6 MAY 2022 VOLUME 24 ISSUE 18

The US Senate has confirmed Dr. John Nkengasong as the US global AIDS coordinator, which will include leadership of the US President's Emergency Plan for AIDS Relief — the US global HIV initiative. The Cameroonian virologist is the first person born on the African continent to take on the role. He currently serves as the director of the Africa Centres for Disease Control and Prevention.

One in ten Namibian infants with HIV had tenofovir resistance and one in six had resistance to abacavir before starting treatment, while two-thirds had resistance to a non-nucleoside reverse transcriptase inhibitor (NNRTI). The study investigators say the level of resistance to tenofovir is the highest observed in any country study to date and highlights the need to accelerate access to alternative antiretroviral regimens for young children.

Forty years in, despite reams of data, advances in testing and treatment, and the best of intentions, experts continue to grapple over the best solution for reaching and convincing millions of people — especially adolescents and young adults — to take highly effective, daily preexposure prophylaxis (PrEP) for HIV.

On 18 May, the world will mark HIV Vaccine Awareness Day — the Aurum Institute, in partnership with the International AIDS Vaccine Initiative, will unveil new research on HIV vaccines.

The use of mandrax may contribute to HIV risk among adolescent girls and young women (AGYW), according to new research published by the South African Medical Journal. The study titled: ‘Mandrax use, sexual risk, and opportunities for pre-exposure prophylaxis (PrEP) among out-of-school adolescent girls and young women in Cape Town, South Africa’ sought to examine the role of mandrax use in sexual behaviours and the extent to which AGYW who use mandrax were aware of and willing to initiate PrEP.

In early April, drugs for HIV treatment financed by PEPFAR reached Ukraine. But there’s another layer of challenge: distributing them to regions across the country. It’s no small feat given how parts of Ukraine remain in active war with Russia, and Russian soldiers have taken control of some areas, making deliveries difficult and at times close to impossible.

Since the beginning of the HIV epidemic in the early 1980s, Black women have been heavily affected — making up over half of new diagnoses among US women today. With that, they’ve been equally impacted by stigmas that exist around the virus. Now they’re speaking up about it.

There’s a special kind of HIV cure research going on at the Ragon Institute in Cambridge, Massachusetts. Scientists there are collecting blood samples from folks who’ve been on HIV treatment for 15 years or longer. They’ll analyze the samples to determine if these folks are good candidates to do an HIV treatment interruption study with a lofty goal: to see if, by this point, people’s own immune systems have developed the ability to control HIV without meds.

Major themes related to barriers emerged across the individual, family, community, and structural level. Limited barriers related to partners, instead partners with HIV encouraged PrEP use. Participants commonly reported low perceived HIV risk, fear of disclosure, barriers relating to insurance/cost, and medication use as reasons for nonuse of PrEP. For youth to remain on a healthy life course, HIV preventative measures will need to be adopted early in adolescence for those at risk of HIV acquisition.

By recapitulating the early HIV-1 human neutralizing antibody responses in a nonhuman primate immunization model, we demonstrate remarkable similarities as well as the potential of using this approach as a starting point to drive neutralizing antibody breadth, one of the ultimate goals of vaccine design.

Under the assumption that making PrEP easily accessible for all adults in sub-Saharan Africa in the context of community education leads to risk-informed use, PrEP is likely to be cost-effective in settings with prevalence of HIV viral load greater than 1000 copies per mL among all adults higher than 2 percent, suggesting the need for implementation of such approaches, with ongoing evaluation.

Establishing HIV resistance monitoring within PrEP programs is feasible. Approaches to drug resistance monitoring may evolve as the PrEP programs mature and expand. The methods and implementation support offered by GEMS assisted countries in developing methods to monitor for drug resistance that best fit their PrEP program needs and resources.

Over 25 percent of MSM with newly diagnosed HIV from 2020-2021 had ever used PrEP. Over 50 percent who discontinued PrEP were diagnosed <6 months after stopping. Strategies to preempt PrEP discontinuations, enhance retention, and facilitate resumption of PrEP are critical to decrease new HIV diagnoses.

Virtual service delivery is possible in the context of COVID-19 and might strengthen HIV prevention service delivery in the long-run. These platforms can also be leveraged for COVID-19 service delivery.

Structural determinants of health drive inequities in the acquisition of human immunodeficiency virus (HIV) and the use of preexposure prophylaxis (PrEP) for HIV prevention among cisgender women in the United States. However, current PrEP clinical guidance and implementation paradigms largely focus on individual behaviors and characteristics, resulting in missed opportunities to improve PrEP access, and the implicit transferring of prevention work from health systems to individuals.

Literature review reveals that the elimination of latent or active Mtb infections in a given population seems to be an epigenetic process. With a better understanding of the connections between bacterial infections and gene expression conditions in epigenetic events, opportunities arise in designing protective vaccines or therapeutic agents, particularly as epigenetic processes can be reversed. Therefore, this review provides a brief overview of different approaches towards novel vaccination strategies and the mechanisms underlying these approaches.

A better understanding of the molecular mechanisms of HIV-1 latency allows for the development of innovative antiviral strategies. As a proof-of-concept, we showed that pharmacological inhibition of UHRF1 in ex vivo HIV+ patient cell cultures resulted in potent viral reactivation from latency. Together, we identify UHRF1 as a novel actor in HIV-1 epigenetic silencing and highlight that it constitutes a new molecular target for HIV-1 cure strategies.