8 OCTOBER 2021 VOLUME 23 ISSUE 40

The world has gained a new weapon in the war on malaria, among the oldest known and deadliest of infectious diseases: the first vaccine shown to help prevent the disease. By one estimate, it will save tens of thousands of children each year.

Antiretroviral therapy (ART) has helped to substantially reduce mortality, morbidity, and transmission rates for HIV. However, according to the Joint United Nations Program on HIV/AIDS (UNAIDS), there are still 1.7 million new HIV infections each year.

My mum gave birth to me in 1981, the same year as the first cases of what would come to be as known as HIV were reported in the US.

People who inject drugs (PWID) are one of the most high-risk groups for contracting HIV. However, PWID have been reluctant to begin using pre-exposure prophylaxis (PrEP), a proven effective method of HIV prevention. Suspecting one reason for this could be low access to care, investigators from Tufts Medical Center examined inpatient admissions for missed opportunities to provide PrEP to PWID.

Primary care practitioners who scored higher on a scale indicating unconscious or conscious racism were less willing to discuss HIV preexposure prophylaxis (PrEP) with Black women, citing concerns that the women wouldn't be able to take the daily HIV prevention pill every day.

The COVID-19 pandemic has deepened global inequities. The world’s poor have borne the brunt of national lockdowns and will struggle to recover and poorer countries have been unable to rollout comprehensive vaccination campaigns because of a grossly unequal distribution of vaccines. On top of this COVID-19 has also derailed progress against diseases that affect poor people. Imraan Valodia sat down for a conversation with Winnie Byanyima, the Executive Director of UNAIDS.

Meet people where they are. It's a disruptive concept is taking hold in many areas of medicine, none so much as in the HIV/AIDS arena, where home-based self-testing finally appears to be gaining traction beyond the boundaries of clinical research and advocacy.

Perhaps a bit quietly—relative to the authorization and rollout of the first COVID-19 vaccines occurring at that time—the US Food and Drug Administration (FDA) approved the first long-acting injectable antiretroviral therapy (ART) for the treatment of HIV in adults this January.

Overall, participants reported favorable acceptability of the gel, the same or more at the end of the study compared to when they started the study. Additionally, when discussing their preferred administration modality, they noted that both methods had positive qualities but also potential areas of improvement. Our findings underscore the need to create multiple delivery methods for a future microbicide gel (i.e., with and without the need for an applicator) and highlight the importance of offering MSM choices in how biomedical HIV prevention strategies are delivered.

Before starting PrEP, participants’ experiences with sex were highly associated with HIV-related anxiety. Participants stated they did not explicitly initiate PrEP to reduce HIV-related anxiety, yet many described significant reductions of HIV-related anxiety after starting PrEP. Participants described feeling that the sex they were having was safer following their initiation of PrEP, which resulted in increased ability to access heightened experiences of pleasure, desire, and intimacy.

Participants received islatravir or placebo subdermal implants for 12 weeks and were monitored throughout this period and after implant removal. Based on preclinical data, two doses were assessed: 54 mg and 62 mg. Islatravir implants at both doses were safe and resulted in mean concentrations above the pharmacokinetic threshold through 12 weeks, warranting further investigation of islatravir implants as a potential HIV prevention strategy.

HIV pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission. United States Public Health Service (USPHS) clinical practice guidelines define biobehavioral indications for initiation. To assess guideline implementation, it is critical to quantify PrEP nonusers who are indicated and PrEP users who are not indicated.

We examined recent pre-exposure prophylaxis (PrEP) use (past 6 months) and its correlates among a large sample of men who have sex with men and transgender and gender non-conforming persons participating in a home HIV self-testing program conducted by the New York City Health Department.... All HIV-related behaviors, except for injection drug use, were individually associated with PrEP use. More research is needed to better understand barriers to PrEP use among patients who are low income and/or uninsured as this may help improve current public health efforts to increase PrEP uptake among disproportionately impacted populations.

HIV-1 broadly neutralizing antibodies (bNAbs) targeting the viral envelope have shown significant promise in both HIV prevention and viral clearance, including pivotal results against sensitive strains in the recent Antibody Mediated Prevention (AMP) trial. Studies of bNAb passive transfer in infected patients have demonstrated transient reduction of viral load at high concentrations that rebounds as bNAb is cleared from circulation.