Calling African Transgender Advocates: Apply for new AVAC program

[UPDATE: AVAC is no longer accepting applications.]

AVAC is pleased to announce a call for applications for participation in its inaugural PxROAR Transgender program, specifically for transgender and gender non-conforming HIV prevention advocates in Eastern and Southern Africa.

Application forms are available here. The submission deadline is 15 October.

About PxROAR Transgender Africa

PxROAR Transgender Africa will offer HIV prevention education and advocacy assistance with the goal of creating a regional agenda for HIV prevention research and implementation for the transgender community. The program is modeled on AVAC’s PxROAR Africa Program, which is tailored for key populations. Advocacy for self-determination and free expression is mutually dependent on the goal to seek control and, eventually, end HIV epidemics in underserved communities.

PxROAR Transgender Africa has two primary goals

1) To enhance awareness of and advocacy for biomedical HIV prevention.
2) To contribute to a transgender presence at country and regional level articulating a rights and biomedical prevention agenda.

Time commitments

The PxROAR Transgender Africa program is voluntary and intended to complement ongoing work in HIV, gender and/or human rights advocacy. The time commitment depends on your own level of availability. Outside of a required monthly group call, you determine your level of engagement. However, AVAC is interested in partnering with those who maximize the opportunity by tapping into all the program’s offerings. Technical and financial support is commensurate with level of commitment.

Who should apply?

Transgender and non-conforming African advocates from Eastern and Southern Africa interested in expanding their knowledge of biomedical HIV prevention research and implementation, creating a roadmap for transgender and HIV prevention research, translating scientific information and mobilizing communities toward the ultimate goal of controlling HIV in highly burdened, underserved populations.

Ideal candidates will have the potential to integrate their PxROAR advocacy, complementing and benefiting their current work.

Please send this request for applications to your relevant networks. If you have any questions, let us know at avac@avac.org.

HIV Cure Research Strategy for Women: Where are we?

This blog post first appeared on Positively Aware. It represents a report taken from a session presentation summary at this year’s US Conference on AIDS (USCA), a community-based event which was held in September in Washington, DC.

The authors are Danielle Campbell, Julie Patterson, David Evans, Pedro Goicochea, Moisés Agosto, Dawn Averitt, Catalina Ramirez, and Karine Dubé Danielle Campbell, Julie Patterson, David Evans, Pedro Goicochea, Moisés Agosto, Dawn Averitt, Catalina Ramirez, and Karine Dubé.

The need for a cure is critical, but will the search for HIV cure strategies include women? Women are drastically underrepresented in HIV cure research studies. A review of 159 studies showed that only 18 percent of HIV cure study participants were women. Women have a high willingness to participate in research, although they are in general less willing than men to take risks related to HIV cure research interventions. Research is in the works to better understand the differences in willingness, but studies outside of the HIV cure arena suggest that if structural barriers to participation are diminished, and more effort is made to establish trusting relationships between investigators and participants, more women will participate.

Currently, there is no cure for HIV. Only one person has been cured, Timothy Ray Brown, after receiving two bone marrow transplants that simultaneously rid his body of HIV infected cells and gave him new cells that are resistant to HIV. Scientists are trying to replicate his cure. The transplant of stem cells is a central HIV cure strategy being investigated, particularly to eliminate nearly all traces of the virus from a person’s body (e.g., an eradicating, or sterilizing, cure). Other methods include the early administration of antiretroviral treatment, combined with a variety of strategies that make HIV more visible to infection-fighting immune cells, improving the immune system’s ability to detect and eliminate infected cells, and possibly rendering immune cells impervious to HIV infection.

Scientists suspect that there are gender-based differences that affect how these investigational interventions might work inside the body. For example, two studies have suggested that the presence of female hormones and hormone receptors on immune cells might make it more difficult to flush HIV out of hiding. In addition, cis-gender women who have female chromosomes are genetically primed for stronger immune responses to infection and to vaccines. They might, perhaps, have an advantage if vaccines or other approaches to prime the immune system’s response to HIV are used.

While studies of all diseases have traditionally lagged far behind in terms of participation by women, HIV has more recently had a better track record in terms of prevention and treatment trials, and improvements in recruitment and retention guided in part by the efforts of the Women’s Interagency HIV Study (WIHS), which is an NIH-funded cohort (or group) that studies the impact and progression of HIV infection among women in the United States. It is the largest and longest running HIV cohort focused on women. In total, 4,982 women at nine sites have participated in the cohort to date. The WIHS cohort is also uniquely diverse in that it is reflective of the US epidemic among women. The WIHS cohort is a great platform to advance HIV cure-related research in the United States. WIHS participants volunteer in studies that measure the HIV reservoir in the blood, genital tract, and other tissues, that study the role of sex hormones on HIV reservoirs and that examine the relationship with ART pharmacology.

The WIHS cohort has been creative in overcoming challenges to women’s participation in HIV cure research. For example, if women are asked to come in fasting for a lab test, the study site provides a substantive meal after the procedure. Providing mileage reimbursements, metro vouchers, and taxi rides are critically important, since transportation issues are a main deterrent to participation in research. Other strategies to improve sex equity in HIV cure-related research include addressing eligibility criteria, adapting recruitment strategies, and engaging community members as early as possible in the process. For this reason, WIHS could serve not only as a model for successful recruitment and retention of women living with HIV into research, but also as a source of participants who might be inspired to participate in HIV cure-oriented research.

Including women in HIV cure research means:

Thinking about what they need: different types of recruitment strategies and study coordination which may benefit from partnerships with different organizations or advocacy groups
Listening to what they want: information and a chance to participate, fair reimbursement and compensation, assistance with logistical barriers
Designing studies that reflect them: re-thinking eligibility criteria to balance participant risk with exclusions that disproportionally affect women
Prioritizing their involvement: a few women or a single study is not enough, we need to advocate for representation of all women, including transwomen

More Resources on Women and HIV Cure-Related Research

The Well Project/Women’s HIV/AIDS Research Initiative
The Well Project is a non-profit organization whose mission is to change the course of the HIV/AIDS pandemic through a unique and comprehensive focus on women and girls.

Treatment Action Group
A great resource for articles, reports and other information related to HIV cure research efforts.

Advocacy resources: treatmentactiongroup.org/CURE/advocacy

Media monitor which tracks cure research related news, places stories in context and addresses inaccuracies:
treatmentactiongroup.org/cure/media-monitor

A listing of clinical trials and observational studies related to the research effort to cure HIV infection:
treatmentactiongroup.org/cure/trials

AVAC
AVAC’s work includes a range of activities aimed at addressing: ethical issues, including community involvement in research; standards of prevention and care in trials; and community engagement and research literacy outside the context of a specific clinical trial or intervention.

HIV Cure Research Glossary
This glossary is designed for the media and laypersons interested in understanding the issues involved in HIV cure-related research.

CUREiculum
The CUREiculum is a suite of tools that provides simple, accessible information on HIV cure research, organizing into a systematic format for ongoing or issue-specific learning.

Social and Ethical Aspects of HIV Cure Research (searcHIV)
searcHIV is a multi-site, multi-disciplinary working group focusing on investigating the biosocial implications of HIV cure research.

Women’s Interagency HIV Study (WIHS)
The Women’s Interagency HIV Study (WIHS) is a large, comprehensive prospective cohort study designed to investigate the progression of HIV disease in women.

PrEP and Trial Design — A no brainer for some

Clinical trials for new HIV prevention methods offer participants counseling and access to the existing ways to protect oneself from HIV. It’s called the “standard of prevention” and is a package of prevention methods and services.

Now that oral PrEP is a proven HIV prevention method and WHO-recommended, some trials are adding it to the package. And that makes trials more complex. That’s a good problem to have, says Slim Abdool Karim, the director of the Centre for the AIDS Program of Research in South Africa, also known as CAPRISA. As the co-principal investigator of the landmark CAPRISA 004 tenofovir gel study and the recipient of multiple awards for his research, Karim brings incomparable perspective to this question. In this interview with AVAC’s Jeanne Baron, Karim talks about why designing trials with oral PrEP is a must—scientifically and ethically.

Listen here.

This interview is part of an ongoing series, and look out for our upcoming podcast—Px Pulse, which will feature interviews and discussions that explore vital topics in HIV Prevention research today. Tell us what you think!

Click on the links below to learn more about PrEP and standard of prevention in trials:

New Px Wire: PrEP, money and more

The latest issue of AVAC’s quarterly newsletter, Px Wire, is now available. Check it out for a deep dive into the data that suggest men who have sex with men may be protected by oral PrEP, even if they don’t dose every day—and for the reasons why these data do not apply to women. You’ll also find out why messages about global AIDS are on our mind—and what we’d change about the current global conversation.

Because money matters as much as messages, we’ve provided a centerspread that summarizes current investments, and trends over time, in HIV-prevention research and development. This full-color feature is excerpted from the recently-released report on HIV prevention research and development investment produced by AVAC and partners in the field.

Golden Age or Fools Gold?

Are we in the Golden Age of HIV prevention, as first heralded in Durban, South Africa at the 2016 International AIDS Society conference? Dr. Carl Dieffenbach is the Director of the Division of AIDS at the US National Institutes of Health, (NIH). He oversees one of the largest research budgets in the world for HIV.

In this interview with AVAC’s Jeanne Baron, Dr. Dieffenbach explains the recent progress and upcoming HIV prevention trials, and what it will take to “put out the fire.”

Check out this interview, our first in a series that preview our upcoming podcast — Px Pulse — which will feature interviews and discussions that explore vital topics in HIV Prevention research today.

Listen here.

Want to learn more about the research and trials Dr. Dieffenbach talks about? Follow these links:

On HVTN 702:

On Janssens’s Ad26 Mosaic program:

On HPTN 083 & 084:

Funding Opportunity: RFA-AI-17-028 Next Generation Multipurpose Prevention Technologies (NGM) (R61/R33 – Clinical Trials Optional)

NIAD and NIMH will be accepting applications to support the development of new and innovative multipurpose prevention technologies (MPTs) with the dual purpose of contraception and HIV prevention. Letters of Intent due 19 February 2018.

Informing the Research Enterprise: Webinar with Carl Dieffenbach on future priorities for HIV research networks

UPDATE: The webinar recording is now available: YouTube / Audio / Slides

Join a conversation with US government research leadership about the future of investments in the US National Institutes of Health’s (NIH) HIV clinical trial research networks in the US and internationally. Mark your calendar for Tuesday, September 5 at 2pm ET for a conversation with Dr. Carl Dieffenbach, the Director of the Division of AIDS (DAIDS) at the NIH’s National Institute of Allergy and Infectious Diseases.

Every seven years, the NIH reviews the structure and funding of its HIV clinical research networks. This “network recompetition” process involves decisions that will help determine the focus and priorities of its HIV clinical trial networks through 2027, as well as the number and structures of the various networks that undertake this research. These are critical questions for advocates to weigh in on—whether you are in the US or not.

The webinar will include a brief introductory presentation from Dr. Dieffenbach followed by a Q&A session. NIAID is also currently accepting public comments and questions online, so now is your chance!

Can’t make the webinar but have a question? Please send it on! We will also be scheduling a second webinar at a time more convenient for advocates outside of the US. And, as always, slides and a recording will be posted shortly after the conclusion of the webinar.