6 NOVEMBER 2020 VOLUME 22 ISSUE 43

Media Coverage

• What Do Men Who Have Sex With Women Think About PrEP?

  A study from Eswatini, where 27 percent of people are living with HIV, has provided important insight into heterosexual men’s views on pre-exposure prophylaxis (PrEP).

  November 6, 2020

  PrEP

  Avert

• HIV Diagnoses in Gay and Bisexual Men at 20-Year Low

  A new report shows a drop in diagnosed cases across people of all sexualities and genders. And it's not just because we've been in lockdown and not having sex with new people, because these numbers are all about 2019. The report shows there were 1,700 new HIV diagnoses in gay and bisexual men last year, compared to the previous low of 1,500 in 2000.

  November 6, 2020

  Male and Female Condoms, PrEP, Treatment

  BBC

• USAID Provides US$78m for Critical HIV Healthcare Services

  Zimbabwe has received US$78 million from the United States Agency for International Development (USAID) to provide critical HIV healthcare services to 1.4 million people living with the virus.

  November 6, 2020

  General

  Chronicle

• ‘PrEP for Women Too’ Campaign Aims to Bring This Empowering HIV Prevention Tool to More Black and Latinx Women

  Earlier this fall, Planned Parenthood of Greater New York (PPGNY) launched a new campaign that focuses on connecting cisgender Black and Latinx women to pre-exposure prophylaxis (PrEP), a drug that protects users from HIV transmission.

  November 5, 2020

  PrEP

  The BodyPro

• UN Commends Nigeria’s Bold Step Towards Ownership, Sustainability of HIV Treatment Programme

  The United Nations system in Nigeria and the United States Embassy in Nigeria have acknowledged Nigeria’s commitments and recent bold actions to ending Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) as a public health threat by 2030.

  November 5, 2020

  Treatment

  The Guardian Nigeria

• Black Women’s Uptake of PrEP Hampered by Numerous Factors

  Among African-American women at risk for HIV who participated in a recent interview study in Milwaukee, their potential use of Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP) was apparently impeded by numerous factors, including a lack of awareness of their HIV risk as well as mistrust of the medical establishment.

  November 4, 2020

  PrEP

  POZ

• Women Can Wait Up to Two Months to Find Out if Their Babies Have HIV. This Could Fix That

  The world has more than halved the number of babies who contract HIV from their mothers in the last two decades. But in some places, rates of mother-to-child transmission of HIV are rising again and we don’t have a moment to lose when it comes to diagnosing — and treating — babies born with the virus.

  November 4, 2020

  Treatment

  Bhekisisa

• Can a Single Vaccine Injection Functionally Cure HIV?

  HIV scientist Jose M. Martinez-Navio, PhD, and his team at the University of Miami Miller School have been awarded an $80,000 Campbell Foundation grant to continue their research into a functional cure for HIV via a single vaccine injection. If successful, the approach could also be used by HIV-negative people as pre-exposure prophylaxis to prevent contracting the virus.

  November 3, 2020

  HIV Vaccine

  POZ

• First HIV Self-test Approved in Canada

  Federal regulators have approved the first HIV self-test in Canada, a long-awaited move that experts have said is critical to reaching people who don't know they have the virus. Canada follows dozens of other countries in greenlighting the technology, which has been endorsed by the World Health Organization as a tool to reduce the number of people with undiagnosed HIV.

  November 3, 2020

  General

  CBC

• CDC Cautions About HIV Outbreaks Among People Who Inject Drugs

  Building on lessons learned from a series of HIV outbreaks among people who inject drugs (PWID) over the past five years, the Centers for Disease Control and Prevention (CDC) has issued an advisory cautioning health departments and other groups servicing this population to be on their guard against such outbreaks during the COVID-19 pandemic.

  November 3, 2020

  General

  POZ

• Namibia: Dreams Ambassadors Instrumental in Expanding HIV Education From 21,000 to 64,000 Prospects

  The first group of young women to complete the DREAMS Ambassadors programme on HIV prevention, containment and lifestyle management, has just graduated. From here on, the ambassadors will mobilize and support participation in the programme in their respective communities in Windhoek, Katima, Onandjokwe, Omuthiya and Tsumeb.

  November 2, 2020

  General

  All Africa

Published Research

• Identifying Regions of Greatest Need for Ending the HIV Epidemic: A Plan for America

  Many of the highest priority areas, both by density of HIV cases and by lack of viral suppression and pre-exposure prophylaxis use, were not covered by the original plan, particularly in the South. The current plan to end the HIV epidemic must be expanded to these areas to feasibly allow for a 75 percent reduction in new HIV cases within 5 years.

  December 1, 2020

  General, PrEP, Treatment

  JAIDS

• Long-Acting Injectable Cabotegravir + Rilpivirine for HIV Maintenance Therapy: Week 48 Pooled Analysis of Phase 3 ATLAS and FLAIR Trials

  This combined analysis demonstrates monthly injections of CAB + RPV LA were noninferior to daily oral CAR for maintaining HIV-1 suppression.

  December 1, 2020

  Treatment

  JAIDS

• Pre-exposure Prophylaxis Use and Detected Sexually Transmitted Infections Among Men Who Have Sex With Men in the United States-National HIV Behavioral Surveillance, 5 US Cities, 2017

  The prevalence of extragenital STI was high for both MSM on PrEP and those not on PrEP in the past year. MSM on PrEP were more likely to have rectal chlamydia but not pharyngeal STIs or rectal gonorrhea. Our findings support regular STI testing at exposed anatomic sites as recommended for sexually active MSM, including those on PrEP.

  December 1, 2020

  PrEP

  JAIDS

• Pre-exposure Prophylaxis Uptake Among Men Who Have Sex With Men Who Used nPEP: A Longitudinal Analysis of Attendees at a Large Sexual Health Clinic in Montréal (Canada)

  Over one-third of nPEP users were subsequently prescribed PrEP. However, the large proportion of men who repeatedly use nPEP calls for more efficient PrEP-linkage services and, among those who use PrEP, improved persistence should be encouraged.

  November 6, 2020

  PrEP

  JAIDS

• HIV Drug Resistance Profile in South Africa: Findings and Implications From the 2017 National HIV Household Survey

  Twenty-seven percent of virally unsuppressed respondents had HIVDR, increasing to 75 percent among those who had discontinued ARV. Our findings support strengthening first-line ARV regimens by including drugs with a higher resistance barrier and treatment adherence strategies, and close monitoring of HIVDR.

  November 6, 2020

  Treatment

  PLOS One

• A Call to Improve Understanding of Undetectable Equals Untransmittable (U = U) in Brazil: A Web-Based Survey

  There was a significant difference in perceived accuracy of U = U across population groups. Accurate understanding of the slogan needs to be promoted in more vulnerable populations such as PLHIV of Black identity and GBM of lower income to maximize individual and societal prevention benefits. Moreover, broader understating of U = U among the general population can help decrease societal stigma towards PLHIV.

  November 6, 2020

  Treatment

  JIAS

• PrEP Discontinuation Among Latino/A and Black MSM and Transgender Women: A Need for PrEP Support Services

  PrEP is an important prevention tool for BLMSM and BLTW, particularly during periods of heightened HIV risk. However, both individual (e.g., inability to adhere to medication, changes in HIV sexual risk behaviors) and structural/logistical (e.g., loss of insurance, navigating complex medical systems) factors can cause temporary or indefinite PrEP discontinuation. Additional support services, beyond those offered by medical providers, are needed to help BLMSM and BLTW PrEP users overcome barriers to discontinuation and assist them to remain persistent with their PrEP regimen.

  November 5, 2020

  PrEP

  PLOS One

• Ethics of Pursuing Targets in Public Health: The Case of Voluntary Medical Male Circumcision for HIV-Prevention Programs in Kenya

  We describe ethically problematic practices in Kenyan VMMC programmes revealed by our fieldwork, how the problems are related to the pursuit of targets and discuss possible approaches to their management. Although the establishment and pursuit of targets in public health can have many benefits, assessments of target-driven programmes tend to focus on quantifiable outcomes rather than the processes by which the outcomes are obtained.

  November 4, 2020

  Voluntary Medical Male Circumcision

  Journal of Medical Ethics

• Hormonal Contraception Alters Vaginal Microbiota and Cytokines in South African Adolescents in a Randomized Trial

  Adolescents randomized to combined oral contraceptives (COC) had lower vaginal microbial diversity and relative abundance of HIV risk-associated taxa compared to Net-En or CCVR. Cervicovaginal inflammatory cytokine concentrations were significantly higher in adolescents randomized to CCVR compared to COC and Net-En. This suggests that COC use may induce an optimal vaginal ecosystem by decreasing bacterial diversity and inflammatory taxa, while CCVR use is associated with genital inflammation.

  November 4, 2020

  Hormonal Contraceptives and HIV

  Nature Communications

• A Review of Reported Cases of HIV Pre-Exposure Prophylaxis Failure With Resultant Breakthrough HIV Infections

  Although it is uncommon, ‘true’ PrEP failure can occur in a real‐world situation, contrary to the outcome of early RCTs. Failure to identify HIV infection while on PrEP can potentially lead to the emergence of drug‐resistant virus. To achieve effective HIV prevention, PrEP programmes should emphasize safer sexual practice in addition to drug adherence. Early identification of PrEP failure is crucial, which requires the development of highly sensitive assays and their clinical application.

  November 3, 2020

  PrEP

  HIV Medicine

• Characteristics of Women Who Use Hormonal Contraceptives and Their Population-Level Impacts on HIV Infection in a Cohort of South African Women (2002–2016)

  Our analysis presented evidence for the overlapping characteristics of the women who used hormonal injectables and those at high-risk of HIV infection. These findings reinforce the importance of comprehensive contraceptive counselling to women about the importance of dual protection, such as male condoms and hormonal contraceptives use.

  November 3, 2020

  Hormonal Contraceptives and HIV

  The European Journal of Contraception & Reproductive Health Care

• Assessing Human Immunodeficiency Virus (HIV) Prevention Through Knowledge and Condom Use Among Female Sex Workers at the Border of Haiti and Dominican Republic

  Condom use was significantly lower among FSWs on the Haitian side of the border compared to the Dominican side, yet levels of HIV knowledge were similar; specifically, 81 percent of respondents on the Dominican side reported using condoms every time they had sex with a client, compared to 38 percent of peers in Haiti. After introducing controls, FSWs in Haiti continued to have lower odds of using condoms with clients, noncommercial partners, and regular partners compared to peers in the Dominican Republic.

  November 2, 2020

  Male and Female Condoms

  AIDS Patient Care and STDs

• Heritability of the HIV-1 Reservoir Size and Decay Under Long-Term Suppressive ART

  We find that a moderate but significant fraction of the HIV-1 reservoir size 1.5 years after the initiation of ART is explained by genetic factors. At the same time, we find more tentative evidence for the heritability of the long-term HIV-1 reservoir decay. Our findings indicate that viral genetic factors contribute to the HIV-1 reservoir size and hence the infecting HIV-1 strain may affect individual patients' hurdle towards a cure.

  November 2, 2020

  Cure

  Nature Communications

• Policy and Accountability in Global HIV Responses

  The delivery of scientific advances and access to the medicines, interventions, and knowledge that can prevent infection with HIV and ill health and death due to HIV are enabled by policies set by governments—or, as is all too often the case, hindered by bad policy. A new online resource, the HIV Policy Lab, provides a powerful approach to help hold governments to account when policies fail.

  November 1, 2020

  General

  Lancet HIV

• Vital Voices: HIV Prevention and Care Interventions Developed for Disproportionately Affected Communities by Historically Underrepresented, Early-Career Scientists

  Focused funding that supports historically underrepresented scientists and their HIV prevention and care intervention research can help facilitate reaching national goals to reduce HIV-related disparities and end the HIV epidemic. Maintaining these funding streams should remain a priority as one of the tools for national HIV prevention.

  October 30, 2020

  General

  Journal of Racial and Ethnic Health Disparities

• Evaluation of Novel HIV Vaccine Candidates Using Recombinant Vesicular Stomatitis Virus Vector Produced in Serum-Free Vero Cell Cultures

  In light of the recently approved Ebola virus disease vaccine based on a recombinant vesicular stomatitis virus (rVSV-ZEBOV), we present the results of our work on three novel VSV-vectored HIV vaccine candidates. We describe the design, rescue, production and purification method and evaluate their immunogenicity in mice prior to preclinical studies that will be performed in non-human primates.

  October 30, 2020

  HIV Vaccine

  Vaccine

• HIV Testing Amid COVID-19: Community Efforts to Reach Men Who Have Sex With Men in Three Kenyan Counties

  Although HIV testing in clinical spaces among those who were once regular and occasional program attendees dropped off noticeably in the early months of the COVID-19 lockdown, the program eventually began to rebound as outreach approaches shifted to virtual platforms and strategies. Importantly and unexpectedly, HIV self-testing kits proved to fill a major gap in clinic-based HIV testing at a time of crisis.

  October 29, 2020

  General

  Gates Open Research

• Integrating HIV Pre-Exposure Prophylaxis With Community-Based Syringe Services for Women Who Inject Drugs: Results From the Project SHE Demonstration Study

  Integrating PrEP with SSP services is feasible and acceptable for WWID. This supports that daily PrEP is a viable prevention tool for this vulnerable population.

  October 28, 2020

  PrEP

  JAIDS

• A Pragmatic Randomized Controlled Trial to Increase Pre-Exposure Prophylaxis Uptake for HIV prevention: 55-week results from PrEPChicago

  A peer change agent Type I network intervention is effective at diffusing PrEP through a network of individuals highly susceptible to HIV over 55 weeks of follow-up. This low intensity intervention demonstrated preliminary network level impact among populations that have experienced limited PrEP care engagement in the United States.

  October 23, 2020

  PrEP

  JAIDS

• Expanding the Vision for Differentiated Service Delivery: A Call for More Inclusive and Truly Patient-Centered Care for People Living With HIV

  DSD 2.0 provides an opportunity for the HIV and Universal Health Coverage (UHC) agendas—which can appear to be at odds-- to achieve greater collective impact for patients and health systems by integrating strong vertical HIV, TB and FP programs, and relatively weaker NCD programs. Increasing coordination of care for PLHIV will increase the likelihood of achieving and sustaining UNAIDS’ goals of retention on ART and viral suppression.

  October 23, 2020

  Treatment

  JAIDS

• Modeling the Impact of Voluntary Medical Male Circumcision (VMMC) on Cervical Cancer in Uganda

  Planned VMMC scale-up to 90 percent coverage from current levels could prevent a substantial number of CC cases and deaths in the absence of rapid scale-up of HPV vaccination to 90 percent coverage.

  October 23, 2020

  Voluntary Medical Male Circumcision

  JAIDS

Announcements