Upcoming TCA Webinars On CROI And The Ring!

The Choice Agenda, a global forum for advocacy on the latest in HIV prevention, has two webinars coming up you won’t want to miss:

the Choice Agenda logo

CROI and Community and YOU – Preparing for CROI 2023
Wednesday, September 7 at 10:00-11:00am ET; 2:00-3:00pm GMT

Register here.

Join the conversation with co-chairs of the Conference on Retroviruses and Opportunistic Infections (CROI), as well as researchers, advocates, community educators and members of the Community Liaison Subcommittee. The discussion will touch on what to expect at CROI 2023, which features some of the most consequential research on HIV, monkeypox, SARS-CoV-2 and more. The webinar will also cover how to apply for a Community Scholarship, and key dates and deadlines for engaging with the conference. Remarks from:

  • Dawn Averitt, Member of the Community Liaison Subcommittee
  • Dr. James Hoxie, Chair of the 2023 CROI Planning Committee
  • Drs. Diane Havlir, Vice-Chair of the 2023 CROI Planning Committee
  • Landon Myer, Vice-Chair of the 2023 CROI Planning Committee
  • Jim Pickett, Member of the Community Liaison Subcommittee
  • Ntando Yola, Member of the Community Liaison Subcommittee

RINGing the bell for Choice: Actions and Solutions on Dapivirine Ring Access
Thursday, September 22 at 9:00-10:30am ET; 1:00-2:30pm GMT

Register here.

This webinar will offer the latest from African advocates leading efforts to demand access to the dapivirine vaginal ring. In recent weeks, advocates have been pressing PEPFAR and others to do more to deliver the ring to women who want it. The Population Council will also discuss their plans for moving forward a full agenda for ring technology, including rolling out the approved monthly PrEP Ring, and continuing research on a three-month ring and multipurpose technology. In July, the Population Council announced it had acquired the ring technologies from the International Partnership for Microbicides, the ring’s developer. Speakers include:

  • Yvette Raphael, Advocacy for Prevention of HIV and AIDS, South Africa
  • Leonard Solai, IPM, South Africa
  • Erica Gollub, Pace University
  • Chris Obermeyer, The Global Fund

For previous webinars from The Choice Agenda, check out our archive here! And join more than 600 advocates on the TCA listserve by reaching out to Jim at jimberlypickett@gmail.com.

AVAC’s August Reading List

Yesterday we heard that Dr. Anthony Fauci will step down from his role leading the US National Institute of Allergy and Infectious Diseases (NIAID) after a half a century of public service. His vision, passion and commitment to ending the AIDS epidemic and advancing global health equity has been an inspiration to AVAC and to so many. As we contemplate the huge leadership gap Dr. Fauci leaves, we look forward to working with him and all stakeholders to ensure that hard fought gains in public health under his leadership are not lost and are further built upon.

This August reading (and listening) list is a great place to start building on the legacy of Dr. Fauci and taking charge of the work ahead. As Dr. Fauci reminds us: “much accomplished; much still to do”.

For Your Advocacy – A Research Agenda for Pregnant and Lactating People

For prevention options to meet the real life circumstances of the people who need them, we need an inclusive research agenda. Advocacy for the inclusion of pregnant and lactating populations (PLP) in research has been gaining traction in recent years, building on growing evidence, several global and national initiatives and an increased focus from prevention advocates. AIDS 2022 in Montreal featured exciting discussions advancing this work. If you’ve been taking part or just getting up to speed on the issue, AVAC has resources for you—including An Advocate’s Guide to Research in Pregnant and Lactating Populations; a dedicated page on AVAC.org with background and further resources; and a four-point action plan, Advancing HIV Prevention Research in Pregnant and Lactating Populations: Priority Advocacy objectives and Next Steps.

Pregnancy and the post-partum period after giving birth are times of heightened HIV risk. Cisgender women are two to three times more likely to acquire HIV during pregnancy and four times more likely post-partum than otherwise. Women who acquire HIV during pregnancy have an 18 percent chance of transmitting HIV to their newborn, which goes up to a 27 percent chance if they acquire HIV while breastfeeding. But HIV prevention options for (PLP) are limited, and their inclusion in research has been inadequate, resulting in evidence gaps across the research landscape for new prevention products.

(Image from AVAC’s Advocates Guide)

An approach based on principles of reproductive justice is reframing the research agenda for PLP. But action is needed from a variety of stakeholders to promote ethical inclusion rather than exclusion of pregnant people from clinical trials. A multi-stakeholder think tank led by AVAC and the PHASES project brought together advocates, researchers, ethicists, regulators and donors and resulted in a four point action plan, with additional contributions from Pangaea Zimbabwe AIDS Trust. The plan identifies next steps and four priority goals:

1) Embrace a reproductive justice framework:

(Reproductive Rights Framework, Image from PHASES, 2020)

2) Engage stakeholders in an early and sustained process in the design and conduct of clinical trials

3) Develop the necessary regulations to generate needed data for PLP to safely use new therapeutics

4) Ensure sound ethics reviews that include adolescent girls and young women in HIV prevention research.

An inclusive research agenda for PLP is essential for the HIV response, elemental to equity in global health, and key to having an impact on the epidemic. If you are interested in getting involved in AVAC’s work in this area, contact avac@avac.org

For other resources toward an inclusive research agenda, check out

  • The Choice Agenda list serve: a global forum for advocacy on the latest in HIV prevention research, with monthly webinars on the hottest topics.
  • No Data No More: A Manifesto to Align HIV Prevention Research with Trans and Gender-Diverse Realities
  • Good Participatory Practice Guidelines: systematic guidance on effective stakeholder engagement in HIV prevention research.

A Look Back at Montreal

In Montreal the pressure was on.

AIDS 2022 showed the global response to HIV at a crossroads. The field has achieved groundbreaking advances in biomedical solutions. But intensifying disparities in HIV prevention and global health at large threaten to eclipse these achievements. Scrutiny of the inequities was center stage in Montreal. While the UNAIDS report In Danger, released at the conference, documents what HIV advocates have known—that during the earliest phases of the COVID-19 pandemic, progress against HIV did not just stall, it actively lost ground—the HIV Prevention 2025 Road Map by the Global HIV Prevention Coalition released just days later navigates a path to get back on track.

Click here to download the issue

Advocates see how much is at stake at this moment and were making the connections to crises across the field of global health. Their call to action was constant. Protests, formal and informal, were diverse and targeted. They demanded political support and full funding to rollout the dapivirine vaginal ring (PrEP Ring), confronted the developer of injectable cabotegravir for PrEP to go further in affordable and transparent pricing, took on an anemic response to monkeypox (POZ coverage here, TheBodyPro coverage here), challenged ongoing criminalization of sex workers and other key populations, and criticized Canada for blocking the visas of hundreds of delegates to the conference.

Veteran voices such as Fatima Hassan of the Health Justice Initiative were calling out the implications of “vaccine apartheid” in the COVID response and the “pandemic profiteering” that drives it. Global health activist and epidemiologist Gregg Gonsalves called on health advocates to go beyond “the technocratic solutions… and fight our way back to equity.” Advocates challenged the legacy of colonial imperialism in global health, and some voices demanded total reform of the intellectual property and trade system, to name a few of the issues and actions raising the heat.

Are They Listening?

Important steps in decolonizing global health are beginning to take shape. Advocates from the Global South hosted and co-hosted meetings with key decision-makers to make the urgent case for faster and more equitable access to new PrEP options—including meetings with Winnie Byanyima of UNAIDS, Amb. John Nkengasong of PEPFAR and Atul Gawande and Han Kang of USAID. These discussions, as they go beyond community engagement and towards community leadership, represent a model for how the global response must change—voices from communities where HIV is hitting the hardest must be in leadership at every stage, for every crucial decision. The UNAIDS, PEPFAR and USAID leaders say they are listening. Advocates are watching this space closely. Accountability, at every level, is essential—for HIV prevention, treatment, human rights, health systems and health equity.

Getting Rollout Right

Fulfilling the current promise of new HIV prevention options requires advancing a people-centered, integrated approach for introducing proven products. This priority was also center stage in Montreal. The Coalition to Accelerate Access to Long-Acting PrEP (with AVAC serving as the secretariat), The HIV Prevention Road Map announced by the Global HIV Prevention Coalition, and the just-launched WHO guidelines for injectable PrEP that simplify PrEP delivery, are helping to lay the groundwork. The agreement between the Medicines Patent Pool (MPP) and ViiV is also a welcome step toward a sustainable market of generic manufacturers for injectable CAB and future products.

But more must be done. Delivering the fruits of science must become as urgent as their development. Putting in place the right programs, policies and investment to deliver choices at scale and bend the curve of the epidemic utterly depends on a commitment to integrated, equitable, people-centered, and community-led approaches. Be sure to read AVAC’s Plan for Accelerating Access and Introduction of Injectable CAB for PrEP, (or a summary of it), which outlines why funding commitments, creating demand, WHO guidelines, implementation studies, technology transfer, generic manufacturing and more must be coordinated and expedited now.

Several sessions and events at AIDS 2022 took a deep dive into why and how this people-centered, integrated approach must frame product introduction. Here are quick highlights on key sessions:

Scientific Advances

The meeting saw incremental progress in research on several of the pandemics destroying life around the world today. Sessions on TB, HIV, COVID-19, monkeypox, and STIs drew lessons from the COVID-19 response. But with all that the world is learning, research and discussion have yet to tackle how to create the integrated systems needed for a truly effective global health response. This kind of pandemic preparedness means advancing health equity.

Our friends at aidsmap provided in-depth reporting on a number of sessions; you can check out their highlights here. In the meantime, here is a brief summary of some of the scientific advances we found interesting at AIDS 2022:

Populations and Products in Focus

The following sessions put an important spotlight on particular populations or products:

AVAC at AIDS 2022

For a look at AVAC’s work at AIDS 2022 go to our dedicated page. And in case you missed it, the latest webinar from The Choice Agenda provided a status update on the rollout of injectable PrEP, with presentations from providers, researchers, the WHO and others.

The picture of HIV prevention today is full of promise and peril. Navigating the challenges is both possible and imperative. Here’s how AVAC Executive Director Mitchell Warren put it at the launch of the new Global HIV Prevention Roadmap:

“In 41 years we’ve never had such opportunity in prevention. We have a package of proven methods for the first time, and global health leaders are offering renewed commitments to spearhead and sustain programs that are designed to reach those who need prevention most. These programs should be focused on integrating HIV services with sexual reproductive health and rights. But we won’t get this done without going beyond simple community engagement and the old siloed models of delivery. Now is the time to integrate, coordinate, and invest. Now is the time for a global response that is community led.”

Injectable PrEP: Upcoming Webinar from The Choice Agenda

AIDS 2022 in Montreal just wrapped up, and stay tuned for our full summary soon. For now, though, a quick update on injectable cabotegravir for PrEP (CAB), which was a hot topic at the conference and the subject of next week’s Choice Agenda webinar.

  • New data from the HPTN 083 and 084 trials re-confirmed the safety and efficacy of CAB for PrEP;
  • WHO guidelines added injectable PrEP as an additional prevention option;
  • ViiV, the drug-maker of CAB for PrEP, and the Medicines Patent Pool announced an agreement to provide a voluntary license and begin the process of identifying generic manufacturers;
  • A new coalition convened by Unitaid, WHO, UNAIDS and the Global Fund, with AVAC serving as the secretariat, will collaborate with civil society, normative agencies, governments, and funders, in accelerating access to longer-acting PrEP; and
  • Advocacy and activism around global access to CAB included on-stage protests, meetings with key decision makers and many, many other discussions led by advocates and partners.
  • Join us Monday, 8 August at 9:00 ET / 15:00 SAST for our next The Choice Agenda webinar, Faster, Smarter and More Equitable – Accelerating Roll Out and Uptake of CAB for PrEP.

    title card for webinar

    As injectable cabotegravir (CAB) as PrEP begins to be introduced, what lessons have we learned from the first 10 years of oral PrEP implementation? How can the field do better with a new PrEP intervention that offers new opportunities and distinct challenges? These are the questions our panel will be discussing and more.

    • Rachel Baggaley, World Health Organization
    • Caroline Carnevale, New York Presbyterian Hospital
    • Monica Gandhi, University of California San Francisco
    • Mitchell Warren, AVAC
    • US cabotegravir (Apretude) user – RJ Mitchell