17 JANUARY 2020 VOLUME 21 ISSUE 2

Media Coverage

• For Black New Yorkers, HIV Progress Is Challenged by Housing Costs and Trump Anti-Immigrant Policies

  As New York City touts numbers showing a near-end to its four-decade epidemic, Manhattan’s HIV population is divided between middle-class gay men and a low-income, Black and Brown and heavily immigrant community in Harlem struggling with more than the virus.

  January 17, 2020

  The Body

• HIV Infections Among Gay and Bi Men Fall by 71 percent in UK

  The number of people diagnosed with HIV in the UK has dropped substantially since 2012, according to figures released by Public Health England.

  January 16, 2020

  PrEP

  BBC

• HIV Prevention: Employed or Unemployed – Who Is More Likely to Be HIV-Positive?

  In many areas in South Africa, HIV is spreading faster among those with jobs than people without employment. Yet employers refuse to implement HIV programmes — even when they’re offered for free.

  January 16, 2020

  Treatment, Voluntary Medical Male Circumcision

  Daily Maverick

• Despite Outbreak, Ebola Treatment and Vaccine Represent ‘Resounding Scientific Success’

  Recently, the FDA formally approved the first vaccine to prevent the Ebola virus. The advance comes at a crucial time, as Democratic Republic of Congo is suffering an outbreak that has lasted over a year and a half and sickened more than 3,000. But the death toll would be much higher without the unprecedented rate of medical progress in treatment.

  January 16, 2020

  General

  PBS News Hour

• Targeting HIV "Hotspots" May Not Be Effective for Ending the Epidemic

  HIV prevention investigators sometimes identify particular regions with a high density of HIV prevalence as “hotspots.” These hotspots are often believed to be disproportionately involved in new HIV transmission compared with other areas and are subjected to targeted interventions.

  January 16, 2020

  General

  Contagion Live

• First Malaria Vaccine Tried Out in Babies in Three African Nations

  A pinch in the leg, a squeal and a trickle of tears. One baby after another in Malawi is getting the first and only vaccine against malaria, one of history’s deadliest and most stubborn of diseases.

  January 16, 2020

  AP News

• Neural Tube Defect Prevalence Similar Between Infants Exposed to HIV and General Population

  A new investigation published by the US Centers for Disease Control and Prevention (CDC) in the Morbidity and Mortality Weekly Report indicates that neutral tube defect (NTD) prevalence is similar between infants exposed to HIV during pregnancy and unexposed infants.

  January 15, 2020

  Treatment

  Contagion Live

• Truvada Should Remain First Choice for PrEP, Experts Argue

  Claims about the superiority of Descovy, the new pre-exposure prophylaxis (PrEP) option, are “overstated,” and Truvada remains a highly effective and safe choice for the vast majority of PrEP users, according to a commentary in the Annals of Internal Medicine.

  January 14, 2020

  PrEP

  POZ

• In Search of Comprehensive HIV Prevention

  A nightclub at Balaka Town is bulging with sex workers and their clients in search of pleasure and money. Within the compound, faint lights from florescent tubes are casting small beams onto an entrance into an adjoining room.

  January 13, 2020

  PrEP

  The Times Malawi

• Activists Call for Single Method for Pregnancy and HIV Protection

  After a trial ruled out any increased risks of HIV acquisition associated with use of contraceptives – implants, depo provera injections and copper inter uterine device, activists are now calling for research into a method that can provide double protection against both HIV and pregnancy when used concurrently.

  December 18, 2019

  Hormonal Contraceptives and HIV, PrEP

  The Independent

Published Research

• Brief Report: Sexual Mixing Patterns by HIV Status and PrEP Use Among Men Who Have Sex With Men Partnerships in Melbourne, 2011–2018

  The pattern of sexual mixing by HIV status and PrEP use among MSM partnerships has changed over time. PrEP use in both men within MSM partnerships is not common. About 79 percent of concordant HIV-negative partnerships were not protected against HIV as neither man taking PrEP.

  February 1, 2020

  PrEP

  JAIDS

• Brief Report: Phase IIa Safety Study of a Vaginal Ring Containing Dapivirine in Adolescent Young Women

  Young women aged 15–24 years are disproportionately affected by the HIV epidemic. Two phase III trials of a vaginal ring containing 25-mg dapivirine demonstrated HIV-1 risk reduction in adult women older than 21 years but not in those aged 18–21 years. Lack of protection was correlated with low adherence. The dapivirine vaginal ring, a promising topical microbicide, was well tolerated and acceptable in young US adolescents.

  February 1, 2020

  Microbicides

  JAIDS

• The Mediating Role of Partner Selection in the Association Between Transactional Sex and HIV Incidence Among Young Women

  Both partner age difference and partner number mediate the relationship between transactional sex and incident HIV infection. Through this mediation analysis, we provide important longitudinal evidence to suggest that young women who engage in frequent transactional sex select multiple partners, often older male partners that may be part of higher risk sexual networks.

  February 1, 2020

  General

  JAIDS

• HIV Partner Service Delivery Among Transgender Women — United States, 2013–2017

  Providing partner services to index transgender women and transgender women partners requires additional efforts to address the social and structural barriers unique to this population, provide timely prevention services, help reduce HIV transmission, and end the HIV epidemic in the United States.

  January 17, 2020

  General

  Morbidity and Mortality Weekly Report (MMWR)

• Evaluating DREAMS HIV Prevention Interventions Targeting Adolescent Girls and Young Women in High HIV Prevalence Districts in South Africa: Protocol for a Cross-Sectional Study

  Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a ‘real world, non-trial setting’.

  January 16, 2020

  BMC Women's Health

• Leveraging Community Engagement: The Role of Community-Based Organizations in Reducing New HIV Infections Among Black Men Who Have Sex with Men

  Culturally appropriate HIV prevention interventions that explicitly acknowledge the social determinants of health, particularly stigma and discrimination, both racial and sexual, are critical to reducing the number of new infections. These culturally appropriate and locally derived HIV prevention interventions provide a model for HIV health-care providers, public health officials, and community leaders to address the unique needs of Black MSM.

  January 15, 2020

  General

  Journal of Racial and Ethnic Health Disparities

• Community Perspectives on Barriers and Challenges to HIV Pre-Exposure Prophylaxis Access by Men Who Have Sex With Men and Female Sex Workers Access in Nigeria

  Although MSM and FSW are interested in the use of PrEP, numerous individual and structural barriers need to be addressed to facilitate access to it in Nigeria.

  January 15, 2020

  PrEP

  BMC Public Health

• Economic Compensation Interventions to Increase Uptake of Voluntary Medical Male Circumcision for HIV Prevention: A Systematic Review and Meta-Analysis

  Economic compensation interventions, particularly transport/food vouchers, positively impacted VMMC uptake among adult men and were generally acceptable to potential clients. Carefully selected economic interventions may be a useful targeted strategy to enhance VMMC coverage.

  January 15, 2020

  Voluntary Medical Male Circumcision

  PLoS One

• Crowdsourcing Contests to Facilitate Community Engagement in HIV Cure Research: A Qualitative Evaluation of Facilitators and Barriers of Participation

  Our data identified facilitators and barriers of participation in HIV cure crowdsourcing contests in China. Our findings could complement existing HIV community engagement strategies and help to design HIV contests for community engagement in other settings, particularly in low- and middle-income countries.

  January 15, 2020

  Cure

  BMC Public Health

• Glycan Profiles of gp120 Protein Vaccines From Four Major HIV-1 Subtypes Produced From Different Host Cell Lines Under Non-GMP or GMP Conditions

  ur data confirmed previous studies in the field showing high abundance of oligomannose on Env protein, with 40-50 percent of glycans having Man5-Man9 on all four proteins under all production conditions. Overall the differences in occupancy and glycan forms among Env from different subtypes produced under different conditions were less dramatic than anticipated and antigenicity analysis with a panel of six monoclonal antibodies showed that all four gp120s maintained their antibody-binding profiles, including antibodies that recognize glycan forms.

  January 15, 2020

  HIV Vaccine

  Journal of Virology

• Tenofovir Alafenamide for HIV Preexposure Prophylaxis: What Can We DISCOVER About Its True Value?

  Daily preexposure prophylaxis (PrEP) with a single pill containing tenofovir disoproxil fumarate with emtricitabine (TDF–FTC) virtually eliminates sexual HIV transmission, and scale-up of PrEP is a critical component of the federal initiative. Before TDF–FTC was used for PrEP, it was a cornerstone of HIV treatment, but it has been largely replaced by tenofovir alafenamide with emtricitabine (TAF–FTC), a newer regimen that was believed to be equally effective but safer.

  January 14, 2020

  PrEP

  Annals of Internal Medicine

• Quantifying HIV Transmission Flow Between High-Prevalence Hotspots and Surrounding Communities: A Population-Based Study in Rakai, Uganda

  Cross-community HIV transmissions between Lake Victoria hotspots and surrounding inland populations are infrequent and when they occur, virus more commonly flows into rather than out of hotspots. This result suggests that targeted interventions to these hotspots will not alone control the epidemic in inland populations, where most transmissions occur. Thus, geographical targeting of high prevalence areas might not be effective for broader epidemic control depending on underlying epidemic dynamics.

  January 14, 2020

  General

  Lancet HIV

• A Pharmacist-Led, Same-Day, HIV Pre-Exposure Prophylaxis Initiation Program to Increase PrEP Uptake and Decrease Time to PrEP Initiation

  This pilot program suggests that an on-site pharmacist working in a nonclinical testing center in the southern United States can successfully initiate PrEP among predominately low-income black MSM. Future efforts should seek to better integrate laboratory testing into this demedicalized model of PrEP and to improve retention in care.

  January 14, 2020

  PrEP

  AIDS Patient Care and STDs

• Usability Assessment of Seven HIV Self-Test Devices Conducted With Lay-Users in Johannesburg, South Africa

  The UI (usability index) and interpretation of results was high and in-line with previous usability studies, suggesting that these kits are appropriate for use in the general, untrained and unsupervised public.

  January 14, 2020

  General

  PLoS One

• Same-Day Antiretroviral Therapy Initiation for HIV-Infected Adults in South Africa: Analysis of Routine Data

  SDI (same-day initiation) has increased over time as per national guidelines, but there is serious concern regarding the reduced rate of retention among same-day initiators. Nevertheless, SDI may result in a net programmatic benefit provided that interventions are implemented to support client readiness for treatment and ongoing engagement in ART care, particularly among younger adults in large ART programmes such as Johannesburg.

  January 14, 2020

  Treatment

  PLoS One

• Key Barriers and Enablers Associated With Uptake and Continuation of Oral Pre-Exposure Prophylaxis (PrEP) in the Public Sector in Zimbabwe: Qualitative Perspectives of General Population Clients at High Risk for HIV

  Results of this study can be used to provide operational guidance for national public sector roll-out of PrEP as part of combination HIV prevention in Zimbabwe. Based on feedback and experiences of clients, the training materials for health workers can be refined to ensure that health workers are prepared to counsel clients on the decision to start and/or continue PrEP and answer common client questions. Program advertisements should also be targeted with key messages that speak to client experiences.

  January 13, 2020

  PrEP

  PLoS One

• The State of the HIV Epidemic in Rural KwaZulu-Natal, South Africa: A Novel Application of Disease Metrics to Assess Trajectories and Highlight Areas for Intervention

  Using data from a population-based cohort study, we report impressive progress toward HIV epidemic control in a severely affected South African setting. However, overall progress is off track for 2020 targets set by the UNAIDS. Spatial estimates of the metrics, which demonstrate remarkable heterogeneity over place and time, indicate areas that could benefit from additional or optimized HIV prevention services.

  January 13, 2020

  General

  International Journal of Epidemiology

• Service Delivery Interventions to Increase Uptake of Voluntary Medical Male Circumcision for HIV Prevention: A Systematic Review

  Innovative changes in male-centered VMMC services can improve adult men’s and adolescent boys' VMMC uptake. Limited evidence on interventions that enhance access and acceptability show promising results, but evidence gaps persist due to inconsistent intervention definition and delivery, due in part to contextual relevance and limited age disaggregation.

  January 13, 2020

  Voluntary Medical Male Circumcision

  PLoS One

• Perceptions of and Interest in HIV Pre-Exposure Prophylaxis Use Among Adolescent Girls and Young Women in Lilongwe, Malawi

  General interest in PrEP among AGYW was high. Discrete packaging and access to youth-friendly PrEP delivery modalities may facilitate the utilization of PrEP as a prevention strategy among sexually active AGYW. Attention to potential negative reactions from partners and community members to PrEP use will be needed when introducing PrEP to this population.

  January 13, 2020

  PrEP

  PLoS One

• PrEP Implementation Behaviors of Community-Based HIV Testing Staff: A Mixed Methods Approach Using Latent Class Analysis

  A subset of HIV testing staff differentially discuss PrEP based on perceived client eligibility; others inconsistently talk to clients about PrEP. Targeted training based on PrEP implementation groups may be beneficial.

  January 13, 2020

  PrEP

  JAIDS

• PrEP4Love: The Role of Messaging and Prevention Advocacy in PrEP Attitudes, Perceptions, and Uptake Among YMSM and Transgender Women

  Social marketing campaigns are promising interventions that have the potential to alleviate barriers to HIV prevention, particularly among MSM and TW. Future research should evaluate the impact of these initiatives at multiple time points.

  January 13, 2020

  PrEP

  JAIDS

• A Couple-Focused, Integrated Unplanned Pregnancy and HIV Prevention Program in Urban and Rural Zambia

  Integrated HIV and unplanned pregnancy prevention can be implemented in low-resource public sector facilities. Combination services offered to couples mutually leverage HIV prevention and unplanned pregnancy prevention. The addition of long-acting reversible contraceptives is an important complement to the method mix available in government clinics. Demand creation in the clinic and in the community must be coordinated with a growing supply of well-trained providers.

  January 13, 2020

  General

  AJOG

• Using a Quality Improvement Approach in the Prevention of Mother-to-Child HIV Transmission Program in Uganda Improves Key Outcomes and Is Sustainable in Demonstration Facilities: Partnership for HIV-Free Survival

  Partnership for HIV-Free Survival’s QI approach increased exclusive breastfeeding (EBF), retention in care, and data completeness during the program. These benefits were sustained at demonstration but not at scale-up facilities.

  January 13, 2020

  Treatment

  JAIDS

• Medically, Traditionally, and Dually Circumcised Men in Lesotho: Population-Based Measurements of HIV/STI Infections, Sexual Risk Behaviors, and Service Use Patterns

  Our findings indicate other unmeasured behavioral factors may mitigate VMMC's protective effect against HIV and STI infections in dually circumcised men. Further research can help identify counseling and demand creation strategies for traditionally circumcised men presenting for VMMC.

  January 11, 2020

  Voluntary Medical Male Circumcision

  AIDS and Behavior

• Block-And-Lock Strategies to Cure HIV Infection

  In this review, we first describe the underlying mechanisms of HIV transcription and silencing. Next, we give an overview of the different block-and-lock strategies under investigation.

  January 10, 2020

  Cure

  Viruses

• Neural Tube Defects in Pregnancies Among Women With Diagnosed HIV Infection — 15 Jurisdictions, 2013–2017

  Current US recommendations state that dolutegravir is a preferred antiretroviral drug throughout pregnancy (with provider-patient counseling) and an alternative antiretroviral drug in women who are trying to conceive. Although no difference in NTD prevalence in HIV-exposed pregnancies was found, data on the use of integrase strand transfer inhibitors in pregnancy are needed to understand the safety and risks of these drugs during pregnancy.

  January 10, 2020

  Treatment

  Morbidity and Mortality Weekly Report (MMWR)

• Pharmacy PEP Access Intervention Among Persons Who Use Drugs in New York City: iPEPcare Study—Rethinking Biomedical HIV Prevention Strategies

  Biomedical HIV prevention uptake has not taken hold among Black and Latinx populations who use street-marketed drugs. A pilot intervention providing a PEP informational video and direct pharmacy access to a PEP starter dose was conducted among this population. Four study pharmacies were selected to help facilitate syringe customer recruitment (2012–2016).

  January 10, 2020

  General

  AIDS and Behavior

• Hormonal Contraception and HIV Acquisition Among Women: An Updated Systematic Review

  High-quality RCT data comparing use of DMPA, LNG implant and Cu-IUD does not support previous concerns from observational studies that DMPA-IM use increases the risk of HIV acquisition. Use of other hormonal contraceptive methods (oral contraceptives, NET-EN and implants) is not associated with an increased risk of HIV acquisition.

  January 9, 2020

  Hormonal Contraceptives and HIV

  BMJ Sexual and Reproductive Health

• Copper Intrauterine Device Use and HIV Acquisition in Women: A Systematic Review

  The collective evidence, including that from a large high-quality RCT, does not indicate an increased risk of HIV acquisition among users of Cu-IUDs.

  January 9, 2020

  General

  BMJ Sexual and Reproductive Health

• Vaginal Polyelectrolyte Layer-by-Layer Films Based on Chitosan Derivatives and Eudragit® S100 for pH Responsive Release of Tenofovir

  The multilayer films formed by a mixture of chitosan citrate and Eudragit® S100 proved to be the most promising, with zero toxicity, excellent mechanical properties, moderate swelling (<100 percent), high mucoadhesion capacity, and Tenofovir release of 120 h and 4 h in vaginal fluid and the simulated fluid mixture respectively.

  January 9, 2020

  Microbicides

  Marine Drugs

• Human Immunodeficiency Virus Prevention Strategies in China

  This review focuses on HIV prevention measures in general, such as education, testing, and counseling and in specific responses to transmission modes, such as blood safety, harm reduction for people who inject drugs, and condom promotion to reduce sexual transmission. We also assess newly developed prevention measures, such as prevention treatment, pre-exposure prophylaxis, post-exposure prophylaxis, male circumcision, and promising potential future preventions, including microbicides and vaccines. Based on this assessment, we provide recommendations for their implementation in China.

  January 6, 2020

  HIV Vaccine, Microbicides, PrEP, Treatment, Voluntary Medical Male Circumcision

  Chinese Medical Journal

• Community Inclusion in PrEP Demonstration Projects: Lessons for Scaling Up

  We briefly describe the community engagement strategies employed by seven Bill & Melinda Gates Foundation-funded PrEP demonstration projects and the lessons these projects offer for community engagement in PrEP implementation.

  December 17, 2019

  PrEP

  Gates Open Research

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