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19 FEBRUARY 2021 VOLUME 23 ISSUE 7

Media Coverage

  • Modern Art Paints Soweto Bright Pink To Advertise the Latest HIV Drug

    Over a period of fewer than two weeks, 20 bright pink murals began appearing around Soweto and Alexandra townships outside Johannesburg. The murals were positioned in high-visibility locations such as bus stops, community centres, health facilities, schools, taverns and free Wi-Fi hotspots.

    February 18, 2021
    Treatment
    Daily Maverick

  • My Experience With HIV/AIDS Dapivirine Ring

    Recently, the World Health Organization, (WHO) added the ring to WHO’s list of prequalified medicines. The action confirms that the device ring meets global standards for quality, safety and efficacy. This will help in guiding national and global procurement decisions, pending country regulatory approval for its use.

    February 18, 2021
    Microbicides
    CGTN

  • Rectal Lube May Need to Be Supercharged Before It’s Feasible

    Early human trials of a lubricant formulated specifically for anal sex and infused with the HIV prevention drug dapivirine showed higher drug concentrations in blood plasma than previous models. But those levels were still 35 percent lower than when people used the gel with an applicator, and the drug didn’t show up in rectal tissue at all.

    February 17, 2021
    Microbicides
    POZ

  • Counting the Cost of COVID-19 on HIV Care in Africa

    An analysis of COVID-19’s impact in KwaZulu-Natal – where 27 percent of adults are living with HIV – finds that rates of HIV testing halved in April 2020, the first month of lockdown. The weekly number of people starting antiretroviral treatment (ART) also fell by around 200.

    February 17, 2021
    General
    Avert

  • Unprotected African Health Workers Die as Rich Countries Buy Up COVID-19 Vaccines

    On 6 January, gastroenterologist Leolin Katsidzira received a troubling message from his colleague James Gita Hakim, a heart specialist and noted HIV/AIDS researcher. Hakim, chair of the department of medicine at the University of Zimbabwe, had fallen sick and had tested positive for COVID-19. He was admitted to a hospital in Harare 10 days later and moved to an intensive care unit (ICU) after his condition deteriorated. He died on 26 January.

    February 17, 2021
    General
    Science Magazine

  • Byanyima: Closing Inequality Gaps Will Halt HIV Infections

    This year, 2021, is of particular significance (to the global community) as it marks the 40th anniversary since the first reported cases of HIV. Forty years on, the fight is far from over.

    February 15, 2021
    General
    The Independent

  • PrEP Shortages Hit Pharmacies in Sydney, Melbourne

    A shortage of PrEP hit pharmacies in Sydney and Melbourne over the past couple of months, with some users reporting difficulties in securing their medication.

    February 15, 2021
    PrEP
    Star Observer

  • How Some HIV Controllers Contain the Virus

    Currently living in Sacramento, Loreen Willenberg, a 66-year-old landscape designer with HIV, is among a group referred to as “elite controllers,” individuals who aren’t on antiretroviral medications, have no symptoms of illness and possess a robust immune system with disease-fighting CD4 and CD8 T-cells that are highly active against HIV. According to the National Institutes of Health (NIH), elite controllers account for less than 0.5 percent of people living with HIV.

    February 15, 2021
    General
    POZ

  • An Exception to the Rule

    Afew months ago, Loreen Willenberg stood on the cusp of launching the website for her landscape design business. You could say the moment marked a return to her roots. In 2007, Willenberg, now age 66, walked away from her career as a landscaper and dedicated herself full-time to HIV research and advocacy. True, she had taken on this work for deeply personal reasons and found it immensely satisfying. But eventually, the pull of her innate and instinctive passion for working with the earth became too insistent to ignore.

    February 15, 2021
    General
    POZ

  • Staring Down the Stigma of Sexually Transmitted Diseases

    Ina Park’s résumé is impressive: She’s a physician, part of the faculty of the University of California, San Francisco, and a medical consultant on sexually transmitted diseases at the CDC. But these are not the credentials that gave me hope that she would write a great book about sexually transmitted infections and the stigma surrounding them.

    February 12, 2021
    General
    New York Times

Published Research

  • Brief Report: Modeling the Impact of Voluntary Medical Male Circumcision on Cervical Cancer in Uganda

    Planned VMMC scale-up to 90 percent coverage from current levels could prevent a substantial number of CC cases and deaths in the absence of rapid scale-up of HPV vaccination to 90 percent coverage.

    March 1, 2021
    Voluntary Medical Male Circumcision
    JAIDS

  • Epidemiology of HIV in the USA: Epidemic Burden, Inequities, Contexts, and Responses

    The HIV epidemic in the USA began as a bicoastal epidemic focused in large cities but, over nearly four decades, the epidemiology of HIV has changed. Public health surveillance data can inform an understanding of the evolution of the HIV epidemic in terms of the populations and geographical areas most affected.

    February 18, 2021
    General
    Lancet

  • HIV and Women in the USA: What We Know and Where To Go From Here

    We conclude that, to end the US HIV epidemic, substantially greater inclusion of US women in clinical research will be required, as will better prevention and treatment efforts, with universal access to health care and other supportive services that enable women to exercise agency in their own HIV prevention and care. Ending the epidemic will also require eliminating the race, class, and gender inequities, as well as the discrimination and structural violence, that have promoted and maintained the distribution of HIV in the USA, and that will, if unchecked, continue to fuel the epidemic in the future.

    February 18, 2021
    General
    Lancet

  • The Persistent and Evolving HIV Epidemic in American Men Who Have Sex With Men

    In the current era of pre-exposure prophylaxis and the undetectable equals untransmittable campaign, training of health-care providers to create culturally competent programmes for all MSM is crucial, since the use of antiretrovirals is foundational to optimising HIV care and prevention. Effective control of the HIV epidemic among all American MSM will require scaling up programmes that address their common vulnerabilities, but are sufficiently nuanced to address the specific sociocultural, structural, and behavioural issues of diverse subgroups.

    February 18, 2021
    General, PrEP, Treatment
    Lancet

  • Insurance Coverage and Financing Landscape for HIV Treatment and Prevention in the USA

    While uninsurance has drastically declined over the past decade, the USA trails other high-income countries in key HIV-specific metrics, including rates of viral suppression. In this paper in the Series, we provide an overview of the coverage and financing landscape for HIV treatment and prevention in the USA, discuss how the Affordable Care Act has changed the domestic health-care system, examine the major programmes that provide coverage and services, and identify remaining challenges.

    February 18, 2021
    General
    Lancet

  • The Opioid Crisis and HIV in the USA: Deadly Synergies

    If the USA is serious about HIV prevention among this group, stigma must be eliminated, discriminatory policies must change, and comprehensive health care must be accessible to all. Finally, root causes of the opioid epidemic such as hopelessness need to be identified and addressed.

    February 18, 2021
    General
    Lancet

  • Call to Action: How Can the US Ending the HIV Epidemic Initiative Succeed?

    The six papers in the Lancet Series on HIV in the USA have each examined the underlying causes of these challenges and laid out paths forward for an invigorated, sustained, and more equitable response to the US HIV epidemic than has been seen to date. The sciences of HIV surveillance, prevention, treatment, and implementation all suggest that the visionary goals of the Ending the HIV Epidemic initiative in the USA might be achievable. However, fundamental barriers and challenges need to be addressed and the research effort sustained if we are to succeed.

    February 18, 2021
    General
    Lancet

  • Ending the HIV Epidemic in US Latinx Sexual and Gender Minorities

    A focus of the US Ending the HIV Epidemic (EHE) initiative in 2019 was the 57 geographical areas with a high burden of new HIV diagnoses. Yet the most vulnerable populations are not usually well represented in the activities to implement this plan and have not benefited equally. Targeting the highest burden populations will be crucial for the success of the EHE initiative.

    February 18, 2021
    General
    Lancet

  • Same Script, Different Viruses: HIV and COVID-19 in Us Black Communities

    The Lancet Series on HIV in the USA describes the current state of the nation's HIV epidemic, including ongoing inequities and challenges for key populations and comorbidities. Black Americans have consistently shouldered many of these HIV inequities, a pattern also seen in the COVID-19 pandemic. The overlapping racial disparities related to COVID-19 and HIV, highlight lessons that policy makers, public health practitioners, providers, and communities can leverage in their strategies to eliminate the disproportionate burden of HIV and COVID-19 in Black communities.

    February 18, 2021
    General
    Lancet

  • Relationship Dynamics and Anticipated Stigma: Key Considerations for PrEP Use Among Tanzanian Adolescent Girls and Young Women and Male Partners

    Couples counseling for PrEP uptake and adherence might be a well-placed strategy for couples who are living without HIV to educate one another about the relationship benefits of using PrEP, thereby increasing its acceptance and adherence, addressing unequal power dynamics, and reducing associated relationship distrust. Community awareness and education about PrEP can help curb persistent PrEP stigma, including intersectional stigma.

    February 17, 2021
    PrEP
    PLOS One

  • “Yes, I’m Interested in Taking PrEP!”: PrEP Interest Among Women Respondents to the European Community-Based Survey “Flash! PrEP in Europe”

    These results show that women at HOR and those who perceived themselves to be at high risk are interested in using PrEP. There is a critical need for targeted information and improved access to PrEP to increase uptake of this HIV prevention tool to meet PrEP interest among women.

    February 17, 2021
    PrEP
    PLOS One

  • Depot Medroxyprogesterone Acetate (DMPA) Enhances Susceptibility and Increases the Window of Vulnerability to HIV-1 in Humanized Mice

    These findings suggest DMPA may enhance susceptibility to HIV-1 in Hu-mice by impairing the vaginal epithelial barrier, increasing vaginal target cells (including macrophages), and extending the period of time during which Hu-mice are susceptible to infection; mechanisms that might also affect HIV-1 susceptibility in women.

    February 16, 2021
    Hormonal Contraceptives and HIV
    Scientific Reports

  • The Search for an HIV Cure: Where Do We Go From Here?

    Since the first case of an HIV sterilizing cure was published, remarkable progress has been made in our understanding of the mechanisms behind HIV persistence. However, our goal of achieving a safe and broadly-available treatment for sustained HIV remission has proven elusive. In this supplement, we provide a series of articles reviewing the technical hurdles facing the field, key assays to measure HIV persistence and the next-generation of therapeutics for HIV remission.

    February 15, 2021
    Cure
    Journal of Infectious Diseases

  • Low Inducibility of Latent Human Immunodeficiency Virus Type 1 Proviruses as a Major Barrier to Cure

    The low inducibility of latent proviruses is a major problem for the shock-and-kill strategy for curing HIV-1 infection, which uses latency-reversing agents to induce viral gene expression and render infected cells susceptible to immune clearance. The latency-reversing agents developed to date are much less effective at reversing latency than T-cell activation. Taken together, these results indicate that HIV-1 eradication will require the discovery of much more effective ways to induce viral gene expression.

    February 15, 2021
    Cure
    Journal of Infectious Diseases

  • Challenges and Promise of Human Immunodeficiency Virus Remission

    In this review, we first outline challenges in targeting the HIV reservoir, including difficulties identifying HIV-infected cells, ongoing work elucidating the complex intracellular environment that contribute to HIV latency, and barriers to reactivating and clearing the HIV reservoir. We then review reported cases of HIV sterilizing cure and explore natural models of HIV remission and the promise that such HIV spontaneous and posttreatment controllers may hold in our search for a broadly-applicable strategy for the millions of patients living with HIV.

    February 15, 2021
    Cure
    Journal of Infectious Diseases

  • Antibodies for Human Immunodeficiency Virus-1 Cure Strategies

    Over the last decade, a multitude of human monoclonal antibodies that are broadly neutralizing across many HIV-1 subtypes have been identified and are currently being explored for HIV eradication strategies. Antibody development also includes novel Fc engineering approaches to increase engagement of effector cells and optimize antireservoir efficacy. In this review, we discuss the usefulness of antibodies for HIV eradication approaches specifically focusing on antibody-mediated strategies to target latently infected cells and options to increase antibody efficacy.

    February 15, 2021
    Antibody Related Research, Cure
    Journal of Infectious Diseases

  • The Emerging Role for CTL Epitope Specificity in HIV Cure Efforts

    In this review, we discuss the emerging role that CTLs have in HIV cure efforts, with particular emphasis on epitope specificity. Recent studies have demonstrated that successful in vivo containment of the virus is rooted in the specific targeting of fitness-constrained, mutation-resistant regions of the HIV proteome. We highlight these new insights, providing context with previous observations in HIV and other models of viral control, and delineate their translation into a therapeutic vaccine.

    February 15, 2021
    Cure, Therapeutic Vaccines
    Journal of Infectious Diseases

  • Challenges and Opportunities of Using Adoptive T-Cell Therapy as Part of an HIV Cure Strategy

    A successful HIV cure strategy will likely involve a durable and potent police force that can effectively recognize and eliminate remaining virus that may emerge decades after an individual undergoes an HIV cure regimen. T cells are ideally suited to serve in this role, but given the state of the HIV-specific T-cell response, it is unclear how to best restore HIV-specific T-cell activity prior initiation of a HIV cure strategy.

    February 15, 2021
    Cure
    Journal of Infectious Diseases

  • Research Gaps in Medical Treatment of Transgender/Nonbinary People

    With the growing number of transgender and gender-nonbinary individuals who are becoming visible, it is clear that there is a need to develop a rigorous evidence base to inform care practice. Transgender health research is often limited to HIV/AIDS or mental health research and is typically subsumed in larger studies with general LGBTQ focus. Although the number of knowledgeable health care providers remains modest, the model for the medical approach to transgender health is shifting owing to growing social awareness and an appreciation of a biological component.

    February 15, 2021
    General
    Journal of Clinical Investigation

  • The Block-and-Lock Strategy for Human Immunodeficiency Virus Cure: Lessons Learned from Didehydro-Cortistatin A

    Here we review the mechanisms by which didehydro–cortistatin A inhibition of Tat’s feedback loop transcriptional amplification results in epigenetic silencing of the HIV promoter, and we discuss the benefits and limitations of the block-and-lock approach for an HIV cure.

    February 15, 2021
    Cure
    Journal of Infectious Diseases

  • Preference for Daily Versus On-Demand Pre-Exposure Prophylaxis for HIV and Correlates Among Men Who Have Sex With Men: The China Real-World Oral PrEP Demonstration Study

    MSM in China prefer both daily and on‐demand PrEP when both regimens are provided free. Social structural factors and subjective risk of HIV infection have significant impacts on PrEP preference and use. The upcoming national PrEP guideline should consider incorporating both regimens and the correlates to help implement PrEP in China.

    February 15, 2021
    PrEP
    JIAS

  • A Phase 2b Study To Evaluate the Safety and Efficacy of VRC01 Broadly Neutralizing Monoclonal Antibody in Reducing Acquisition of HIV-1 Infection in Women in Sub-Saharan Africa: Baseline Findings

    This proof-of-concept, large-scale mAb study demonstrates the feasibility of conducting complex trials involving IV infusions in high-incidence populations in sub-Saharan Africa.

    February 11, 2021
    Antibody Related Research
    JAIDS

  • Feasibility and Successful Enrollment in a Proof-of-Concept HIV Prevention Trial of VRC01, a Broadly Neutralizing HIV-1 Monoclonal Antibody

    HVTN 704/HPTN 085 exceeded accrual and retention expectations. With exceptional safety of IV administration and operational feasibility, it paves the way for future large-scale mAb trials for HIV prevention and/or treatment.

    February 11, 2021
    Antibody Related Research
    JAIDS

  • Long-Term Virological Outcomes in Women Who Started Option B+ Care During Pregnancy for Prevention of Mother-to-Child Transmission of HIV in Dar Es Salaam, Tanzania: A Cohort Study

    High rates of viral suppression among women starting option B+ who remain in HIV care are sustainable, and might increase, at least up to 53 months. This rate might be further improved by addressing challenges of adolescent mothers, late presenters, and couples HIV testing at antenatal care.

    February 11, 2021
    Treatment
    Lancet HIV

  • Community Belonging and Attitudes Towards HIV Pre-Exposure Prophylaxis (PrEP) Among Transgender Women

    There were significant differences noted between trust in various communication channels and perceptions of PrEP; the least community-connected cluster had less trust and more negative perceptions of PrEP. Analyses suggest that psychographic differences exist based on perceived community belongingness in this population, and this in turn may be consequential in determining how information about PrEP is communicated and diffused to trans women for whom PrEP may be indicated.

    February 11, 2021
    PrEP
    AIDS and Behavior

  • Strengthening Measurement and Performance of HIV Prevention Programmes

    Indicators for the measurement of programmes for the primary prevention of HIV are less aligned than indicators for HIV treatment, which results in a high burden of data collection, often without a clear vision for its use. As new evidence becomes available, the opportunity arises to critically evaluate the way countries and global bodies monitor HIV prevention programmes by incorporating emerging data on the strength of the evidence linking various factors with HIV acquisition, and by working to streamline indicators across stakeholders to reduce burdens on health-care systems.

    February 9, 2021
    General
    Lancet HIV

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