15 APRIL 2022 VOLUME 24 ISSUE 15

After three years of squabbling, Bristol Myers Squibb has agreed to pay up to $11 million to settle a lawsuit that accused several drugmakers of conspiring to block generic competition to HIV medicines.

A nurse-led multidisciplinary initiative targeted at providers and medical staff doubled the number of patients who scheduled a follow-up routine visit for HIV preexposure prophylaxis, or PrEP.

The United Nations Population Fund recently released the 2022 State of World Population report. It highlights that almost half of all pregnancies between 2015 and 2019 were unintended. That amounts to roughly 121 million unintended pregnancies each year.

In 2019, the Mexican government cut all funding for civil society organizations, including those funded via the National Center for the Prevention and Control of HIV and AIDS, which was responsible for most of the country’s syringe service programs. When the pandemic hit a year later, the US-Mexico border closed, throwing the drug supply into chaos and disrupting cross-border health care services.

In Amsterdam, the waitlist for the GGD's PrEP program stretches to 500 people and the program has been full since last autumn, said the head of the Center for Sexual Health. Around 20 people per week sign up for the PrEP program online. In Utrecht, the AD reports that 300 people are currently on the GGD's waiting list to receive pills preventing an HIV infection, and some became infected with the virus while waiting.

Researchers in Kenya have kickstarted trials for injectable HIV drugs cabotegravir and rilpivirine. The World Health Organisation 2020, licensed a combination of the two ARVs as injectable given once every two months. However, studies that led to this licensing were mostly done in Europe, Americas and Asia whose populations and socioeconomic backgrounds significantly differ from Africa.

This is the first study to investigate PrEP-taking experiences incorporating established medication adherence taxonomy. We highlight key experiences regarding the initiation, implementation and persistence with PrEP and describe how taking PrEP may promote positive engagement with sexual health services. These findings may be useful for informing PrEP rollout programmes and need to be explored in other key populations.

There are inequities in PrEP uptake across communities at higher risk for HIV—Black and Hispanic communities, cisgender women, transgender women, and people living in the South—because of high brand-name medication costs and limited access to financial resources to cover costs of PrEP-associated medical visits and laboratory tests, among other factors.5Counterintuitively, the most updated available PrEP-utilization data demonstrate that health systems and public health efforts have been less effective at reaching those most at risk for HIV.

Here we report on a clinical study in which people living with HIV received seven doses of a combination of two broadly neutralizing antibodies over 20 weeks in the presence or absence of ART. Without pre-screening for antibody sensitivity, 76 percent (13 out of 17) of the volunteers maintained virologic suppression for at least 20 weeks off ART. Individuals in whom virus remained suppressed for more than 20 weeks showed rebound viraemia after one of the antibodies reached serum concentrations below 10 µg ml−1. Two of the individuals who received all seven antibody doses maintained suppression after one year. Reservoir analysis performed after six months of antibody therapy revealed changes in the size and composition of the intact proviral reservoir. By contrast, there was no measurable decrease in the defective reservoir in the same individuals. These data suggest that antibody administration affects the HIV-1 reservoir, but additional larger and longer studies will be required to define the precise effect of antibody immunotherapy on the reservoir

Addressing IPV and relationship dynamics remain important factors influencing HIV risk, and addressing these within the context of PrEP delivery is an important synergistic opportunity. CHARISMA was highly acceptable to participants, and further adaptation and testing of the intervention to other populations and settings will augment the evidence base.

Reaching the first UNAIDS 90 target by the end of this project seems possible. Future strategies should focus on improving PITC coverage, implementing more targeted testing modalities, together with current universal community-based approach.

Peer-led PrEP interventions require funding and foregrounding, particularly for women and non-binary people who are Black, trans, migrants, and people of colour, situated relative to their wider health needs, life pressures, and priorities. This requires concurrent challenge of the racist and patriarchal structures that continue to obscure the sexual and reproductive health needs of racially minoritized and marginalized women and non-binary people.

Respondents identified an ideal cure strategy as one which would durably control HIV infection, protect the individual from re-acquisition, and eliminate transmission to others. Known and unknown risks should be anticipated and perceived as learning opportunities to preserve and honor the altruism of participants. Preclinical studies should support these considerations and be transparently reviewed by regulatory experts and peers prior to first-in-human studies. To protect the public trust in CGT HIV cure research, ethical and practical considerations should be periodically revisited and updated as the science continues to evolve. Additional ethics studies are required to expand stakeholder participation to include traditionally marginalized groups and clinical care providers.

Here, we utilized a diverse phage-display library to construct T cell receptor (TCR)-mimic antibodies to HIV-1 peptide-major histocompatibility complexes (pMHC). We show that single-chain diabody forms of these antibodies recognize distinct epitopes in Gag and reverse transcriptase in a specific manner and induce T cell-mediated killing of HIV-1–infected CD4+ T cells. This study lays the groundwork for future exploration of pMHC-based immunotherapeutic approaches toward elimination of the latent reservoir once effective latency-reversing strategies are developed.

Here, we analyze why so many HIV-1 vaccines have failed, summarize the outcomes of vaccination in NHPs and humans, and discuss the value and pitfalls of hunting for CoPs other than NAbs. We contrast the failure to find a consistent CoP for HIV-1 vaccines with the identification of NAbs as the principal CoP for SARS-CoV-2.