would also increase penalties for other sexual offenses when the person convicted has HIV....In a hearing on the bill, Troy Williams, executive director of Equality Utah,...expressed concern that HB 369 could hamper efforts to prevent sexually transmitted infections, according to the Salt Lake Tribune.

Cash or food was provided for 6 or less consecutive months, conditional on visit attendance. The primary outcome was medication possession ratio at 6 months. Secondary outcomes were appointment attendance and loss to follow-up (LTFU) at 6 and 12 months. Results: Short-term conditional cash and food assistance improves ART possession and appointment attendance and reduces LTFU among food-insecure ART initiates in Tanzania.

A simple, scalable three-drug combination of tenofovir, lopinavir and ritonavir] in a lipid-stabilized nanosuspension (TLC-ART101) exhibited persistent drug levels in cells of lymph nodes and the blood (HIV host cells) and in plasma. With appropriate dose adjustment, TLC-ART101 may be a useful HIV treatment with a potential to impact residual virus in lymph nodes.

To better understand factors associated with high VL, we examined characteristics of patients presenting for treatment in Hanoi, Vietnam. In our study, cigarette smoking in the last 30 days was associated with a 1.5 to 2-fold higher odds of having an HIV VL >100,000 cp/ml among patients presenting for ART. These findings provide further evidence of the negative effects of tobacco use among HIV-infected patients.

A study of 104 of the largest patient advocacy groups based in the US found that 83% received financial support from drug, device, and biotechnology companies. The study also found that 39% of the advocacy groups had a current or former executive of such a company on their governing board, with at least 12% having a former industry executive in a board leadership position. In many cases, industry support for the groups was substantial.

We provide a summary of the nine naturalistic longitudinal studies of cognitive change conducted in samples of HIV+ participants....Despite long-term viral suppression, we found mostly subclinical levels of decline in psychomotor speed and executive functioning (mental flexibility and cognitive inhibition), well-established markers of HAND progression. Moreover, 57% of our cohort is undergoing slow evolution of their disease, challenging the notion of prevalent neurocognitive stability in virally suppressed HIV infection.

Originally developed by medical anthropologists to make sense of HIV/AIDS, the theory of syndemics offers an innovative way of understanding why diseases cluster together in populations disproportionately affected by poverty, social exclusion, gender-based violence, climate change, displacement arising from agricultural or industrial waste or pollution, and other forms of social and environmental stress.

We did a pragmatic, multicentre, open-label, randomised controlled trial in 7 HIV clinics at academic and non-academic hospitals in the Netherlands, [examining] the effectiveness and cost-effectiveness of the Adherence Improving self-Management Strategy (AIMS) compared with treatment as usual....AIMS reduced viral load, increased QALYs, and saved resources. Implementation of AIMS in routine clinical HIV care is therefore recommended.

Switching to rilpivirine, emtricitabine, and tenofovir alafenamide was non-inferior to continuing rilpivirine, emtricitabine, tenofovir disoproxil fumarate in maintaining viral suppression and was well tolerated at 48 weeks. These findings support guidelines recommending tenofovir alafenamide-based regimens, including coformulation with rilpivirine and emtricitabine, as initial and ongoing treatment for HIV-1 infection.