12 NOVEMBER 2021 VOLUME 23 ISSUE 45

Raltegravir is used by people living with HIV that are on third-line treatment. It is administered as a tablet, chewable tablet, and as granules for oral suspension, prescribed for decreasing chances of developing Acquired Immunodeficiency Syndrome (AIDS) and HIV-related illnesses such as serious infections or cancer.

Rewind your mind, if you will, to 2004, 2005—a good seven years before the US Food and Drug Administration (FDA) would approve Truvada for PrEP as an HIV preventive breakthrough. The drug had already been proven safe as an HIV treatment pill, primarily in US trials, and was being tested as a preventive on gay men throughout the US. But soon after parallel PrEP trials began in Cambodia and Cameroon—funded by the US government and the Gates Foundation, with free Truvada (tenofovir disoproxil fumarate/emtricitabine) provided from Gilead, its manufacturer—they were shut down amid protests from global activists, primarily from ACT UP/Paris. The trials were not adequately providing for the health care of trial participants, primarily low-income sex workers, either during or after the trials, the activists charged.

HIV is the leading cause of death for women (15-49 years of age), with 1000 new infections occurring each day in adolescent girls and young women across the world. Investigators from the Desmond Tutu HIV Centre at the University of Cape Town identified factors that complicate reducing HIV infection among adolescent girls and young women (AGYW), including lack of communication between men and women on sexual health issues, gender inequality and violence in sexual relationships, difficulties negotiating condom use, and overall low awareness of HIV vulnerability in AGYW.

The probability that people living with HIV in Thailand survive five years after starting antiretroviral therapy was just 75 percent, according to a recent study published in AIDS Research and Therapy. In 2020, Thailand had an estimated 500,000 people living with HIV and 12,000 people died of AIDS-related causes. Although the ministry of public health has set a goal to reduce AIDS mortality to fewer than 4,000 deaths per year by the year 2030, many people in Thailand start antiretroviral therapy late, which impedes attaining this goal.

Prince Nhlanganiso Zulu, son of the late monarch King Goodwill Zwelithini, recently attended an event to encourage medical male circumcision. The event was held in Vosloorus on Saturday and included traditional leaders from across Gauteng. Prince Nhlanganiso Zulu said that medical male circumcision was a core component of South Africa’s HIV prevention strategy since 2010.

A qualitative study in South Africa and Kenya looked at barriers and facilitators along the PrEP journey of adolescent girls and young women. Intentional PrEP pauses and restarts, corresponding to changing circumstances and seasons of risk, were common among participants in this study. The researchers suggest that PrEP providers should be encouraged to accept seasons of risk and normalise PrEP pauses and restarts among adolescent girls and young women. Globally, over 1,000 adolescent girls and young women aged 15-24 acquire HIV every day.

The Home Office has been threatened with legal action over an HIV patient who continues to be denied life-saving treatment while being held in an immigration detention centre, The Independent has learned.

A prophylactic vaccine would be a powerful tool in the fight against HIV. Passive immunization of animals with broadly neutralizing antibodies (bnAbs) affords protection against viral challenge, and recent data from the Antibody Mediated Prevention clinical trials support the concept of bnAbs providing protection against HIV in humans, albeit only at broad and potent neutralizing antibody titers.

This study reports on the lived experiences of young women living in a peri-urban slum in Kenya and its impact on perceived HIV risk and prevention needs. Guided by the theory of gender and power and postcolonial theory, 73 women 15–24 years of age participated in individual and focus group interviews. Results revealed that the built environment inside and outside the home such as inadequate physical space and lack of security impacted perceived HIV risk.

Methamphetamine (METH), a potent addictive psychostimulant, is highly prevalent in HIV-infected individuals. Clinically, METH use is implicated in alteration of immune system and increase of HIV spread/replication. Therefore, it is of importance to examine whether METH has direct effect on HIV infection of monocytes, the major target and reservoir cells for the virus.

Social biases may influence providers’ judgments related to pre-exposure prophylaxis (PrEP) and patients’ consequent PrEP access. US primary and HIV care providers completed an experimental survey. Each provider reviewed one fictitious medical record of a patient seeking PrEP. Records varied by patient race (Black or White) and risk behavior (man who has sex with men [MSM], has sex with women [MSW], or injects drugs [MID]). Providers reported clinical judgments and completed measures of prejudice. Minimal evidence of racially biased judgments emerged.

HIV testing among men in sub-Saharan Africa is sub-optimal. Despite several strategies to improve access to underserved populations, evidence regarding engaging men in professional and formal occupations in HIV testing is limited. This study explored employed professional men’s preferences for uptake of HIV self-testing, and linkage to HIV care, or prevention services.

Low adherence to investigational products can negatively impact study outcomes, limiting the ability to demonstrate efficacy. To continue advancing potential new HIV prevention technologies, efforts are needed to improve adherence among study participants. In MTN-020/ASPIRE, a phase III randomized, double-blind, placebo-controlled study of the dapivirine vaginal ring carried out across 15 sites in sub-Saharan Africa, a multifaceted approach to adherence support was implemented, including a strong focus on participant engagement activities (PEAs).

The uptake and use of HIV self-testing by FSW in the Gaborone, Botswana region were high, and most women taking home HIV self-test kits also shared a test kit with a partner, family member or friend. HIV self-testing (and test kit distribution) by FSW appears to be a viable HIV testing approach in Botswana.

A cornerstone of HIV prevention clinical trials is providing a combination prevention package to all trial participants. The elements included in that standard of care (SoC) package evolve as new prevention modalities are developed. Pre-exposure prophylaxis (PrEP) was recommended by the World Health Organization for persons at high risk of acquiring HIV, but not all countries immediately adopted those recommendations.

Pre-exposure prophylaxis (PrEP) is an effective tool to prevent HIV and has recently been approved in Taiwan. However, more research regarding PrEP acceptability and effective PrEP implementation is needed in Taiwan. Little is known about the intention to use PrEP and salient psychosocial factors among men who have sex with men (MSM). The purpose of this study was to examine health beliefs linked to PrEP use intention among young MSM (YMSM) in Taiwan.

Human papillomavirus (HPV) immunisation with a bivalent vaccine (Cervarix) was introduced in England, UK, in Sept 1, 2008: routine vaccination was offered to girls aged 12–13 years with a catch-up programme for females aged 14–18 years in 2008–10. We quantified the early effect of this immunisation programme on cervical cancer and cervical carcinoma in situ, namely grade 3 cervical intraepithelial neoplasia (CIN3), registrations.

Despite the significant progress that has been made to eliminate vertical HIV infection, more than 150,000 children were infected with HIV in 2019, emphasizing the continued need for sustainable HIV treatment strategies and ideally a cure for children. Mother-to-child-transmission (MTCT) remains the most important route of pediatric HIV acquisition and, in absence of prevention measures, transmission rates range from 15 percent to 45 percent via three distinct routes: in utero, intrapartum, and in the postnatal period through breastfeeding.

Identifying the immune responses needed for protection against HIV is critical to finding an effective vaccine. In this issue of Cell Reports Medicine, Thomas and colleagues1 show that antibodies that kill infected cells correlate with infant HIV infection outcomes more so than antibodies that block viral entry.

Since their discovery, antibodies capable of broad neutralisation have been at the forefront of HIV-1 research and are of particular interest due to in vivo passive transfer studies demonstrating their potential to provide protection. Currently an exact definition of what is required for a monoclonal antibody to be classed as a broadly neutralising antibody (bnAb) has not yet been established. This has led to hundreds of antibodies with varying neutralisation breadth being studied and has given insight into antibody maturation pathways and epitopes targeted.