18 JUNE 2021 VOLUME 23 ISSUE 24

Media Coverage

• Intentionally Delayed Pharmaceutical Innovation Under Perverse Incentives: Gilead’s HIV Pipeline As A Case Study

  As Congress continues its attention to pharmaceutical development and prices, the US Senate Committee on Finance’s Subcommittee on Fiscal Responsibility and Economic Growth has called for a hearing entitled “Promoting Domestic Competition and International Competitiveness.” The Subcommittee has invited Gilead Sciences CEO, Daniel O’Day to testify about the current state of competition in the pharmaceutical industry and the impact of Gilead’s pricing decisions on access.

  June 16, 2021

  PrEP

  Health Affairs

• How Children Are Paying the Price in Pakistan’s Mass HIV Outbreak

  Since his son was diagnosed with HIV during a mass outbreak among babies and children in Pakistan, Shahzado Shar has often been forced to choose between food and medicine. His five-year-old was one of the hundreds who tested positive in 2019 after a whistle-blower doctor uncovered a scandal involving the reuse of needles in southern Sindh province.

  June 15, 2021

  General

  Al Jazeera

• New ACON Campaign Focuses on PrEP for Mandarin Speaking Gay Men

  HIV diagnosis among overseas-born gay and bisexual men, especially those who have come to Australia from Asia, has increased from 28 per cent in 2008 to 52 per cent in 2017, according to the Australian Annual Surveillance report. Now, a new video campaign in Mandarin from ACON hopes to reach out to this vulnerable population to raise awareness about HIV prevention drug PrEP.

  June 15, 2021

  PrEP

  Star Observer

• People Who Use Drugs Who Are Homeless Good Candidates for PrEP With Appropriate Support

  The Boston Health Care for the Homeless Program more than doubled the number of PrEP prescriptions among people who use drugs who are experiencing homelessness compared to the previous year after adopting an innovative, low-threshold model of care.

  June 15, 2021

  PrEP

  aidsmap

• UN 5th High Level Meeting on HIV/AIDS: Civil Society Says “Yes — AND” to the 2021 Political Declaration

  On Tuesday (June 8), the UN General Assembly voted overwhelmingly to approve the 2021 Political Declaration on HIV and AIDS introduced as part of the now fifth High Level Meeting on HIV/AIDS. Previous Declarations were accepted by unanimous consent, following months of negotiations. This year’s Political Declaration includes much to applaud, including new ambitious targets for prevention, investment goals to ensure everyone who needs treatment has access to it, and a financial and moral commitment to end gender inequality, stigma and discrimination.

  June 14, 2021

  General

  Science Speaks

• COVID-19 to HIV Vaccines: Lessons Learnt From the COVID-19 Vaccine Development

  Vaccine development is an important strategy for the prevention of infectious diseases and reducing the morbidity and mortality rates. Researchers have been working on finding an HIV vaccine since the 1980s but the development of an effective vaccine has been slow-moving.

  June 14, 2021

  HIV Vaccine

  Health-E News

• To Vaccinate Our Economy, Boost Support for the NIH

  The National Institutes of Health (NIH) is the world’s single largest funder of medical research, the very fuel that feeds the American engine of medical discovery and the linchpin to our country’s post-COVID economic recovery. The Biden administration is proposing to fund the NIH at $52 billion in 2022, a 21 percent increase over the current level. It’s a good start, but not nearly enough.

  June 13, 2021

  General

  Fortune

• Young Women in Sub-Saharan Africa Still the Most Affected by HIV/AIDS

  The goal to end AIDS by 2030 could be achievable according to the latest United Nations AIDS (UNAIDS) report, and while many countries have taken great strides to end their HIV epidemics, some countries and entire regions may have stalled their progress.

  June 13, 2021

  PrEP, Treatment

  IOL

• HIV Stigma: A Vicious Cycle for Women

  Research in rural Kenya and Uganda has again highlighted the persistence of HIV-related stigma, and the damaging impact it has. In particular, it found women were likely to both hold and be the targets of negative attitudes.

  June 11, 2021

  Treatment

  Avert

• Change to Gilead Assistance Program Threatens PrEP Access, HIV Advocates Say

  Dr. John Carlo is concerned that patients at Prism Health North Texas who rely on the health care safety net will soon be struggling even more to stay on PrEP, a medication that prevents HIV transmission.

  June 11, 2021

  PrEP

  PBS NewsHour

• Cross-Sector Partnerships: The Fight Against HIV/AIDS Is Everyone’s Business

  With COVID-19 having engulfed the entire globe, HIV prevention, testing, treatment and care services are being disrupted, particularly in countries with fragile health systems. This is a major threat to the gains we’ve made fighting the HIV/AIDS epidemic, because we know that any slowing down of these initiatives will leave many vulnerable populations at greater risk of infection.

  June 10, 2021

  General

  Daily Maverick

• HIV/AIDS and COVID: A Dual Battle

  The rapid and devastating movement of COVID around the world has eclipsed other health priorities over the last 18 months. The emergence of SARS-CoV-2 has overcome fragile health systems, led to the deaths of over 3.7 million people and reversed decades of progress on expanding social protection, education, child protection, and gender equality. In the shadow of this new pandemic, we have also seen some of the hard-won gains against HIV, TB, and malaria begin to unravel—especially in countries where COVID vaccination is scarce.

  June 7, 2021

  General

  Think Global Health

Published Research

• Perceived Social Influences on Women's Decisions to use Medications not Studied in Pregnancy. A Qualitative Ethical Analysis of Preexposure Prophylaxis Implementation Research in Kenya

  Our study reveals that women navigate a complex network of social influences, expectations, support, and gender roles, not only with male partners, but also with clinicians, family, and friends when making decisions about PrEP or other drugs that lack complete safety data during pregnancy.

  June 16, 2021

  PrEP

  Journal of Empirical Research on Human Research Ethics

• Evidence of an Untamed HIV Epidemic Among Msm and Tgw in Rio de Janeiro, Brazil: A 2018 to 2020 Cross-Sectional Study Using Recent Infection Testing

  Our results suggest that the HIV epidemic in Rio de Janeiro, Brazil, continues to disproportionately burden vulnerable populations, including MSM and TGW despite the existence and availability of effective preventive and therapeutic interventions.

  June 16, 2021

  General

  JIAS

• Understanding Willingness to Participate in HIV Biomedical Research: A Mixed Methods Investigation

  Across all procedures, there was greater willingness to participate if asked by a primary care provider and if experimental results were shared. However, half of participants reported that they would experience undue influence (i.e., excessive persuasion) to participate from their primary care provider. In thematic analyses, altruism and personal benefit were identified as facilitators while medication changes, confidentiality, and perceived stigma were identified as barriers to participation in HIV biomedical research.

  June 15, 2021

  General

  AIDS and Behavior

• Phase 1 Pharmacokinetics and Safety Study of Extended Duration Dapivirine Vaginal Rings in the United States

  The extended duration DPV rings were well-tolerated and achieved higher DPV concentrations compared with the monthly DPV ring. These findings support further evaluation of three-month DPV rings for HIV prevention.

  June 12, 2021

  Microbicides

  JIAS

• Epidemic of HIV Infection Among Persons Who Inject Drugs in Mainland China: A Series, Cross-Sectional Study

  Although the HIV prevalence has been declining in general population, the HIV prevalence among persons who inject drugs (PWIDs) has shown an increasing trend since 2010. Current policies on HIV control in PWIDs should be reassessed.

  June 12, 2021

  General

  Harm Reduction Journal

• Prevalence, Recent Infection and Predictors of HIV Infection in Fishing Community Along the Shore of Lake Victoria in Tanzania

  A proportion of HIV recent infection among the fisherfolks was relatively high, signifying the continuous spread, which is predisposed by some demographic and behavioural characteristics.

  June 12, 2021

  General

  Journal of Public Health

• Incorporating Oral PrEP Into Standard Prevention Services for South African Women: A Nested Interrupted Time-Series Study

  On-site access to PrEP as part of standard of prevention in a clinical trial among women in South Africa was associated with halving HIV incidence, when approximately a quarter of women started PrEP. Providing access to on-site PrEP could decrease incidence in HIV prevention trials. These data are also among the first to show in any setting that access to PrEP is associated with decreased HIV acquisition among South African women.

  June 11, 2021

  PrEP

  Lancet HIV

• Correlates of Adherence to the Dapivirine Vaginal Ring for HIV-1 Prevention

  Using data from a randomized, double-blind, placebo-controlled, phase III trial of the dapivirine vaginal ring conducted in four African countries, generalized estimating equation models were used to evaluate correlates of ring adherence.... Time on study, calendar time, primary partner knowledge that the participant was taking part in the study, and use of long-acting contraceptive methods were associated with ring adherence whereas younger age, ring worries, condom use, episodes of menstrual bleeding and vaginal washing were associated with non-adherence.

  June 11, 2021

  Microbicides

  AIDS and Behavior

• Making Voluntary Medical Male Circumcision Services Sustainable: Findings From Kenya’s Pilot Models, Baseline and Year 1

  Sustainability-focused circumcision service delivery models can successfully achieve target volumes at lower unit expenditures than existing models, but strategies for domestic financing remain a crucial challenge to address for long-term maintenance of the program.

  June 11, 2021

  Voluntary Medical Male Circumcision

  PLOS One

• Knowledge About Mother to Child Transmission of HIV/AIDS, Its Prevention and Associated Factors Among Reproductive-Age Women in Sub-Saharan Africa: Evidence From 33 Countries Recent Demographic and Health Surveys

  Knowledge about mother to child transmission (MTCT) of HIV/AIDS and its prevention among reproductive-age women in SSA was low. Therefore, it is better to consider the high-risk groups during the intervention to increase awareness about this essential public health issue and to tackle its devastating outcome.

  June 11, 2021

  Treatment

  PLOS One

• Sexual Network and Condom Use Among Male Migrants in the Context of China’s Gender Imbalance

  Married male migrants were more likely to use condoms with casual partners; unmarried male migrants were less likely to use condoms in emotional and stable relationships. Variation in individual factors, sex partners, and sexual relationship characteristics contribute to participation in condomless sex by male migrants. HIV prevention strategies should target unmarried male migrants and their casual sex partners by increasing their awareness of the risk of HIV transmission and the availability of free condoms.

  June 11, 2021

  Male and Female Condoms

  AIDS Care

• Criminalization of Sexual and Gender Minorities and Its Consequences for the HIV Epidemic in Zambia: A Critical Review and Recommendations

  Anti-sexual and gender minority (SGM) legislation has limited legal protections for SGM people and increased vulnerability of criminal prosecution and HIV exposure, persistent stigma/discrimination, insufficient public health resources, and lessened access to HIV-related services. We recommend enacting legal protections for SGM people, decriminalizing anti-SGM laws, rectifying misinformation to destigmatize SGM people, targeting health care for SGM people, and including SGM people in the national HIV strategy.

  June 10, 2021

  General

  JANAC

• Coordinated FC-Effector and Neutralization Functions in HIV-Infected Children Define a Window of Opportunity for HIV Vaccination

  These results are consistent with previous observations that children may develop high levels of neutralization breadth. Furthermore, the striking association between neutralization breadth and Fc effector function suggests that HIV vaccination in children could yield multifunctional antibodies. Pediatric populations may therefore provide an ideal window of opportunity for HIV vaccination strategies.

  June 10, 2021

  HIV Vaccine

  AIDS

• Microbial Mismanagement: How Inadequate Treatments for Vaginal Dysbiosis Drive the HIV Epidemic in Women

  Here, we provide an overview of the mechanisms by which the vaginal microbiome may contribute to HIV acquisition risk. Furthermore, we address the advantages and limitations of historical treatments and emerging technologies under investigation to modify the vaginal microbiome, including: antibiotics, bacteriophages, probiotics, topicals, and engineered bacteria.

  June 10, 2021

  General

  Seminars in Immunology

• Reaching Early Adolescents With a Complex Intervention for HIV Prevention: Findings From a Cohort Study To Evaluate Dreams in Two Informal Settlements in Nairobi, Kenya

  Uptake of DREAMS interventions among a representative sample of early adolescent girls (EAG; aged 10–14 years) was high and quickly increased over the implementation period. The majority accessed multiple interventions, indicating that it is feasible to integrate and deliver a package of interventions to EAG in a challenging informal context.

  June 10, 2021

  General

  BMC Public Health

• Reaching Unaids 95-95-95 Targets Worldwide: Predicted Benefits and Treatment Costs With Generic Manufacture

  At $2 billion/year, the 164 countries in our analysis could be treated for the price of four weeks of current global sales. Global access to generic alternatives could reduce expenditure and improve clinical outcomes.

  June 9, 2021

  Treatment

  AIDS

• HIV PrEP Implementation: A Multi-Level Systems Approach

  The primary factors associated with increased PrEP uptake included co-location of navigation and clinical PrEP services and providing navigation to payment assistance programs. The evaluation results suggest that a multi-level framework that includes diverse support services is needed to implement a sustainable PrEP program.

  May 30, 2021

  PrEP

  Evaluation and Program Planning

• Knowledge From London and Berlin: Finding Threads to a Functional HIV Cure

  Developing a cure for HIV infection remains a high priority. In this review, we discuss the increasing progress of coreceptor-based hematopoietic stem cell gene therapy, cART, milder conditioning regimens, and shock and kill strategies that have important implications for designing potential strategies aiming to achieve a functional cure for the majority of people with HIV.

  May 27, 2021

  Cure

  Frontiers in Immunology

• Advancing HIV Broadly Neutralizing Antibodies: From Discovery to the Clinic

  Here, we review the development of bNAbs as therapies for HIV-1, exploring advances in discovery, insights from animal models and early clinical trials, and innovations to optimize their clinical potential through efforts to extend half-life, maximize the contribution of Fc effector functions, preclude escape through multiepitope targeting, and the potential for sustained delivery.

  May 26, 2021

  Antibody Related Research

  Frontiers in Public Health

• Dimensions of HIV-Related Stigma in Rural Communities in Kenya and Uganda at the Start of a Large HIV ‘Test and Treat’ Trial

  Narratives among women, in particular, revealed acute internalized stigma including feelings of worthlessness, shame, embarrassment, and these resulted in anxiety and depression, including suicidality among a small number of women. Anticipated stigma included fears of marital dissolution, verbal and physical abuse, gossip and public ridicule. Anticipated stigma was especially salient for women who held internalized stigma and who had experienced enacted stigma from their partners. Anticipated stigma led to care avoidance, care-seeking at remote facilities, and hiding of HIV medications.

  May 17, 2021

  Treatment

  PLOS One

Announcements