7 JUNE 2019 VOLUME 20 ISSUE 22

Media Coverage

• Free Sexual Health Services for Bulawayo

  “Population Services International (PSI) and Bulawayo City Council signed a Memorandum of Understanding to award Nkulumane New Start Centre a framework subcontract in support of the Zimbabwe Sexual Reproductive Health and HIV Prevention Project and provide HIV counselling and testing services,” read recent council meeting minutes.

  June 7, 2019

  General

  Chronicle

• US Avails N$1.2b HIV War Chest

  The government of the United States of America, through its President’s Emergency Plan for AIDS Relief (PEPFAR) this year committed nearly N$1.2 billion (U.S $82 million) for HIV programmes in Namibia.

  June 7, 2019

  General

  New Era

• How Promoting HIV Self-Testing in Communities Reduces Prevalence of AIDS

  As part of measures to achieve zero prevalence of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome among young people in Nigeria, youths across different tertiary institutions have set out to implement HIV self-testing solutions they developed in communities.

  June 6, 2019

  General

  The Guardian

• This Drug Could End HIV. Why Hasn’t It?

  Dr. Robert Grant developed a treatment — a daily pill known as pre-exposure prophylaxis, or PrEP — that could stop the AIDS crisis. We look at why that hasn’t happened.

  June 5, 2019

  PrEP

  New York Times

• Opinion: The US Must Continue to Support Africa’s Advances in Health

  A child born today in Kenya, Senegal, or Uganda is far more likely than ever before to live a healthy, full, and productive life. There has been an extraordinary increase in life expectancy of 20% to 32% in these countries since the turn of the century, in large part due to a significant increase in childhood vaccination, the increase in HIV-positive people receiving lifesaving treatment which also prevents new infections including transmission from mothers to infants, and highly successful efforts to treat malaria and prevent new infections.

  June 5, 2019

  General

  Devex

• Trump Administration Restricts HIV Testing and Research With New Policy

  On Wednesday, 5 June, the Trump Administration implemented a new policy ending research done by government scientists using fetal tissue. This severely limits research done on HIV.

  June 5, 2019

  General

  Gay Star News

• Kenya’s Anti-AIDS Policy a ‘Global Standard’: UN Envoy

  Kenya's success in reducing the rates of AIDS-related deaths and HIV infections results from a national policy that stands as a global trendsetter, the country's United Nations envoy declared on Monday.

  June 5, 2019

  General

  Daily Nation

• What’s in the Pipeline?

  Although advances in combination antiretroviral therapy (ART) have greatly reduced morbidity and mortality associated with HIV, the pipeline for development of novel drug mechanisms and new agents in the existing drug classes remains full. This article presents a review of investigational drugs furthest along in development with propitious results in human subjects.

  June 5, 2019

  Treatment

  Contagion Live

• Tanzania: Initiative On to Lower HIV Testing Age to 15

  Ministry of Health, Community Development, Gender, the Elderly and Children will submit a bill for amendment of law to change statutory age of consent for independently consenting to HIV/AIDS testing and counseling from 18 to 15 years, to control the spread of the epidemic.

  June 5, 2019

  General

  All Africa

• Trudeau Announces Plan to Invest $1B Annually on Women and Girls’ Health

  Canadian Prime Minister Justin Trudeau on Tuesday announced an ambitious plan to annually invest the approximate equivalent of $1 billion to support global women and girls' health.

  June 4, 2019

  General

  The Hill

• Gene Mutation Protects Against HIV but Comes With Heightened Risk of Death

  People with a DNA mutation that reduces their chance of HIV infection may die sooner, according to a study that suggests tinkering with a gene to try to fix one problem may cause others.

  June 3, 2019

  Cure

  Los Angeles Times

• Chinese Social Platform Uses Geolocation to Promote HIV Testing in MSM

  Leveraging the geolocation-based functions of social media platforms could be useful in promoting HIV testing campaigns among men who have sex with men (MSM), a new report in the US Centers for Disease Control and Prevention (CDC’s) Morbidity and Mortality Weekly Report suggests.

  June 3, 2019

  General

  Contagion Live

• HIV Criminalisation Cases Recorded in 72 Countries, Including 49 in the Last Four Years

  HIV criminalisation continues: a global review has found that HIV-related arrests, investigations, prosecutions and convictions have ever occurred in at least 72 countries, with recent cases occurring in 49 countries, including 14 in which the law appeared to be applied for the first time.

  June 3, 2019

  General

  aidsmap

Published Research

• Increasing Male Engagement in the Prevention of Vertical Transmission of HIV: What Works in Sub-Saharan Africa?

  Despite the prioritisation of active engagement of male partners in many sub-Saharan Africa countries, explicit implementation guidelines are largely absent in national policy documents. Variability of definitions and strategies of male partner engagement, coupled with wide differences in sociocultural contexts, complicate the translation of research into policy and practice.

  June 6, 2019

  General

  BMJ

• Durable Control of HIV Infection in the Absence of Antiretroviral Therapy: Opportunities and Obstacles

  Achieving a sustained, durable ART-free HIV remission by a variety of minimally toxic approaches that are potentially scalable remains an overarching priority in HIV research. Success of such an effort has important implications for the economic costs of lifelong ART in large numbers of patients, medical issues such as drug resistance and/or drug toxicities that are associated with lifelong ART, and the personal and societal stigma associated with the indefinite requirement of ART.

  June 6, 2019

  Treatment

  JAMA

• Sexual Behaviour and Incidence of HIV and Sexually Transmitted Infections Among Men Who Have Sex With Men Using Daily and Event-Driven Pre-Exposure Prophylaxis in AMPrEP: 2 Year Results From a Demonstration Study

  Although the overall incidence of STIs did not change during 2 years of PrEP use, the incidence of STIs was higher among participants using daily PrEP than those using event-driven PrEP, which is likely a result of differences in sexual behaviour. This finding suggests the need to tailor STI prevention interventions according to behavioural profiles.

  June 6, 2019

  PrEP

  Lancet HIV

• The Breadth of HIV-1 Neutralizing Antibodies Depends on the Conservation of Key Sites in Their Epitopes

  So far, no HIV-1 vaccine has elicited broadly neutralizing antibodies (bnAbs) in humans. HIV-1, one of the most rapidly evolving pathogens, is remarkable for its high variability across individuals and adaptability within hosts. We tested the relationship between HIV-1 diversity and neutralization breadth. While bnAbs did not specifically target more conserved regions of HIV-1 Env, we found that the broadest bnAbs relied forcibly more on structural interactions at key sites of the Ab:Env interaction than other Abs.

  June 6, 2019

  Antibody Related Research, HIV Vaccine

  PLoS Computational Biology

• Are Policy Initiatives Aligned to Meet UNAIDS 90-90-90 Targets Impacting HIV Testing and Linkages to Care? Evidence From a Systematic Review

  From the studies identified, we deduced a clear, positive correlation between implementation of policies and programs that resulted in an increase in patient awareness and an increase in partner notification with services that encouraged them, and together these resulted in increasing testing rates, and deployment of linkage/retention programs that improved retention in care. An analysis of these studies also suggests that policies, combined with the scale-up incentives, are needed to change the status quo.

  June 5, 2019

  General

  PLoS One

• A Young Black MSM on PrEP Is Lost to Follow-Up and Acquires HIV Infection: A Case to Call for Improved Strategies to Support Youth Adherence and Engagement in HIV Prevention

  Young men who have sex with men (YMSM) are disproportionately affected by HIV in the United States. High-risk sexual behaviors are difficult to modify; thus, HIV pre-exposure prophylaxis (PrEP) with a daily pill is a promising prevention tool for this vulnerable population. We present a case of a young black MSM who was able to successfully access PrEP with the help of a community program but was not able to adhere to the regimen or engage in care. He ultimately acquired HIV infection.

  June 4, 2019

  PrEP

  JIAPAC

• CCR5-∆32 Is Deleterious in the Homozygous State in Humans

  We use the genotyping and death register information of 409,693 individuals of British ancestry to investigate fitness effects of the CCR5-∆32 mutation. We estimate a 21% increase in the all-cause mortality rate in individuals who are homozygous for the ∆32 allele. A deleterious effect of the ∆32/∆32 mutation is also independently supported by a significant deviation from the Hardy–Weinberg equilibrium (HWE) due to a deficiency of ∆32/∆32 individuals at the time of recruitment.

  June 3, 2019

  Cure

  Nature Medicine

• Increasing Access to Pre-Exposure Prophylaxis Among Transgender Women and Transfeminine Nonbinary Individuals

  Qualitative data were coded and analyzed using thematic analysis. Participants identified five components to increase PrEP use among TGWNBI: (1) eliminating the practice of conflating TGWNBI with cisgender men who have sex with men, (2) recognition of and support for the contextual factors associated with HIV risk among TGWNBI, (3) ensuring the design and development of transgender-inclusive and gender-affirming sexual health programs that include PrEP, (4) active provider engagement and assistance around PrEP, and (5) identification and implementation of strategies to bolster existing community mobilization/activism around PrEP.

  June 3, 2019

  PrEP

  AIDS Patient Care and STDs

• Enhancing National Prevention and Treatment Services for Sex Workers in Zimbabwe: A Process Evaluation of the SAPPH-IRe Trial

  We identified some gaps in programme fidelity: offering pre-exposure prophylaxis took time to engage FSW, viral load monitoring was not performed, and ratio of peer educators to FSW was lower than intended. During the trial, reaching FSW with HIV testing and treatment became a national priority, leading to increasing attendance at both intervention and control clinics. Throughout Zimbabwe, antiretroviral therapy coverage improved and HIV-stigma declined.

  June 3, 2019

  General

  Health Policy and Planning

• Facilitators and Barriers Affecting PrEP Adherence Among Thai Men Who Have Sex With Men (MSM) in the HPTN 067/ADAPT Study

  Facilitators of PrEP adherence included use of strategies to have PrEP available when needed, simplicity in regimen requirements with recognition that more complex regimens may take some time to master, ability to plan for sex, receipt of social and technology support, ability to use a PrEP regimen that best matches to one’s own patterns of sex, and experiences with PrEP as a part of health and well-being.

  June 3, 2019

  PrEP

  AIDS Care

• Re-thinking Linkage to Care in the Era of Universal Test and Treat: Insights from Implementation and Behavioral Science for Achieving the Second 90

  In this article, we offer a new conceptual framework for linkage to care, tailored to the current universal test and treat era that presents linkage to care as its own nuanced pathway within the larger HIV care cascade. Conceptualizing linkage to care in this way may help better identify and specify processes posing a barrier to linkage, and allow for the development of targeted implementation and behavioral science-based approaches to address them. Such approaches are likely to be most relevant to programmatic and clinical settings with limited resources and high HIV burden.

  June 3, 2019

  Treatment

  AIDS and Behavior

• Using Social Media To Increase HIV Testing Among Men Who Have Sex with Men — Beijing, China, 2013–2017

  A geolocation-based online HIV testing promotion campaign from China’s largest social media platform oriented to MSM coincided with a steep continuous increase in HIV testing, suggesting the campaign is effective in promoting HIV testing among MSM. Leveraging social media platforms and their geolocation-based text messaging functionality might be useful in increasing HIV testing among MSM, particularly those aged ≤35 years.

  May 31, 2019

  General

  Morbidity and Mortality Weekly Report (MMWR)

• HIV Testing and the HIV Care Continuum Among Sub-Saharan African Men Who Have Sex With Men and Transgender Women Screened for Participation in HPTN 075

  These findings demonstrate substantial prevalence of undiagnosed HIV infection and sub-optimal HIV care engagement among MSM and TW in SSA. Increased HIV testing frequency and better linkage to care represent critical steps in preventing further HIV transmission in this population. Once in care, gaps in the HIV care continuum appear less critical.

  May 31, 2019

  General

  PLoS One

• A Multiple Dose Phase 1 Assessment of Rilpivirine Long-Acting in a Model of Pre-Exposure Prophylaxis against HIV

  Multiple dose administration of RPV LA was safe and well tolerated and was associated with prolonged suppression of viral replication in rectal explant tissue.

  May 31, 2019

  PrEP

  AIDS Research and Human Retroviruses

• ‘If Nurses Were in Our Shoes Would They Breastfeed Their Own Babies?’ A Qualitative Inquiry on Challenges Faced by Breastfeeding Mothers on the PMTCT Programme in a Rural Community in Zimbabwe

  HIV and AIDS programmes should pay attention to women’s readiness for interventions. There is need to understand women’s life experiences to ensure informed and targeted programming for PMTCT.

  May 30, 2019

  Treatment

  BMC Pregnancy and Childbirth

• Modeling HPV Vaccination Scale-Up Among Urban Young Men Who Have Sex With Men in the Context of HIV

  Public health HPV preventions strategies should continue to emphasize the complementary roles of condoms and vaccination, especially for preventing oral infection. Improving vaccination coverage will ultimately have the greatest impact on reducing HPV infection among YMSM.

  May 30, 2019

  HPV Vaccines

  Vaccine

• Iowa TelePrEP: A Public-Health-Partnered Telehealth Model for HIV Pre-Exposure Prophylaxis (PrEP) Delivery in a Rural State

  Using widely available technology and infrastructure, public health departments and healthcare systems can collaborate to develop regional telehealth programs to deliver PrEP in small urban and rural settings.

  May 30, 2019

  PrEP

  Sexually Transmitted Diseases

• The Genital Tract and Rectal Microbiomes: Their Role in HIV Susceptibility and Prevention in Women

  A better understanding of the composition, structure and function of the microbiome is needed to identify opportunities to alter the vaginal microbiome and prevent BV and reduce the risk of HIV acquisition.

  May 29, 2019

  General

  JIAS

• Effective Integration of Sexual Reproductive Health and HIV Prevention, Treatment, and Care Services Across Sub-Saharan Africa: Where Is the Evidence for Program Implementation?

  While the SDGs call on the global community to “leave no one behind”, efforts need to be redoubled to address the needs of key and vulnerable populations within the four prongs of PMTCT and adolescent girls and young women within treatment, and care services in emergency settings. This collection of articles demonstrates that bringing together SRHR and HIV will require deliberate interventions and political commitment that places the individual at the center of service delivery.

  May 29, 2019

  General

  Reproductive Health

• Unusual Cysteine Content in V1 Region of gp120 From an Elite Suppressor That Produces Broadly Neutralizing Antibodies

  In this study, we examined 20 clade B proviral sequences isolated from an African American woman, who had the rare bNAb/ES phenotype. Phylogenetic analysis of proviral envelope sequences demonstrated low genetic diversity. Envelope proteins were unusual in that most possessed two extra cysteines within an elongated V1 region. In this report, we examine the impact of the extra cysteines on the binding to bNAbs, virus infectivity, and sensitivity to neutralization.

  May 15, 2019

  Antibody Related Research

  Frontiers In Immunology

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