3 JULY 2020 VOLUME 22 ISSUE 26

Media Coverage

• Does Taking HIV Meds Reduce the Odds of COVID-19? Experts Say, ‘Not So Fast’

  A new study released in Annals of Internal Medicine on June 26 demonstrated that people living with HIV who were on antiretroviral therapy (ART) in Madrid, Spain, were less likely to contract SARS-CoV-2, the virus that causes COVID-19 disease. But people who were using tenofovir disoproxil fumarate (TDF) were far less likely to contract SARS-CoV-2 than those taking other ART medications.

  July 1, 2020

  Treatment

  The BodyPro

• HIV testing in South Africa rises by 45 Percent in 12 years

  An analysis of four national surveys conducted among South African households over 12-years suggests HIV testing has increased by 45 percent. The study analysed large-scale surveys conducted in 2005, 2008, 2012 and 2017. It is the first to examine the trends and factors associated with HIV testing in South Africa over such a long period.

  July 1, 2020

  General

  Avert

• Experimental HIV Drug Seems Effective at a Twice-a-Year Dose, Study Finds

  An experimental new HIV treatment could, with just one dose, reduce the amount of virus in an infected person for up to six months. But experts aren’t convinced the advance will significantly change how we treat HIV anytime soon.

  July 1, 2020

  Treatment

  STAT

• HIV Activists Celebrate As Wales Confirms Life-Saving HIV Drug PrEP Will Be Rolled Out on the NHS

  The once-a-day drug, which prevents people without HIV from acquiring the virus when taken correctly, will be made available across Wales “for all people for whom it is clinically appropriate.”

  June 30, 2020

  PrEP

  Pink News

• What It Means to Be Queer and Living With HIV in Nigeria

  Labi, a Lagos-based fashion designer, was just 21 years old when he tested positive for HIV in 2016. “I was falling sick over and over,” he tells me in a WhatsApp conversation. “My parents suggested I do a full blood test. My sister, a doctor, took the blood samples. I was at an event when she called me to come for a retest. They did a confirmation test, and it came out positive.”

  June 30, 2020

  General

  The Body

• African Countries Fight ‘Vaccine Nationalism’ in Wealthier Nations With First COVID-19 Inoculation Trials

  The fear was immediate: Would poorer countries be left behind in the rush for a vaccine, their people dying, while the citizens of wealthier countries took priority? It reinforced the determination of South African scientists, who have now launched the historic first African trial of a potential vaccine for the coronavirus that causes COVID-19.

  June 30, 2020

  General

  The Globe and Mail

• Nomandla Yako, the HIV/AIDS Activist Who ‘Planted Hope’

  In the despairing, dark days when HIV was ravaging South Africa and access to treatment was priced out of reach for thousands, the most an infected person could wish for some days was hope and a friendly face. Nomandla Yako was that pillar to many.

  June 30, 2020

  General

  Daily Maverick

• US Supreme Court Upholds Curb on Overseas AIDS Funding

  The US Supreme Court on Monday ruled that a 2003 law does not violate constitutional free speech rights by requiring overseas affiliates of American-based nonprofit groups that seek federal funding for HIV/AIDS relief to take a formal stance opposing prostitution and sex trafficking.

  June 29, 2020

  General

  Reuters

• Partnership Science

  Mark Feinberg and Helen Rees joined Mitchell Warren for a webinar titled “Pandemic Vaccine Development and Lessons for COVID-19” in April 2020. It is part of the COVID-19 and HIV webinar series hosted by AVAC, which focuses on global advocacy for HIV prevention.

  June 29, 2020

  General

  POZ

• Remdesivir, the First Coronavirus Drug, Gets a Price Tag

  Remdesivir, the first drug shown to be effective against the coronavirus, will be distributed under an unusual agreement with the federal government that establishes nonnegotiable prices and prioritizes American patients, health officials announced on Monday.

  June 29, 2020

  Treatment

  New York Times

Published Research

• Low HIV Incidence Among Women Following Sexually Transmitted Infection Does Not Support National Pre-Exposure Prophylaxis Recommendations

  Current United States guidelines recommend that clinicians offer HIV pre-exposure prophylaxis (PrEP) to women with gonorrhea or syphilis. We estimated HIV incidence among women following a syphilis, gonorrhea, or chlamydia diagnosis among women in King County, WA using surveillance data from 2008 to 2018. Among women with diagnosed with gonorrhea and among women diagnosed with chlamydia the estimated HIV incidence rates were 0.06 and 0.02 per 100 person years, respectively. No women reported with syphilis were diagnosed with HIV.

  July 15, 2020

  PrEP

  AIDS

• Four Decades of HIV/AIDS — Much Accomplished, Much to Do

  The dramatic saga of the acquired immunodeficiency syndrome (AIDS) features an early sense of helplessness and frustration in the face of a mysterious new disease, courage on the part of the afflicted, and the gradual accrual of groundbreaking scientific advances that have brought hope to a formerly desperate situation. This progress began with a series of detailed epidemiologic studies, which were followed by the discovery of the human immunodeficiency virus (HIV) as the causative agent of AIDS, and has culminated in highly effective treatment regimens that have transformed HIV from a near-certain death sentence to a manageable disease (see timeline). Looking ahead, and considering the spectacular scientific advances that have been made over nearly four decades, it is conceivable that with optimal implementation of available prevention strategies and treatments, the end of HIV/AIDS as a global pandemic will be attainable.

  July 2, 2020

  General

  NEJM

• Clinical Targeting of HIV Capsid Protein With a Long-Acting Small Molecule

  Oral antiretroviral agents provide life-saving treatments for millions of people living with HIV, and can prevent new infections via pre-exposure prophylaxis. However, some people living with HIV who are heavily treatment-experienced have limited or no treatment options, owing to multidrug resistance6. In addition, suboptimal adherence to oral daily regimens can negatively affect the outcome of treatment—which contributes to virologic failure, resistance generation and viral transmission—as well as of pre-exposure prophylaxis, leading to new infections.

  July 1, 2020

  Treatment

  Nature

• Learning from People with HIV: Their Insights are Critical to Our Response to the Intersecting COVID-19 and HIV Pandemics in Africa

  To date, more than 150,000 cases and 4000 deaths from COVID-19 have been reported in the region. Due to lack of testing infrastructure and stigma around COVID-19, the actual numbers are likely much larger. We do not know yet know if HIV infection is a biological risk factor for SARS-CoV-2 infection or severe COVID-19 disease. Either way, it is readily apparent that COVID-19 and related containment measures are having a profound impact on the lives of PWH.

  June 30, 2020

  General

  AIDS and Behavior

• Sexual Health of Rural and Urban Young Male Couples in the United States: Differences in HIV Testing, Pre-exposure Prophylaxis Use, and Condom Use

  The present study used data from a randomized controlled trial of a relationship education and HIV prevention program for male couples to test associations of rurality with HIV/STI testing, PrEP use, number of sexual partners, and condomless anal sex (CAS) acts. Participants were 430 YMSM in relationships. Rural YMSM were less likely to have been tested for HIV/STIs, and to have used PrEP, compared to urban YMSM.

  June 30, 2020

  Male and Female Condoms, PrEP

  AIDS and Behavior

• Multimonth Dispensing of Antiretroviral Therapy Protects the Most Vulnerable From 2 Pandemics at Once

  Multimonth dispensing, which provides patients with several months of antiretroviral therapy, benefits HIV patients by decreasing the number of required clinic visits, improving retention, and improving viral suppression. With the increased spread of severe acute respiratory syndrome coronavirus 2, we encourage governments, ministries of health, and health care facilities to implement multimonth dispensing for patients with HIV who are stable to reduce clinic visits and safeguard both health care workers and patients from coronavirus disease 2019.

  June 30, 2020

  Treatment

  Global Health: Science and Practice

• Recognition Patterns of the C1/C2 Epitopes Involved in Fc-Mediated Response in HIV-1 Natural Infection and the RV114 Vaccine Trial

  Our data indicate that most vaccine Abs recognize the 7-stranded β-sandwich of gp120, a unique hybrid epitope bridging A32 and C11 binding sites. Although primarily directed at the 7-stranded β-sandwich, some accommodate the gp120 N terminus in C11-bound 8-stranded conformation and therefore recognize a broader range of CD4-triggered Env conformations. Our data also suggest that Abs of RV144 and RV305, the RV144 follow-up study, although likely initially induced by the ALVAC-HIV prime encoding full-length gp120, matured through boosting with truncated AIDSVAX gp120 variants.

  June 30, 2020

  HIV Vaccine

  mBio

• Sociodemographic and Behavioural Factors Associated With Testing for HIV and STIs in a US Nationwide Sample of Transgender Men Who Have Sex With Men

  These findings indicate that a notable percentage of TMSM had never tested for HIV and bacterial and viral STIs, though at rates only somewhat lower than among cisgender MSM despite similar patterns of risk behaviour. Efforts to increase HIV/STI testing among TMSM, especially among those who engage in condomless anal sex, are needed.

  June 30, 2020

  Male and Female Condoms, General

  Sexually Transmitted Infections

• Clinical Trials of Broadly Neutralizing Monoclonal Antibodies for HIV Prevention: A Review

  Since 2010, several new highly potent bnAbs have been assessed in clinical trials alone or in combination for HIV prevention. If bnAbs are shown to be effective in preventing HIV infection, they could fast-track vaccine development as correlates of protection, and contribute as passive immunization to achieving the goal of epidemic control. This review provides a synopsis of the available data on bnAbs in clinical trials for HIV prevention.

  June 30, 2020

  Antibody Related Research

  Journal of Infectious Diseases

• Pre-exposure Prophylaxis Among Men Who Have Sex With Men in Côte d'Ivoire: A Quantitative Study of Acceptability

  Overall, 35.3 percent reported that they would use PrEP very probably if made available. In multivariate analysis, factors associated with high PrEP acceptability were condom use at last sexual intercourse; insertive sex as compared to versatile sex; free PrEP delivery, concerns about side effects, and being preoccupied by the fact that post-PrEP antiretroviral therapy could be inefficient. PrEP implementation among MSM in Côte d’Ivoire should be accompanied by awareness raising campaigns explaining its utility.

  June 30, 2020

  PrEP

  AIDS Care

• A Review of HIV Pre-Exposure Prophylaxis (PrEP) Programmes by Delivery Models in the Asia-Pacific Through the Healthcare Accessibility Framework

  PrEP programmes could be classified by delivery models through the five constructs of healthcare accessibility. While the coverage of PrEP remains limited in the Asia‐Pacific, an evaluation of these models could benchmark best practices, which would in turn allow effective models to be designed.

  June 30, 2020

  PrEP

  JIAS

• Utility of Digitising Point of Care HIV Test Results to Accurately Measure, and Improve Performance Towards, the UNAIDS 90-90-90 Targets

  Digitisation of PoCT results provides individuated HIV testing data to assist in linkage to care and in differentiating newly diagnosed patients from positive patients retesting. Actionable and accurate data can improve the measurement of performance towards the UNAIDS 90-90-90 targets.

  June 30, 2020

  General

  PLOS One

• The Relationship Between Perception of HIV Susceptibility and Willingness to Discuss PrEP With a Health Care Provider: A Pilot Study

  Men who had an increased perception of HIV susceptibility were significantly more likely to feel comfortable discussing PrEP with a health care provider. Men who distinguish themselves to be at increased risk of acquiring HIV were significantly more likely to report having either insertive or receptive condomless anal intercourse within the previous 3 months, while men who reported condomless vaginal intercourse perceived low HIV susceptibility.

  June 30, 2020

  PrEP

  American Journal of Men's Health

• Impact Along the HIV Pre-Exposure Prophylaxis "Cascade of Prevention" in Western Kenya: A Mathematical Modelling Study

  Implementation challenges along the prevention cascade compound to diminish the population‐level impact of oral PrEP. Long‐acting PrEP is expected to be less impacted by user uptake and adherence, but it is instead dependent on product availability in the short term and retention in the long term. To maximize the impact of long‐acting PrEP, ensuring timely product approval and rollout is critical. Research is needed on strategies to improve retention and patterns of PrEP re‐initiation.

  June 30, 2020

  PrEP

  JIAS

• Evaluation of a Pre-Exposure Prophylaxis Programme for Men Who Have Sex With Men and Transgender Women in Thailand: Learning Through the HIV Prevention Cascade Lens

  PrEP service cascades from the Princess PrEP programme identified no or low-risk perception as key barrier to PrEP acceptance among MSM and TGW who met PrEP eligibility criteria. More implementation research studies are needed to explore PrEP motivation and access in larger communities outside of clinical services. This is to identify gaps and strategies to address them within motivation, access and effective use domains of the HIV prevention cascade.

  June 30, 2020

  PrEP

  JIAS

• Operationalizing the HIV Prevention Cascade for PWID Using the Integrated Bio-Behavioural Survey Data From Ukraine

  Overall, the cascade framework was useful to describe the status of HIV prevention among PWID in Ukraine and to identify areas for improvement in the programming and evaluation of HIV prevention. Access to needle/syringe and condom programmes was substantially below the recommended levels. Effective use of clean syringes was reported by a vast majority of PWID, although likely affected by self‐report bias; whereas consistent condom use was infrequent.

  June 30, 2020

  JIAS

• Using a HIV Prevention Cascade for Identifying Missed Opportunities in PrEP Delivery in Kenya: Results From a Programmatic Surveillance Study

  The application of a PrEP cascade framework facilitated this large‐scale oral PrEP programme to conduct granular programmatic analysis, detecting “leaks” in the cascade. These informed programme adjustments to mitigate identified gaps resulting in improvement of selected programmatic outcomes. PrEP programmes are encouraged to introduce the cascade analysis framework into new and existing programming to optimize HIV prevention outcomes.

  June 30, 2020

  PrEP

  JIAS

• Strengthening Primary HIV Prevention: Better Use of Data to Improve Programmes, Develop Strategies and Evaluate Progress

  It is heartening to learn from recent data in multiple settings that decreasing community viral load through “universal test and treat” (UTT) programmes is having a significant impact on HIV morbidity, mortality and the rate of new HIV infections in some settings. However, focusing only on preventing transmission from a person already living with HIV to one who is not, is only half of the equation and will by itself not “end HIV.”

  June 30, 2020

  General

  JIAS

• A Tale of Two Cascades: Promoting a Standardized Tool for Monitoring Progress in HIV Prevention

  The HIV prevention field has been grappling for years with the idea of developing a standardised way to regularly assess progress and to monitor and improve programmes accordingly. The cascade provides the potential to do this, but it is complicated and highly nuanced. We believe the two models proposed here reflect emerging consensus among the range of stakeholders who have been engaging in this discussion and who are dedicated to achieving global HIV prevention goals by ensuring the most appropriate and effective programmes and methods are supported.

  June 30, 2020

  General

  JIAS

• HIV Risk, Risk Perception, and PrEP Interest Among Adolescent Girls and Young Women in Lilongwe, Malawi: Operationalizing the PrEP Cascade

  These results highlight key relationships between epidemiologic HIV risk, risk perception and interest in PrEP. While risk perception did partially explain the relationship between epidemiologic risk and PrEP interest, there may be other important motivational mechanisms that are not captured in many HIV prevention cascades. The high number of participants with risk scores below the high‐risk cutoff who both expressed high perceived risk and interest in PrEP suggests that demand for PrEP among AGYW may not be well aligned with epidemiologic risk.

  June 30, 2020

  PrEP

  JIAS

• Use of Data From Various Sources to Evaluate and Improve the Prevention of Mother-To-Child Transmission of HIV Programme in Zimbabwe: A Data Integration Exercise

  Data integration was feasible and identified gaps in programme implementation/documentation leading to corrective interventions. Incident infections among mothers are the largest contributors to MTCT: there is need to strengthen the prevention cascade among HIV‐negative women.

  June 30, 2020

  Treatment

  JIAS

• Disparities in the PrEP Continuum for Trans Women Compared to MSM in San Francisco, California: Results From Population-Based Cross-Sectional Behavioural Surveillance Studies

  We found PrEP disparities for trans women compared to MSM and the need for differentiated implementation strategies to meet the specific PrEP barriers trans women face. Inclusion of trans women’s HIV risks is needed in CDC guidance for PrEP. Interventions to increase trans women’s awareness of PrEP including at the provider and community level are also needed. Finally, programming that addresses trans women’s barriers to housing and income is also needed to reduce PrEP disparities.

  June 30, 2020

  PrEP

  JIAS

• Access to HIV Prevention Services in East African Cross-Border Areas: A 2016-2017 Cross-Sectional Bio-Behavioural Study

  Individuals visiting venues in cross‐border areas report poor access to and low effective use of condoms and other prevention services. Availability of HIV prevention services differed by venue and population type and cross‐border area, suggesting opportunities for more granular targeting of HIV prevention interventions and transnational coordination of HIV programming.

  June 30, 2020

  General

  JIAS

• Can HIV Recent Infection Surveillance Help Us Better Understand Where Primary Prevention Efforts Should Be Targeted? Results of Three Pilots Integrating a Recent Infection Testing Algorithm Into Routine Programme Activities in Kenya and Zimbabwe

  We successfully identified recently acquired infections among persons testing HIV‐positive in routine testing settings and highlight the importance of incorporating additional information to accurately classify recent infection. We identified a number of groups with a significantly higher proportion of recent infection, suggesting recent infection surveillance, when rolled‐out nationally, may help in further targeting primary prevention efforts.

  June 30, 2020

  General

  JIAS

• Condom Use Among Young Women Who Sell Sex in Zimbabwe: A Prevention Cascade Analysis to Identify Gaps in HIV Prevention Programming

  Despite high knowledge about efficacy of and access to condoms, there remain large gaps in self‐reported consistent condom use among YWSS. Addressing the structural determinants of YWSS’ inconsistent condom use, including violence, could reduce this gap. YWSS who do not self‐identify as FSW have less access to condoms and may require additional programmatic intervention.

  June 30, 2020

  Male and Female Condoms

  JIAS

• Factor Structure of a Male Involvement Index to Increase the Effectiveness of Prevention of Mother-To-Child HIV Transmission (PMTCT) Programs: Revised Male Involvement Index

  Given the low rates of male involvement participation in antenatal care, interventions are needed to increase male involvement. However, a method of quantifying male partner participation was needed to assess the effectiveness of such interventions. We hope that the Revised Male Involvement Index will stimulate further research in this area, thus increasing the effectiveness of PMTCT programs aimed at increasing male partner involvement.

  June 30, 2020

  Treatment

  AIDS Care

• Youth Preferences for HIV Testing in South Africa: Findings from the Youth Action for Health (YA4H) Study Using a Discrete Choice Experiment

  We conducted a discrete choice experiment (DCE) and quantified preferences for HIV testing among South African youth (Nov 2018 to Mar 2019). Six attributes and levels were identified through qualitative methods: source of HIV information; incentive amount and type; social support; testing method; and location. Each participant chose one of two options that comprised six attributes across 18 questions. Conditional logistic regression estimated the degree of preference.

  June 30, 2020

  General

  AIDS and Behavior

• Qualitative Characterizations of Relationships Among South African Adolescent Girls and Young Women and Male Partners: Implications for Engagement Across HIV Self-Testing and Pre-Exposure Prophylaxis Prevention Cascades

  Screening to identify AGYW relationship dynamics can support tailoring prevention services to relationship‐driven barriers and facilitators. HIV prevention counseling for AGYW should address relationship goals or partner’s influence, and engage with MP around female‐controlled prevention interventions.

  June 30, 2020

  PrEP

  JIAS

• Cost-effectiveness of Couples' Voluntary HIV Counselling and Testing in Six African Countries: A Modelling Study Guided by an HIV Prevention Cascade Framework

  Our model indicates that nationalized CVCT could prevent over half of adult HIV infections for 7 percent to 21 percent of the modelled countries’ five‐year PEPFAR budgets. While other studies have indicated that CVCT motivation is high given locally relevant promotional and educational efforts, without required indicators, targets and dedicated budgets, access remains low.

  June 30, 2020

  General

  JIAS

• Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy: A Cohort Study

  HIV-positive patients receiving TDF/FTC have a lower risk for COVID-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV.

  June 26, 2020

  Treatment

  Annals of Internal Medicine

• Addressing Vulnerable Population Needs in the Last Mile to the elimination of mother to child transmission of HIV: (Re)Claiming the HIV Response for Female Sex Workers and Their Children

  As countries strive to eliminate mother-to-child transmission of HIV, female sex workers (FSW) and their children still face barriers to accessing these essential services. Data on FSW uptake of HIV and reproductive health services before, during, and after pregnancy reveal inadequate service utilization. Stigma encountered by FSW in healthcare settings may contribute to low uptake of HIV testing, antiretroviral therapy (ART), and other prevention of mother-to-child HIV transmission (PMTCT) services.

  June 26, 2020

  BMC Public Health

• "You Talk About Problems Until You Feel Free": South African Adolescent Girls' and Young Women's Narratives on the Value of HIV Prevention Peer Support Clubs

  Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.

  June 26, 2020

  PrEP

  BMC Public Health

• The Impact of COVID-19 on HIV Treatment and Research: A Call to Action

  Given that HIV also has a disproportionate impact on marginalized communities, COVID-19 is affecting people with HIV (PWH) in unique ways and will continue to have an impact on HIV research and treatment after the COVID-19 crisis passes.

  June 24, 2020

  Treatment

  Int. J. Environ. Res. Public Health

• The Use of Toll-Like Receptor Agonists in HIV-1 Cure Strategies

  Here, we review preclinical and clinical data on the impact of TLR stimulation on HIV-1 latency as well as antiviral and HIV-1-specific immunity. We also focus on the promising role of TLR agonists in combination strategies in HIV-1 cure research. Different combinations of TLR agonists and broadly neutralizing antibodies or TLRs agonists as adjuvants in HIV-1 vaccines have shown very encouraging results in non-human primate experiments and these concepts are now moving into clinical testing.

  June 11, 2020

  Cure

  Frontiers in Immunology

Announcements