IAS 2021: Our take and updates

COVID-19 may have forced some limiting factors onto the 11th IAS Conference on HIV Science—the conference was primarily online; the attendance was lower; and we couldn’t interact with our colleagues face-to-face—but moving in and out of virtual sessions, something transformative was in the air. The intersection of the responses to COVID-19 and HIV and the glaring disparities in health made ever more undeniable by COVID-19, are giving new meaning and momentum to changes advocates have been pressing for years, even decades. Where to begin…

DSD: The time is now

Differentiated service delivery (DSD) accelerated by orders of magnitude—telephone counseling, dispensing multi-month supplies of drugs, home delivery, community-based refills, and other innovation staved off hundreds of thousands of predicted HIV deaths, which were expected if people couldn’t get to the pharmacy or the clinic for treatment during COVID-19 lockdowns.

Multiple conference sessions referred to numerous initiatives where DSD scaled up rapidly, and with success. A few examples: An initiative from the CQUIN network coordinated among 21 different countries to share resources and lessons on DSD. PEPFAR’s Catherine Godfrey reported from a review of 52 countries that found 30 of them had scaled up and expanded eligibility for multi-month dispensing for treatment, with a 79 percent increase in the total number of people receiving a six-month supply of drugs. A different review from seven PEPFAR-supported countries, showed overall treatment interruption did not increase. And a UNAIDS analysis showed global trends in ART initiation continued despite the lockdown. Crucial to these successes, said Godfrey, were community health workers and community-based drug distribution.

These lessons from antiretroviral treatment have been applied in prevention as well. The session, Paving the road for new PrEP products: The promise of differentiated, simplified, and decentralized delivery to maximize the potential of new products, expanded the discussion on the need for innovations in PrEP delivery. Panelists at the satellite session, convened by AVAC, IAS and PATH, noted delivery must evolve as new products move through the pipeline, or years will be wasted with low uptake. Simplifying and Improving PrEP Delivery is one of four issue briefs just published by the Prevention Market Manager project and launched at the satellite, along with Reframing Risk in the Context of PrEP, Generating and Sustaining Demand for PrEP, and Next Generation M&E for Next-Generation PrEP. All echo core principles embedded in DSD: center the development of programs, policies and products in the leadership and knowledge of those who need prevention most.

This movement to DSD holds tremendous potential for prevention just as the field is poised to add powerful new prevention options to the tool kit. Data on next-generation options were also presented at IAS.

The latest on the prevention pipeline

Days before IAS began, The HealthTimes reported Zimbabwe’s approval of the monthly Dapivirine Vaginal Ring (DVR), which would be the first country to do so. Data presented at IAS on ring use from the REACH study underscore what can be achieved by tailoring the design of products and programs. REACH is a study looking at safety and adherence of oral PrEP and the ring in young women ages 16-21. Data from the study showed a marked increase in adherence to both the ring and oral PrEP among adolescent girls compared to previous studies. The key factor in the uptick? Intensive, individualized support that allowed participants to select from a menu that included text messages, weekly check-ins by phone, “peer-buddy” and adherence support groups. These findings build on evidence from other studies, including the POWER study, that adolescents greatly benefit from intensive adherence support. REACH data on preferences between the ring and oral PrEP are forthcoming.

A ring-focused session—Intravaginal options: Today and in the future—covered a lot of ground, from early-stage research on multipurpose rings for prevention, to work the World Health Organization (WHO) is doing to help facilitate the introduction of the Dapivirine Vaginal Ring. The WHO already recommends the ring and its Coordinator of Treatment and Care in the Department of HIV/AIDS, Meg Doherty, said the WHO plans to develop tools and guidance to assist countries to fit this new tool into their context, work on the supply chain, generate demand and more. These tools and guidance are expected by early 2022.

On the research front, Andrea Thurman (CONRAD) presented data from Phase I studies of a ring loaded with levonorgestrel (LNG) and tenofovir (TFV) and showed it is safe, acceptable and met benchmarks for drug levels in the body. Further research is warranted. Another presentation in that session came from Sharon Hillier (UPMC Magee-Womens Hospital), who presented highlights from the pipeline of intravaginal ring research including a three-month Dapivirine Ring and a novel MPT ring that’s both non-hormonal and includes a non-ARV-based antiviral.

A satellite session, Bringing the Dual Prevention Pill to Market: Opportunities for HIV and Pregnancy Prevention and Implications for Future Multipurpose Prevention Technologies (MPTs), reviewed the status of the Dual Prevention Pill, which could be available as early as 2024. If approved, it would be the first MPT to go to market since male and female condoms. This novel strategy provides unprecedented opportunities to integrate sexual and reproductive health (SRH) with HIV services, but major challenges must be met. The field of women’s health and family planning, policy makers and all stakeholders will need to understand why and how HIV prevention is their priority too, and how the DPP fits in the context of community health. Early, frequent and comprehensive consultations across both fields can and must serve as a model for breaking down these silos.

In a late-breaker session, Sharon Hiller presented data from the Phase 2a study of monthly oral islatravir, building on data presented earlier this year at HIVR4P. Hillier’s presentation at IAS 2021 showed this strategy met—and exceeded—key benchmarks for drug levels in the body that researchers think will be needed for it to be effective. The week-24 data also showed that it’s safe and well-tolerated. Efficacy data on this new prevention option will come from two large-scale efficacy trials (IMPOWER-22 and IMPOWER-24), results of which are expected in 2024. Islatravir is also being studied for long-term use via an implant.

And vaccines?

With a robust non-vaccine prevention pipeline, some of the vaccine session titles seemed to hint at a field wondering about its place: Will there be a next generation HIV vaccine if current ones fail?; An HIV vaccine: who needs it?; and HIV vaccines and immunotherapy: Quo vadis? (Latin for “Where are you going?”) The answer to that question is that HIV vaccine research is moving forward. Discussions at these sessions pointed to intensifying global interest in vaccine research and implementation, with COVID on everyone’s mind—and much of the success in COVID vaccines owed to the legacy of research in HIV. HIV vaccine research is moving forward with diverse approaches, and efficacy data from the two ongoing large-scale trials of Janssen’s Adeno 26-based vaccine are expected within the next two years. The AMP trials, and their implications for vaccine and antibody research, were also part of the discussion and are discussed in more detail in our recent document, Understanding Results of the AMP Trials.

But this momentum can’t be taken for granted. As Lynn Morris, from the University of the Witwatersrand and a leading antibody researcher, said in her plenary, it’s important now to galvanize political will, support increased investment and industry involvement in HIV vaccine development, run more parallel trials and take more risk.

And no matter the challenges of vaccine science, once available people will need to take it. AVAC’s Daisy Ouya reminded attendees at a UNAIDS/HIV Vaccine Enterprise satellite session that early and consistent community engagement is essential. If the field is going to reach coverage targets, community mistrust can’t be a barrier.

COVID-19 and HIV

A WHO report found HIV is a risk factor for severe or critical COVID-19. The WHO Global Clinical Platform for COVID-19 drew data from 24 countries and more than 15,000 people. This report offers another picture on HIV and COVID from the largest pool of data to date compared to other smaller studies that did not find a link, including one from the US, also presented at IAS 2021. The results have reinforced the need to ensure people living with HIV are listed as priority populations to receive COVID vaccines across the globe. This must happen in the context of massive scale-up to produce and distribute vaccines and close the gap in vaccination between the global north and south.

PrEP and resistance

The GEMS project monitored for the development of drug resistance among PrEP-takers. The project analyzed samples from 104,000 people from PrEP programs in Eswatini, Kenya, South Africa and Zimbabwe. There were 229 documented seroconversions overall and 118 were sequenced (some participants didn’t provide samples and some samples had low viral load and couldn’t be sequenced). Of those 118, 23 percent had HIV with a PrEP-associated mutation for drug resistance. Urvi Parikh, Senior Project Advisor of GEMS, presented the data and put the findings in context: the number of reported infections while on PrEP was very small, and an even smaller number had resistant mutations.

Based on the GEMS data, the most common mutation, M184V/I, is not expected to undermine the efficacy of one of the most important treatments across Africa, dolutegravir-based regimens. It will be important to monitor where these mutations will affect future treatment. It will also be vital to carefully screen for HIV among people who want PrEP in order to catch early infections that could lead to resistance. For additional background, our colleague Gus Cairns did a terrific summary of these findings as part of the NAM/AIDSMAP reports throughout the conference.

Calls for people-centered solutions

IAS 2021 heard an emphasis on the importance of community-led, client-controlled empowerment and leadership, which starts at the beginning of the research process, framing the questions that must be answered and how to answer them.

No Data No More: Manifesto to Align HIV Prevention Research with Trans and Gender Diverse Realities launched during IAS 2021. Developed by trans and gender-diverse (TGD) advocates from South Africa, Europe and the United States, with support and solidarity from AVAC, the manifesto demands an HIV prevention research agenda based on the priorities of TGD communities, with those communities driving decisions throughout the process.

Among the demands: provide gender-affirming hormone treatment (GAHT) across the continuum of HIV research, prevention and care; address the barriers that limit access to research and prevention for TGD people; recruit TGD researchers and other experts to design and implement solutions at all phases of the response.

At a session, What is missing in the HIV response?: Strengthening HIV programmes for trans populations in the Global South, presenters decried the absence of data on trans health outcomes even as TGD people face high risk of HIV. See US CDC statistics that show 1 in 7 (14 percent) transgender women in the United States have HIV and an estimated 3 percent of transgender men have HIV, with even less data available for non-binary individuals.

Liberty Matthyse of Gender Dynamix in South Africa said “trans and gender-diverse healthcare is greatly understudied,” fundamentally undermining the effort to end the epidemic. “We need to prioritize community-led participatory research, plug into existing community-led movements, co-create context-specific methodology to reach missing and undocumented cases. And we need to decentralize access to hormonal care and make it part of a package of HIV services. Every person should have the right to gender self-determination.”

Rena Janamnuaysook’s presentation at this session provided a model. At Thailand’s Tangerine Clinic, members of the trans community identified priority health needs, co-designed a program of services, and received training to deliver qualified care. About 4,000 community members rely on the clinic, which offers hormone services and other gender-affirming care as an anchor to generate demand for other health services including HIV testing, prevention and treatment. Nearly all (94 percent) of the 10 percent who have tested positive have initiated ART, nearly all of them (97 percent) are virally suppressed, and 18 percent of those who have tested negative initiated PrEP. “Key populations-led services increased access to testing, simplified services, and promoted a sustainable HIV response,” said Rena.

New targets old problems

These stories from IAS 2021 put the past year in perspective. The science that was needed to respond to both SARS-CoV2 and HIV has seen significant advances and must continue. The innovation to deliver treatment and prevention has also seen unprecedented effort, and must accelerate and expand. But policy and political will has failed to close gaping inequities that mean, among other things, the 3.3 billion doses of COVID vaccine delivered to date are concentrated in a few wealthy countries, that lockdown drove up reports of rape in Uganda by 24 percent while the use of PEP dropped by 17 percent, that 150 million people will fall into extreme poverty this year, that COVID remains a threat to global health everywhere.

The new UNAIDS targets, the so called “10’s” aimed at social factors that drive epidemics (punitive laws and policies, stigma, discrimination and gender-based violence) should galvanize action from every quarter. Approved by the UN’s High Level Meeting on HIV in June, these new targets must be used to build on the sweeping changes underway in 2020, to dismantle structural barriers and to embrace new evidence-based models that will make prevention a reality everywhere it’s needed.

Ethical Guidance in Focus

The field of HIV prevention research has two updated ethical guidance documents, one from the US National Institutes of Health-funded HIV Prevention Trials Network (HPTN) and the other jointly published by UNAIDS and WHO. Each of these documents updates prior versions, last published in 2009 for the HPTN and 2012 for UNAIDS/WHO. Here we explore the key similarities and differences in the two documents and their implications for the field.

Taken together, the HPTN’s Ethics Guidance for Research and UNAIDS/WHO’s Ethical Considerations in HIV prevention trials address the dominant issues in today’s world of HIV prevention research. They reflect the expanded array of prevention tools—including antiretroviral treatment as prevention for people living with HIV and a PrEP landscape that includes tenofovir-based oral PrEP today, with the Dapivirine Vaginal Ring (DVR) and injectable long-acting cabotegravir (CAB-LA)—and provide deeper guidance on critical decisions that come with trial operations and regulations.

The considerations and obligations put forward in these documents are not binding, but they are widely accepted by civil society, trial designers, product developers and researchers as crucial considerations for the design and execution of biomedical prevention trials.

The publications serve different primary audiences. The HPTN guidance is written specifically for the network’s researcher staff and partners and reflects US government policy and positions. The UNAIDS/WHO document is aimed at a global audience, including all research institutions as well as other decision-making bodies such as national ministries of health. Both set out principles that can be referenced by communities, researchers, policy makers, funders, regulators, and anyone engaging with a specific trial or with research overall.

In both cases, the authors were digesting major forces that affect HIV prevention research. The advent of oral PrEP, increasingly accessible since 2012, is making HIV prevention trials more complex. Participants must be offered this highly protective option—either in the “comparator” arm of a study where there’s no placebo, or as part of the standard package of prevention that participants receive when they are randomized to either a placebo product or an experimental one. (For more on issues in innovative trial design check out Bill Snow’s blog on AVAC, Designing a New Generation of HIV Prevention Efficacy Trials, and the May 2021 statement from the AVAC-convened Trial Design Academy on the future of HIV prevention trials.)

But providing PrEP involves a web of decisions about how to ethically fulfill this obligation, and how to design a trial that will be able to answer key questions in research. As new forms of PrEP move through the pipeline, this complexity will only grow. In addition, ethics bodies have been increasingly concerned with a number of other issues including: building lasting capacity to conduct research and respond to healthcare needs in the places where research takes place; addressing the social and political pressures faced by vulnerable populations as a factor in trial design; and expanding and deepening partnerships among host communities, populations that need prevention, and those who fund and conduct research.

Each of the 15 guidance points of HPTN’s Ethics Guidance for Research receives a designation as an “obligation” or an “aspiration” and names accountable entities, such as trial sponsors, researchers, community representatives, study teams and/or research sites.

Ethical Considerations in HIV prevention trials by UNAIDS/WHO tackles the ethics of trial design and conduct in 14 guidance points. Guidance Point 1 reasserts, in contemporary terms, why HIV prevention trials remain imperative. Despite the efficacy of PrEP and its increasing availability, transmission of HIV is outpacing current efforts to control the epidemic, and more choices for effective prevention are essential.

Many of the most significant changes in each publication echo each other, but there are some distinctions. This table (downloadable here) summarizes some of the key changes in both documents and their implications.

These two foundational documents set a standard that all HIV prevention stakeholders should seek to meet, and transparently. It’s important to note that they are intended and should be used as guides, not prescriptions. Where they leave off, the Good Participatory Practice Guidelines for biomedical HIV prevention trials (GPP) pick up. Developed by AVAC and UNAIDS, the GPP Guidelines look at how to involve stakeholders and build the partnerships that make research relevant and ensure results will lead to innovation that works for the people who need it. Researchers, sponsors, advocates, ministries of health, trial-site staff, regulators and anyone interested in HIV prevention research should know what’s in them all.

Ethical Guidance In Focus: New blog and August 5 webinar

We’re taking a long look at two new guidance documents on ethics for HIV prevention trials, one by the HIV Prevention Trials Network (HPTN) and another from UNAIDS/WHO.

Check out Ethical Guidance in Focus, a blog by Jeanne Baron that spotlights what’s new, how the two publications contrast, and implications for advocacy.

And we hope you’ll join next week’s webinar New Ethical Guidelines for HIV prevention trials in people: What’s changed and Why Does it Matter? on Thursday, 5 August at 9am US EDT / 3-4pm Southern Africa / 4-5pm Eastern Africa.

Register here.

The webinar will explore the guidance documents in-depth, and offer a discussion on the changes and what they mean for HIV prevention research.

Panelists include:

  • Catherine Slack, PhD. Head, HIV/AIDS Vaccines Ethics Group, University of KwaZulu-Natal, Pietermaritzburg, South Africa
  • Andreas Reis, MD, MSc. Co-Lead, Health Ethics & Governance Unit, WHO, Geneva
  • Jeremy Sugarman, MD, MPH, MA. Professor of Bioethics and Medicine, Johns Hopkins University, Baltimore, US, and Chair of the HPTN Ethics Working Group

Looking forward to working with you all on a future for trial design that’s ready for next generation prevention.

Research Literacy Zone Roundup

Alongside last week’s IAS 2021 Conference, AVAC and partners hosted a range of dynamic sessions in the virtual Research Literacy Zone, where researchers and advocates explored timely topics including: Dapivirine Vaginal Ring rollout, advances in vaccine and cure research, U=U, new approaches to understanding social factors that impact health, vaccine hesitancy and more. The Zone is a gathering place for researchers and community advocates to dive deep on critical topics in a small-scale environment.

All Zone sessions are available on our Research Literacy Zone page and on ENGAGE, AVAC’s online platform for peer-to-peer resource-sharing and collaborative learning. Register for your free account today, join the conversation, and access all that ENGAGE has to offer.

Also, the Zone isn’t just for conferences! AVAC hosts virtual events and conversations throughout the year (including an August 11 rectal microbicides webinar with AFC!). Have a topic idea for a future session? Drop us a note!

RESEARCH LITERACY ZONE @ IAS 2021

HIV Cure Research in Africa: Challenges and opportunities included a panel of researchers and advocates exploring some of the challenges and opportunities of HIV cure research on the African continent, strategies that are currently being pursued, and the science of the cases of HIV cure reported in the news. Listen to the recording.

Pushing U=U Jigsaw Puzzle into the HIV Prevention Agenda focused on efforts to use the science of U=U to promote HIV treatment uptake, enhance adherence and eliminate stigma and discrimination, so that PLWHIV can live longer and have healthy relationships while protecting their partners from contracting HIV. Listen to the recording.

Models, Maps and Measures: What advocates need to know about new strategies assessing social determinants focused on how to assess the social determinants of HIV and a special NIH-funded initiative on the issue. The expanding pipeline for HIV prevention was one of the driving factors motivating the NIH to fund an initiative examining new ways of measuring social determinants.. The discussion focused on two new strategies: using models to determine what factors enhance the effectiveness of cash transfers in adolescent girls and young women in South Africa, and the use of GPS tracking to determine barriers to PrEP access in young MSM in NYC. Listen to the recording.

A Conversation with Advocates on Vaccine Hesitancy provided attendees a space to reflect on the urgent need for vaccine equity and potential vaccine hesitancy. Panel members discussed why some individuals are hesitant in their communities. The discussion also focused on solutions, with panel members and participants sharing what has worked in their contexts and resources they are developing to engage communities in the discussion now. Listen to the recording.

Inclusion of Pregnant and Breastfeeding Women in HIV Prevention Research: What can you and I do to move this agenda forward centered on the importance of including pregnant and breastfeeding women in HIV prevention trials. The discussion outlined barriers to participation and implementation and focused on steps to move the field forward. Listen to the recording.

Ring Roundup covered updates in the research program and rollout plans for the Dapivirine Vaginal Ring (DVR). Attendees learned about IPM’s DVR research program and the early-phase research pursuing a longer-acting formula and dual prevention (HIV and pregnancy). Discussion also focused on the current regulatory approval process of the ring as a prevention option for women and the steps advocates can take to secure national approvals. Listen to the recording.

Stay tuned for our full roundup of IAS conference news later this week, and remember, check out ENGAGE for future events and conversations, and let us know if you have an idea to share!

NO DATA NO MORE! A Manifesto to Align HIV Prevention Research with Trans and Gender-Diverse Realities

Worldwide, trans and gender-diverse (TGD) people face a highly disproportionate burden of HIV but are frequently and often systematically left out of HIV prevention research and responses. That ongoing exclusion is a major barrier to efforts to end the global HIV pandemic, according to No Data No More, a new HIV prevention manifesto written by TGD advocates from South Africa, Europe and the United States, with support and solidarity from AVAC.

No Data No More: Manifesto to Align HIV Prevention Research with Trans and Gender Diverse Realities takes aim at an achilles heel in the global response to HIV: the neglect of trans and gender-diverse communities. Trans women bear a disproportionate burden of HIV globally with 19 percent living with HIV—49 times greater than the general population. HIV in trans men is woefully underreported and understudied and the absence of data leads to a false assumption that they bear little to no burden of the virus. Gender nonbinary people face even greater underrepresentation in HIV surveillance and research.

No Data No More analyzes how TGD communities are left out of HIV prevention research and responses through structural barriers such as discriminatory attitudes and punitive laws, non-inclusive language, failure to recognize the diverse and unique identities of different members of TGD communities and a lack of understanding of the role of gender-affirming hormone therapy (GAHT) in TGD health. And this manifesto provides a vision for a course-correction.

Addressing researchers, implementers, funders and advocates, highlights of manifesto demands include:

  • Inclusion of the full range of the gender spectrum in clinical trials, with an emphasis on trans men.
  • Efficacy and safety questions regarding on-demand oral PrEP for trans people on GAHT are resolved.
  • Local research sites funded to recruit TGD participants and to follow the Good Participatory Practice.
  • Guidelines, which must involve engaging with the local LGBTQ community, including transgender-led organizations.

No Data No More offers practical and essential priorities to ensure viable HIV interventions for TGD people. We encourage you to engage with these important insights, because the future must include peer-led HIV prevention research with true ownership and acceptability in TGD communities.

Watch this space for details on an upcoming webinar. And for more information and to advocate for TGD inclusion in HIV research, go here tgagenda@avac.org.

AVAC’s Micheal Ighodaro in The Legend of the Underground

The latest episode of Px Pulse goes behind the scenes of the new HBO movie, The Legend of the Underground. The film documents the lives of AVACer Micheal Ighodaro and other LGBTQ Nigerians as they confront enormous risks to ‘live out loud’. As the movie unfolds, individual stories of resilience are woven together into a tapestry that portrays a revolution for cultural change in Nigeria.

In this special Px Pulse interview, Micheal reflects on what the movie means to him and how he sees himself in the young Nigerian activists at the forefront of the movement today. Micheal says, “change starts by people sharing their stories… Telling my story helps, hopefully, to give light to other stories that need to be told—that’s why I do it”.

AVAC applauds Micheal and the other Nigerian activists and their fight for freedom. The Legend of the Underground, directed by Nneka Onuorah and Giselle Bailey, is streaming now on HBO. For the full podcast episode, highlights and more resources, visit avac.org/px-pulse. And subscribe on Apple Podcasts, Spotify or wherever you get your podcasts!

AVAC Previews IAS 2021 Virtual

IAS 2021 is around the corner! This year’s virtual event covering advances in HIV research runs from Sunday, July 18 to Wednesday, July 21. AVAC will be tracking the landscape of prevention research to explain, frame, connect and contextualize what’s new, what’s next and what it all means for advocacy.

Below we’ve gathered some resources and highlights so you won’t miss a thing!

Resources

  • Use AVAC’s Prevention Roadmap to find sessions where prevention is in the spotlight. You can download it as a sortable spreadsheet or pdf.

  • AVAC’s Research Literacy Zone takes the conversation deeper with advocates and researchers exploring timely topics including: updates on rolling out the Dapivirine Vaginal Ring, updates on recent results and new trials, advances in vaccine and cure research and new approaches to understanding social factors that impact health. See the full schedule here.

  • To follow events in real time, AVAC will offer comments and updates on Twitter, and our friends at NAM/AIDSMAP who will be reporting throughout the conference. Join the conversation using the conference hashtag, #IAS2021.

Satellites, sessions and panels featuring AVAC and partners

Sunday, July 18

Symposium – Pivoting HIV prevention during a parallel pandemic
Ch. 4 14:00-14:50 CEST / 8:00-8:50 EDT

This session explores how the COVID-19 pandemic has impacted HIV prevention services and some of the positive changes to how services are managed. Co-moderated by AVAC’s Micheal Ighodaro and Loice OMBAJO, University of Nairobi, Kenya.

Monday, July 19

Satellite – Paving the road for new PrEP products: The promise of differentiated, simplified, and decentralized delivery to maximize the potential of emerging PrEP products

Ch. 2 08:30-09:30 CEST / 2:30-3:30 EDT
PrEP uptake has increased over 100 percent since 2019, largely due to efforts to innovate and adapt PrEP delivery. The next generation of PrEP must learn from these experiences. Implementers, advocates and researchers discuss these models and others to scale up all forms of PrEP to reach those who need it. Chaired by AVAC’s Jessica Rodrigues, Anna Grimsrud of the International AIDS Society, Davina Canagasabey and Kim Green of PATH. Download the flyer.

Symposium – What is missing in the HIV response? Strengthening HIV programmes for trans populations in the Global South (CME)
Ch. 3 11:00-11:50 CEST / 5:00-5:50 EDT
There’s a serious dearth of information on health outcomes for trans populations in much of the world. Without this information how can HIV programmes effective? Join this session for a dialogue among academics, HIV service providers and trans community members on where research must expand and to engage the trans community in the development of this research agenda.

Symposium – Build it: But will they come? Prevention efficacy versus population effectiveness

Ch. 3 14:00-15:50 CEST / 8:00-9:50 EDT

Community uptake is crucial for the success of prevention interventions. This session will discuss how the field can better prepare for the delivery of effective prevention interventions and how communities can contribute to ensuring their success. Co-moderated by AVAC’s Manju Chatani-Gada and Moses R. Kamya of Makerere University, Kampala, Uganda.

Satellite – Bringing the Dual Prevention Pill to Market: Opportunities for HIV and Pregnancy Prevention and Implications for Future Multipurpose Prevention Technologies

Ch. 1 21:00-22:30 CEST / 15:00-16:30 EDT
The Dual Prevention Pill (DPP), a tablet containing oral PrEP and combined oral contraceptive, is likely to be the first MPT with PrEP to go to market. This combination, preventing both pregnancy and HIV, may transform challenges related to stigma that women face taking PrEP alone. Using the DPP as a case study, this session will highlight practical considerations for future MPTs such as: What are best practices with end users and providers? How do different financing sources for family planning and HIV shape next steps? What approaches can be used to estimate impact?

Tuesday July 20

Satellite – An HIV vaccine: who needs it?

Ch. 3 19:00-20:30 CEST / 13:00-14:30 EDT
The response to the HIV epidemic, now in its fourth decade, has marked tremendous progress in developing effective treatments and prevention options, but the challenge of developing a safe and effective HIV vaccine persists. Co-sponsored by the Global HIV Vaccine Enterprise at IAS and UNAIDS, this satellite offers. A panel discussion, including AVAC’s Daisy Ouya and others, will explore critical questions that will come when an HIV vaccine is discovered, such as who should be immunized, what will be the benefits, the costs, and who will pay?

Access these resources, conference highlights and more at AVAC’s dedicated IAS 2021 event page. And watch this space for further updates. Hope to see you in the virtual halls!

Understanding the AMP Results and So Much More

We’re delighted to share our new publication Understanding Results of the AMP Trials. The first results of these landmark trials were announced in early 2021, but their implications will be echoing for years to come. This guide provides a foundation for advocates.

The AMP trials evaluated the ability of a broadly neutralizing antibody (bNAb), called VRC01, to protect against HIV. The trials showed that VRC01 did not reduce the overall risk of acquiring HIV. However, VRC01 protected some individuals from infection by HIV viruses that were particularly vulnerable or “sensitive” to the antibody. Together these results mean AMP will inform future bNAb and vaccine studies. Read Understanding Results to learn more; listen to our Px Pulse podcast to dive into the AMP trials; and check out AVACer Daisy Ouya’s commentary on the AMP trials in the latest issue of IAVI’s Voices: Community Perspectives on Clinical Research.

Also, in case you missed it, we’re highlighting a few other important resources to inform prevention advocacy:

Looking at PEPFAR, with Emily Bass on her new book, To End a Plague

The latest episode of Px Pulse takes a deep dive into PEPFAR, The President’s Emergency Plan for AIDS Relief, looking at its pioneering successes and its challenges. In this episode, AVAC’s former Director of Strategy and Content, Emily Bass, discusses her new book, To End a Plague: America’s fight to end AIDS in Africa.

Emily began reporting this comprehensive history of PEPFAR not long after George W. Bush launched the program in 2003. Since its creation, PEPFAR had an enormous impact and radically changed expectations of what a foreign aid program should be.

But the program has also faced challenges. Emily covers it all in her new book, including questions related to health equity, drug costs, patents, and the best ways to design and implement a foreign aid program and address pandemics.

This podcast episode is bittersweet for us at AVAC. After nearly 16 years with AVAC, Emily is taking on new challenges in the larger field of global health as part of the new Pandemic Prevention Institute. Her leadership at AVAC has provided a legacy of passionate, far-sighted advocacy and she will be deeply missed. Congratulations, Emily, on this book, and we look forward to our continued collaborations with you in fighting against pandemics and for global health equity.

Happy Listening!