22 NOVEMBER 2019 VOLUME 20 ISSUE 45

As HIV activists around the world are pushing for Pre-exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) to be accessed over the counter, the health ministry says that it will not be considered in Uganda.

A survey of German PrEP users reported at the recent 17th European AIDS Conference (EACS 2019) found that one in nine of them had not had a single HIV, STI or renal function test during the time they were on PrEP. Of those who had taken an HIV test while on PrEP, 15.5 percent had taken a test less often than the recommended interval of three months, and 8.5 percent had had an STI check-up less often than the recommended once every six months. One in 25 PrEP users had not even had an HIV test shortly before starting PrEP.

Given how doggedly persistent individuals seeking to obtain a pre-exposure prophylaxis (PrEP) prescription often must be, it should come as little surprise that many people at high risk for HIV fall through the cracks of a health care system poorly equipped to provide them access to a highly effective form of prevention.

HIV diagnoses have fallen 16 percent in Paris in the 3 years since the rollout of a strategy that combines extensive pre-exposure prophylaxis (PrEP) coverage and screenings with political support for community engagement, according to new data.

The country boasts the world's largest HIV treatment programme. Find out how South Africa's nine provinces stack up when it comes to getting patients onto life-saving antiretrovirals with this interactive map.

Several non-human primate studies looking at HIV's relative – SIV – provided evidence that creating too many soft targets can weaken vaccination that would have otherwise protected against infection.

US Ambassador Lisa Johnson launched the new PEPFAR-funded voluntary medical male circumcision (VMMC) programme “Safe VMMC” in Namibia a programme that will cost the US aid agency a whopping N$497,140,000 over a five-year period.

While diverse global participants with differing beliefs and values look forward to sharing knowledge about global progress in stopping the epidemic that has lived for centuries, there is more they can learn about Rwanda’s approach towards preventing new HIV infections while raising the life expectancy of people living with HIV. And this is a tremendous story.

For men who sleep with men, pills that block HIV from taking hold are making unprotected sex feel fun and safe again. Women aren’t getting in on that action.

Bioengineering approaches grounded in immunology have the potential for the discovery and development of a successful HIV vaccine. The overarching goal is to engineer immunity through a fusion of immunology with bioengineering to create novel strategies for the design, development and delivery of vaccines based on the controlled modulation of the immune system.

Among PrEP-eligible men, PrEP use was independently associated with lower levels of HIV anxiety. In addition to avoiding HIV infection, PrEP use may help reduce anxiety among men at risk of HIV. This feature of PrEP could be promoted as part of demand creation initiatives to increase PrEP uptake.

These results demonstrate that high and persisting frequencies of HIV vaccine–induced TH1-biased CD4 T cells in the intestinal and genital mucosa can mitigate beneficial effects of protective antibodies and CD8 T cells, highlighting a critical role of priming immunization and vaccine adjuvants in modulating HIV vaccine efficacy.

Although our data do not establish a causative link between HPV status and the risk of HIV, we suggest that increasing HPV vaccination coverage may carry an additional benefit of reducing the risk of contracting HIV infection, particularly in regions with high HPV prevalence.

In this qualitative study, we interviewed 22 people living with HIV and used standard gamble methodology to assess the maximum chance of death a person would risk for an HIV cure. We probed participants’ reasoning behind their risk‐taking responses. Conventional inductive content analysis was used to categorize key themes regarding decision‐making. We found that some people would be willing to risk even death for an HIV cure, and some of their reasons were plausible and went far beyond the health‐related utility of an HIV cure.

Switching from TDF to TAF caused a statistically significant worsening of the lipid profile that may have clinical relevance. The benefit of the lipid-lowering effect of TDF should be considered in selected patients with low risk for kidney and bone toxicity.

A large burden of HIV is likely to be attributable to HSV-2 infection, even if the effect of HSV-2 infection on HIV had been imperfectly measured in studies providing adjusted RR estimates, potentially because of residual confounding. The contribution is likely to be greatest in areas where HSV-2 is highly prevalent, particularly Africa. New preventive interventions against HSV-2 infection could not only improve the quality of life of millions of people by reducing the prevalence of herpetic genital ulcer disease, but could also have an additional, indirect effect on HIV transmission.

Poor adherence resulted in drastic decrease in efficacy in the female genital tract FGT) but not colorectal tissue. However, greater forgiveness was seen when maraviroc was combined with tenofovir or emtricitabine, suggesting that maraviroc should not be used alone as PrEP.

We demonstrate that trained macaques reliably adhere to a daily oral ARV regimen, although unexpected adherence issues are possible. Our approach, using clinical doses of oral FTC and TAF daily, further refines macaque models of HIV treatment and prevention by mimicking the human route and timing of ARV administration.

This study addresses critical gaps in current knowledge about the HIV prevention and care experiences of TGD youth. Findings have implications for the development of HIV interventions across levels to support the health and well-being of TGD youth. Future research is warranted to replicate and expand on lessons learned regarding recruitment and engagement of communities of TGD youth, including longitudinal designs to assess engagement across their developmental stages. Lessons learned working with TGD youth through developing and implementing the study protocol are shared.

TtR (time to rebound) could be an optimal surrogate marker of response in HIV cure strategies. Our results underline the importance of taking into account baseline VL and other confounding factors in the design and interpretation of these studies.

The delivery of high-quality HIV care in rural settings is a global challenge. Despite the successful expansion of antiretroviral therapy (ART) in Africa, viral load (VL) monitoring and ART adherence are poor, especially in rural communities. This article describes a case study of an ART program in the deeply rural Eastern Cape of South Africa.