5 JUNE 2020 VOLUME 22 ISSUE 22

Media Coverage

• Life-Saving HIV Drug PrEP On NHS Delayed Amid Coronavirus Pandemic

  PrEP, the life-saving HIV prevention drug, was due to be available on the NHS in April 2020. But today it has emerged one sexual health clinic is telling its patients it's been "indefinitely delayed."

  June 5, 2020

  PrEP

  Forbes

• HIV Positive South Africans Urged to Take Treatment Amid COVID-19 Pandemic

  As South Africans with compromised immune systems are continuously warned to be extra cautious amid the COVID-19 pandemic, questions have been raised about the vulnerability of the country’s large HIV population on antiretroviral treatment.

  June 5, 2020

  Treatment

  Eyewitness News

• As We Race Toward a COVID-19 Vaccine, Where Are We With HIV?

  Allow me to begin with scenes from my life: In my office men’s room, a man kicks the toilet seat up with his foot to avoid touching it. Passengers on the subway look suspiciously at her other, searching for signs of illness, and quickly move away from anyone who coughs. Family members or friends perceived to be “at risk” are admonished to be “extra careful” with their health. Healthcare professionals express fear of being exposed on the job.

  June 5, 2020

  HIV Vaccine

  HIV Plus Mag

• We Can’t Ignore Racism When Thinking About HIV and COVID-19

  “I don’t know a single Black person who is sleeping properly these days” tweeted Dr Crystal Fleming in New York City the other night. As a black British woman this is my new reality. Each morning I wake up with a twist of fear about how I’ll keep my family safe and what new horrors I’ll hear about being unleashed on my community.

  June 5, 2020

  General

  aidsmap

• Sex Workers Abandoned As COVID-19 Crackdowns Undo Africa’s HIV Efforts

  In the days before the COVID-19 crisis, Ugandan sex worker Lillian Namiiro worked on the Tanzanian border, educating colleagues and connecting people to the national HIV response.

  June 4, 2020

  PrEP, Treatment

  Mail & Guardian

• OraSure to Buy UrSure, an HIV Startup That Tests Adherence to PrEP

  OraSure Technologies, best known for its rapid HIV tests, is purchasing UrSure Inc., a private Boston-based company that has developed tests to measure adherence to pre-exposure prophylaxis, or PrEP, the daily tablet taken by HIV-negative people to prevent contracting the virus.

  June 3, 2020

  General

  POZ

• Before Deliberately Infecting People With Coronavirus, Be Sure It’s Worth It

  The severity of the COVID-19 pandemic has prompted serious consideration of a type of research — challenge trials — that might ordinarily be dismissed as too risky. Challenge trials intentionally expose healthy people to a pathogen to quickly learn more about the disease it causes or to gain early insight into whether a new vaccine or treatment works. These studies can be done ethically, but are not typically done for emerging viruses we know so little about, and for which there are no proven cures.

  June 2, 2020

  General

  New York Times

• Only 891 in Free HIV-Prevention Drug Program Meant for 200,000

  A Trump administration program to get 200,000 uninsured patients access to the HIV prevention drug Truvada only has 891 participants, HHS Assistant Secretary for Health Brett Giroir said Monday at a virtual meeting of the Presidential Advisory Council on HIV/AIDS.

  June 1, 2020

  PrEP

  Bloomberg Law

• Remembering Dr. Ron Simmons, Black Gay Activist and HIV Champion Who Was So Much More

  Simmons was best known for his 24 years of transformative work with Us Helping Us, People Into Living, Inc.—an organization dedicated to improving the well-being of Black gay men and reducing the impact of HIV/AIDS throughout the entire Black community—which he led as president and CEO until 2016. In accordance with his excellence—and in observation of the 30th anniversary of the HIV/AIDS pandemic—the Obama White House honored his work against the disease by declaring him a Champion of Change on June 10, 2011.

  June 1, 2020

  General

  The Body

• HIV Cure Research Has Slowed, But Still Progresses

  For years, the scientific community has been pursuing the holy grail of a complete cure for HIV, the infection linked to the deadly AIDS disease which has 35 million people worldwide since its discovery 4 decades—and to this day afflicts nearly 38 million.

  May 31, 2020

  Cure

  Contagion Live

Published Research

• COVID-19 Vaccine Development Pipeline Gears Up

  Vaccine development is typically a long game. The US Food and Drug Administration only approved a first vaccine against Ebola virus last year, 43 years after the deadly virus was discovered. Vaccinologists have made little headway with HIV or respiratory syncytial virus, despite huge investments. On average, it takes 10 years to develop a vaccine. With the COVID-19 crisis looming, everyone is hoping that this time will be different.

  June 6, 2020

  General

  Lancet

• HIV Prevention Clinical Trials’ Community Engagement Guidelines: Inequality, and Ethical Conflicts

  We reflect on the events that led to the controversies and identified that scientific and ethical concerns raised by members of local communities at each of these sites were erased by trialists, causing crisis that led to premature shut down the early PrEP trials. In the aftermath of these trials, the World Health Organisation, UNAIDS, and AVAC developed ethics guidelines intended to recognize the concerns as authentic, and developed guidelines to improve researchers’ engagement of communities in biomedical HIV prevention trial design and implementation.

  June 5, 2020

  PrEP

  Global Bioethics

• Optimizing PMTCT Efforts by Repeat HIV Testing During Antenatal and Perinatal Care in Resource-Limited Settings: A Longitudinal Assessment of HIV Seroconversion

  The low rates of seroconversion suggest that testing pregnant women multiple times during ANC and PNC may not be cost effective, but a follow-up test during birth may be protective of the newborn.

  June 5, 2020

  Treatment

  PLOS One

• Comparison Of HIV Incidence In The Zimbabwe Population-Based HIV Impact Assessment Survey (2015-2016), With Modeled Estimates: Progress Toward Epidemic Control

  The observed HIV incidence in ZIMPHIA 2015/16 validated the 2016 Spectrum estimates and Zimbabwe’s progress toward epidemic control.

  June 5, 2020

  General

  AIDS Research and Human Retroviruses

• Early Adopters of Event-driven Human Immunodeficiency Virus Pre-exposure Prophylaxis in a Large Healthcare System in San Francisco

  Among 279 patients within a large healthcare system in San Francisco, event-driven HIV pre-exposure prophylaxis using a 2–1–1 regimen was a desirable alternative to daily dosing. Problems with adherence, planning sex in advance, or side effects were infrequent (13.9 percent). We found no new HIV infections over 136 person-years of follow-up.

  June 4, 2020

  PrEP

  Clinical Infectious Diseases

• How to Have Sex in an Epidemic Redux: Reinforcing HIV Prevention in the COVID-19 Pandemic

  In this Note, we draw on lessons learned from four decades of the HIV response with GBMSM communities, and our respective programs of research, to advocate carefully recalibrated, community-engaged approaches to reinforcing HIV prevention in the COVID-19 pandemic.

  June 4, 2020

  General

  AIDS and Behavior

• The Potential Impact of Long-Acting Cabotegravir for HIV Prevention in South Africa: A Mathematical Modelling Study

  Delivering CAB LA to 10 percent of the adult population could avert more than 15 percent of new infections from 2023-2050. The impact would be lower but more efficient if delivered to populations at higher HIV risk: 127 person-years of CAB LA use would be required to avert one HIV infection within five years if used by all adults and 47 if used only by the highest risk women.

  June 3, 2020

  PrEP

  The Journal of Infectious Diseases

• Regional Disparities in Qualified Health Plans’ Prior Authorization Requirements for HIV Pre-exposure Prophylaxis in the United States

  Compared with qualified health plans (QHPs) in the Northeast, QHPs in the South were almost 16 times as likely to require prior authorization for PrEP, and the reasons for these disparities are unknown. The prior authorization requirement is a possible barrier to PrEP access in the South, which is the region of the United States with the most annual new HIV diagnoses. There is limited regulation of QHPs’ prior authorization requirements. Federal- or state-level health policy laws may be necessary to remove this system-level barrier to ending the HIV epidemic in the United States.

  June 3, 2020

  PrEP

  JAMA Network Open

• Induction of Neutralizing Responses against Autologous Virus in Maternal HIV Vaccine Trials

  Maternal antiretroviral therapy (ART) has effectively reduced but not eliminated the burden of mother-to-child transmission of HIV across the globe, as an estimated 160,000 children were newly infected with HIV in 2018. Thus, additional preventive strategies beyond ART will be required to close the remaining gap and end the pediatric HIV epidemic. A maternal active immunization strategy that synergizes with maternal ART could further reduce infant HIV infections.

  June 3, 2020

  HIV Vaccine

  mSphere

• The Impact of HIV Pre-Exposure Prophylaxis (PrEP) Counseling on PrEP Knowledge and Attitudes Among Women Seeking Family Planning Care

  Introducing PrEP counseling into routine FP care is feasible, and effectively improves knowledge and attitudes about PrEP within a large population of women, broadening access to PrEP on individual and population levels. The Women's PrEP Counseling Checklist (WPCC) tool both enhances the impact of counseling on patients and reduces the work burden on providers.

  June 3, 2020

  PrEP

  Journal of Women's Health

• Willingness to Distribute HIV Self-Testing Kits to Recent Sex Partners Among HIV-Negative Gay and Bisexual Men and an Examination of Free-Response Data from Young Men Participating in the Nationwide Cohort

  The findings highlight the need for supportive intervention strategies such as informational content for HIVST, using motivational interviewing when providing the testing kits to index clients and providing skills-based training through role-playing exercises. Secondary distribution of HIVST kits through index patients is a potentially acceptable approach that could be used to expand access to HIV testing and aid in efforts to end the HIV epidemic in the US.

  June 3, 2020

  General

  Archives of Sexual Behavior

• Impact of the COVID-19 Pandemic on HIV Testing and Assisted Partner Notification Services, Western Kenya

  On March 13, 2020, the first case of COVID-19 was confirmed in Kenya. In response, national guidelines were enacted to prevent its spread. Clinics and HIV programs were faced with the challenge of balancing the safety of staff with healthcare needs of the community. Here we report the impact of COVID-19 on clinics providing aPS services in western Kenya using programmatic data to assess trends over time and conversations with in-country staff to explore perspectives and challenges associated with aPS provision during COVID-19.

  June 2, 2020

  General

  AIDS and Behavior

• In the Shadow of HIV & TB: A Commentary on the COVID Epidemic in South Africa

  Overcoming the grave threats to public health presented by COVID-19 requires both international cooperation and country-specific efforts that reflect local histories, needs, and resources. Already concerns are being expressed among health officials about how COVID-19 might be devastating in Africa. Currently, South Africa has the highest number of diagnosed COVID-19 cases on the continent and has been identified as being at high risk in the pandemic.

  June 2, 2020

  General

  Global Public Health

• Syndemic Theory, Structural Violence and HIV Among African–Americans

  These studies have yielded valuable insights into links between HIV-related outcomes and mental health, experience of violence and abuse, and substance use. But a key feature - and major utility - of the syndemics framework is its potential for examining not only synergistic individual-level risk factors but also the interactions with economic, political and social systems that influence these individual-level factors and thereby shape the HIV epidemic among African-Americans.

  June 1, 2020

  General

  Current Opinion in HIV and AIDS

• Implications of HIV Treatment Policies on the Health Workforce in Rural Malawi and Tanzania Between 2013 and 2017: Evidence From the SHAPE-UTT Study

  Although increasing patient numbers bodes well for achieving universal antiretroviral therapy coverage, the quality of care may be undermined by increased workloads and insufficient provider training. Task-shifting strategies may help address workload concerns, but require careful monitoring, supervision and mentoring to ensure effective implementation.

  June 1, 2020

  Treatment

  Global Public Health

• Tail-Phase Safety, Tolerability, and Pharmacokinetics of Long-Acting Injectable Cabotegravir in HIV-Uninfected Adults: A Secondary Analysis of the HPTN 077 Trial

  The clinical significance of the long pharmacokinetic tail of cabotegravir observed in female participants compared with male participants, and those with higher BMI compared with a lower BMI, need to be addressed in future trials.

  June 1, 2020

  PrEP, Treatment

  Lancet HIV

• Chasing the Cabotegravir Tail: Implications for Prevention

  In The Lancet HIV, Raphael Landovitz and colleagues describe the safety and pharmacokinetic tail (ie, how long the drug persists after final administration) of cabotegravir. The authors estimated that injectable cabotegravir might remain detectable after discontinuation for nearly 3 years in men and 4 years in women. Higher body-mass index (BMI), irrespective of sex, also contributed to longer exposure.

  June 1, 2020

  PrEP, Treatment

  Lancet HIV

• Characteristics of Gay and Bisexual Men Who Rarely Use HIV Risk Reduction Strategies During Condomless Anal Intercourse: Results From the FLUX National Online Cohort Study

  NRR men were largely similar to other Australian GBM. However, our analysis suggests it may be appropriate to focus HIV prevention interventions on younger, less socially engaged and less educated GBM, as well as men who prefer receptive anal intercourse to promote the use of effective HIV risk reduction strategies.

  June 1, 2020

  Male and Female Condoms

  PLOS One

• Getting to 90-90-90: Experiences From the MaxART Early Access to ART for All (EAAA) Trial in Eswatini

  As low- and middle-income countries adopt the Treat All approach in their national HIV care and treatment guidelines, further implementation science research is needed to understand and address the system-level barriers to achieving the benefits of Treat All for HIV-infected individuals and those at risk.

  May 30, 2020

  Treatment

  Current HIV/AIDS Reports

• Specificity of CD8+ T-Cell Responses Following Vaccination with Conserved Regions of HIV-1 in Nairobi, Kenya

  Here, we study fine details of CD8+ T-cell responses elicited in HIV-1/2-uninfected individuals in Nairobi, Kenya, who received a candidate vaccine delivering conserved regions of HIV-1 proteins called HIVconsv. Using 10-day cell lines established by in vitro peptide restimulation of cryopreserved PBMC and stably HLA-transfected 721.221/C1R cell lines, we confirm experimentally many already defined epitopes, for a number of epitopes we define the restricting HLA molecule(s) and describe four novel HLA-epitope pairs.

  May 29, 2020

  HIV Vaccine

  Vaccines

• Gene Editing in CHO Cells to Prevent Proteolysis and Enhance Glycosylation: Production of HIV Envelope Proteins As Vaccine Immunogens

  In this paper, we describe the development of two novel CHOK1 cell lines with the C1s gene inactivated by gene editing, that are suitable for the production of any protein susceptible to C1s proteolysis. One cell line, C1s-/- CHOK1 2.E7, contains a deletion in the C1s gene. The other cell line, C1s-/- MGAT1- CHOK1 1.A1, contains a deletion in both the C1s gene and the MGAT1 gene, which limits glycosylation to mannose-5 or earlier intermediates in the N-linked glycosylation pathway. In addition, we compare the substrate specificity of C1s with thrombin on the cleavage of both rgp120 and human Factor VIII, two recombinant proteins known to undergo unintended proteolysis (clipping) when expressed in CHO cells. Finally, we demonstrate the utility and practicality of the C1s-/- MGAT1- CHOK1 1.A1 cell line for the expression of clinical isolates of clade B Envs from rare individuals that possess broadly neutralizing antibodies and are able to control virus replication without anti-retroviral drugs (elite neutralizer/controller phenotypes). The Envs represent unique HIV vaccine immunogens suitable for further immunogenicity and efficacy studies.

  May 29, 2020

  HIV Vaccine

  PLOS One

• Acceptability and Tolerability of Repeated Intramuscular Electroporation of Multi-antigenic HIV (HIVMAG) DNA Vaccine Among Healthy African Participants in a Phase 1 Randomized Controlled Trial

  Repeated intramuscular electroporation for vaccine delivery was found to be acceptable and feasible among healthy African HIV vaccine trial participants. The majority of participants reported an acceptable pain level at all vaccination time points. Further investigation may be warranted into the value of EP to improve immunization outcomes.

  May 29, 2020

  HIV Vaccine

  PLOS One

• Unlocking HIV Pre-Exposure Prophylaxis Delivery: Examining the Role of HIV Providers in Pre-Exposure Prophylaxis Care

  The following themes were identified: (1) to reach a greater proportion of patients at risk for HIV and address racial/ethnic and gender disparities, PrEP should be available in a variety of settings and provided by different types of providers within proximity to affected populations; (2) financial support is needed beyond addressing medication cost; and (3) multidisciplinary teams and population-specific clinic protocols can assist providers in conducting high-quality visits and addressing these barriers to PrEP.

  May 28, 2020

  PrEP

  AIDS Patient Care and STDs

• Integrating HIV Pre-Exposure Prophylaxis into Family Planning Care: A RE-AIM Framework Evaluation

  Embedding HIV prevention services in the family planning setting was feasible in this pilot. The proportion of women screened for PrEP rapidly increased. In this high HIV prevalence community, nearly all screened women were eligible and 6 percent initiated PrEP.

  May 28, 2020

  PrEP

  AIDS Patient Care and STDs

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