29 OCTOBER 2021 VOLUME 23 ISSUE 43

Media Coverage

• To Save Lives, Confirm Dr. John Nkengasong to Head PEPFAR by World AIDS Day

  We were among the many advocates and global health leaders who called on the Biden Administration to move quickly in naming a permanent head for the US President’s Emergency Plan for AIDS Relief. Now that President Biden has selected Dr. John Nkengasong as his nominee, Congress must act swiftly to confirm his nomination and give US global efforts to address HIV – a preventable and treatable disease that still claims nearly 700,000 lives a year around the world, four decades after the first case was discovered – the permanent leadership it needs and deserves.

  October 29, 2021

  General

  Science Speaks

• First Efficacy Results From England’s PrEP IMPACT Trial

  Dr. Ann Sullivan told the conference: “PrEP use substantially reduced HIV incidence in men who have sex with men attending sexual health clinics in England, with no suggestion of significant biological failure." However, the markers of higher risk failed to identify 29 percent of the non-PrEP users who could benefit from PrEP. They need to be further developed to better identify those who may benefit, she said.

  October 28, 2021

  PrEP

  aidsmap

• Half of Speciality Guidelines for Medical Conditions Suggesting HIV Don’t Recommend HIV Testing

  More widespread HIV testing in Europe is being hampered by medical guidelines which do not recommend testing people who have AIDS-defining conditions or other illnesses that could be linked to HIV, the 18th European AIDS Conference (EACS 2021) heard today. In order to achieve the first of UNAIDS’ 95-95-95 goals – in which 95 percent of people living with HIV have been diagnosed – HIV testing programmes increasingly need to reach individuals who are not viewed as belonging to a risk group for HIV or who do not see themselves as at risk, but who may nonetheless have HIV.

  October 28, 2021

  General

  aidsmap

• It’s 2021. Where Are the Women in HIV Clinical Trials?

  A troubling fact was revealed at this year’s International AIDS Society Conference on HIV Science: When it comes to women in HIV-related clinical trials, the numbers even in 2021 remain, as Dawn Averitt, founder of the Well Project, put it, “abysmally low.” In fact, among the studies presented during the conference, women made up as few as 7 percent of participants.

  October 27, 2021

  Treatment

  TheBodyPro

• Gilead and Merck Begin Phase 2 Trials for Islatravir and Lenacapavir Combination HIV Treatment

  Gilead Sciences, Inc. and Merck (MSD) announced the commencement of a phase 2 clinical trial to study their investigational HIV treatment regimen. The treatment, a combination of islatravir and lenacapavir, is a once-weekly oral regimen designed for people living with HIV who are virologically suppressed and on antiretroviral therapy (ART).

  October 27, 2021

  Treatment

  Contagion Live

• Take Notes From TikTok’s HIV+ Community

  "Today's word of the day is nescience. It's a noun meaning lack of knowledge or understanding, ignorance," posted Josh Odam on his TikTok account, @healingwhileblk. "Used in a sentence: not only did DaBaby reveal himself to be a raging homophobe, he also revealed his nescience around sexual health, HIV awareness, and transmission."

  October 26, 2021

  General

  Paper

• Einstein-Developed Treatment Strategy May Lead to HIV Cure

  Scientists at Albert Einstein College of Medicine have successfully suppressed HIV infections in mice — offering a path to a functional cure for HIV and other chronic viral infections. Their findings were published Thursday in the Journal of Clinical Investigation. The research involved proteins designed to selectively stimulate the immune system’s CD8+ “killer” T cells to multiply and specifically attack HIV-infected T cells.

  October 26, 2021

  Cure

  Bronx Times

• Premature Mortality Highest Among Black Women With HIV

  Many people with HIV are living longer lives, but not all of them. In fact, data released at the 2021 virtual IDWeek conference showed that Black women continue to have the highest rate of premature death among anyone living with HIV. In this exclusive MedPage Today video, study author Jessica Castilho, MD, MPH, of Vanderbilt University Medical Center in Nashville, discusses the study, its limitations, and future steps in working toward an explanation.

  October 26, 2021

  General

  MedPage Today

• Meet the Advocates Who Are Reframing the Reproductive Rights Conversation to Address the Lived Experiences of Black Women

  This past summer, In Our Own Voice: National Black Women’s Reproductive Justice Agenda, Interfaith Voices for Reproductive Justice, and SisterLove, Inc. released the Black Reproductive Justice Policy Agenda. Developed in collaboration with more than 30 Black women’s organizations and reproductive justice activists, the agenda highlights policy issues and recommendations on contraceptive equity and reproductive health care, sexual health education, LGBTQ+ liberation, Black maternal health, economic and environmental justice, and abortion access, among others.

  October 26, 2021

  General

  TheBodyPro

• Vaccines Needed. But Not if It Adds to HIV Burden

  The nagging, unresolved issue of whether immunizations relying on a cold virus promote the spread of HIV has escalated again. That’s after South Africa’s health products regulator vetoed initial approval of Russia’s Sputnik V coronavirus vaccine last week. While Africa desperately needs more vaccines, governments know that to avoid vaccine hesitancy, their populations have to be confident that COVID-19 protection won’t come with increased risk for those already facing other prevalent diseases. The two-dose Sputnik V uses two components, which are not interchangeable.

  October 25, 2021

  HIV Vaccine

  Bloomberg

• Namibia To Suspend Use of Russian COVID-19 Vaccine – Ministry

  Namibia will suspend its rollout of Russia's Sputnik V COVID-19 vaccine, its health ministry said on Saturday, days after the drugs regulator in neighbouring South Africa flagged concerns about its safety for people at risk of HIV. The Gamaleya Research Institute, which developed Sputnik V, said Namibia's decision was not based on any scientific evidence or research.

  October 24, 2021

  General

  Reuters

• COVID-19 Has Changed Our Approach to Testing – It’s Time to Turbo Charge Our Efforts With HIV Too

  Recent figures from Public Health England show that the UK is on course to hit United Nations targets of diagnosing 95 percent of those who have HIV before the deadline of 2025. But – however good that 95 percent sounds – it is far from ambitious enough. This data confirms London has met this goal already, while the rest of the country is teetering on the edge at 94 percent.

  October 22, 2021

  General

  Telegraph

• Medical Circumcision: FS Group Urges Boys To Reconsider

  A Free State men’s health advocacy group is encouraging men and boys to consider undergoing medical circumcision instead of the traditional practice. And, in doing so, they won’t be placing themselves at risk after 13 initiates died in the Eastern Cape last year.

  October 22, 2021

  Voluntary Medical Male Circumcision

  Health-E News

Published Research

• Traditional Healer-Delivered Point-of-Care HIV Testing Versus Referral to Clinical Facilities for Adults of Unknown Serostatus in Rural Uganda: A Mixed-Methods, Cluster-Randomised Trial

  HIV counselling and testing are essential to control the HIV epidemic. However, HIV testing uptake is low in sub-Saharan Africa, where many people use informal health-care resources such as traditional healers. We hypothesised that uptake of HIV tests would increase if provided by traditional healers. We aimed to determine the effectiveness of traditional healers delivering HIV testing at point of care compared with referral to local clinics for HIV testing in rural southwestern Uganda.

  November 1, 2021

  General

  Lancet Global Health

• Syringe Services Programs’ Role in Ending the HIV Epidemic in the US: Why We Cannot Do It Without Them

  Ending the HIV epidemic among PWID is achievable. We understand how HIV is transmitted among PWID and we have highly effective behavioral and biomedical interventions to substantially reduce risk and get close to 0 new HIV infections. SSPs are highly effective, cost effective, and safe in reducing HIV transmission in the communities where they operate. Their impact is maximized when they can follow best practices (e.g., needs-based access to sterile syringes) and are combined with access to MOUD, PrEP, and ART.

  November 1, 2021

  Treatment

  AJPM

• HIV Cluster and Outbreak Detection and Response: The Science and Experience

  The use of CDR can identify rapid transmission so that proven, effective strategies can be implemented in affected populations or networks. Efforts to address important gaps in service delivery revealed by CDR can strengthen prevention efforts broadly through multidisciplinary, multisector collaboration. In this way, the Respond pillar embodies the collaborative, data-guided approach critical to the overall success of the Ending the HIV Epidemic in the US initiative.

  November 1, 2021

  General

  AJPM

• Public Health Detailing to Promote HIV Pre- and Postexposure Prophylaxis Among Women's Healthcare Providers in New York City

  By facilitating PrEP and PEP knowledge and prescribing among women's health providers, detailing may be one method to reduce the gender gap in PrEP awareness and use. Knowledgeable and willing providers can increase PrEP and PEP access by supporting patients who initiate requests and, importantly, introduce the option. Women may need to hear about PrEP multiple times and from multiple sources before deciding whether it is right for them; ensuring that a women's entire healthcare team reinforces key messages is one way to achieve that goal.

  November 1, 2021

  PrEP

  AJPM

• Academic Detailing to Increase Prescribing of HIV Pre-exposure Prophylaxis

  This review provides an overview of academic detailing and how it is currently being used to increase pre-exposure prophylaxis prescribing. Academic detailing is outreach education that engages with clinicians in 1-to-1 or small group interactions focused on identifying and addressing an individual clinician's needs to increase their use of evidence-based practices.

  November 1, 2021

  PrEP

  AJPM

• Pre-Exposure Prophylaxis Uptake, Adherence, and Persistence: A Narrative Review of Interventions in the US

  The interventions reviewed in this paper collectively show promise for achieving the higher levels of uptake and effective use of PrEP that will be needed to end the HIV epidemic. Rigorous trial designs in expanded populations are needed to maximize the understanding of effectiveness and impact, including alignment of adherence and risk of HIV exposure. Further research is needed to understand the comparative advantage of different approaches as well as the optimal means for implementation in clinical practice.

  November 1, 2021

  PrEP

  AJPM

• Toward Greater Pre-exposure Prophylaxis Equity: Increasing Provision and Uptake for Black and Hispanic/Latino Individuals in the US

  This review identifies many key barriers and promising strategies to address PrEP scale-up in Black and H/L communities across the U.S. The barriers to PrEP uptake and provision operate across the individual, network, healthcare system, and structural levels. To reach the PrEP-related goals of EHE, the federal government, HDs, and academic and community partners must implement innovative and effective programs and policies that overcome these barriers.

  November 1, 2021

  PrEP

  AJPM

• HIV Testing Strategies for Health Departments to End the Epidemic in the US

  Ending the HIV epidemic (EHE) in the US by 2030 is an ambitious goal. The COVID-19 pandemic has slowed initial progress but has also taught valuable lessons about both disparities in access to health care and public health services. All other EHE activities start with an awareness of HIV status, which is the EHE indicator for which the US is closest to its targets. There are proven and emerging approaches to both increasing HIV screening and increasing the frequency of HIV screening available.

  November 1, 2021

  PrEP

  AJPM

• The HIV Treat Pillar: An Update and Summary of Promising Approaches

  A wide variety of interventions discussed in this paper suggest a positive impact on care-related outcomes that can be used by HDs and service providers to achieve the goals of the EHE Treat pillar.

  November 1, 2021

  Treatment

  AJPM

• A Community Health Worker Approach for Ending the HIV Epidemic

  However, the results do suggest that CHWs can effectively engage hard-to-reach populations through street outreach in communities most impacted by HIV. Future research is needed to assess the effectiveness of the CHW model in other communities and with different populations. In EBR, the CHW team successfully facilitated access to HIV prevention and treatment for priority populations. The CHW model should be considered as a strategy in future efforts to end the HIV epidemic.

  November 1, 2021

  General

  AJPM

• Response to a Large HIV Outbreak, Cabell County, West Virginia, 2018–2019

  Evidence of rapid transmission in this outbreak galvanized robust collaboration among federal, state, and local partners, leading to critical improvements in HIV prevention and care services. HIV outbreak response requires increased coordination and creativity to improve service delivery to people affected by rapid HIV transmission.

  November 1, 2021

  Treatment

  AJPM

• The Evidence Base for Initial Intervention Strategies for Ending the HIV Epidemic in the US

  June 2021 marked 40 years since the first reported cases of AIDS. In the 30 years that followed its detection, there have been several critical successes: identifying HIV as the causative agent; defining the sexual and injection drug use behaviors that lead to a high risk for HIV transmission or acquisition; developing HIV antibody tests of increasing sensitivity and ease of use that allowed accurate monitoring of epidemic trends, provision of blood product transfusion safety, and identification of people in need of treatment; identifying a broad array of medications used in combinations to effectively treat HIV infection and prevent perinatal transmission; and developing HIV nucleic acid tests that allow monitoring of treatment effectiveness.

  November 1, 2021

  General

  AJPM

• Bringing Iowa TelePrEP to Scale: A Qualitative Evaluation

  Iowa TelePrEP expansion shows that regional PH-partnered telehealth models can scale up to the state level. Regional telehealth programs and local health departments considering collaboration should assess how to fully integrate PrEP into HIV/STI CTR services in clinical and outreach settings. In addition, regional collaborations planning for growth should carefully consider how to balance current flexibility and adaptability with scalability. Further work is needed to assess the program impacts and explore the perspectives of program users and nonusers as well as of other stakeholders.

  November 1, 2021

  PrEP

  AJPM

• Georgia Leverages Telehealth to Expand HIV Care Management in Underserved Areas

  Technology provides a unique opportunity to empower patients and providers. In Georgia, sociodemographic characteristics of Ryan White HIV/AIDS Program clients who received HIV care by telehealth were comparable with those of Ryan White HIV/AIDS Program clients overall, and HIV outcomes were equivalent. The use of virtual care models is increasing and may become an ongoing model of care throughout Georgia.

  November 1, 2021

  Treatment

  AJPM

• Correlates of Condomless Anal Intercourse With Different Types of Sexual Partners Among Men Who Have Sex With Men and Transgender Women in Lima, Peru

  In Lima, Peru, men who have sex with men (MSM) and transgender women (TW) are disproportionately affected by HIV. Patterns of sexual behavior vary by sexual partner type, which has implications for HIV prevention intervention design. We examine correlates of sex and condomless anal intercourse (CAI) with each of four types of partners among HIV-negative MSM and TW in Lima who completed monthly questionnaires about partnership types and CAI.

  October 28, 2021

  Male and Female Condoms

  AIDS Care

• Barriers to Pre-Exposure Prophylaxis Uptake Among Online Male Sex Workers in the US

  Though barriers to HIV pre-exposure prophylaxis (PrEP) uptake among gay, bisexual, and other men who have sex with men (MSM) have received substantial research attention, less is known about what factors may be affecting PrEP uptake among male sex workers (MSWs), a population at high risk of HIV. This paper presents qualitative findings regarding why a subsample of MSM engaged in exchange sex (receiving money, drugs, shelter, or other goods in exchange for sex) with partners they met on dating/hookup websites and apps had never used PrEP.

  October 27, 2021

  PrEP

  AIDS and Behavior

• “PrEP’s Just To Secure You Like Insurance”: A Qualitative Study on HIV Pre-Exposure Prophylaxis (PrEP) Adherence and Retention Among Black Cisgender Women in Mississippi

  In addition to preventing HIV, PrEP may yield secondary positive impacts on the health and relationships of Black cisgender women. However, very few Black cisgender women in the South are using PrEP given intersectional barriers and thus necessitates adaptive strategies to support PrEP initiation and persistence. Efforts aimed at increasing the coverage of PrEP among Black cisgender women should consider implementation strategies responsive to lived realities of Black women.

  October 26, 2021

  PrEP

  BMC Infectious Diseases

• Evaluating the Impact of DREAMS On HIV Incidence Among Adolescent Girls and Young Women: A Population-Based Cohort Study in Kenya and South Africa

  Substantial declines in HIV incidence among AGYW were observed, but most began before DREAMS introduction and did not accelerate in the first 3 years of DREAMS implementation. Like the declines observed among young men, they are likely driven by earlier and ongoing investments in HIV testing and treatment. Longer-term implementation and evaluation are needed to assess the impact of such a complex HIV prevention intervention and to help accelerate reductions in HIV incidence among young women.

  October 25, 2021

  General

  PLOS MEDICINE

• Global Health Facility-Based Interventions to Achieve UNAIDS 90-90-90: A Systematic Review and Narrative Analysis

  To evaluate whether health facility-based HIV interventions align with UNAIDS 90-90-90 targets, we performed a systematic review through the lens of UNAIDS targets. We searched 11 databases, retrieving 5201 citations with 26 eligible studies classified by country income and UNAIDS target. We analyzed whether reporting of study outcome metrics was in line with UNAIDS targets using a standardized extraction form and results were summarized in a narrative synthesis given data heterogeneity.

  October 25, 2021

  General

  AIDS and Behavior

• HIV Care Outcomes Among Transgender Persons With HIV Infection in the United States: A Systematic Review and Meta-Analysis, 2006–2021

  HIV care outcomes for transgender women were not ideal, and research gaps exists for transgender men. High heterogeneity was observed; therefore, caution should be taken interpreting the findings. Integrating transgender-specific health needs are needed to improve outcomes of transgender persons across the HIV care continuum.

  October 25, 2021

  Treatment

  AIDS

• HIV Serostatus Disclosure Among Men Who Have Sex with Men in China in the Era of U=U and PrEP

  Overall, HIV serostatus disclosure was low among this young and relatively highly educated sample of Chinese MSM in the era of U=U and PrEP. The awareness of PrEP and U=U was not associated with either informing or asking behaviors. Common barriers to HIV disclosure included perceiving a low risk of HIV infection, engaging in receptive sex, and having sex with casual partners. Having a positive attitude towards living with HIV was associated with always informing partners about one’s HIV status.

  October 25, 2021

  PrEP, Treatment

  AIDS and Behavior

• HIV Infection and HIV-Associated Behaviors Among Persons Who Inject Drugs — 23 Metropolitan Statistical Areas, United States, 2018

  Low-barrier access is needed to comprehensive and integrated needs-based syringe service programs (where legally permissible) that include provision of sterile syringes and safe syringe disposal, HIV and hepatitis C virus testing and referrals for treatment, HIV preexposure prophylaxis, and treatment for substance use and mental health disorders for PWID.

  October 22, 2021

  General, PrEP, Treatment

  Morbidity and Mortality Weekly Report (MMWR)

• T-Cell Receptor-Specific Immunotherapeutics Drive Selective In Vivo HIV and CMV-Specific T-Cell Expansion in Humanized Mice

  The synTac platform flexibility supports facile delineation of in vivo effects of different costimulatory signals on patient-derived virus-specific CD8+ T cells, enabling optimization of individualized therapies, including HIV cure strategies.

  October 21, 2021

  Cure

  JCI

• Long-Acting Biodegradable Implant for Sustained Delivery of Antiretroviral (ARV) and Hormones

  Women worldwide confront two major reproductive health challenges: the need for contraception and protection from sexually transmitted infections, including Human Immunodeficiency Virus (HIV). Multipurpose Prevention Technologies (MPTs) that simultaneously prevent unintended pregnancy and HIV could address these challenges with a single product. Here, we developed a long-acting (LA) subcutaneously administered and biodegradable implant system that provides sustained delivery of contraceptive and antiretroviral (ARV) with zero-order release kinetics.

  October 20, 2021

  Hormonal Contraceptives and HIV, Multipurpose Prevention Technologies, Treatment

  Journal of Controlled Release

• Human Papillomavirus Vaccine Course Completion Among Gay and Bisexual Men Who Have Sex With Men From a Time-Limited HPV Vaccination Catch-Up Program in Victoria, Australia

  To examine completion of the human papillomavirus (HPV) vaccination 3-dose regimen and factors associated with completion among men who have sex with men (MSM) aged ≤ 26 years participating in a time-limited HPV catch-up vaccination program in Victoria, Australia.

  October 7, 2021

  HPV Vaccines

  Frontiers in Public Health

• Analysis of HPV Vaccination Willingness Amongst HIV-Negative Men Who Have Sex With Men in China

  Objective: Men who have sex with men (MSM) are high-risk groups of human papillomavirus (HPV) infection, the best measure to prevent this is the HPV vaccine. However, few studies have investigated HPV vaccination willingness in the MSM population in China. We aimed to explore the willingness of human immunodeficiency virus (HIV)-negative MSM for HPV vaccination and the factors affecting their willingness to vaccinate.

  September 24, 2021

  HPV Vaccines

  MDPI

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