World AIDS Day Must-Read: AVAC’s annual report untangles mixed messages

On the eve of World AIDS Day, AVAC is excited to share our annual “state of the field” report on biomedical prevention research and implementation. AVAC Report 2017: Mixed Messages and How to Untangle Them is straight talk about today’s complex context for HIV prevention.

Read this report if, in recent months you’ve wondered:

    Report 2017 Cover

  • What does it mean when there’s more rhetorical support than ever before for primary prevention for HIV-negative individuals—but no more money?
  • How can there be talk of being “on the path to epidemic control” while human rights remain in shambles in many places, and rates of HIV diagnoses and deaths climb in others?
  • How can scientists be so sure they know what women (or anyone at risk of HIV) want, without doing research to find out?

This year’s report offers answers, in the form of analysis and recommendations for change. We hope you’ll read it and, more importantly, join us in action to make the recommendations a reality.

Download AVAC Report 2017

The report also provides valuable context for some of today’s exciting developments, including the launch of two efficacy trials: HPTN 084, which is evaluating a long-acting injectable antiretroviral for prevention in women in sub-Saharan Africa; and HVTN 705/HPX2008, a vaccine trial of a novel “mosaic” strategy that might block multiple viral strains. These two studies aim to enroll nearly 6,000 women in East and Southern Africa.

Both trials are planned to run through 2022; both could pave the way for valuable new long-acting prevention options. As the report describes, now is the time to structure research networks and agendas, oral PrEP programs and comprehensive approaches to HIV prevention in such a way that they lay the groundwork for strategies like those being tested in these trials. At the same time, we cannot assume these strategies will solve issues posed by user-dependent methods like condoms, oral PrEP and more.

New data released yesterday from the Rakai Health Sciences Program in Uganda offer a glimpse of what the future could hold. Tracked since 1999, the latest data from the Rakai cohort show a 42 percent drop in HIV incidence over the past seven years, primarily attributed to soaring rates of ART and VMMC coverage in the population.

Opinionated, informative and filled with useful graphics, AVAC Report 2017 helps put these developments on clinical trials and combination prevention packages in context, identifying what has to happen, who should do it and how to track progress along the way.

New HIV Prevention Trials Hold Promise for New Prevention Options for Women

Just ahead of another World AIDS Day, two new efficacy trials officially launched in Africa today with the potential of additional HIV prevention methods in the future.

The two trials – one studying a new vaccine strategy from Janssen/Johnson & Johnson that could protect against multiple strains of HIV and the other with an injectable antiretroviral PrEP strategy every two months from ViiV/GSK – join five other efficacy trials that are hoped to expand the options available to meet the varied needs women and men have for HIV prevention over the course of their lives.

“It is unprecedented to have so much diverse activity in the field, with nearly 25,000 trial participants to be enrolled across all of these trials around the world. As we commemorate World AIDS Day, it’s important to pause and be thankful for the many thousands of women and men around the world who have stepped up to volunteer for clinical trials that have given us the means to respond to this epidemic, in whose footsteps the 6,000 African women who will take part in these two new trials now follow,” said Mitchell Warren, executive director of AVAC, a global HIV prevention organization.

“Equally unprecedented is the level of pharmaceutical engagement within these trial partnerships. While both of these new trials are jointly funded by the US National Institutes of Health and the Bill & Melinda Gates Foundation, the two product developers are active financial partners,” said Warren. “We hope that the examples of ViiV and Janssen will prompt additional and sustainable industrial partnerships in HIV prevention research.”

“These new trials come at one of the most dynamic times for HIV prevention. There are more trials of new concepts; more programs beginning to deliver daily oral PrEP; a vaginal ring going through regulatory review; record numbers of people on HIV treatment; new guidelines reflecting the scientific evidence behind undetectable = untransmittable; and real-world evidence from Uganda that scaling up treatment and voluntary medical male circumcision can reduce new HIV infection at a population level,” said Warren.

This dynamism also makes the field far more complex than ever before, as these multiple signs of progress co-exist and compete for resources. Later today, AVAC will be releasing its annual “state of the field” report—Mixed Messages and How to Untangle Them—which addresses these realities. The report will be available online at www.avac.org/report2017.

“Both new trials could pave the way for valuable new long-acting prevention options—in addition to, not instead of, the interventions we have today. As the AVAC Report describes, now is the time to structure research agendas and networks, oral PrEP programs and comprehensive approaches to HIV prevention in such a way that they lay the groundwork for strategies like those being tested in these trials,” Warren said.

ICASA 2017: A conference guide to participating on-site and virtually

The 19th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA 2017) is coming right up, December 4-9 in Abidjan, Cote D’Ivoire. Find details below on select events related to biomedical HIV prevention research and implementation as well as how to follow the conference from afar.

The theme for ICASA’s biennial gathering in 2017 is Africa: Ending AIDS-delivering differently, and AVAC will be there along with many of our partners participating in sessions both before and during the conference. There are several ways you can link to HIV prevention research and rollout-related events—both in-person and from afar:

ICASA 2017 HIV Prevention Research Roadmap
Amidst a wide range of topics that will be covered at the conference (full program available here), we have pulled together a roadmap of select sessions that may be of interest to those tracking biomedical prevention research and rollout. Download as a PDF or XLS file and please let us know of any other related events that should be added to the roadmap. And on arrival, be sure to check out the various Networking Zone schedules in the Global Village for more great programming on prevention and more!

Biomedical HIV Prevention Forum (BHPF) Pre-conference Session
Hosted by the New HIV Vaccine and Microbicide Advocacy Society (NHVMAS), in collaboration with a number of partners including WACI Health and the Society for AIDS in Africa (SAA), this session will explore data trends in Africa, hot topics in prevention research and African leadership in prevention research. Sunday, 3 December from 8:00 to 17:00 at the Sofitel Abidjan Hotel Ivoire. See the BHPF website for more information.

Key Population Pre-conference Session
Hosted by African Men for Sexual and Health Rights (AMSHeR), African Sex Workers Alliance (ASWA), Gender Dynamix/Southern Africa Trans Forum, the Coalition of African Lesbians (CAL) and other networks of key populations (KP), the theme for this pre-conference session is Onto the African Map: Youth Key Populations and HIV. Saturday, 2 December and Sunday, 3 December from 9:00 to 17:00 each day. For more information go here or contact info@amsher.org.

Satellite Session
WHO and the OPTIONS Consortium is sponsoring a session titled, Making the Case for PrEP for Women: What we know and experiences to date to review what we know and have learned about delivering oral PrEP to women, in particular adolescent girls and young women. Presenters will review the evidence, the status of oral PrEP rollout for women, and opportunities for oral PrEP delivery for women through the private sector. A facilitated panel with audience discussion will explore the challenges, innovative solutions and future direction for Kenya, South Africa and Zimbabwe. Tuesday, 5 December from 12:45 to 14:15 at the Chandelier Room, Sofitel Abidjan Hotel Ivoire.

Satellite Session
Health GAP and AVAC are hosting a workshop on PEPFAR’s Country Operational Plan (COP) process. Advocates will learn about changes to the 2018 process, explore strategies to increase PEPFAR investment in community priorities, and get an introduction to tools for analyzing PEPFAR data. Wednesday, 6 December at the Hotel Palm Club from 10:45 to 13:15.

ICASA on Social Media
Follow the conference in real-time on social media by following us on Twitter and Facebook — and using the official conference hashtag #ICASA2017.

New Episode of Px Pulse, AVAC’s New Podcast Series

We are excited to share with you our new episode of Px Pulse, AVAC’s podcast covering vital topics in HIV prevention research. Find it at avac.org/px-pulse or listen on iTunes!

This month Px Pulse looks at the standard of care in HIV prevention trials in the era of oral PrEP. This issue has been discussed and hotly debated lately—and for good reason: It’s complicated. In this episode, we take you deeper into this pressing issue.

Around the world, a number of large clinical trials, ongoing and planned, are testing new HIV prevention interventions. Many of these trials are happening in a few regions of Southern Africa. In these same areas, oral PrEP—a proven and highly effective prevention method—is rolling out and reaching some places and populations better than others. The obligation of researchers to provide oral PrEP to participants in HIV prevention trials, and precisely how they should do so, was the focus of a summit convened by the South African Medical Research Council in October in Cape Town.

In this episode, you’ll hear veteran advocate voices, Tian Johnson and Yvette Raphael, challenge the thinking that providing oral PrEP in trials can be separate from national rollout. They call on researchers to partner with advocates so that what happens at the trial site can be integrated with the national PrEP agenda. Director of Research at Wits RHI Sinead Delany-Moretlwe discusses the future of trial design and research, touching on how the prevention options of tomorrow will further complicate these questions.

Don’t miss it—and do let us know what you think!

New Px Wire: AVAC recommendations on future DAIDS network restructuring

AVAC’s newest issue of Px Wire is coming to you at a critical moment. We’re sharing our recommendations to the US National Institutes of Health’s Division of AIDS (DAIDS), which is in the final days of accepting comments before it begins the process of restructuring the clinical trials networks responsible for a large share of the world’s HIV research.

Download the new issue of Px Wire.

In Px Wire, we preview part of the AVAC Report 2017, which includes a set of recommendations and priorities that keep funding and research crossing-cutting, strategic and responsive to people’s real-world needs.

Check out the infographic, which provides a visual history of the DAIDS Networks and a look at what’s proposed for the next funding cycle.

And keep a look out for the full AVAC Report, our annual analysis of the state of the field, coming later this month. This year’s theme, Mixed Messages, untangles a web of potentially contradictory and confusing debates coming to the fore now that advances in prevention are creating new opportunities, challenges and complexity.

The Weekly NewsDigest and Its Remarkable Editor

Even close readers of the Weekly NewsDigest may be surprised to know that we are closing in on 18 years of weekly updates. Much has changed over these years – the HIV prevention news itself, the media world, and the technologies that help us compile and edit each issue. But there has always been one constant – the remarkable Polly Harrison!

Polly the advocate, scientist, policy wonk and editor is first and foremost an intrepid guide to all of us who have learned from her and been inspired by her – and that includes just about everyone working in HIV prevention research.

Every Friday for over 18 years, thousands of people receive what looks like a simple email digest of news covering HIV prevention research and relevant science in peer-reviewed journals. But it has always been so much more than that, thanks to Polly!

The Digest was Polly’s brainchild at the Alliance for Microbicide Development, which she founded as a catalyst for the microbicide field. The Alliance and AVAC were always close collaborators and share an unyielding commitment to raise awareness and provide a neutral, objective basis for decision-making and evidence-based advocacy. So when Polly “retired” the Alliance 8 years ago, AVAC was incredibly fortunate to make sure that she herself didn’t retire.

As our Senior Advisor on so many things over the years, Polly guided the Digest at its new home – ensuring your weekly summary arrived on schedule and mentoring all of us at AVAC – and made us all marvel how anyone of any age could do all that she did.

Alas, Polly has decided to hang up her weekly editorial role (but will happily remain our trusted Senior advisor). We wish her much joy as she looks ahead to other adventures and, hopefully, some relaxation. But she will always be the founding editor and honorary publisher, because every Weekly NewsDigest will reflect her legacy and continue to curate stories from countless sources covering the world of HIV prevention research — and we know who our closest reader will be each week!

Polly’s wisdom, insight, humor, passion and commitment are all models to us at AVAC – and, undoubtedly, to the field at large. While we can imagine (barely) the Digest without her, we can’t imagine this field without her influence!

Thank you so much, Polly, and happy reading – at your own pace, without a deadline.