Decriminalization of Sex Work Prevents HIV: South Africa could overturn its outdated laws

South Africa could possibly reform its outdated and misguided criminal legislation that punishes consenting adults who offer or procure sexual services for money. AVAC supports the move toward decriminalization as evidence shows that its social, legal and economic injustices create a perfect storm for sex workers’ increased HIV risk. South African HIV and human rights activists deserve credit for their advocacy in bringing the Sexual Offenses Act of 1957 and its follow-on Amendment Act of 2007 up for a repeal vote.

AVAC Fellow, Liyema Somnono, authored an opinion in Health-e News (Jan 27), Decriminalization of sex work can help prevent HIV, unpacking the reasons for legitimizing and recognizing sex work as work, rather than as a stigmatizing crime with broad, negative effects that exacerbate an environment of social exclusion, violence and HIV. Liyema lays out a powerful case for repeal:

  • Sex work is work. It’s an income-generating activity. Sex workers are not criminals, victims, vectors of disease, or sinners.
  • Sex workers support between five and eight other people with their earnings.
  • Under the current punitive laws, sex workers face human rights violations in their treatment by police officers, health practitioners, clients, and other members of society.
  • Stigma and discrimination prevent most sex workers from accessing quality HIV prevention and HIV care services.
  • Criminalization deems it difficult to negotiate safer sex or report abuse from clients, partners, police or health providers.
  • Repeal of the legislation that punishes sex workers would have a profound impact on the course of HIV epidemics across all settings. A third to half of HIV infections would be averted in a decade.

For those residing in South Africa, please voice your opinion in favor of the Criminal Law Amendment Bill of 2022 at The comment period is open through 31 January.

Liyema is a 2022 Fellow, hosted by Passionate Unlimited Peers in Action, in South Africa where she partners closely with SWEAT and Sisonke, a national movement of sex workers working towards a South Africa where people who choose sex work are able to enjoy freedom, rights and human dignity. As part of her rights-based advocacy, Liyema works to integrate access to HIV prevention choices for sex workers and other women in the rural Eastern Cape.

This Week! Webinars on Mosaico Study and Trans Manifesto

AVAC has two webinars this week you won’t want to miss!

Tomorrow, January 25, at 9 AM PST/12 PM EST/6 PM CET, AVAC and HIV Vaccine Trials Network (HVTN) will host a webinar called Where Are We and Next Steps. As the field explores what the ending of the Mosaico study means for vaccine research, we’ll be joined by study investigators and community representatives to further interrogate what a post Mosaico trial looks like, key takeaways from the study, and ways to remain hopeful for an HIV vaccine. Register here.

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On Thursday, January 26 at 10:00 AM EST / 3:00 PM GMT, The Choice Agenda is hosting its first webinar of 2023, Trans Inclusion: Charting HIV Research into the Future: A Manifesto and Scorecard for Advocates and Researchers. The webinar will explore why trans-inclusive and trans-centered research is not only the right the thing to do for equity in the global response, but also necessary to end the epidemic. Register here and join our growing community of HIV prevention advocates (Over 1,000 and counting!) with The Choice Agenda listserv.

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We look forward to virtually connecting soon!

What’s Next for HIV Vaccines? Mosaico Study Webinar on Jan 25

On the heels of Wednesday’s announcement from Janssen Pharmaceutical Company that the Mosaico HIV vaccine trial is ending for lack of efficacy, there’s much to learn and discuss.

Please join AVAC and the HIV Vaccine Trials Network (HVTN) for a webinar on January 25th at 9am PST/12pm EST/6pm CET. The webinar will include study investigators and community representatives as we all discuss the outcome of the Mosaico study, what these results mean and next steps. Register here.

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The Mosaico study, also known as HVTN 706/HPX3002, was the third large-scale vaccine efficacy study to conclude early for non-efficacy since 2020. Uhambo/HVTN 702 and Imbokodo/HVTN 705 were stopped in 2020 and 2021 respectively. One large-scale, Phase 2b trial known as PrEPVacc is continuing, studying two vaccine regimens and two daily oral PrEP regimens (F/TAF and TDF/FTC) in men and women; expected completion in late 2024. In addition, several early phase trials using mRNA technology have launched. It’s a field in transition.

This latest announcement raises critical questions about the direction of the essential work to develop an HIV vaccine. Understanding the results of the Mosaico study is central to this task. A vaccine strategy is vital for a durable end to the epidemic but a clear path is not in sight, and new longer-acting PrEP options, which hold promise to bring the world closer to controlling the epidemic, add to the complexity, the opportunities and challenges for HIV vaccine development.

To help navigate all of this, see our updated resources on the issue:

AVAC’s statement on the Mosaico trial

Years Ahead in Biomedical HIV Prevention Research (Detailed)

Years Ahead in HIV Prevention Research (Simple)

A Review of Pipeline of New HIV Prevention Options

A Vaccine Factsheet

We look forward to hearing from you on the 25th and working with you going forward.

Mosaico HIV Vaccine Study Stopped Early for Non-Efficacy

Today, the Mosaico study, a large-scale HIV vaccine efficacy study also known as HVTN 706/HPX3002, was stopped early for non-efficacy. The study took place in several countries in North and South America and Europe to test the safety and efficacy of the adenovirus26-based vaccine regimen among 3,900 cis-gender men and transgender individuals who have sex with cis-gender men and/or transgender individuals. An independent data and safety monitoring board, at a scheduled review of the trial data, found the regimen to be safe, but that it did not meet the pre-defined criteria for efficacy and recommended that the study be stopped and trial participants informed.

The Mosaico study used a similar version of the vaccine regimen in its companion study, the Imbokodo trial, which was stopped in August 2021 as it also did not significantly reduce the overall risk of HIV acquisition among over 2,600 cis-gender women in five sub-Saharan African countries.

Read the Janssen Pharmaceutical Company press release.

Read the HVTN press release.

Read the AVAC press release.

● The HVTN and AVAC will host a global webinar on Wednesday, January 25 to reflect on this news and how it may impact HIV vaccine R&D and prevention globally. Stay tuned for registration details soon.

“The hard truth is the science of HIV vaccine development is extremely challenging,” AVAC said in its statement. “HIV remains a global threat, and a safe, efficacious and accessible HIV vaccine is still needed to provide a durable end to the pandemic. At the same time, we now have more proven HIV prevention options than ever before, but they are not reaching everyone who needs and wants them. Even as researchers continue the necessary work of accelerating HIV vaccine research, the broader HIV response must act as if we may never have a vaccine and prioritize the roll out of existing prevention options and research for additional ones. Ending this pandemic requires simultaneous action on multiple fronts of research, development and delivery.”

We hope you join us on January 25 with your questions and comments to discuss the ways forward.

AVAC Launches the Advocacy Navigator!

AVAC is excited to launch the Advocacy Navigator, an extension of our Advocacy Fellows program, which has involved more than 90 advocates and dozens of civil society organizations in 15 countries to drive groundbreaking advocacy on HIV prevention research, rollout, and human rights. AVAC now seeks applications from early-career professionals from Eastern and Southern Africa interested in strengthening their skills in HIV prevention advocacy. Applications for the Advocacy Navigator program are now being accepted through 13 February 2023.

Find details about the Advocacy Navigator program and application process here.

The Advocacy Navigator combines training and mentorship to young and emerging advocates in the field of HIV prevention advocacy. The program will mobilize a cohort of ambitious individuals and empower them with the knowledge, skills, and confidence to meaningfully advance HIV prevention advocacy. The program includes online coursework, personalized mentorship, and opportunities to directly apply learning through a community advocacy project. The program begins with three months of coursework and project development, followed by three months of implementation, when advocates implement their plans.

Since 2009 and the beginning of the Advocacy Fellows program, AVAC has recognized the imperative to invest in mobilizing a growing cadre of HIV prevention advocates. They represent a global movement of seasoned veterans and passionate newcomers, who call out neglect, insist on equity, monitor commitments and identify solutions. This movement has been and will continue to be absolutely essential to the fight against HIV and progress in global health. See the 2019 evaluation of the Fellows program and highlights of what the current class of Fellows did last World AIDS Day.

Now the Advocacy Navigator Program is leveraging the strength of this extraordinary alumni community to sustainably expand this model to a larger number of people, continue to support and engage mentors, and prepare future Fellows for long-term projects.

Find the application and additional information at

A Year of Action in 2023

At AVAC we saw tremendous work to accelerate HIV prevention and invest in global health resilience in 2022, and the year ahead will require critical advocacy to keep the field on track. What does this mean?

Our year-end letter, HIV Prevention and Equity in 2022 & Beyond, explores in depth the many initiatives, resources and collaborations that powered advocacy in 2022 — a historic juncture for HIV and global health. The field is facing a turning point where the right commitments in funding, policy and programming in 2023 could put the world on track to hit 2025 targets, end HIV as a public health threat by 2030, and lay a solid foundation for global health security against future pandemics.

The world finds itself at this moment because of the convergence of the approval of two new biomedical options for HIV prevention—the dapivirine vaginal ring (DVR, or the ring) and injectable cabotegravir for PrEP (CAB for PrEP)— with the launch of critical new strategies to advance HIV prevention from PEPFAR, the Global Fund, the Global HIV Prevention Coalition, and The Coalition to Accelerate Access to Long-Acting PrEP. All this in the context of a growing consensus and commitments to invest in pandemic preparedness and strengthening health systems.

In 2023, advocacy must meet the moment. Here’s just a sample of what AVAC’s preparing for in the weeks and months ahead.

Access Access Access

Accelerated planning and engagement with the Coalition to Accelerate Access to Long-Acting PrEP and pushing key action steps for comprehensive and effective delivery of injectable CAB everywhere it’s needed.

• Taking action across our partnerships to establish the policies, budgets and programs that will deliver the ring to women who need it and want it.

Funding: Innovation and Expansion

• Defining a robust advocacy agenda for PEPFAR’s multi-year reauthorization starting in 2023.

• Supporting partners to help shape priorities for the Global Fund, the Pandemic Fund, PEPFAR country operational plans (COPs).

The Research Pipeline

• Tracking the trials on injectable lenacapavir as PrEP and the Dual Prevention Pill, and engaging in the development of next-generation PrEP options.

• Translating developments in research on and HIV vaccines and broadly neutralizing antibodies, including possible results from the Mosaico vaccine trial, the application of mRNA technology and new approaches to research and trial design.

• Advancing a research agenda for the prevention of other sexually transmitted infections (STIs), including greater investment in STI vaccine development.

People Centered Advocacy

• Advancing the reach of the GPP guidelines by compiling a body of evidence on GPP’s value, impact, and best practices as a key resource for partners and for clinical research broadly.

• Watch-dogging the status of the HIV research agenda for: trans and gender diverse people, pregnant and breastfeeding populations, and other key populations.

• Engaging with new leadership at the National Institutes of Health and National Institutes of Allergy and Infectious Diseases to deepen collaboration with civil society, community and advocacy leadership.

Key Dates for January and February

Pull out your calendars for the first three months of 2023, these convenings will help shape your advocacy for the rest of the year.

Jan 26: The Choice Agenda webinar: Trans Inclusion: Charting HIV Research into the Future: A Manifesto and Scorecard for Advocates and Researchers, at 10 am. Register

Feb 13: CROI is coming! Join The Choice Agenda and partners for the February 13 webinar “Ready, Set, CROI 2023 – Prepare for the 30th Year of CROI”

● Stay tuned for the Margarita Breakfast Club series of three webinars highlighting the latest in science presented at CROI, open to all, held during the CROI conference, Feb 20 – 22.

Feb 19-22: Whether or not you are attending CROI, AVAC will have you covered as we track the research and the advocacy. Plus, we’ll have recordings from the Margarita Breakfast Club, for a curated discussion with CROI researchers.

Buckle up and lean in, let’s make 2023 an unforgettable year of collaboration and solutions.

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