20 DECEMBER 2019 VOLUME 20 ISSUE 49

Not disclosing HIV status to a sexual partner can land you in prison in Ohio and other states, even if they don't contract the disease. A move is underway to embrace medical science and change that.

Amid the ongoing impeachment hearings against Donald Trump, congress unveiled a spending package this week that mostly meets the $300 million request laid out in the government’s plan to end HIV by 2030.

A mobile application 'PrEP Uganda' can now be downloaded from the Google play store for those who might need to get Pre-Exposure Prophylaxis (PrEP), a course of HIV drugs taken by HIV-negative people to prevent infection.

Fishing communities on Lake Victoria are brimming with energy and ambition. This much seems evident from the bustle around boats and sheds lining the shore. But along with this dynamism comes many health challenges and risks, including lack of clean water and basic health care services, poor sanitation, high rates of drowning and high rates of HIV/AIDS infection.

Inad never planned on being an AIDS advocate. He was set to become a lawyer, enrolling in law school in Mindanao, an island in southern Philippines. But in 2011, in the middle of his studies, he received the news that changed that trajectory. Inad found out he was HIV positive.

Every year, the New York State Department of Health hosts an Ending the Epidemic Summit, and this year on Dec. 3 and 4, New York stakeholders in HIV prevention and care gathered in Albany to share best practices, learn from one another, and continue their encouragement toward the goals of the New York governor’s plan to end AIDS.

In sub-Saharan Africa, 42 percent of adolescent girls and young women living in urban areas and more than 50 percent of those living in rural areas had a pregnancy before the age of 18. Adolescent girls also comprise the majority of new HIV infections in this region. Four of every 5 new HIV infections among people ages 15-19 occur among girls.

Nearly half of the Nigerian GBMSM in this study had no prior awareness of PrEP, but after being informed about its potential benefits, the majority were willing to use it. However, PrEP uptake among Nigerian GBMSM remains low. Findings suggest that educational messages are necessary to ensure appropriate PrEP scale-up, especially tailored towards Nigerian GBMSM.

Although antiretroviral therapy (ART) provides immense benefits, it is not inexpensive. ARV drugs remain the largest cost driver. Hospital costs have remained low. Substantial costs of lifelong ART necessitate innovative, locally applicable strategies for ARV selection and use.

The Middle East and North Africa (MENA) is one of only two global regions where rates of HIV are currently on the rise. In Lebanon, new HIV infections are increasing most rapidly among young men who have sex with men (YMSM). While, the majority of YMSM in Lebanon report having recently engaged in condomless anal intercourse, many report reluctance to seek HIV prevention services for fear of stigma and discrimination. Pre-exposure prophylaxis (PrEP) is an effective alternative HIV prevention strategy but there is a dearth of research looking at willingness to take PrEP among YMSM in MENA.

Youth-focused TasP succeeds, in large part, because it protects HIV- adolescents entering the sexually active population; i.e., a population that would otherwise be at high risk not only for getting infected but also for spreading the virus to others. This protection of adolescents leads to a steadily expanding AIDS-free generation that drives the virus to extinction.

Here we show that IgG3 V2-specific broadly neutralizing antibodies from donor CAP256 mediated both enhanced cytotoxic functions and neutralization potency compared to an IgG1 variant. We demonstrate that the long hinge region of IgG3 facilitated this increased functionality. These data suggest that isotype may be tuned to enhance both neutralization and cytotoxic activity of broadly neutralizing antibodies that can be used to improve the efficacy of passive immunization strategies for HIV prevention.

Pre-exposure prophylaxis (PrEP) is not widely available in China. Previous studies reported low awareness and inconclusive findings on the acceptability of PrEP among Chinese men who have sex with men (MSM). Our findings may help inform PrEP messaging in areas where PrEP has yet to be scaled up.

SRH needs are constants throughout women’s lives. Small annual costs can become large costs when considered cumulatively over time. As South Africa and other countries grapple with increasing access to SRH services under the rubric of universal access, it is important to remember that individuals incur costs despite free care at the point of service. Policies that address geographic proximity and service quality would be important for reducing costs and ensuring full access to SRH services.

Regardless of race/ethnicity, not knowing one’s HIV status was a significant correlate of condomless receptive anal intercourse (CRAI) among younger men, whereas having a black sex partner was a significant correlate among older men. HIV prevention initiatives could address these and other correlates specific to race/ethnicity groups to target their prevention resources and messaging.

These results define the molecular development of a vaccine-induced HIV-1 glycan antibody, providing insight into why vaccines rarely elicit antibodies against the glycans on the HIV-1 outer coat protein.

Despite the low transmission rate in this cohort, reaching elimination will require further work, and this study illustrates several areas to improve implementation of PMTCT services and reduce paediatric infections including retesting at-risk HIV-negative mothers through the duration of breast feeding, infant HIV testing at any admission in addition to routine testing and improved counselling to prevent defaulting from treatment. Better data surveillance systems are essential for determining the implementation of PMTCT guidelines.

Fertility desires remain high post-HIV diagnosis. HIV services should include integrated reproductive health programs that address the fertility desires of clients and include considerations for fertility services.

An ultrasensitive LC-MS/MS assay has been developed and validated for the quantitation of dapivirine in breast milk. The described method meets validation acceptance criteria and has been applied to a phase 1 clinical trial.

Our work demonstrates that PLHIV expectations of ATI in cure-focused clinical trials do not align with current practices, with PLHIV less accepting of viremia during ATI and preferring less frequent monitoring. Clear education messages and careful consent processes need to be developed in relationship to ATIs in HIV cure research.