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21 July 2017 VOLUME 18 ISSUE 29

Media Coverage

  • The road to IAS 2017: insights from International AIDS Society President Linda-Gail Bekker

    As we lead up to IAS 2017, the premier international HIV/AIDS scientific conference, Dr. Bekker shares some valuable perspectives with USAID HIV/AIDS Research Division Chief, Dr. Benny Kottiri.

    July 21, 2017
    USAID

  • What's Changed Since the Last HIV Meeting?

    As the world's top HIV experts head to Paris for an International AIDS Society meeting, word is we're still playing catch-up with the virus. And if resistance to antiretroviral drugs grows, things will only get worse.

    July 20, 2017
    Treatment
    Deutsche Welle

  • For first time in history, half of all people with HIV are getting treatment

    A new update on the global HIV/AIDS epidemic offers “scorecards” for countries....Collectively, the world receives high marks for its HIV/AIDS efforts from UNAIDS....But several countries are falling far short of...what it takes to bring an epidemic to an end, which essentially requires slowing the rate of virus transmission to the point that new infections peter out....The United States, surprisingly, did not provide enough finalized data for UNAIDS to fill out its scorecard.

    July 20, 2017
    Science

  • House committee approves foreign aid budget in late-night session

    On Wednesday, the US House of Representatives Committee on Appropriations approved a foreign affairs budget bill that would cut funding to the State Department, USAID, and other international agencies and organizations by $10 billion. ...Now...the bill can move to the full House of Representatives for a vote....Democrats objected to the overall funding level,...cuts to US foreign assistance programs and contributions to international organizations,...and expansion of [the] “global gag rule.”

    July 20, 2017
    Devex

  • Social scientists reveal structure of AIDS denialist online communities

    HSE researchers examined the structure of online communities of Russian AIDS denialists...and the manner in which they spread their ideas. The findings are published in American Behavioral Scientist. Having focused their study on Russia's largest AIDS denialist group, the researchers found it consistently ranking at the top of Google's search results for HIV. The group has over 15,000 participants and provides some 40 external links, mainly to other AIDS denialist online communities such as Vaccination Kills and others.

    July 20, 2017
    HSE

  • Report links US Gov global health funding to thousands of US jobs, millions lives saved

    As policymakers consider drastic budget cuts to US-sponsored global health and medical research initiatives, GHTC and Policy Cures Research have unveiled a new report – Return on Innovation – [that] provides an in-depth analysis of US government funding for global health research and development (R&D), as well as analysis of health impact and economic returns from these investments.

    July 20, 2017
    GHTC

  • How cows are helping the fight against HIV

    Scientists estimate that only about 20% of people infected with HIV produce what are called broadly neutralizing antibodies (bNAbs): naturally occurring antibodies that can defend a cell against the virus....[Says NIAID Director Anthony Fauci:]...”People infected do not seem to make really good antibodies”....In a new study published in Nature, researchers at the Scripps Research Institute, International AIDS Vaccine Initiative and Texas A&M University showed they were able to induce potent antibodies against HIV in cows.

    July 20, 2017
    Antibody Related Research
    Time

  • Scales tip in AIDS fight as death rates decline, treatment rates rise

    In its latest global report,...UNAIDS said there were particularly encouraging signs in Africa, [with]....Eastern and southern Africa...reducing new HIV infections by nearly 30 percent,....Malawi, Mozambique, Uganda, Zimbabwe...by 40 percent or more since 2010. And among the most significant impacts of a vast scale-up of HIV testing, treatment and prevention programmes, has been reduction of AIDS-related deaths, which have dropped by almost half since 2005.

    July 20, 2017
    Treatment
    Trust

  • AIDS Deaths are Almost Half of What They Were in 2005 — But Experts Worry Trump Could Reverse That

    A new report from the United Nations shows promising progress in treating the global HIV/AIDS crisis, but some experts worry President Donald Trump’s policy proposals might turn the trend right back around.

    July 20, 2017
    Mic

  • PrEP and lactic acidosis warnings: context matters

    Gilead recently relaunched the "Truvada.com"...But scrolling down the page, one is exposed to a myriad of alarming safety warnings, notably "lactic acidosis" and "severe liver problems," despite the fact that these side effects were not seen in any efficacy trials, demonstration projects or real world reporting.

    July 20, 2017
    PrEP
    The Body

  • Threatened HIV Funding Cuts in Limelight at IAS 2017

    Researchers, clinicians, and advocates converging in Paris for the International AIDS Conference 2017 will not only be talking about new HIV treatment and prevention and how to roll out innovative medications in a comprehensive, integrated way, they will also be making a case to funders...."If funders feel the progress we're making, it will create dividends in more ways than one," said International AIDS Society President Linda-Gail Bekker. "We may see some threatened cuts put on hold."

    July 19, 2017
    Medscape

  • HPV vaccine: anger over decision not to extend NHS scheme to boys

    The Joint Committee on Vaccination and Immunisation, which has been reviewing the HPV programme, concluded that it was “highly unlikely to be cost-effective” to extend the scheme to include adolescent boys as well as girls....The committee...said in an interim statement that studies “consistently show” boys are afforded “considerable herd protection” when there is high uptake of the vaccine in girls. Critics called the decision “indefensible”.

    July 19, 2017
    The Guardian

  • PrEP delays HIV detection in seroconverters but does not boost resistance risk

    Continuing pre-exposure prophylaxis (PrEP) in HIV seroconverters may delay HIV infection detection but does not increase the risk of drug resistance, researchers report.

    July 19, 2017
    PrEP
    Reuters

  • Gates is still gunning for HIV. Here's the latest

    While the Gates Foundation has seemingly eased up on its HIV funding from time to time, it has remained dogged in its goal “to accelerate the decline in HIV infection worldwide”....One area of focus in the foundation’s five-point strategy is improving diagnostic testing...[I]ts new partnership with OraSure Technologies underscores that. The foundation entered into a four-year, $20 million Charitable Support Agreement with OraSure for its OraQuick HIV Self-Test.

    July 18, 2017
    Inside Philanthropy

  • Escaping big pharma's pricing with patent-free drugs

    How’s this for a great deal? The US government funded research and development of a new vaccine against Zika. But the Army...is planning to grant exclusive rights to the vaccine to the manufacturer, Sanofi Pasteur, along with...up to $173 million. Sanofi will be free to charge US...health care providers and patients any price it wishes...[but] history suggests many Americans would not be able to afford it....But there’s one drug company that behaves differently.

    July 18, 2017
    NY Times

  • What do teens think about when they think about HIV?

    Teens today have never known a world where HIV was a certain death sentence....[D]espite (and in some cases, because of) teens’ lack of experience with the worst effects of the AIDS crisis, they remain an at-risk group...[L]ack of dialogue is key, according to the dozen or so experts—doctors, youth educators, youth living with HIV—I interviewed for this article.

    July 18, 2017
    Jezebel

  • Global health price tag could be $371 billion a year by 2030, WHO says

    Meeting life-saving global health targets by 2030 could require investments by donors and national governments of up to $58 per person per year, or $371 billion annually, the WHO said Monday. In a best case scenario of increasing investment to meet the goals, some 97 million premature deaths could be prevented between now and 2030, and up to 8.4 years of life expectancy could be added in some countries, the WHO said....While most countries can afford the funds needed, the poorest nations will need donor help, it added.

    July 18, 2017
    Reuters

  • Research tries 'shock and kill' to eliminate HIV

    In 2012, a University of North Carolina research group published a proof of concept for a cure called "shock and kill." They showed that cancer drug Vorinostat can "shock" some infected cells into producing HIV again. That brings the virus out of hiding so it can be "killed”....Once reactivated, those cells should self-destruct or be killed by the immune system....But the UNC team's findings confirm previous evidence showing that isn't happening. It's not yet clear why.

    July 17, 2017
    Cure
    VOA

  • Excluding pregnant women from clinical studies because they're classed as 'vulnerable' is 'harmful'

    Pregnant women are often ruled out of participating in clinical trials because they’re classified as a “vulnerable” group, and this creates a knowledge void around the impact of drugs taken during pregnancy and “unfairly excludes” them from taking part in clinical studies, concluded researchers writing in the Journal of Medical Ethics. “There is a desperate need to shift the paradigm to protect pregnant women through research, not just from research,” the researchers wrote.

    July 17, 2017
    Huffington Post

  • Three-year PrEP pilot begins in Wales

    A trial has begun in Wales to assess the use of the antiretroviral combination treatment emtricitabine/tenofovir disoproxil (marketed as Truvada) for pre-exposure prophylaxis (PrEP) against HIV infection. Announced on 28 April 2017 by Welsh health secretary, Vaughan Gething, the study aims to show the best way to provide the preventive treatment...in Wales. It is also hoped the pilot will help answer questions raised by the All-Wales Medicines Strategy Group about the cost-effectiveness of PrEP.

    July 17, 2017
    PrEP
    Pharmaceutical Journal

  • New CDC chief lays out priorities as agency faces cuts

    The new director of the CDC said she will prioritize a wide range of public health issues, from fighting infectious disease to strengthening early-childhood development, as the federal agency faces potentially substantial budget cuts....Brenda Fitzgerald said she would make a strong case for public health spending should the agency fall on tough times.

    July 17, 2017
    WSJ

  • Why Donald Trump is bad for the health of the world – in five charts

    [A]ccording to the Kaiser Family Foundation, Trump’s 2018 budget provides for the deepest cuts to global healthcare funding ever, [estimating that]...there would be at least 50,000 additional new HIV cases, at least 7,600 additional new TB cases, and decrease in women receiving contraception ranging from 6.5 million to 25 million. “These estimates are based on one-year budget cuts only; if funding levels remain at the new, reduced level in the subsequent year, the cumulative impact would be doubled”.

    July 17, 2017
    The Guardian

  • Run rings around HIV

    NGO International Partnership for Microbicides was told last week that the European Medicines Agency had begun reviewing its application to register a dapivirine-impregnated ring for use in African countries...as a preventative drug for women at high risk of contracting HIV - including women in South Africa....The NGO said it would send its documents to the SA Health Product Regulatory Authority....European approval for the ring, if granted, is expected in early 2019.

    July 17, 2017
    Microbicides
    Times Live

  • South Korean HIV/AIDS patients suffer exceptionally high levels of stigma

    The Joint South Korean People Living with HIV Stigma Index Investigation Planning Team announced its findings in a press conference...in central Seoul on July 12....At 75%, the proportion of South Korean respondents reporting that they “blame themselves” for their HIV infection was over two times greater than the 32.2% among German respondents. The percentage reporting feeling “guilt” was also roughly three times higher at 64.4%, compared to 22.8% among German respondents. 36.5% of respondents reported feeling the urge to commit suicide.

    July 16, 2017
    Hankyoreh

  • Wiley and International AIDS Society announce partnership to publish fully open access journal

    John Wiley and Sons, Inc., is pleased to announce a new partnership with the International AIDS Society (IAS) to publish their fully open access journal, Journal of the International AIDS Society (JIAS). JIAS is well-established with an Impact Factor of 6.296, and all articles in the journal are open access and free to view, download and share.

    July 14, 2017
    News Medical

  • House Republicans move to bar funding for NIH fetal tissue research

    Republicans in the House of Representatives have launched an effort to prevent the NIH from funding research using fetal tissue obtained from elective abortions....[A] late 2015 article in Nature broke down the grants using fetal tissue NIH funded in 2014...Nearly 40% involved HIV/AIDS, followed by, in descending order: developmental biology; eye development and disease; other infectious diseases like hepatitis C; miscellaneous; and in utero diseases, toxic exposures, and congenital conditions....The new provision is far from certain to become law.

    July 14, 2017
    Science

  • Men often control use of women’s HIV prophylactic gel in Zambia

    In Zambia, men often control use of a [vaginal] microbicide gel meant to give women autonomy in preventing HIV infection. Use of the gel...is limited by social norms that entrench male dominance....Oliver Mweemba, University of Zambia, and colleagues wrote in Global Public Health:...“The same constructs of masculinity seemed to produce both positive and negative influences on decisions to use the gel and use it autonomously, and the ability to use it consistently.”

    July 14, 2017
    PrEP
    Healio

  • Family planning pledges more important than ever

    Governments and donors meeting in London this week stepped up pledges to help more than 200m women around the world who seek but have no access to contraceptives. The global family planning summit saw participants pledge $2.5bn, but much of that was reaffirmation of existing commitments, and the general mood was damped by proposed US cuts to global family planning programmes. Now it is more important than ever that donors ensure that their promises are met.

    July 14, 2017
    Financial Times

  • Defeating HIV/AIDS means listening to young people

    [A]dolescents and young people in [sub-Saharan Africa] are being left behind in the HIV/AIDS response,...their views and needs overlooked - a stark reality brought home to us and global leaders in HIV/AIDS during a recent roundtable discussion....If we are to reduce stigma, break down barriers to treatment and care, and provide services tailored to the reality of being a young person living with or at risk of HIV, young people need to play an integral part in research and policymaking.

    July 14, 2017
    Huffington Post

  • The playboy president and women’s health

    Mr. Trump has already surpassed George W. Bush as the American president most hostile to reproductive rights and measures to promote sexual health....This will be true whether or not the Republicans’ health care plan ever passes....Mr. Trump...shows no sign of caring about Pepfar. Indeed, his draft budget would cut the program by more than $1 billion....The president appears similarly indifferent to H.I.V./AIDS in the United States.

    July 14, 2017
    NY Times

  • Trump administration suddenly pulls plug on teen pregnancy programs

    The Trump administration has quietly axed $213.6 million in teen pregnancy prevention programs and research at more than 80 institutions around the country.....The decision by the Department of Health and Human Services will end five-year grants...designed to find scientifically valid ways to help teenagers make healthy decisions that avoid unwanted pregnancies....The program...had two strikes against it: Former President Barack Obama started it, and social conservatives don’t want to give teens access to birth control.

    July 14, 2017
    Reveal News

  • Gilead’s new HIV therapy under EU review

    The once-daily single tablet regimen, combining a novel investigational integrase strand transfer inhibitor with emtricitabine/tenofovir alafenamide (FTC/TAF), has demonstrated high rates of virologic suppression and no treatment-emergent resistance through 48 weeks in Phase III clinical trials...in which the regimen met its primary goal of non-inferiority to ViiV Healthcare’s flagship drug dolutegravir.

    July 14, 2017
    Pharma Times

Published Research

  • Hormonal contraceptive methods and HIV: research gaps and programmatic priorities

    WHO and leaders in the research community will continue to monitor evolving literature and communicate evidence clearly to stakeholders, advocates, and the public. We hope the suggested research and programmatic foci presented here will spark conversation and action, to move toward the best ways to collect quality data on the relationship between HIV and HC methods and best ways to provide high quality, appropriate services for women and men, living with HIV and at risk of HIV acquisition.

    August 1, 2017
    Contraception

  • A phase I randomized postcoital testing and safety study of the Caya diaphragm used with 3% Nonoxynol-9 gel, ContraGel or no gel

    The Caya Diaphragm is a newly approved single-size, nonlatex diaphragm. Contragel is a personal lubricant containing lactic acid approved in Europe and other countries for use with vaginal barrier devices....This study, [in health sexually active women 18-45 years old in Norfolk, VA, USA, and Santo Domingo, Dominican Republic] supports conclusion that Caya with ContraGel is safe and functions as well as Caya with N-9 in preventing sperm from reaching midcycle cervical mucus.

    August 1, 2017
    Hormonal Contraceptives and HIV
    Contraception

  • Rapid elicitation of broadly neutralizing antibodies to HIV by immunization in cows

    No immunogen to date has reliably elicited broadly neutralizing antibodies to HIV in humans or animal models...we immunized four cows with BG505 SOSIP...Immunization of cows may provide an avenue to rapidly generate antibody prophylactics and therapeutics to address disease agents that have evolved to avoid human antibody responses.

    July 20, 2017
    Antibody Related Research
    Nature

  • Enhanced prophylaxis plus antiretroviral therapy for advanced HIV infection in Africa

    A total of 1805 patients (1733 adults and 72 children or adolescents) in Kenya, Malawi, Uganda, and Zimbabwe] underwent randomization to receive either enhanced prophylaxis or standard prophylaxis and were followed for 48 weeks....Among HIV-infected patients with advanced immunosuppression, enhanced antimicrobial prophylaxis combined with ART resulted in reduced rates of death at both 24 weeks and 48 weeks without compromising viral suppression or increasing toxic effects.

    July 20, 2017
    PrEP
    NEJM

  • The value of social, behavioral, and economic sciences to national priorities: A report for the National Science Foundation

    Nearly every major challenge the United States faces—from alleviating unemployment to protecting itself from terrorism—requires understanding the causes and consequences of people’s behavior. Even societal challenges that at first glance appear to be issues only of medicine or engineering or computer science have social and behavioral components. The diverse disciplines of the social, behavioral, and economic sciences...all produce fundamental knowledge, methods, and tools that provide a greater understanding of people and how they live.

    July 20, 2017
    NAP

  • Comment: Vaginal dysbiosis and pre-exposure prophylaxis efficacy

    In The Lancet HIV, Renee Heffron and colleagues report that the efficacy of daily oral tenofovir disoproxil fumarate pre-exposure prophylaxis for HIV prevention among African women who participated in the Partners PrEP Study was not affected by vaginal microbiota status....This analysis was prompted by a report in Science by Klatt [et al.] of a large difference in efficacy of 1% tenofovir vaginal gel against HIV relative to vaginal microbiota status in the CAPRISA 004 trial....However, 1% tenofovir gel was efficacious against herpes simplex virus type 2 in both groups.

    July 18, 2017
    PrEP
    Lancet HIV

  • Efficacy of oral pre-exposure prophylaxis (PrEP) for HIV among women with abnormal vaginal microbiota: a post-hoc analysis of the randomised, placebo-controlled Partners PrEP Study

    Among African women with a high prevalence of bacterial vaginosis and high adherence to PrEP, the efficacy of daily oral PrEP for HIV prevention did not differ significantly among women with abnormal versus healthy vaginal microbiota as defined by Nugent score. These data are reassuring that oral PrEP delivery to women can continue without the need for concurrent testing for bacterial vaginosis or vaginal dysbiosis.

    July 18, 2017
    PrEP
    Lancet

  • HIV & opportunistic infection treatment: spotlight on access gaps

    This issue brief provides information regarding the changing product landscape, and updates on pricing and access to three critical medical interventions: optimal HIV therapy with dolutegravir; paediatric HIV therapy; and opportunities to improve treatment for two common opportunistic infections: cryptococcal meningitis and Kaposi’s sarcoma.

    July 17, 2017
    Treatment
    MSF Access Brief

  • Financing transformative health systems towards achievement of the health Sustainable Development Goals: a model for projected resource needs in 67 low-income and middle-income countries

    We estimate that an additional $274 billion spending on health is needed per year by 2030 to make progress towards the SDG 3 targets (progress scenario), whereas US$371 billion would be needed to reach health system targets in the ambitious scenario....All countries will need to strengthen investments in health systems to expand service provision in order to reach SDG 3 health targets, but even the poorest can reach some level of universality.

    July 17, 2017
    Lancet

  • Examining the effects of HIV self-testing compared to standard HIV testing services: a systematic review and meta-analysis

    HIV self-testing (HIVST) is associated with increased uptake and frequency of testing in randomized control trials. Such increases, particularly among those at risk who may not otherwise test, will likely identify more HIV-positive individuals compared to standard testing services alone. However, further research on how to support linkage to confirmatory testing, prevention, treatment and care services is needed. (WHO now recommends HIVST as an additional HIV testing approach.

    July 15, 2017
    JIAS

  • Leveraging peer-based support to facilitate HIV care in Kenya

    After overcoming staff reservations about introducing a new healthcare cadre in the inpatient setting, the program gained acceptance within the medical teams and hospital staff. Current challenges include high patient volumes and lack of privacy on the inpatient wards. A prospective evaluation of our peer navigator program is underway.

    July 14, 2017
    PLoS

  • Impact of early cART on HIV blood and semen compartments at the time of primary infection

    We provide the first evidence that HIV reservoir cells in semen begin to establish early during HIV infection....The presence of infected cells in semen is likely to increase the risk of HIV transmission during primary HIV infection, via cell-cell contact. We show that early treatment purges not only viral particles but also infected cells in the genital compartment.

    July 14, 2017
    PLoS ONE

  • Access to medical and mental health services across the HIV care continuum among young transgender women: a qualitative study

    Participant (n=25) mean age 21.2 years; majority non-white (76%), had less than college education (76%), unemployed (52%), and income <$12,000/year (80%). More than one-third were unstably housed and uninsured, 28% reported transactional sex. Qualitative themes included lack of respect for or misunderstanding of gender identity, mismatch of mental health needs with provider skills, challenges in finding HIV prevention services..., and importance of representation of transgender women in care teams.

    July 1, 2017
    Transgender Health

  • Genetic characterization of human immunodeficiency virus type 1 transmission in the Middle East and North Africa

    HIV-1 spread in the Middle East and North Africa (MENA) has not been previously characterised using the phylogenetic approach. The aim of the current study was to investigate genetic diversity and domestic transmission of HIV-1 in the MENA....We found extensive HIV-1 diversity...and a high proportion of sequences in transmission clusters. This study highlights the need for preventive measures in the MENA to limit HIV-1 spread in this region.

    July 1, 2017
    Science

  • Ethics of public health surveillance: new guidelines

    On June 23, 2017, WHO issued the first international ethics guidelines on public health surveillance.... Despite the existence of landmark international guidelines on the ethics of research, including epidemiological studies, and specific ethical guidelines for surveillance of specific diseases in specific countries, there has never been a comprehensive international ethics framework governing public health surveillance that considers risk factors, environmental conditions, infectious diseases, non-communicable diseases, outbreak situations, and national borders.

    June 27, 2017
    Lancet

  • Models for improving linkage to care for people living with HIV released from jail or prison

    Formerly incarcerated individuals often struggle with various issues, including: substance use disorders, mental health, family estrangement, lack of support, lack of employment and housing after being released back into their communities....This resource guide summarizes effective models and best practices of linkage to care programs for PLWH leaving jail or prison and reentering society.

    June 15, 2017
    National Center for Innovation in HIV Care

  • The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia

    Men were seen as heads of households and decision-makers who approved partners’ intentions to initiate gel use. Autonomous gel use by women was not supported because it challenged men’s dominant position in sexual matters and at a family level. The socially accepted notion that men engaged in multiple sexual relationships also influenced women’s decision to use the gel. Sustained gel use depended on [its] perceived effect on men’s sexual desires, sexual performance, fertility, and sexual behaviour.

    June 12, 2017
    Global Public Health

  • Paid HIV rapid testing in general medicine private practice in French Guiana: a pilot project

    Physicians were provided with rapid tests and paid to perform them. About 4868 tests were performed, among which 43 were positive. HIV rapid testing in private practice was feasible and acceptable for patients and practitioners...[and the] pilot study [was] scaled up into regional policy throughout French Guiana.

    June 2, 2017
    Public Health

  • How much do clinical trials cost?

    With the aim of providing companies with a comparative baseline for how much clinical trials cost, KMR Group conducted the landmark Clinical Trial Cost Study in 2016. This assessment provided reliable cross-industry cost data to senior management at major biopharma companies, so they could evaluate their operational efficiency, make more accurate financial projections, [and] more effectively evaluate the cost burden of licensing and asset acquisition. Here, we present some key findings of this analysis.

    May 19, 2017
    Reviews Drug Discovery

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