13 MAY 2022 VOLUME 24 ISSUE 19

Botswana is testing almost all pregnant women for HIV when they register for antenatal care and retesting HIV-negative women on multiple occasions: every three months during pregnancy, at labour and delivery if there hasn’t been a recent test, six to eight weeks after birth, and every three months whilst breastfeeding.

This is a story about infections, sex and underwear. More specifically, it’s about sexually-transmitted infections, oral sex and ultrathin, super-stretchy, vanilla-flavored panties. The Food and Drug Administration has authorized the panties to be considered protection against infections that can be transmitted from the vagina or anus during oral sex. It is a first for underwear.

About a year ago, Dr. Jesse Clark was taking care of people hospitalized with COVID when he met a man he'll never forget. "I thought he was sleeping," says Clark, who's an infectious disease specialist at the University of California, Los Angeles. The man was lying still in the bed. "But when I got around to the other side of the bed, he looked up at me and said, 'My mother just died of COVID. My cousin brought this into the family. She said she was wearing a mask, but she didn't. She got COVID. Now she's dead, too. She has two kids. What's going to happen to them?' "

South African researcher Dr. Edith Phalane is using big data to see which are the most effective HIV control programs in sub-Saharan Africa, with the goal of ending HIV/AIDS as an epidemic by 2030.

One individual treated with the broadly neutralizing antibody 3BNC117 plus the latency-reversing agent romidepsin remains in remission nearly four years after stopping antiretroviral therapy, according to study results presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2022). He and other study participants who received the antibody showed enhanced HIV-specific CD8 T-cell responses.

The COVID-19 pandemic is having a surprising silver lining — it's breathing new life into the fight against HIV by accelerating the development of a new type of HIV vaccine.

As someone who’s 52 and has lived with HIV for more than 20 years, I have to say I’ve very much enjoyed the PrEP (pre-exposure prophylaxis) revolution of the past decade among gay men. (To be clear, I mean some gay men—but more on that later.) Suddenly, after a lifetime of always using condoms—well, almost always—I found myself having good old-fashioned 1970s-style bareback sex with no unsexy pre-coital talk about serostatus. I’ve barely used a condom in the past 10 years. (And yes, I do get screened regularly for all those other sexually transmitted infections.)

For millions of people around the world, isolation has become synonymous with COVID-19. But in the early 1990s, Fijian woman Jokapeci Cati spent six months at home, unable to face the world, amid a global pandemic of a different kind – HIV/AIDS. Just 22 years old, Ms Cati had tested positive to the virus.

Here, we show that among HIV-infected women with broad and potent neutralization activity, more postpartum-transmitting women had a mappable plasma broadly neutralizing antibody (bnAb) specificity, compared to that of nontransmitting women, suggesting that the nontransmitting women more often have multispecific bnAb responses or bnAb responses that target uncommon epitopes. Such responses may be required for protection against vertical HIV transmission in the setting of maternal bnAb responses.

As we walk through the lobby of a modern clinic for the treatment of patients with human immunodeficiency virus (HIV) infection or review antiretroviral regimens in the electronic medical record, it is easy to forget the days when managing multidrug-resistant HIV-1 was routine. Although the advent of protease inhibitors has saved lives, many patients already had resistance mutations to then-available nucleoside reverse-transcriptase inhibitors (NRTIs).

PrEP is safe and effective in MSM, serodiscordant couples and PWIDs. Additional research is needed prior to recommending PrEP in heterosexuals. No RCTs reported effectiveness or safety data for other high-risk groups, such as transgender women and sex workers.

Differentiated approaches to deliver PrEP, create demand, and provide more intensive support for adherence and continuation may support scale-up of PrEP in Cameroon for equitable and prolonged impact on HIV prevention.

We found mixed interpretations of what the residual drug level (RDL) meant and strong emotional reactions with a focus on the external validation of the level itself. Counseling was critical to help participants process their reactions to the RDL and make decisions accordingly (i.e., persistence, adherence improvement, and/or switching to another HIV prevention method). Providing drug adherence feedback was complex to implement yet proved useful as a component of a multi-pronged adherence support strategy.

Community-based participatory research, co-led by community members, is an important strategy for identifying the multi-level individual, interpersonal, community, institutional and structural factors that increase HIV vulnerability in African, Caribbean, and Black (communities, notably anti-Black systemic racism. Study findings suggest the need for targeted community-based strategies and strategies aimed at reducing health system barriers to testing and care.

The current armamentarium for the treatment of HIV infection has advanced from taking multiple pills several times a day to a single-combination tablet daily. Now people living with HIV also have the promise of long-acting injectable antiretroviral treatment, such as long-acting injectable cabotegravir, an integrase strand inhibitor, together with rilpivirine, a long-acting nucleoside reverse transcriptase inhibitor.1 This advance in drug delivery is a potential game changer in the management of HIV infection.