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11 SEPTEMBER 2020 VOLUME 22 ISSUE 35

Media Coverage

  • Pharmacies Grapple With Red Tape as States Try to Allow Pharmacists to Prescribe PrEP

    The California law allowing pharmacists to prescribe HIV prevention medication has encouraged lawmakers around the country to pass similar measures to reduce hurdles and expand access to pre-exposure prophylaxis (PrEP). With the passage of Senate Bill 159, California became the first state in the nation to allow pharmacists to provide PrEP and post-exposure prophylaxis (PEP).

    September 10, 2020
    PrEP
    The BodyPro

  • $14.6M Grant to Explore a Therapy to Control HIV Without Meds

    In nearly 40 years of the HIV epidemic, only two people have likely been cured of the virus. Both scenarios resulted from stem cell transplants needed to fight blood cancers such as leukemia. Inspired by these two cases, a team of scientists is studying a multipronged way to potentially control HIV without medication. It involves two different genetic alterations of immune cells and with a safer method of stem cell transplants, also referred to as bone marrow transplants, a procedure that is generally toxic and dangerous.

    September 10, 2020
    Cure
    POZ

  • Two Years Since HIV & AIDS Act Was Notified, Gov'ts Have Done Little to Implement It

    On September 10, 2020, today, it is two years since the HIV & AIDS (Prevention and Control) Act 2017 came into force. However, going by the response given by the National AIDS Control Organisation (NACO) to an RTI application filed by the author regarding the implementation of the Act, it would seem there has been little progress.

    September 10, 2020
    Treatment
    The Wire

  • Cost Puts HIV-Preventing PrEP Out of Reach for Many

    The daily drug regimen known as PrEP is a nearly foolproof way to prevent HIV infection. But a new study suggests that many high-risk Americans may be giving the medication a pass because of cost.

    September 10, 2020
    PrEP
    US News & World Report

  • India Progresses Towards Eliminating Vertical Transmission of HIV but Is Not There Yet

    The global targets to eliminate vertical transmission of HIV by 2020 were set in 2014. But till now, only a dozen countries have been able to do so. With less than four months left to meet the 2020 goal of eliminating vertical transmission of HIV, India has a long way to go despite having made considerable progress in the past five years.

    September 10, 2020
    Treatment
    aidsmap

  • SF HIV Cases Fell by 19 Percent in 2019

    New HIV diagnoses in San Francisco continue to fall but disparities remain, according to the latest HIV epidemiology report from the San Francisco Department of Public Health. While acknowledging last year's good news, health officials are concerned that the COVID-19 crisis could compromise the city's progress going forward.

    September 10, 2020
    General
    Bay Area Reporter

  • Gov’t Asked to Integrate HIV, Sexual Reproductive Health Services

    Civil Society Organizations which deal with Gender-Based Violence [GBV], Sexual Reproductive Health and Rights [SRHR] and HIV have called on the Ministry of Health to integrate these services to enable people to easily access them.

    September 9, 2020
    General
    The Independent

  • COVID-19 Sets HIV Treatment and Testing Back

    Testing for HIV at public health facilities declined 57 percent during the first month of lockdown instituted because of the COVID-19 pandemic in South Africa, according to data from the national health department.

    September 9, 2020
    Treatment
    Mail & Guardian

  • Why Do People in Southern Africa Stop Taking PrEP?

    People who start taking pre-exposure prophylaxis (PrEP) in sub-Saharan Africa often discontinue taking it. A team led by Kate Bärnighausen of University of Witwatersrand, South Africa, interviewed former PrEP users in the general population in Eswatini to discover why this might be. They found that reasons for discontinuing included objections from male partners, decisions about perceived necessity of taking PrEP, and barriers to attending clinic appointments. Cost of PrEP itself was not an issue because it is free at point of care in Eswatini.

    September 8, 2020
    PrEP
    aidsmap

  • Trans and Cis Women and Men All Have Similar Levels of PrEP Drugs in Blood, Directly-Observed Dosing Study Finds

    A study in which 24 trans women and 24 trans men who were taking gender-affirming hormone therapy were directly observed to take a daily dose of the standard formulation of the HIV prevention medication PrEP found that the levels of the two PrEP drugs tenofovir and emtricitabine were similar to the levels seen in similar cis men and women, and were all above levels associated with efficacy.

    September 7, 2020
    PrEP
    aidsmap

Published Research

  • Preserving 2 Decades of Healthcare Gains for Africa in the Coronavirus Disease 2019 Era

    Programs like the Academic Model Providing Access to Healthcare are currently leveraging widely available technologies in Africa to prevent patients from experiencing significant interruptions in care as the healthcare system adjusts to the challenges presented by COVID-19. These approaches are designed to preserve social contact while incorporating physical distancing. The gains and successes made through approaches like group-based medical care must not only continue but can help expand upon the extraordinary success of programs like President's Emergency Plan for AIDS Relief.

    October 1, 2020
    General
    AIDS

  • What One Pandemic Can Teach Us in Facing Another

    Almost exactly 39 years ago, the US Centers for Disease Control reported five cases of Pneumocystis carinii pneumonia among previously healthy gay men. By the end of 1985, HIV was reported from every region in the world. Three decades later, 75 million people have acquired HIV and about 32 million have died from it.

    October 1, 2020
    General
    AIDS

  • PrEP Uptake and Adherence in Relation to HIV-1 Incidence Among Kenyan Men Who Have Sex With Men

    HIV-1 incidence among MSM with access to programmatic PrEP was high and did not differ by reported PrEP use. Only one in seven MSM taking PrEP had protective tenofovir concentrations and four out of five MSM who acquired HIV-1 while reporting PrEP use had not taken it. Strengthened PrEP adherence support is required among MSM in Kenya.

    September 9, 2020
    PrEP
    EClinicalMedicine

  • HIV Incidence Among Men Who Have Sex With Men and Transgender Women in Four Provinces in Thailand

    Overall this study found a lower HIV incidence in the highest risk population in Thailand compared with similar studies in Bangkok. Accelerated prevention efforts are needed to make the goal of 'zero new infections' possible in Thailand.

    September 9, 2020
    General
    International Journal of STD & AIDS

  • Post-Exposure Prophylaxis in the Era of Pre-Exposure Prophylaxis

    At 56 Dean Street (56DS), PEPSE is appropriately given for high-risk HIV exposures. For those who use PrEP, It is important to support their adherence and ensure adequate supply. As PrEP uptake increases, the need for PEPSE may decrease.

    September 9, 2020
    PrEP
    HIV Medicine

  • Towards Achieving the 90-90-90 HIV Targets: Results From the South African 2017 National HIV Survey

    South Africa appears to be on track to achieve the first 90 indicator by 2020. However, it is behind on the second 90 indicator with ART coverage that was ~ 20-percentage points below the target among people who knew their HIV status, this indicates deficiencies around linkage to and retention on ART. Overall viral suppression among those on ART is approaching the target at 87.4 percent, but this must be interpreted in the context of low reported ART coverage as well as with variation by age and sex. Targeted diagnosis, awareness, and treatment programs for men, young people aged 15–24 years old, people who reside in farming communities, and in specific provinces are needed. More nuanced 90–90–90 estimates within provinces, specifically looking at more granular sub-national level (e.g. districts), are needed to identify gaps in specific regions and to inform provincial interventions.

    September 9, 2020
    Treatment
    BMC Public Health

  • Awareness and Acceptability of Undetectable = Untransmittable Among a US National Sample of HIV-Negative Sexual and Gender Minorities

    In total, 85.5 percent of participants reported having heard of U=U. Among those aware of U=U, 42.3 percent indicated they trusted it, 19.8 percent did not, and 38.0 percent were unsure about it. Latinx, Asian, lower income, and Southern participants were less likely to have heard of U=U. Having had a recent clinical discussion about PrEP or being a former-PrEP user were associated with trust in U=U. Willingness to engage in CAS was positively associated with trust in U=U, and varied based on the partner's serostatus, PrEP use and viral load.

    September 8, 2020
    Treatment
    AIDS and Behavior

  • National Trends in Drug Payments for HIV Preexposure Prophylaxis in the United States, 2014 to 2018

    Third-party and out-of-pocket (OOP) payments per 30 TDF-FTC tablets increased annually. The $2.08 billion in PrEP medication payments in 2018 is an underestimation of national costs. High costs to the health care system may hinder PrEP expansion.

    September 8, 2020
    PrEP
    Annals of Internal Medicine

  • Mapping Neutralizing Antibody Epitope Specificities to an HIV Env Trimer in Immunized and in Infected Rhesus Macaques

    Rhesus macaques are considered the most appropriate pre-clinical animal model for monitoring antibody (Ab) responses. Accordingly, we report here the isolation of 45 BG505 autologous neutralizing antibodies (nAbs) with multiple specificities from SOSIP-immunized and BG505 SHIV-infected rhesus macaques. We associate the most potent neutralization with two epitopes: the C3/V5 and V1/V3 regions. We show that all of the nAbs bind in close proximity to known bnAb epitopes and might therefore sterically hinder elicitation of bnAbs.

    September 8, 2020
    Antibody Related Research
    Cell Reports

  • “They Have This Not Care – Don’t Care Attitude:” a Mixed Methods Study Evaluating Community Readiness for Oral PrEP in Adolescent Girls and Young Women in a Rural Area of South Africa

    The health system in this poor, high-HIV incidence area had multiple barriers to a PrEP rollout to AGYW. Norms around adolescent sexuality and gatekeeper concerns that PrEP could divert health resources from treatment to prevention could create barriers to PrEP roll-out in this setting. Alternate modes of delivery, particularly those which are youth-led and demedicalize PrEP, must be explored.

    September 7, 2020
    PrEP
    AIDS Research and Therapy

  • A Longitudinal, Qualitative Exploration of Perceived HIV Risk, Healthcare Experiences, and Social Support as Facilitators and Barriers to PrEP Adoption Among Black Women

    This study demonstrated actual, rather than hypothetical, PrEP interest and attitudes among Black women, and the barriers that arose over time during the study. PrEP awareness needs to be promoted among Black women and medical providers. Future research should address individual risk perception, medical mistrust, increasing social support, and decreasing transportation barriers.

    September 4, 2020
    PrEP
    AIDS and Behavior

  • Mother-to-Child HIV Transmission and Its Correlates in India: Systematic Review and Meta-Analysis

    In India, pooled HIV prevalence of MTCT as high as 8.78 percent among babies born to infected mothers warrants urgent need of focused intervention for providing ART (PMTCT intervention), ensuring proper infant ARV prophylaxis, and avoiding delivery without proper medical facility to pregnant women with HIV for reduction of occurrence in HIV transmission from mothers to children.

    September 4, 2020
    PrEP, Treatment
    BMC Pregnancy & Childbirth

  • Cohort Profile: IAVI’s HIV Epidemiology and Early Infection Cohort Studies in Africa to Support Vaccine Discovery

    In 2003, IAVI identified several gaps in HIV epidemiology and vaccine research. IAVI launched cohort studies to better understand at-risk populations, their suitability for clinical trial participation and their unmet needs for preventive services and products. Our goals included (i) improving our understanding of HIV incidence and volunteer retention among ‘key populations’ of at-risk persons suitable for participation in large-scale HIV prevention trials; (ii) identifying and addressing unmet needs for health care, counselling and prevention among these key populations; (iii) understanding host–virus interactions both shortly after virus acquisition and longer term; (iv) generating data and reagents from recently transmitted HIV to support new vaccine product discovery; and (v) understanding clinical outcomes of HIV disease in the African context to define clinical trial endpoints where antiretroviral therapy (ART) was not (yet) widely available, while building the clinical, laboratory and quality systems to support future trials.

    September 3, 2020
    HIV Vaccine
    International Journal of Epidemiology

  • Substantial Need for PrEP Among MSM in Hanoi, Vietnam

    We utilized data from the HIM-Hanoi cohort to determine the proportion of HIV-negative MSM with PrEP indications in Hanoi. Among 717 MSM, 537 had ≥1 PrEP indication, signaling substantial need for PrEP scale-up. Condomless anal intercourse was the most frequent indication, followed by previous/current STI.

    September 2, 2020
    Male and Female Condoms, PrEP
    Sexually Transmitted Diseases

  • Use of HIV Pre-Exposure Prophylaxis Among Men Who Have Sex With Men in England: Data From the AURAH2 Prospective Study

    PrEP awareness and use increased substantially from 2013 to 2018 among a cohort of MSM in England. Improving access to PrEP by routine commissioning by National Health Service England could increase PrEP use among all eligible MSM, but should include public health strategies to target socioeconomic and demographic disparities in knowledge and use of PrEP.

    September 1, 2020
    PrEP
    Lancet Public Health

  • Engineering CAR T Cells to Target the HIV Reservoir

    In this review, we summarize current developments in engineering HIV directed CAR-expressing cells to facilitate HIV elimination. We also summarize current LRAs that enhance the “kick” strategy and how new generation and combinations of LRAs with HIV specific CAR T cell therapies could provide an optimal strategy to target the viral reservoir and achieve HIV clearance from the body.

    August 13, 2020
    Cure, Treatment
    Frontiers in Cellular and Infection Microbiology

  • Designing Safer CRISPR/Cas9 Therapeutics for HIV: Defining Factors That Regulate and Technologies Used to Detect Off-Target Editing

    This review highlights four widely used methods for detecting off-target events: (1) genome-wide unbiased identification of double-stranded break events enabled by sequencing (GUIDE-Seq), (2) discovery of in situ Cas off-targets and verification by sequencing (DISCOVER-Seq), (3) circularization for in vitro reporting of cleavage effects by sequencing (CIRCLE-Seq), and (4) breaks labeling in situ and sequencing (BLISS). Each of these technologies has advantages and disadvantages, but all center around capturing double-stranded break (DSB) events catalyzed by the Cas9 endonuclease.

    August 12, 2020
    Cure
    Frontiers in Microbiology

  • Sex Hormone Therapy and Tenofovir Diphosphate Concentration in Dried Blood Spots: Primary Results of the iBrEATHe Study

    CGM, TGM, and TGW had comparable TFV-DP concentrations in DBS after 4 weeks of directly observed daily FTC/TDF PrEP use. Serum hormone concentrations were not affected by FTC/TDF PrEP use.

    August 8, 2020
    PrEP
    Clinical Infectious Diseases

  • Structural, Dosing, and Risk Change Factors Affecting Discontinuation of Pre-exposure Prophylaxis (PrEP) in a Large Urban Clinic

    Improving PrEP retention may require multifaceted interventions-e.g., tailored discussions about stopping and restarting PrEP safely as HIV risk changes, ensuring consistent access to affordable PrEP, and alternative dosing strategies. An emailed survey may be a simple, effective strategy to reengage some PrEP clients.

    August 1, 2020
    PrEP
    AIDS Education and Prevention

  • The Impact of Male Partner Circumcision on Women's Health Outcomes

    Women with circumcised partners had a significantly reduced risk of syphilis acquisition, hazard ratio 0.51 (0.26, 1.00), p value = .05. Participants with uncircumcised partners were significantly less likely to have used a condom at the last sex act than the other two groups, adj. relative risk 0.86 (0.80, 0.92), adj. p value < .0001. We found no evidence of sexual risk compensation in women with circumcised partners.

    August 1, 2020
    Voluntary Medical Male Circumcision
    AIDS Education and Prevention

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