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11 OCTOBER 2019 VOLUME 20 ISSUE 39

Media Coverage

  • PrEP Use Among Pregnant Women in Kenya: No Adverse Effects Found

    The study found no difference between women who did and did not use pre-exposure prophylaxis (PrEP) while pregnant in regards to premature birth, infant age and weight at birth, infant growth at six weeks and birth defects.

    October 11, 2019
    PrEP
    Avert

  • Global Fund Claims Last-Minute Victory on $14B Replenishment Target

    The Global Fund to fight AIDS, Tuberculosis and Malaria said it secured its $14 billion funding target at its replenishment conference Thursday, with the Bill & Melinda Gates Foundation and the French government upping their earlier pledges to get donors over the line.

    October 10, 2019
    General
    Devex

  • Coming Out Plays Important Role in HIV Prevention

    Being open about one’s homosexuality is an important step in preventing HIV. Openly gay men are more concerned with the risks of HIV and other sexually transmitted diseases and are more likely to seek counselling, according to a Swiss study.

    October 10, 2019
    General
    Swissinfo

  • These Laws Were Meant to Protect People From HIV. They’ve Only Increased Stigma and Abuse

    Laws in many states make it a crime to have sex without disclosing your HIV status. Advocates say they may actually worsen the spread of the virus.

    October 10, 2019
    General
    Vox

  • 120,000 People in Western Pacific Get Infected With HIV Each Year: WHO

    The World Health Organization (WHO) said on Thursday an estimated 120,000 additional people in the Western Pacific region are still being infected with HIV each year, with a significant increase in new infections in the Philippines.

    October 10, 2019
    General
    Xinhua

  • California Makes HIV-Prevention Drugs Available Without a Prescription

    Under a new law, pharmacists who undergo special training will be able to provide 60-day supplies of pre-exposure prophylaxis, commonly called PrEP and sold under the brand name Truvada, as well as doses of post-exposure prophylaxis, or PEP, meant to be used in an emergency after possible exposure to the virus, without a doctor’s prescription. Studies have found that the drugs are very effective, but many people at high risk of infection do not take them.

    October 9, 2019
    PrEP
    New York Times

  • Impressive Results From Zimbabwe’s National HIV Sex Worker Programme

    Zimbabwe’s community-led HIV programme for sex workers, Sisters with a Voice, has significantly improved awareness of HIV status among women who sell sex. In a new analysis of the programme from its 2009 launch, investigators found that it also improved engagement along every step of the treatment cascade.

    October 9, 2019
    General
    Avert

  • UNAIDS Lauds Kenya’s Progress in Fight Against HIV

    The United Nations Programme on HIV and AIDS (UNAIDS) on Tuesday lauded Kenya for making good progress in the fight against HIV/AIDS in the country. Medhin Tsehaiu, new country director of the UNAIDS, however, urged Kenya to adopt innovative approaches that appeal more to the youth who are a high-risk population.

    October 9, 2019
    General
    Xinhua

  • More Groups Most at Risk of HIV Shun Prevention Pill

    Most people at the highest risk of HIV infections are not using freely available pills to prevent infection, a new study suggests. Men who have sex with men (MSM) and transgender women have among the highest infection risks, but researchers said the majority of them are not using the prevention pills.

    October 9, 2019
    PrEP
    The Star

  • Bill Gates Highlights Novel HIV Drug in $700 Million Disease Pledge

    Billionaire philanthropist Bill Gates committed $700 million to battle diseases that kill millions of people a year, saying experimental technologies like a matchstick-sized implant to prevent HIV could become new weapons in the global effort.

    October 9, 2019
    General
    Bloomberg

  • Sexually Transmitted Disease Cases Rise to Record High, CDC Says

    The number of combined cases of syphilis, gonorrhea and chlamydia in the United States rose to a record high last year, including an alarming jump in the rate of newborn deaths caused by congenital syphilis, according to figures released by the Centers for Disease Control and Prevention on Tuesday.

    October 8, 2019
    General
    New York Times

  • For PrEP 2-1-1 Dosing, the Information Is Often Bottom Up

    Seven years after the Food and Drug Administration (FDA) approved Truvada (FTC/tenofovir disoproxil fumarate) as pre-exposure prophylaxis (PrEP), it's become clearer that not everyone who uses it as a primary HIV intervention takes the pill daily. Some people have sex intermittently, which has led to the growing acceptability of a 2-1-1 dosing regimen, also known as "on-demand" or "event-driven" PrEP.

    October 8, 2019
    PrEP
    The Body

  • Anti-Gay Laws Linked to Low Levels of HIV Testing in Africa

    Poor uptake of HIV diagnosis and treatment among gay men in Africa may be linked to government crackdowns on homosexuality, a paper has found. The research, published in the Lancet HIV journal, analysed data from 75 studies involving gay and bisexual men across 28 African countries.

    October 7, 2019
    General
    Telegraph

  • Ibalizumab Monoclonal Antibody Is Effective in Real-World Use

    Ibalizumab (Trogarzo), a long-acting monoclonal antibody that prevents HIV from entering cells, suppressed HIV for 48 weeks in people with highly resistant virus who received the drug in an expanded access programme, according to a presentation at the IDWeek 2019 conference in Washington, DC.

    October 7, 2019
    Antibody Related Research
    aidsmap

  • Early HIV Vaccine Trial Builds on Moderately Successful Predecessor

    By altering the components of the one vaccine ever to show any efficacy against HIV, researchers have succeeded in prompting participants’ immune systems to develop promising antibody and immune-cell responses, according to research published in the Journal of Clinical Investigation. These findings from an early-stage clinical trial suggest that more advanced research is warranted.

    October 7, 2019
    HIV Vaccine
    POZ

  • Women Find Long-Acting Injectable ART 'Emotionally Freeing and Empowering'

    Long-acting (LA) injectables could well be the future of antiretroviral therapy (ART), as it solves the issue of adherence posed by oral ART and could better align with patient preferences. Although LA cabotegravir + rilpivirine is currently in development and has demonstrated non-inferiority to daily oral ART in phase III trials, most of the trial participants have been men.

    October 6, 2019
    Treatment
    Contagion Live

  • World Leaders Once Made Miracles, and Can Again

    We have proven that we have the capacity to save lives, improve education and health, create opportunities for women and girls — yet we also seem to have lost interest.

    October 5, 2019
    General
    New York Times

  • FDA Approves New HIV-Prevention Drug, but Not for Women

    The Food and Drug Administration on Thursday approved a new drug, Descovy, for prevention of infection with HIV, only the second drug approved for this purpose. The first, Truvada, has become a mainstay of government efforts to turn back the HIV epidemic. But the FDA approved Descovy for use only in men and transgender women, because its maker, Gilead Sciences, tested it only in those groups.

    October 4, 2019
    PrEP
    New York Times

  • PrEP in Europe Summit 2019: Sex, The Pill and Getting It Right

    PrEP is a medication that is highly effective at preventing HIV, yet all across Europe people still struggle to get adequate information and access to something that can change lives and radically transform the HIV epidemic. PrEP organizers and advocates mean to change that. The 2019 PrEP in Europe summit convenes in Warsaw, Poland, Oct. 10-12, and it brings together people from all across the continent.

    October 3, 2019
    PrEP
    Hornet

Published Research

  • Is Reaching 90–90–90 Enough to End AIDS? Lessons From Amsterdam

    The HIV Transmission Elimination AMsterdam (H-TEAM) Initiative shows that a city-based concerted effort is feasible. However, major challenges remain, such as reducing the number of late HIV diagnoses, and identifying and providing appropriate services to a diminishing group of individuals who are likely the source of transmission.

    November 1, 2019
    General
    Current Opinion in HIV and AIDS

  • Reaching 90–90–90 in Rural Communities in East Africa: Lessons From the Sustainable East Africa Research in Community Health Trial

    SEARCH provides one example of how to rapidly surpass UNAIDS 90–90–90 targets while addressing community health on the path to HIV epidemic control.

    November 1, 2019
    General
    Current Opinion in HIV and AIDS

  • Trends in Sexual Risk Behaviors Among Hispanic/Latino Men Who Have Sex with Men — 19 Urban Areas, 2011–2017

    Among Hispanic/Latino men who have sex with men (MSM), human immunodeficiency virus (HIV) infection is associated with place of birth and length of US residence. Unprotected anal sex (condomless anal sex and no HIV preexposure prophylaxis [PrEP] use) increases the risk for HIV acquisition. Interventions to prevent HIV acquisition, including PrEP uptake, should address cultural and linguistic needs of Hispanic/Latino MSM.

    October 11, 2019
    Male and Female Condoms, PrEP
    Morbidity and Mortality Weekly Report (MMWR)

  • HIV Testing Services in Healthcare Facilities in South Africa: A Missed Opportunity

    The poor delivery of HTS (HIV testing services) appears to be due to a failure to recommend HTS and the added time burden placed on those accepting testing. There were significant differences in both the offer and acceptance of testing by gender. Health system issues need to be addressed to improve HTS delivery.

    October 10, 2019
    General
    JIAS

  • The Replication-Competent HIV-1 Latent Reservoir Is Primarily Established Near the Time of Therapy Initiation

    These results suggest that the majority of the latent reservoir is seeded in response to therapy and likely is not continually formed prior to ART. HIV treatment and cure efforts could potentially exploit this information to limit the size of the reservoir when treatment is initiated.

    October 9, 2019
    Cure, Treatment
    Science Translational Medicine

  • The Impact of PEPFAR Transition on HIV Service Delivery at Health Facilities in Uganda

    Transition from PEPFAR resulted in facilities reporting worsening patient access and service quality for HIV care, but there is insufficient evidence to suggest negative impacts on volume of HIV services. Facility respondents’ perceptions about access and quality may be overly pessimistic, or they may signal forthcoming impacts. Unrelated to transition, declining retention on ART in Uganda is a cause for concern.

    October 9, 2019
    Treatment
    PLoS One

  • The Changing Science of HIV Epidemiology in the US

    We highlight changes that have occurred in the three major domains that are central to epidemiologic science: changes to key populations at highest risk for HIV, refinements in measurement and shifts in the outcomes of interest, and a new era in the tools and approaches that epidemiologists use to synthesize evidence from measurements made on populations. By embracing foundational principles with modern methods, the epidemiologic approach of analyzing the causes and distributions of diseases in contemporaneous populations will continue to advance HIV science over the next decade.

    October 8, 2019
    General
    American Journal of Epidemiology

  • Trends in HIV Testing Among US Adults, Aged 18–64 Years, 2011–2017

    The percentage of ever tested increased from 42.9 percent in 2011 to 45.9 percent in 2017; testing in the past 12 months increased from 13.2 percent in 2011 to 14.8 percent in 2017. Despite these increases, less than half of US adults have ever been tested for HIV over ten years after CDC’s recommendations. Increasing the prevalence of routine HIV screening and rescreening among individuals at high risk will reduce the number of undiagnosed persons with HIV infection and thus prevent new HIV infections—a key strategy in the Ending the HIV Epidemic initiative.

    October 8, 2019
    General
    AIDS and Behavior

  • Lack of Health Insurance Is Associated With Delays in PrEP Initiation Among Young Black Men Who Have Sex With Men in Atlanta, US: A Longitudinal Cohort Study

    The extended time period between PrEP prescription and taking a first dose increases the risk of HIV transmission. Younger YBMSM and those without health insurance had longer delays in PrEP initiation. Immediate PrEP initiation programmes could decrease the likelihood of this occurrence and mitigate the disparity in initiation between those with and without health insurance.

    October 8, 2019
    PrEP
    JIAS

  • Antibody Fc Effector Functions and IgG3 Associate With Decreased HIV-1 Risk

    HVTN 505 is a preventative vaccine efficacy trial testing DNA followed by recombinant adenovirus serotype 5 (rAd5) in circumcised, Ad5-seronegative men and transgendered persons who have sex with men in the United States. Identified immune correlates of lower HIV-1 risk and a virus sieve analysis revealed that, despite lacking overall efficacy, vaccine-elicited responses exerted pressure on infecting HIV-1 viruses.

    October 7, 2019
    HIV Vaccine
    Journal of Clinical Investigation

  • Glycan-Dependent HIV-Specific Neutralizing Antibodies Bind to Cells of Uninfected Individuals

    A number of highly potent and broadly neutralizing antibodies (bNAbs) against the human immunodeficiency virus (HIV) have recently been shown to prevent transmission of the virus, suppress viral replication, and delay plasma viral rebound following discontinuation of antiretroviral therapy in animal models and infected humans. However, the degree and extent to which such bNAbs interact with primary lymphocytes have not been fully delineated.

    October 7, 2019
    Antibody Related Research, HIV Vaccine
    Journal of Clinical Investigation

  • Safety and Immunogenicity of a Multivalent HIV Vaccine Comprising Envelope Protein With Either DNA or NYVAC Vectors (HVTN 096): A Phase 1b, Double-Blind, Placebo-Controlled Trial

    Co-administration of gp120 Env protein components with DNA or NYVAC vectors during priming led to early and potent induction of Env V1/V2 IgG binding antibody responses. This immunisation approach should be considered for induction of preventive antibodies in future HIV vaccine efficacy trials.

    October 7, 2019
    HIV Vaccine
    Lancet HIV

  • HIV Testing and Engagement With the HIV Treatment Cascade Among Men Who Have Sex With Men in Africa: A Systematic Review and Meta-Analysis

    Despite improvements in HIV testing among MSM in Africa, HIV status awareness, ART coverage, and viral suppression remain much lower than required to achieve UNAIDS 90–90–90 targets. Further studies are urgently needed to provide more accurate estimates of levels of status awareness, engagement in care, ART coverage, and viral suppression among MSM to inform prevention efforts aimed at improving access to HIV services for MSM.

    October 7, 2019
    HIV Vaccine
    Lancet HIV

  • HIV Vaccine: Better to Start Together?

    Persistence of effective immune responses remains an important concern for AIDS vaccines. The rapid onset of antibody development suggests the possibility to reassess vaccination schedules, perhaps prolonging time between boosts. The fact that improved humoral immunity was seen with both the NYVAC vector and the DNA vector shows that this co-delivery strategy can be implemented using different vaccine modalities and suggests applications beyond HIV vaccines.

    October 7, 2019
    HIV Vaccine
    Lancet HIV

  • The Landscape for HIV Pre-Exposure Prophylaxis During Pregnancy and Breastfeeding in Malawi and Zambia: A Qualitative Study

    As a public health intervention, PrEP was not well-known among patients and healthcare workers; however, when it was described to participants, most expressed positive views. Concerns about safety and adherence were raised, highlighting two critical areas for community outreach. The feasibility of introducing PrEP into antenatal services was also a concern, especially if introduced within already strained health systems. Support for PrEP varied among policymakers in Malawi and Zambia, reflecting the ongoing policy discussions in their respective countries.

    October 4, 2019
    PrEP
    PLoS One

  • T cell-based Strategies for HIV-1 Vaccines

    Optimized CD8+ T-cell vaccine strategies are promising in both prophylactic and therapeutic settings. This commentary briefly outlines some encouraging findings from T-cell vaccine studies, and then directly compares key features of some T-cell vaccine candidates currently in the clinical pipeline.

    October 4, 2019
    HIV Vaccine
    Human Vaccines & Immunotherapeutics

  • Ending the HIV Epidemic in the United States Must Start with the South

    The United States (U.S.) is at a crossroads for addressing the HIV epidemic in the southern states (“the South”). Since the height of the HIV epidemic in the late 1980s, prevention work has yielded tremendous successes. Scientific analyses, informed programmatic interventions, and community mobilization have substantially reduced new HIV diagnoses annually. However, progress has stagnated in recent years, as annual HIV diagnoses remain stable at approximately 40,000, and HIV-related disparities persist.

    October 3, 2019
    General
    AIDS and Behavior

  • Factors Associated With the Informal Use of HIV Pre-Exposure Prophylaxis in Germany: A Cross-Sectional Study

    Informal PrEP use was associated with a higher risk of not getting tested before and during PrEP use, which could lead to HIV infections resistant to tenofovir and emtricitabine if people with undiagnosed HIV use PrEP. Health insurance plans that cover PrEP and the accompanying routine tests could ensure adequate medical supervision of PrEP users and reduce barriers to PrEP use. Our findings strongly support the implementation of PrEP programmes in countries with similar patterns of informal PrEP use.

    October 3, 2019
    PrEP
    JIAS

  • Potential Impact of Interventions to Enhance Retention in Care During Real-World HIV Pre-Exposure Prophylaxis Implementation

    Pre-exposure prophylaxis (PrEP) has the potential to significantly reduce HIV incidence among men who have sex with men (MSM) in the United States. However, the extent to which suboptimal PrEP adherence and retention in care may limit successful implementation is unknown. An agent-based model was used to represent the entire population of MSM in Rhode Island from 2013 to 2017. The impact of potential interventions to improve PrEP adherence and retention in care on HIV transmission was evaluated.

    October 3, 2019
    PrEP
    AIDS Patient Care and STDs

  • Reasons Why Young Men Who Have Sex with Men Report Not Using HIV Pre-Exposure Prophylaxis: Perceptions of Burden, Need, and Safety

    Results suggest that efforts are needed to engage communities and individuals around PrEP-related education, facilitate risk evaluation, and reduce PrEP stigma. New formulations and nondaily regimens may also be of particular interest to YMSM who may perceive daily PrEP regimens as highly burdensome.

    October 3, 2019
    PrEP
    AIDS Patient Care and STDs

  • Integrated Care Delivery for HIV Prevention and Treatment in Adolescent Girls and Young Women in Zambia: Protocol for a Cluster-Randomized Controlled Trial

    This integrated service delivery model can also be a platform to implement additional preventive services, so HIV-/u and HIV+ AGYW can receive comprehensive, integrated services.

    October 3, 2019
    General
    JMIR Research Protocols

  • Underutilization of Pre-Exposure Prophylaxis Services Among Transgender and Nonbinary Youth: Findings from Project Moxie and TechStep

    We use quantitative and qualitative data from two ongoing studies to describe pre-exposure prophylaxis (PrEP) awareness, willingness to use PrEP, barriers to facilitators of PrEP uptake, and PrEP use among 15- to 24-year-old transgender and gender nonbinary (TGNB) youth. Most youth were aware of PrEP, but only one participant across both studies reported current use. Uncertainty about willingness to take PrEP may be related to general (e.g., medication cost) and trans-specific (e.g., PrEP–hormone interactions) concerns.

    October 2, 2019
    PrEP
    Transgender Health

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