Biomedical HIV Prevention Summit and PrEP in Black America Summit

AVAC Highlights

Last week, 1,000+ community advocates, researchers, policy experts, federal public health leadership, medical and service providers from around the US and Puerto Rico attended the NMAC annual Biomedical HIV Prevention Summit in Seattle, Washington. The discussion and debate on PrEP access, especially for racial and ethnic minorities and key populations, PrEP research, care, policy and community-based programs are ones to follow. AVAC’s John Meade (Senior Program Manager, Policy), Jessica Salzwedel (Senior Program Manager: Research Engagement) and Kenyon Farrow (Communications Director) presented in workshops and satellite sessions at the Summit and at the PrEP in Black America preconference

The Summit included sessions that updated community advocates on the latest in biomedical research for new diagnostics, PrEP, PEP, STIs and vaccines. Meade co-presented a Clinical Trials 101 for community advocates to learn more about the research process. Farrow presented an epidemiological overview on HIV and Disparities in the United States for NMAC’s Gay Men of Color Fellows. 

AVAC’s John Meade Jr. and Danielle Campbell at the PrEP in Black America: The State of HIV Prevention Research in the Black Community pre-conference

All three AVAC staff contributed to the PrEP in Black America: The State of HIV Prevention Research in the Black Community pre-conference, organized by PrEP in Black America (PIBA). PIBA began in 2022 as a community-led effort to increase Black community mobilization and engagement in PrEP research, policy and access programs. Farrow and Meade are PIBA cofounders, and Meade facilitated the day’s agenda, with more than 200 attendees focused on identifying the research gaps that need to be addressed to increase knowledge, access and use of PrEP. Data shows that while Black people in the U.S. make up 42% of all new HIV diagnoses in 2021, they were only 14% of all PrEP users. By comparison, white Americans are 65% of all PrEP users, but only 26% of all people diagnosed with HIV in the same year.  

Salzwedel co-led the closing consensus session at PIBA, a discussion where attendees named research priorities to be later released as part of a National Black-Centered Biomedical HIV Prevention research agenda. One of the most important priorities named, however, goes beyond singling out the right research questions. Attendees showed strong consensus that the research process itself needs to change. Attendees expressed a need and desire for more investment and commitment to community-led research, that can reflect non-traditional ways of gathering data and designing trials and ending the extractive approach that characterizes conventional researcher/community relationships.  

To stay up to date with PrEP in Black America, follow them on Instagram and Facebook. 

Join AVAC, The Choice Agenda, PrEP4All and HIVMA on Friday, April 26 for a special follow-up webinar, We Can’t End HIV in the United States Without Equitable PrEP Access: Strategies for success. Register here.

Introducing Advocacy Chronicles: A new AVAC podcast takes you behind the scenes with leading advocates

AVAC is thrilled to announce our new PxPulse podcast series, The Advocacy Chronicles, featuring conversations with leading advocates who take us behind the scenes on critical issues at the forefront of global health equity. In each concise conversation, a leading advocacy champion will talk about a priority community issue they identified, the tactics they used to address it, and the wins and outcomes they achieved.   

Our debut episode of PxPulse: The Advocacy Chronicles is with Yvette Raphael, the Executive Director of Advocacy for Prevention of HIV and AIDS (APHA), and one of South Africa’s leading human rights activists. Yvette co-chairs the African Women Prevention Community Accountability Board (AWPCAB), which launched The HIV Prevention Choice Manifesto in September 2023. Yvette discusses the manifesto – a global call, developed and implemented through support from the CASPR project, for increased political and financial commitment to ensure every proven method of HIV prevention is integrated into the HIV response. She lays out why The Choice Manifesto matters, how advocates are leveraging it, and what tactics will advance its priorities.  

Find the full episode here. Follow The Advocacy Chronicles on PxPulse to hear about the issues that advocates are taking on to advance HIV prevention and what they are learning in the process. Upcoming episodes will feature champions behind campaigns to decriminalize sex work; new advocate-created platforms for ongoing engagement between government and young women; successful efforts to set targets and secure funding from PEPFAR; advocacy to challenge anti-gay hate laws and protect communities of key populations, and more!  

Subscribe on Apple Podcasts to catch every episode! 

Save the Date!

Discussing Early Results from the SEARCH Dynamic Choice Study

Join AVAC and SEARCH in conversation with Professor Moses Kamya of Makerere University to find out why the early results of the SEARCH Dynamic Choice study were some of the most exciting news to come out of the CROI meeting in 2024. The webinar will consist of a presentation by Professor Kamya, followed by a robust discussion about the role of choice in HIV prevention.

Register Here!

AVAC’s Samantha Rick Delivers Statement During High-level US HHS Meeting

AVAC’s Samantha Rick delivered a statement during a high-level US HHS meeting on Thursday, April 11. Read the full statement below.

“I am speaking as a representative of AVAC, an international non-profit organization that leverages global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity.

Without civil society having access to the proceedings, it is difficult for civil society to advocate around their own government’s positions. We urge the US to continue to push for civil society access, both to deliberations and to compilation text, so that we can effectively do our jobs and ensure that government priorities incorporate advocates’.

Without such access, we have come to some conclusions through hearsay and leaked documents, which is not ideal. One seemingly bright spot is the status of Article 9. From the most recently leaked version of the text including Member State textual edits from late March, it appears there is some consensus about what is to be included in Article 9, and little objection from the US on these points. We urge the US to push to keep the text in Article 9 as-is, particularly the provision to include access conditions in publicly-funded R&D for pandemic products. We look forward to discussing with the Administration how we can get to a place where this is standard operating procedure for all public funding regardless of its applicability to pandemics, as R&D usually builds on previous work and we may not know of a hypothetical product’s use in a pandemic situation.

A particularly dark spot in the negotiations is Article 12. From the leaked version from late March, it is clear that the US position on the pathogen access and benefits sharing system has significantly shifted. This has raised the ire of civil society advocates around the world and within the US. It is unclear why the negotiations have come this far without this level of disagreement from the US, as we had not seen nearly as many or as all-consuming edits in previous versions of the text that included the same provisions. The US must come to a position of negotiation on this topic – the Africa Group and Group for Equity, among others, have clearly stated that they will not accept lesser commitments to benefits sharing than to those required by the US around pathogen data sharing. This is a perfectly reasonable position. We implore the US to rethink its position on the PABS system and try to come up with a palatable system that has equal levels of commitments from both sectors of the system.”

Jeanne Marrazzo and Community Leaders Amplify Their Voices for Choice

Science and real-world experience continue to generate evidence that expanding access to PrEP options and making choice possible, must be the guidestar in HIV prevention.   

Last week, NIAID Director Jeanne Marrazzo joined our Choice Agenda webinar, The More We Know: Evolving our understanding of PrEP for cisgender women, to present a re-assessment of the safety and effectiveness of PrEP options for women—including oral, vaginal ring, and injectable options. She discussed her recent publication in the Journal of the American Medical Association, HIV Pre-Exposure Prophylaxis with Emtricitabine and Tenofovir Disoproxil Fumarate Among Cisgender Women, which provides reassuring evidence that oral PrEP can reliably prevent HIV infection in cisgender women, even if it’s not taken daily. The results challenge the notion that cisgender women need to be “super-adherers” to achieve protection utilizing oral PrEP and that a one-size-fits all approach to prevention will not work. 

Dr. Marrazzo’s research and her comments represent a powerful voice among a chorus of champions for choice. During the same conversation, Joyce Ng’anga’a of WACI Health and the African Women’s HIV Prevention Community Accountability Board, a coalition of women and girls living and working in Africa who are united in calling for continued political and financial support for more choice in HIV prevention, updated on the recently launched Choice Manifesto. This global call to action demands investment in choice and calls for enshrining a woman’s right to choose and for African women and girls to lead the HIV response. 

At the same time, PEPFAR’s Scientific Advisory Board grappled with the potential role of injectables for treatment and prevention, including an update on the current late-stage efficacy trials of injectable lenacapavir, with results anticipated later this year. It’s no secret that scale-up of all current PrEP options (daily oral, vaginal ring and injectable cabotegravir) has been slower than ideal, especially in the countries and communities with high HIV rates that need it most. So as the HIV prevention community awaits the results of the PURPOSE trials for the twice-annual lenacapavir injectable, discussing how an additional injectable option might be introduced and what infrastructure is needed to implement this new product faster than previous PrEP options is critical.  

“We are 12 years since many of us gathered in Washington, D.C., at the international AIDS conference that was just two days after the FDA approved oral TDF/ FTC,” said panel moderator, AVAC Executive Director and PEPFAR SAB member, Mitchell Warren. “Twelve years later, it’s actually an abomination how poorly we have done as a global community, and when we think about equity in this country and around the world, oral PrEP is still only beginning to find its place. The dapivirine ring has struggled for a number of reasons and cabotegravir is struggling still, but I do want to highlight that it is going faster than we saw with oral PrEP, certainly in terms of regulatory approvals. And the question is how might we apply those learnings for lenacapavir in the next months and years?”

As policy, practice and budgets strive to keep up with advances in research, advocacy around choice becomes a cross-cutting priority—so that the promise of new options in HIV prevention won’t be squandered in siloed programs, or by poorly-planned supply chains, or because of disconnected policy decisions. Be sure to watch this space in 2024 as the African Women’s HIV Prevention Accountability Board, the Young Women’s HIV Prevention Council and the Global Key Populations HIV Prevention Advisory Group, amongst others, lay the groundwork to advance efforts to accelerate prevention options that people want and need. 

Announcing the 2024/25 AVAC Advocacy Fellows

We are pleased to announce our 13th class of the flagship AVAC Advocacy Fellows Program for 2024-2025! This group of seven advocates will participate in an 18-month program that supports their advocacy efforts, invests in the further development of their skills, shapes the agenda for HIV prevention research, and influences how quickly new interventions move into policy and programs in their communities and countries. 

These Fellows were selected from a pool of 200+ applicants from seventeen countries to pursue evidence-based advocacy on a range of issues related to HIV prevention. The 2024/25 Advocacy Fellows and their host organizations include: 

Congratulations to our new class of Fellows and thank you to all the applicants and their proposed host organizations for the time and effort put into the application process, and to the independent review committee of advocates, scientists and former Fellows and hosts who guided our decision-making. 

About AVAC’s Advocacy Fellows Program

Achieving successful HIV prevention relies on programs and research shaped by communities and grounded by their needs and priorities. Skilled and informed community advocates drive this process.  AVAC’s Advocacy Fellows Program expands and strengthens the capacity of civil society advocates and organizations to monitor, support and help shape HIV prevention research and rapid rollout of new effective interventions in low- and middle-income countries facing substantial HIV burdens. 

The program provides intensive support to emerging and mid-career advocates to execute advocacy projects addressing locally identified gaps and priorities. Fellows receive comprehensive training, financial backing, and technical assistance to strategize and execute a targeted 18-month project hosted by an organization within their country. 

In its 15-year history, nearly 100 advocates working with 70+ partner organizations across 15 countries have participated in the program. They have influenced policy, championed community perspectives, strengthened healthcare systems, demystified HIV prevention research, advocated for fairness and transparency on local, regional, and global scales and now lead many national and regional organizations. Discover more about the program’s impact here. And view video reflections from Alumni Fellows both here and here. 

Celebrating Rep. Barbara Lee and the Black Women Who Helped Shape the AIDS Movement

Following Black History Month and during Women’s History Month, it is important to honor Black women who have championed efforts in ending the epidemic and have led the ongoing fight in ensuring healthcare equity and justice for all. Someone who has worn multiple hats both as an advocate and as a US policymaker is no other than Representative Barbara Lee.  

Throughout Rep. Lee’s close to three decades-long tenure as a member of the US House of Representatives, She has single-handedly created material change for people living with HIV and those at risk of infection, marginalization and stigmatization, both in the US and around the world. As AVAC’s executive director Mitchell Warren says, “when the definitive history of this pandemic is finally written, there is no greater shero in our collective story than Barbara Lee. The AIDS response wouldn’t be where it is today without her.” 

From co-authoring the Global AIDS and Tuberculosis Relief Act of 2000 and establishing the framework for the Global Fund to Fight AIDS, Tuberculosis and Malaria, to her instrumental work in drafting and passage of the President’s Emergency Plan for AIDS Relief (PEPFAR), to introducing legislation that would eventually lift the decades-old discriminatory HIV travel ban to the US, to her relentless efforts advocating to reform HIV/AIDS criminalization laws in the US, most recently with the Repeal Existing Policies that Encourage and Allow Legal (REPEAL) HIV Discrimination Act, Rep. Lee has walked the walk. She put grassroots-led efforts at the center of US and global policy in relation to those directly impacted by the HIV/AIDS epidemic. 

Thank you, Rep. Barbara Lee, for the legacy you have built in forging an AIDS-free generation and for centering impacted communities throughout your work. We look forward to your efforts as co-chair and co-founder of the bipartisan and bicameral Congressional HIV/AIDS Caucus and a member of the full appropriations committee in continuing to support HIV/AIDS prevention, education, research and access to treatment while combatting stigma.   

In addition to celebrating the tireless advocacy of Rep. Barbara Lee during Women’s History Month, it’s important to name the Black women who have changed the course of the AIDS epidemic including, but of course not limited to Raniyah Copeland, Dázon Dixon Diallo, Leisha McKinley-Beach, Yvette Raphael, and those we honor in our everyday actions, Hydeia Broadbent, Katrina Haslip, Dawn Smith, and the recently passed, Joan Gibbs. 

HIV Cure Updates and Opportunities

Last week’s Conference on Retroviruses and Opportunistic Infections (CROI) in Denver, Colorado, was full of new research, provocative discussion and debate on a wide range of issues from longer-acting injectable PrEP; the dapvirine vaginal ring (DVR) in pregnancy; doxycycline as post-exposure prophylaxis (DoxyPEP) to prevent sexually transmitted infections (STIs); and so much more. Check out our daily summaries of highlights from CROI and recordings and resources from the daily Community Breakfast Club sessions. 

It was also the setting for important updates on the HIV reservoir lending to new insights into potential HIV cure strategies. Progress in HIV cure research, as part of a pipeline of biomedical tools to help end the epidemic, must be supported and guided by an advocacy agenda that puts communities first. Read on for cure highlights from CROI, new opportunities for cure advocates, and an upcoming webinar on pediatric cure research with Deborah Persaud and Gabriela Cromhout.

Cure Highlights from CROI – Q&A with AVAC’s Jessica Salzwedel

AVAC’s Jessica Salzwedel who leads our advocacy for HIV cure research and serves as the community engagement coordinator for Research Enterprise to Advance a Cure for HIV (REACH), Immunotherapy for Cure (I4C), and Pediatric Adolescent Virus Elimination (PAVE) shares her highlights from the research presented at CROI and insights into what it means for advocacy in this Q&A.

Read the Q&A

“Four preclinical and clinical results stood out because they advanced how researchers might tailor cure strategies to optimize the impact for people with HIV. We heard more about the potential role of sex hormones in directing the immune system in a study looking at fetus acquisition of HIV. Another study showed that women may be better candidates for the so-called “block and lock” strategy. We also heard results from the IMPAACT P1115 trial, which showed that early HIV treatment can lead to control of the virus in children. And a nonhuman primate study of adeno-associated virus (AAV), which delivered broadly neutralizing antibodies (bNAbs) may offer a pathway to a scalable, durable control option for pediatric cure. In basic science new data suggests that autologous neutralizing antibodies in some people delay rebound. And finally, we heard about rare T-cells that seem to resist killing, which could be important in developing strategies that could lead to durable control and eradication of HIV. ” Read the Q&A to see what it all means.  

Join Us for the 2024 Cure Academy

The Advocacy-for-Cure Academy, organized in partnership with the International AIDS Society, awards fellowships to advocates or peer educators to take part in workshops on HIV cure advocacy with international experts. The academy develops fellows’ cure research literacy and reinforces their advocacy and engagement skills in line with recommendations from Research priorities for an HIV cure: International AIDS Society Global Scientific Strategy 2021. Applications are now open. Deadline Monday, 25 March 2024. The next Cure Academy runs June 8 – 10, 2024 in eastern Africa. 

And check out what five alumni from the program are doing with their fellowships intended to create solutions that advance HIV cure research in their local context. 

Webinar

Updates on Pediatric HIV Cure Research From CROI

Thursday, March 2, 10:00-11:30 am EST

Researchers Deborah Persaud and Gabriele Cromhout join AVAC’s Jessica Salzwedel to discuss the latest from CROI on pediatric cure.

REGISTER NOW

Resources

What You Should Know About the FAPP, GAPP and PEPFAR Reauthorization

By Kenyon Farrow

Engaging the US government is vital to advocacy for HIV prevention, as one of the world’s largest contributors to implementation and research and development. The reach and scale of US funded global health programs have profound impact on the lives and health of people in the US and around the world. Two coalitions, founded by advocates, make it their central mission to inform and influence the US federal government to advance funding and policies to end the HIV epidemic.  

In 2024, their work will be as important as at any time in the history of HIV advocacy; as funding for US programs is at stake and advocacy continues for the reauthorization of PEPFAR, one of the greatest US foreign policy and global development achievements in history.

AVAC’s John Meade was just elected co-chair of the Federal AIDS Policy Partnership (FAPP), a national coalition of more than 120+ local, regional, and national organizations advocating for federal funding, legislation and policy to end the HIV epidemic in the United States. John and co-chairs, Mike Weir of NASTAD and Kathie Hiers of AIDS Alabama,  will support the work of seven affiliated working groups, including the AIDS Budget and Appropriation Coalition and the Research Working Group, to produce analysis, build relationships with federal entities, and champion policies and funding that are essential to making progress.  

And AVAC’s Suraj Madoori co-chairs the Global AIDS Policy Partnership(GAPP), a 70 member coalition that leads advocacy for continued robust funding, expansion and improvement of US global HIV/AIDS programming through PEPFAR and the Global Fund. With co-chairs Katie Lapides Coester of EGPAF and Shannon Kellman, formerly of Friends of the Global Fight, now at UNAIDS, this coalition — comprised of civil society and faith-based organizations, funders, professional membership organizations and organizations that implement programs — will continue working every channel to spotlight success, combat misinformation and seize opportunities to secure a new five-year reauthorization of PEPFAR. See AVAC’s blog here.  

Since its creation in 2003 and through previous 5-year reauthorizations, PEPFAR has received near universal, bipartisan support in Congress. This past year, partisan lobbyists and their congressional allies derailed easy passage of its next 5-year reauthorization. In 2024, the GAPP will be mobilizing against efforts to politicize this singularly successful program, and will be working for renewed bipartisan support through the final resolution of federal budget negotiations.  

The efforts of the GAPP and the FAPP will remain essential to ensure sustained funding for efforts to end the epidemic, to save overall HIV funding and advance a national PrEP program in the US, and to win the reauthorization of PEPFAR. Be sure to watch this space for updates. 

Webinars to Look Out for in February!

2024 is off and running and a slew of webinars are on the calendar. This selection of topics is both broad and deep, providing updates on the pipeline from cure to vaccines, insights on critical advocacy, a conversation with the new director of NIAID, and opportunities for you to engage. Scroll down for what’s coming up and recordings of webinars from December and January that you may have missed.  

Coming up!

AVAC in Conversation with NIAID’s Jeanne Marrazzo

February 27, 11:30 am – 12:00 pm EST 

Join AVAC in conversation with the new Director of NIAID, Jeanne Marrazzo. Register here.

The New Public Health Order: How is Africa preparing for pandemics?

February 29, 9:00-10:30 am EST 

WACI Health and The Choice Agenda invite you to join us for a webinar introducing key initiatives of the Africa CDC and the African Union. It will illuminate roles for civil society and community engagement. Register here.

The Adolescent Medicine Trials Network (ATN): Research addressing HIV health inequities among US adolescents and young adults

Join The Choice Agenda for an overview of the newest cycle of the Adolescent Medicine Trials Network! This webinar includes highlights of: ATN 165: Linking Youth to PrEP Services, which tests an innovative mobile delivery and mHealth intervention for PrEP adherence and persistence among sexual minority men; ATN 167: Legal, Economic, and Affirming Peer Support (LEAP) for transgender and gender diverse youth; and how the network prioritizes and amplifies the voices of youth directly impacted by the ATN’s pivotal research. Register here.

Advocacy Navigator Program Info Session

February 13, 10:00-11:00 am EST

This webinar is intended for anyone interested in applying to participate in AVAC’s Advocacy Navigator program. The session will provide an overview of the program, expectations, eligibility, and application process, followed by Q&A with the AVAC team. 

In case you missed it!

Reporting the African Science Story: Decoding scientific research to support public health in Africa

Through the Media Science Café Program, AVAC partners with health media associations in Kenya, Tanzania, Uganda, Zambia and Zimbabwe to bring journalists together with researchers, implementers, civil society, policy makers, regulators and policy makers to build relationships that will foster accurate reporting of HIV, COVID and other science or health stories in those countries. Learn about the model! Recording, slides and resources.

PrEPVacc: An in-depth look at the trial, and what’s next

This webinar reviewed key aspects of PrEPVacc, including its innovative study design, implementation, integrated social science, and data analysis plans. An engaging conversation about what we’ve learned from PrEPVacc, what we can still learn, and what this may mean for the HIV prevention field. Recording, slides and resources.

Cervical Cancer Awareness Month Webinar Series

Check out our 4-part webinar series on cervical cancer, which featured a deep dive on: what cervical cancer is, who is impacted, and prevention and treatment options; advocacy strategies to bring more attention to cervical cancer and its impact on communities; options for screening and treating cervical cancer along with ongoing research; and the impact of cervical cancer on key populations and those vulnerable to HIV infections. Recording, slides and resources.

HIV Cure and the Environment: How location informs cure research

This webinar reviewed core concepts discussed in the previous webinar, Let’s Talk About HIV Cure Research: An Introduction to the science under investigation, and introduced how the environment may impact cure strategies. Recording, slides and resources.

Learn more about the townhall discussion on Black Gay Men and HIV in the US featuring influential figures in the Black Gay community, including Ace Robinson, Daniel D. Driffin, and Kenyon Farrow by checking out highlights on AVAC’s Twitter page and watch the full recording. 

Thanks for checking out these conversations. We hope you will join us in these rich discussions and watch this space for future webinars!  

New issue of POSITIVELY AWARE points the way towards a more equitable future

By Kenyon Farrow

In many ways the world is entering an era of HIV prevention that many of us have spent the last 40 years fighting for— there now exists multiple options for preventing HIV that are safe, highly effective and easy to use. 2012 saw the introduction of the first ARV-based prevention option—daily oral PrEP. And over the past two years, WHO recommended, and several national regulatory agencies have approved, injectable ARVs for treatment and prevention, as well as the dapvirine vaginal ring.  

While these advances are something to celebrate, this is far from the end of the road. Technological gains only go as far as people’s awareness of them, desire to use them, and access to them. And this is where we — as a public health community and as a planet of humans — struggle. Just like with the first ARV therapies in the mid 1990s, and the first PrEP pill for prevention a decade ago, we’re now four years into the FDA approval of the first long-acting ARV therapy and we are several years away from scaling up these long-acting medications and truly seeing the impact they can have on the lives of people (whether living with HIV or in need of PrEP), and on the HIV epidemic itself.  

It takes the HIV response far too long to move these innovative inventions to the point where they become medical miracles, experienced by everyone who needs and wants them, regardless of race, ethnicity, national origin, religion, sexual orientation, gender identity, sex assigned at birth, pregnancy status or income. 

There is a new special issue of the magazine POSITIVELY AWARE, co-edited by Kenyon Farrow, AVAC’s communications director, and Jim Pickett, AVAC’s senior advisor and lead of the Choice Agenda, that explores the impact of long-acting injectable treatment and PrEP. The articles, including a piece co-authored by John Meade, AVAC’s senior policy manager, and Danielle Campbell of PrEP in Black America and longtime AVAC partner, speak to the humans involved in downstream research, and what their experiences as patients, researchers, advocates and medical providers of long-acting treatment and PrEP teach us about how these products could be transformative. These stories make clear how far we still have to go to change our health systems so that they can meet their maximum potential. 

AVAC will continue our work to advocate for global equity in access to prevention and treatment in all their current and future forms. We celebrate this issue of POSITIVELY AWARE as one collection of voices helping to point the way towards a more equitable future.