Scale Up HPV Vaccination in People Living With HIV 

A Call to Action

By Mitchell Warren, Executive Director of AVAC, and Heather White, Executive Director of TogetHER for Health. This post first appeared at togetherforhealth.org.

HIV/AIDS and cervical cancer are two global health emergencies that impact millions around the world – and unfortunately, the relationship does not end there. The dire synergy between HIV/AIDS and cervical cancer can be expressed in some startling statistics: 

  • Cervical cancer is on the relatively short list of “AIDS-defining illnesses”—cancers and opportunistic infections that can be life-threatening to people living with HIV. 
  • Women living with HIV are up to six times more likely to develop invasive cervical cancer than their HIV-negative peers. 
  • Women testing positive for infection with the human papillomavirus (HPV) that causes almost all cervical cancers are twice as likely to be infected with HIV.  
  • The proportion of cervical cancer cases attributable to HIV is greater than 40% among the eight countries with highest HIV prevalence in sub-Saharan Africa, compared to less than 5% in 127 countries with lower HIV prevalence, highlighting major disparities in the global burden.

Additionally, HIV/AIDS and cervical cancer share many barriers to effective prevention, treatment, and care. Efforts to provide services to address both diseases are beset with social stigma and misinformation. 

Due to their elevated risk of disease, women living with HIV, and those at risk of HIV are considered priority populations for cervical screening. The US President’s Emergency Plan for AIDS Relief (PEPFAR) invests more in cervical cancer screening and treatment in low- and lower middle-income countries than any other funder. The Global Fund to Fight AIDS, TB, and Malaria will also fund requests for cervical cancer prevention aligning with HIV prevention programs. The SUCCESS collaboration funded through Unitaid and implemented by Expertise France, Jhpiego, and the Union for International Cancer Control (UICC) is introducing and promoting the best available screen-and-treat tools to prevent cancer in women most at risk, especially those living with HIV.

But these lifesaving efforts are only reaching a fraction of those in need. 

While efforts to develop a preventive vaccine against HIV are underway, vaccines against HPV have proven to be safe and effective for people already living with HIV—greatly reducing their chance of developing cervical cancer. Given their enhanced likelihood of developing cervical cancer, it is critical to focus additional attention on vaccinating people living with HIV, as well as young people vulnerable to both HIV and HPV infections. Unfortunately, few targeted efforts to ensure widescale uptake of HPV vaccination in people living with HIV have been made. 

According to data from the  World Health Organization (WHO), only around 25 percent of women living in the Africa Region – the region with the highest burden of HIV/AIDS—are currently vaccinated against HPVCurrent WHO guidance recommends at least two doses of HPV vaccine for people living with HIV, requiring not just effective implementation of initial vaccination but also efforts to ensure subsequent follow-up to complete the recommended regimen. A lack of disaggregated data on the proportion of people living with HIV who remain unvaccinated against HPV hampers the creation and implementation of targeted HPV vaccination strategies in populations with increased chance of acquiring HIV.

It’s well past time to build an evidence-based plan to ensure access to critical comprehensive health services for adolescent girls and young women at risk for HIV, or those living with the disease, using a lifecourse approach. Specifically, to improve coverage of HPV vaccination, we call on global bodies to take urgent steps to: 

  1. Assess the current status of HPV vaccination among girls and women living with HIV. A dearth of reliable global and regional data must be addressed if we are to ensure wider uptake of HPV vaccination in populations of people living with HIV. Effective monitoring of is a critical first step toward addressing the gap in HPV vaccination coverage for people living with HIV. 
  1. Create evidence-based HPV vaccination strategies for people living with HIV. Programs should take advantage of opportunities to integrate HPV vaccination alongside HIV prevention, treatment, and care services, alongside outreach and awareness activities to break down stigma and combat misinformation. 
  2.  Build the evidence base supporting HPV dosing schedules for people living with HIV. Current WHO guidance has shifted to a single-dose regimen for HIV-negative populations. Clinical research can affirm the need for multi-dose regimens for people living with HIV, but may also support a shift to single-dose schedules that can ensure wider access to more individuals. 

This call to action couldn’t be more timely, as one lingering constraint to accelerating access to HPV vaccination for people living with HIV—limited vaccine supply—is expected to be all but removed in the near future. UNICEF projects that by 2024 the supply of HPV vaccines will for the first time align with the demands of the programs UNICEF services, most notably Gavi, the Vaccine Alliance, the most prominent implementer of HPV vaccination services in low- and lower middle-income countries. Gavi’s ambitious goal of vaccinating 86 million adolescent girls in its focus countries against HPV by 2025 presents a unique opportunity to close a vaccination gap in people living with HIV. 

Today – December 1st – is World AIDS Day. Two weeks ago on November 17th, the world marked the third annual Cervical Cancer Elimination Day of Action. The proximity of these two days of advocacy provides an opportunity to highlight another connection shared by HIV/AIDS and cervical cancer: the opportunity to invest to end these dual health threats by scaling up effective services and meeting global targets – the 95-95-95 HIV treatment goals set by UNAIDS and the 90-70-90 cervical cancer prevention goals set forth by WHO. 

UNAIDS’ Global AIDS Strategy incorporates sub-goals for women and girls vulnerable to developing cervical cancer, representing a confluence of these two remarkable global health endeavors. The Strategy calls for: 

  • 90 percent of girls aged 9–14 in priority countries gaining access to HPV vaccination; 
  • 90 percent of women living with HIV being provided access to integrated or linked services for HIV treatment and cervical cancer; and
  • 90 percent of women, adolescent girls and young women accessing sexual and reproductive health services, including for HPV and cervical cancer, that integrate HIV prevention, testing and treatment services. 

The alignment of HIV/AIDS and cervical cancer targets reflects an evidence-based understanding that ending preventable deaths from these two diseases is best done in tandem.

We know that effective plans supported by sufficient political and financial support can achieve these goals—saving millions of lives. The time to invest to ensure that people living with HIV can live their lives without the threat of cervical cancer is now. 

AVAC and Partners at ICASA 2023

Join AVAC and partners for the biennial International Conference on AIDS and Sexually Transmitted Infections (ICASA), in Harare, Zimbabwe December 4-9. More than 30 of our partners will convene at the meeting to champion community leadership and amplify their role in shaping local, national and global responses and delivering impactful advocacy. Community leadership on a range of issues are instrumental to: 

  • Accelerate and expand access to proven prevention options that people want and need. 
  • Dismantle the structural barriers to health faced by key populations. 
  • Intensify demands for robust domestic and global funding for health. 
  • Integrate HIV services with sexual and reproductive health. 
  • And much more. 

Scroll down for a roadmap to ICASA’s prevention program, and details on sessions and events that you won’t want to miss. 

Sessions of Interest

Sunday, December 3

  • Biomedical Prevention Forum 
    9:00-15:00 GMT 
    The Biomedical Prevention Forum will be held as a hybrid event bringing together advocates, civil society representatives, researchers, government officials and front-line providers to explore and discuss the latest advancements, challenges, and opportunities in biomedical HIV prevention, while emphasizing the importance of choice and its transformative impact on HIV prevention efforts. This is an open event. Register here. 
  • Key Populations Preconference 
    9:00-15:00 GMT 
    The Africa Key Populations Experts Group (AKPEG), African Sex Workers Alliance (ASWA), the African Network of People Using Drugs (AfricanPUD) and African Queer Youth Initiative (AQYI) Advocates for Prevention of HIV and AIDS in Africa (APHA), Global Black Gay Men Connect (GBGMC) and partners will host a safe platform to deliberate on the state of the HIV epidemic among Key Populations and to determine the stumbling blocks for progress on the path that ends AIDS for Key Populations.

Monday, December 4

Tuesday, December 5

  • Advancing Integrated Biomedical Prevention: Best Practices from Zimbabwe (Session 2) 
    8:45-09:30 GMT
    This satellite session will discuss best practices and lessons learned from the delivery of biomedical HIV prevention and Voluntary Medical Male Circumcision services as we work to further universal health coverage and robust health systems. Partners will launch a global call to action to unite, mobilize, and advocate for continued prioritized funding, sustained commitment, and strategic integration of VMMC into national and global prevention strategies.
  • Catalyzing a sustainable HIV prevention agenda: Approaches to expand local action on global commitments
    10:45-11:30 GMT
    Leveraging new strategic plans for HIV prevention, including the PEPFAR’s 5-year Strategy and UNAIDS’ Prevention Road Map, this satellite session will discuss combination prevention in the context of a sustainable HIV response and highlight a variety of approaches and models that leverage country and stakeholder-led innovations to meet the challenge.
  • Coordinating Implementation Science for CAB for PrEP: BioPIC’s Implementation Study Tracker 
    12:25-12:35 GMT
    In this oral abstract session, AVAC will present a new dashboard, which reflects all currently known activities relating to implementation research, modelling, clinical research, and landscaping for new late-stage biomedical HIV PrEP options, including cabotegravir for PrEP and the dapivirine vaginal ring.
  • Policy, Politics and HIV Management 
    13:05-13:50 GMT
    In this oral abstract session, Princess Mharire from Pangaea Zimbabwe AIDS Trust (PZAT) will present, Beyond Metrics: How the Simple Participatory Assessment of Real Change (SPARC) Tool Provides a Holistic Approach to Advocacy Measurement, and Joseph Njowa of PZAT will share the COMPASS MERL model in a presentation, Innovative tools for planning, monitoring, and evaluation of advocacy campaigns. 

Wednesday, December 7

Friday, December 8

  • Strengthen integration for better SRHR outcomes 
    10:45-11:30 GMT
    This concurrent session will feature Advocates for Prevention of HIV and AIDS in Africa’s (APHA) Yvette Raphael and will explore linkages between unintended pregnancies, unsafe abortion, and HIV.
  • HIV Prevention-Right Place, Right time 
    13:05-13:50 GMT
    This concurrent session will feature Maureen Luba of AVAC, Definate Nhamo of PZAT and Yvette Raphael of APHA. 

AVAC and Partner Poster Presentations

Tuesday, December 5 

  • Maximizing private pharmacies for PrEP delivery to increase uptake: Lessons learnt from the Community Retail Pharmacy Distribution Point, Ruth Akulu 

Wednesday, December 6 

  • Journalist Training: A Key Advocacy Strategy, Catherine Madebe
  • Perceptions on the new biomedical HIV prevention methods among adolescent girls and young women in tertiary institutions in Zimbabwe, Cleo Makura
  • Lessons from Crisis Response from TaNPUD in Enhancing Harm Reduction from 2015 to 2018, Marineus Mutongore
  • Implementing Community led Monitoring for improved quality of HIV services in Tanzania, Mathew Kawogo
  • Impact of social media exposure on HIV services uptake among Tanzanian Young people: Implications for enhancing the HIV response, Marineus Mutongore
  • Effective Strategies for Operating COWLHA support groups of Adolescents Living with HIV: Case of Mangochi and Chikwawa Districts of Malawi, Harry Madukani

Thursday, December 7 

  • Understanding Choice of HIV Prevention Options among Adolescent Girls and Young Women (AGYW) in Zambia, Natasha Mwila
  • Leveraging HIV to Build a Global Health Research and Development (R&D) Equity Advocacy Agenda, John Meade
  • Championing advocacy for domestic resource mobilization for health research and development in Africa, Ethel Makila

Friday, December 8 

  • Rural Youth: Underserved and Unsafe When Seeking Care, Liyema Somnono
  • Redefining Coalition Governance and Leadership in Support of Decolonizing Global Health: The Evolution of the COMPASS Coalition, Roberta Sutton
  • Collaborative Monitoring & Evaluation to Support Learning and Strengthen Advocacy Coalitions: The MERL Hub, Grace Tetteh
  • Realities faced by street children predisposing them to HIV and STIs in Dodoma and Dar es Salaam Cities in Tanzania, Simon Shilagwa 

New Issue of PxWire: The latest in HIV prevention R&D and Delivery

As we look back on 2023, powerful cross currents confront HIV prevention and global health equity. More options than ever before could be available, but many forces threaten to undermine access to proven prevention options that exist today and the development of additional options that are still needed. Threats to PEPFAR and hate laws targeting LBGTQI+ people are just a sample.

Upstream research and development is dynamic, but robust stakeholder engagement and sustainable funding must still be secured and integrated into a people-centered research agenda. These commitments are the compass that will ultimately lead to impact in the real world. The highlights in the latest issue of PxWire provide a snapshot of key updates in Q3 of 2023 and resources to inform advocacy on these critical questions.

Read the latest issue here!

On This #GivingTuesday Support Community Leadership in HIV Prevention

Today, UNAIDS released its World AIDS Day report, Let Communities Lead. This year’s focus on community leadership is especially important to all of us at AVAC as it lies at the heart of our work for our entire 28-year history. The UNAIDS report highlights what we and our partners have raised over the years—that communities face enormous barriers, community-led responses are under-recognized, under-resourced and in so many ways, under attack.  

From our almost 30 years of experience in HIV prevention advocacy, it’s clear that working in solidarity with communities is imperative to address the root causes of inequity. Community-led responses are essential components of the comprehensive approach needed to end the epidemic.  

At AVAC, we are incredibly proud of our history and in our collaborative work in 2023 to champion civil society and community leadership in shaping local, national and global responses.

Today, as part of #GivingTuesday, a global day dedicated to giving back, we ask you to consider supporting AVAC so that we and our partners can continue to deliver the effective and impactful advocacy that is described below—and is needed now more than ever.

Your support to AVAC now will ensure that we and our partners can continue putting people and communities at the center of our work, ensuring that the global response is connected to the real needs of affected people.

Advancing bold and innovative agendas for HIV prevention.

In September, the African Women’s HIV Prevention Community Accountability Board (AWCAB) launched its  HIV Prevention Choice Manifesto  in Kampala, Uganda. The manifesto represents a historic milestone in the power of community leadership to re-frame the global discussion around community priorities. The manifesto calls for political will and financial investment to ensure access to the prevention options that women and girls in Africa say that they want. AVAC worked closely with partners to establish this coalition and catalyze its advocacy. 

Learn more.

Supporting communities to engage in the science of HIV and process of R&D. 

The Good Participatory Practice (GPP) guidelines co-developed by AVAC and UNAIDS nearly 15 years ago have become a field-wide standard for broad and inclusive stakeholder engagement in clinical trial research. At AVAC, we train trial staff on the guidelines, support their adaptation to other fields, prepare and support advocates in applying GPP in trial communities, and engage with the research community and ethics boards to maximize their use. Our new  GPP Body of Evidence, takes this a step further, offering GPP resources to advocates that demonstrate its power, show how it can be measured and replicated, and provide GPP training, tools and connection to everyone involved in the research enterprise.

Learn more.

Improving how, when and to whom prevention is delivered.

Developing—and delivering—a rich pipeline of options for HIV prevention must be guided by community priorities that define what products are needed and how they are delivered for impact. In a new opinion editorial published today in South Africa’s Bhekisisa, AVAC’s Wawira Nyagah and Mitchell Warren lay out essential lessons to ensure that a broad range of prevention options that people want and need are developed, tested and distributed equitably, at scale and with urgency. “The world cannot afford to squander another decade through slow, fragmented rollout of life-saving HIV prevention. With longer-lasting options now becoming available… the world could finally bend the curve of HIV—but only if investment and planning for delivery are as evidence-based, person-centered and innovative as research and development in new products.”

Learn more.

Supporting a robust partner network that puts prevention on national and global agendas.

Effective coordination and balanced partnerships are key to creating a policy environment, accelerating ethical product development and advocating for equitable access to emerging health solutions. AVAC partners with a global movement of advocates to bring community voices, sustained attention and greater accountability to science, policy, funding, media, health services and regulatory processes. We are proud of the skills and power-sharing and impact-oriented advocacy that has expanded and refined prevention targets, accelerated development of guidelines and reshaped policies and programs through our long-standing Advocacy Fellows program, the Coalition to build Momentum, Power, Activism, Strategy & Solidarity (COMPASS) Africa and the Coalition to Accelerate and Support Prevention Research (CASPR).

Learn more.

Fighting to keep community priorities at the center of global health.

The Coalition of Advocates for Global Health and Pandemic Preparedness is tracking the issues, keeping civil society informed, and developing tools and resources. These efforts are essential to advocacy for an integrated and holistic approach to pandemic preparedness, which depends on safeguarding equity and building on the success of the HIV response. As founding members of the coalition, we’ve been proud to fight for community priorities in the work of ACT-A, the Pandemic Fund, the Pandemic Accord, the UN High Level Meeting on PPPR, and the development of a medical countermeasures platform. AVAC published the Advocates Guide for PPPR in 2023 as a go-to resource on the issues. 

Learn more.

It is a privilege to do the work that we do. Without communities pointing the way, the HIV response will flounder, and global health will go backwards. The strength and leadership of our partners and the communities in which we work is the foundation of our hope for HIV prevention and for global health equity. We thank you for your support.

Many thanks for your partnership, solidarity and support.

New Resources & Upcoming Webinars

AVAC has a package of resources, and updates to share on cross-cutting issues facing advocates who care about global health equity and HIV prevention. From discussions on PEPFAR reauthorization, to an evolving picture on sexually transmitted infections, to the latest on the Pandemic Accord, to must-read and must-listen to updates on the state of the field and the state of access to new PrEP options, we’ve got it all. Scroll down for the latest and be sure to mark your calendars for five important webinars coming up this month!

Article: Progress Against HIV and AIDS is Fragile

Ahead of World AIDS Day, Mitchell Warren spoke with POZ Magazine for a comprehensive look at where we are in the fight against HIV/AIDS and what advocacy and scientific breakthroughs are needed in ending the epidemic. “I think a lot about the progress we’ve achieved in providing ARVs worldwide, about what the global HIV response contributed to the COVID-19 response and continues to contribute to current conversations about preparing for future pandemics. It’s remarkable… And yet that progress has not been equitable and is not yet sustainable. What we’ve achieved today could slip away so quickly…” 

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PxPulse Podcast: Inclusion of Pregnant and Lactating People in HIV Research

The newest episode of our PxPulse podcast is out now! In this episode, experts discuss why pregnant and lactating people have been excluded from HIV research in the past, and what needs to change. The podcast features Anne Drapkin Lyerly of the PHASES Project, a participant from the HPTN 084 trial in Zimbabwe, Ashley Lima of USAID, Takunda Sola of the Zimbabwe MoH AIDS/TB Unit and AVAC’s Manju Chantani-Gada and Jeanne Baron. 

Bhekisisa Podcast: The Anti-HIV Jab is Coming to South Africa

Advances in HIV prevention represent a huge opportunity to help get actual prevention choices into the hands of people. Listen to this podcast with Bhekisisa’s Mia Malan and in conversation with Mitchell Warren as they breakdown the complexity of issues in getting cabotegravir for PrEP available to those who want and need it as fast as possible. 

Webinar Recording: Boo, Syphilis is Really Back!

AVAC, NACCHO and NNPTC also hosted a webinar on the increasing rates of Syphilis rates to share learnings on how others are addressing these rising rates and the techniques clinicians are using to detect, treat, and prevent infections. 

Webinar Recording: Results from STI Landscaping Analyses in East and Southern Africa

Earlier this year, AVAC awarded seven teams funding to conduct projects in Southern and Eastern Africa to help understand the needs and evolving landscape around STI vaccines, diagnostics, and advocacy. These teams shared their findings and insights on two webinars that are not to be missed. Be sure to listen to the recordings, and to stay up to date with other STI events and resources by subscribing to our newsletter and visiting www.stiwatch.org.

Publication: Motivating Demand for the Dual Prevention Pill (DPP)

Multipurpose prevention technologies (MPTs) combining contraception with HIV prevention offer promising solutions to the challenges of adherence and uptake we’ve seen with oral PrEP. This new manuscript published in Frontiers in Reproductive Health by AVAC’s Wawira NyagahKate Segal and partners shares findings to support a demand generation approach for the DPP (Dual Prevention Pill).

Webinar Recording: Where We Are in the PEPFAR Reauthorization

The reauthorization of PEPFAR—a program that just surpassed 20 years, has been a hot button topic both in the US and abroad. Listen to Practicality Over Panic: What Happens if PEPFAR is not Reauthorized, a candid discussion hosted by the Global Health Council and Global AIDS Policy Partnership and including AVAC’s Richard Muko on where things are at. And don’t miss AVAC’s PxPulse podcast episode, PEPFAR at 20: Keeping the promise, which explores important successes of PEPFAR and why the bipartisan program has been so fundamental in ending the epidemic.

Webinar Recording: HIVR4P Preview

Ahead of the HIVR4P conference in 2024, and the 5th HIV Research for Prevention Conference, experts previewed some of the HIV prevention science to expect at these meetings. Be sure to check out the recordings on three important topics: Implementation and rolling out of CAB-LA; Insights into HIV vaccine research; and the future of bNAbs. 

Analysis: What You Need to Know About the Pandemic Accord

Negotiations around the Pandemic Accord are ongoing. Join us November 21 as we explore what’s in the Accord, what are the stakes, how can civil society engage, how will it affect our work. And to help make sense of it all, read the analysis by the Coalition of Advocates for Global Health and Pandemic Response, which is a compilation of recommendations from civil society and community organisations on the draft Negotiating Text of the WHO convention, agreement or other international instrument on pandemic prevention, preparedness, and response. 

Mark Your Calendars: Upcoming Webinars

November 15, HPTN 096: Building Equity Through Advocacy – An Integrated, Status-Neutral Approach for Ending the Epidemic Among Black Gay Men in the South 
Join The Choice Agenda and partners for a fascinating discussion about a novel, much-needed HIV prevention research study – HPTN 096. Currently in the field, the study addresses social, structural, institutional, and behavioral barriers to HIV prevention and care. Co-sponsored by PrEP in Black America and Federal AIDS Policy Partnership Research Working Group.Register here

November 15: Let’s Talk About HIV Cure Research
Join Dr. Marina Caskey of Rockefeller University and members of the REACH Community Advisory Board as they review the current state of HIV cure research. This webinar is for any person interested in learning about what makes curing HIV so challenging, the strategies being pursued, and what is happening in NYC! Register here. A follow-on webinar is scheduled for November 29

November 20: PrEP Resources Showcase 
Join AVAC and partners for a dynamic, workshop-style event exploring a digital collection of tools and resources on PrEP planning, access, trends in implementation research, and initiations to support robust access to PrEP and HIV prevention. Click here to register and learn more

November 21 to 24: Africa Health R&D Week 2023
Coalition to Accelerate & Support Prevention Research (CASPR) partners AVAC and IAVI are hosting the second Africa Health R&D Week November 21 through 24. The virtual forum will focus on the need for sustainable support for vaccine development and manufacturing in Africa, including through domestic resources mobilization. More information and registration are available here.

November 28: Spotlight on New PrEP Tools and Data: From R&D to access 
Between the recent accelerated growth in global PrEP initiations, and the introduction of new PrEP products like cabotegravir and the dapivirine vaginal ring, the field of PrEP data has never been more exciting or more complex. Join AVAC, the Medicines Patent Pool (MPP), and Unitaid to learn more about three important online PrEP resources and understand how they can support and enhance your work. 

Essential Tools for PrEP Planning and Advocacy!

More HIV prevention options are finally becoming available, including oral pills, injections and vaginal rings. Developing and delivering these options and making them actual choices for people, while also continuing to invest in the development of additional options to meet diverse needs has never been more promising or complex.  

At AVAC, we know that products don’t end pandemics unless they are delivered with equity and urgency. We created PrEPWatch.org in 2007 to serve as a go-to resource for PrEP research, and it has expanded to include toolkits, guides, data, case studies and more to support efforts to improve access to PrEP. Our data, evidence and insights, based on lessons from oral PrEP, are intended to help get the rollout of next generation right this time. 

Please join us and partners for a series of interactive sessions to guide you through these essential resources. 

November 20, PrEP Resources Showcase

Calling for collaboration: This dynamic, workshop-style showcase is the first in a series that will feature multi-media presentations to take you through key resources including a toolkit to ensure programs related to sexual and reproductive health (SRH) and HIV prevention are well designed to reach and support adolescent girls and young women; and a comprehensive database for tracking PrEP uptake, implementation research and other critical data by country. Participants will get to dive deeply into specific resources, explore how they might use these in their work, and have an opportunity to provide input on what resources are still needed.

Register here.

November 28, Spotlight on New Tools and Data: From R&D to Access

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Staying on top of the latest data on PrEP initiations, the introduction of new PrEP products and the upstream pipeline of PrEP research and development is also both essential and complex. Advocates, researchers, funders and others working in HIV prevention must understand the trends and updates to do their job effectively—but how can you navigate the vast amount of PrEP data online?

Join AVAC, Unitaid, and the Medicines Patent Pool (MPP) to learn more about three complementary online PrEP resources and understand how they can support and enhance your work: PrEPWatch.orgLong-Acting Therapeutics Patents and Licenses Database (LAPaL) and the Access to Medicines Tracker — quarterly-update on regulatory filings, regulatory approvals and product supplies of MPP-licensed generic medicines at the country level.

Register here.

Advances in HIV prevention represent a huge opportunity to help get actual prevention choices into the hands of people. We are grateful to support from the Gates Foundation for the Biomedical Prevention Implementation Collaborative (BioPIC) and from USAID and PEPFAR for the Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC) Consortium that help make these resources possible.

We hope you’ll join us as we walk through ways you can use our resources to make this happen.

Announcing 5 New Advocacy Projects Devoted to Advancing Cure Research!

AVAC is excited to announce five new awards to accelerate advocacy for cure research.   

Five alumni from AVAC and the International AIDS Society’s renowned Advocacy-For-Cure Academy program will now receive 10-month, $10,000 fellowship awards, to identify local needs and create solutions that advance HIV cure research in their local context. These fellowships are part of the overall Advocacy-For-Cure Academy, which is a training program to prepare a generation of cure advocates to fight effectively for research that matters to the people who are most impacted by HIV. Launched in 2018 by AVAC and IAS, this program has supported 96 alumni to attend five academies. To learn more about the academy program click here

The first fellowships were issued to Cure Academy alumni in 2019 who have since developed training tools like the Series of Jojo, built partnerships between traditional healers and local researchers and promoted better understanding and translation of cure research by journalists.  

Advocates and community leaders play an important role accelerating ethical research and creating an enabling environment that allows research to thrive. These fellows are building awareness among key stakeholders about the current landscape of HIV cure research and supporting the growing movement to build a cure agenda led by countries most affected by HIV.  

Learn more about the newest cohort of fellows below. 

Josephine Achieng 

Josephine’s project uses a collaborative approach to promote HIV cure information and education for sex worker and other key population (KP) community advocates and health care workers for inclusive access to potential cures. Her project builds on former grantee Philister Adhiambo’s project to raise awareness and support among key populations. The project goal is to promote and strengthen efforts towards HIV cure research in Nairobi, Kenya. 

Charles Brown 

Charles’ HIV cure research advocacy focuses on increasing the participation of the community, policy makers and funders in HIV cure research engagement in Uganda. Charles will conduct interactive dialogues with HIV cure researchers to share information and simplify the HIV cure science while sharing opportunities to get engaged in the science. Charles will also build on advocacy efforts by past academy alumni to advance his work.  

Gastón Devisich 

Based in Buenos Aires, Argentenia, Gaston will work with regional alumni of IAS’ Research-for-a-Cure Academy and leading advocates and researchers to build The Latin American and the Caribbean HIV Cure Consortium. The Consortium will integrate and shed light on the work being conducted in the region and enhance collaborations to develop efficient, productive research and a strong advocacy agenda — producing a regional repository of HIV cure related resources in Spanish and Portuguese and a 2-year advocacy roadmap for the region. 

Doreen Moraa 

Doreen’s “”RAYS of Progress” is an HIV cure literacy project that aims to empower adolescents and young people living with HIV (AYPLHIVs) by delivering accessible information about current HIV cure research through social media platforms. She plans to meet with key stakeholders to elevate the importance of HIV cure research in Kenya. Her project, encompasses the aspect of hope, simplifying scientific concepts, encouraging involvement, and addressing stigma while showcasing the beauty of science in HIV cure research. 

Kennedy Mupeli 

Kennedy’s project aims to enhance cure literacy and advocacy skills among HIV long-term survivors  (HTLS) in four regions of Botswana by training 40 participants in basic HIV and cure science. HTLS, who have lived with HIV for decades, provide invaluable insights into the disease’s progression and resilience, underscoring the importance of their inclusion in research. From this group, four core HIV Cure Champions will receive further advocacy training in cure research, targeting both local and national levels, and will lead a National Cure Advocacy Academy to build a Botswanan agenda. 

These projects have been funded through the generous support of Aidsfund.

STIWatch Newsletter, October 2023

AVAC’s STIWatch newsletter is a curated resource on the latest in STI vaccines, diagnostics, and other prevention tools and strategies. 

STIs and HIV are commonly linked and impact similar priority populations including young people, gay, bisexual, and other men who have sex with men, transgender people, and those living with HIV. To end the AIDS epidemic, there is great need to better prevent, detect, and treat STIs as having an STI can make it easier to get HIV. However, STI research and development lags behind HIV efforts, highlighting a need for new options and programs to better address both epidemics.  

In 2022, AVAC launched an STI advocacy program to mobilize advocates to accelerate the development and equitable implementation of new STI vaccines, diagnostics, and other prevention options. Through this quarterly newsletter, we hope to share valuable information that sparks advocacy for a robust pipeline of interventions for STI prevention.  

New Resources

Visit STIwatch.org, AVAC’s updated and expanded online resource to understand and advocate for research, development and rollout of STI vaccines and diagnostics. This site features updates on the status of vaccines and diagnostics for curable STIs including:  

  • Information on chlamydia, gonorrhea, syphilis, trichomoniasis, and more. 
  • An STI clinical trials dashboard that provides information about trials focused on STI vaccines, diagnostics, and DoxyPEP. 
  • Updated graphics on the state of STI vaccines and diagnostic development. 

STI Advocacy Updates

To understand the needs and evolving landscape around STI vaccines, diagnostics, and advocacy, AVAC awarded seven teams funding to conduct projects in South and Eastern Africa. Congratulations to Nyanza Reproductive Health Society in Kenya, Lesotho Network of AIDS Service Organizations in Lesotho, JournAIDS in Malawi, HIV Survivors and Partners Network in South Africa, ACTS 101 in Uganda, Latu Human Rights Foundation in Zambia, and Pangaea Zimbabwe in Zimbabwe.  

These projects will help shed light on community needs and perceptions around STI advocacy; better understand issues and opportunities related to local STI vaccine and diagnostic research and development and identify areas to improve STI prevention efforts. Read more about the grantees and their landscaping work and join the webinar below.  

Upcoming Events

What We’re Reading

  • JournAIDS calls for increased focus on STIs in Malawi. JournAIDS Program Manager, Dingani Mithi, recently spoke about results from an STI landscaping report that identified challenges and opportunities to improve STI prevention in Malawi. As STIs can increase HIV transmission, Mithi discussed the need for increased STI screening, treatment, and education programs to reduce HIV burden. 
  • ASHM’s 2023 consensus statement on doxycycline prophylaxis (DoxyPEP). ASHM provides DoxyPEP recommendations for community and clinicians along with recommendations for research, guidelines, and policy. These recommendations are intended for gay, bisexual, and other men who have sex with men in Australia to prevent syphilis, chlamydia, and gonorrhea. Using DoxyPEP for a pre-defined period, continuing to promote STI screening, and the need for additional molecular tests to monitor AMR are all discussed within this guide.  
  • Centers for Disease Control and Prevention (CDC) Request for Comment on Guidelines for the Use of Doxycycline Post-Exposure Prophylaxis for Bacterial STIs. The CDC is requesting comments on recently released draft guidance on the use of DoxyPEP to prevent chlamydia, gonorrhea, and syphilis infections among gay, bisexual, and other men who have sex with men, and transgender women. This is an opportunity for advocates to provide feedback on guidelines that will shape clinical practices. Comments are being accepted through November 16, 2023 so share your thoughts today! 

Learn More

To learn more about AVAC’s STI Program, visit STIwatch.org and avac.org/sti. Email [email protected] for questions or additional information. And to sign up for specific updates on STIs, click here.

Paving the Road for STI Prevention Advocacy

AVAC is thrilled to announce awards to seven advocacy partners in Southern and East Africa to conduct projects on community needs for the prevention of sexually transmitted infections (STIs). Join us November 7 and November 9 as our partners present insights from these surveys, and, together, we begin to build an advocacy agenda to accelerate development of new STI vaccines, diagnostics, and other prevention tools and strategies. 

HIV is inextricably linked with other STIs. The same populations are disproportionately affected; experiences around stigma, shame, and lack of access can be remarkably similar, and STIs can increase HIV transmission and acquisition unless coupled with prevention methods like condoms and regular STI testing. Over the past decade, the global burden of STIs has increased dramatically, with the WHO estimating more than a million new cases acquired every day, while funding and other investments have lagged.  

Advocacy is needed to bring more awareness on the impact that STIs have on the health of people and communities and the need for vaccines and diagnostics to better prevent, detect, and treat infections. These advocacy projects are helping build a stronger advocacy movement to help improve funding and commitments in and around STI vaccines and diagnostics.  

The seven partners who will present their findings on the November calls include: 

ACTS101, Uganda
Team Members: Bridget Jjuuko Ndagaan, Shakira Namwanje, Arafat Kabugo

ACTS101 is engaging stakeholders across Uganda to assess and document the status of STI prevention awareness, research and development (R&D) capacity for STI prevention research, and challenges and opportunities to STI services. Learn more about ACTS101 on Twitter.

JournAIDS, Malawi
Team Members: Dingaan Mithi, Christopher Bauti, Sosten Chilumpha

JournAIDS is evaluating how best to enhance STI prevention programs in Malawi and will document critical STI advocacy opportunities. The team will work with local development partners, donors, experts, civil society, scientists, researchers and the Malawi Ministry of Health to identify priorities and next steps for STI diagnostic R&D, prevention and treatment. Learn more about JournAIDS at their website.

Lesotho Network of AIDS Service Organizations (LENASO), Lesotho
Team Members: Mamello G. Makoae, Katleho Ntheri, Tsepo Holoane, Tseliso Makoa, Nthabeleng Ntsekalle, Masheane Khasoane, Peter Raliile, Moleleki Thejane

LENASO is seeking to understand the community needs and landscape around common STIs in Lesotho in the district of Mokhotlong in Mapholaneng area where the big dam construction and mining projects are happening. LENASO is conducting interviews and focus groups for youth who are in and out of school, groups of girls and young women, and groups of males to understand the community needs and perceptions regarding STI advocacy, vaccines and diagnostics. Learn more about LENASO on Twitter @LENASO7

HIV Survivors and Partners Network, South Africa
Team Members: Mandisa Dukashe, Sakhile Xaba, Joy Neo Malesa, Khumalo Moqebelo, Phindile Nkambule

HIV Survivors and Partners Network is engaging diverse stakeholders, including government, civil society and HIV/STI implementing partners to identify community needs and perceptions around STI prevention, diagnosis and advocacy; examine challenges and opportunities related to local STI vaccine and diagnostic access; research and development needs; and opportunities to integrate existing community led programs. Learn more about the HIV Survivors and Partners Network at their website and on Facebook.

Pangaea Zimbabwe AIDS Trust (PZAT), Zimbabwe
Team Members: Imelda Mahaka, Joseph Murungu, Barbra Ncube, Cleopatra Makura, Joseph Njowa

PZAT is conducting a national situation analysis to understand the strengths, gaps, needs, opportunities, and threats in implementing a successful program focused on STI prevention and management in Zimbabwe. The situation analysis will identify existing assets in the community that could support the implementation of STI prevention and management programs; identify gaps and unmet needs that can strengthen these programs; and understand the opportunities and threats that are affecting their implementation. Learn more about PZAT at their website and on Facebook and Twitter

Nyanza Reproductive Health Society, Kenya
Team Member: Simon Odiwuor Ondiek

This project is using mixed-methods to conduct a comprehensive landscape analysis to identify existing advocacy efforts for STI vaccines and diagnostics in Kenya. By assessing the landscape, evaluating gaps and challenges, and engaging key stakeholders, the project will develop actionable recommendations and an advocacy action plan. Ultimately, the project intends to foster collaboration among stakeholders, leading to a coordinated and impactful agenda for equitable access to STI prevention tools in Kenya. In this project, Simon and NRHS collaborates closely with the National AIDS & STIs Control Program (NASCOP), Kenya’s Government agency that focuses on coordinating and overseeing the country’s efforts to combat HIV/AIDS and Sexually Transmitted Infections (STIs). Learn more about Nyanza Reproductive Health Society at their website and on Facebook and Twitter.

Latu Human Rights Foundation, Zambia
Team Member: Henry Sakala

The Latu Human Rights Foundation is examining community needs and perceptions around STI advocacy in the Lusaka Kabwe and Ndola Districts of Zambia. Findings from this landscape analysis will contribute to evidence-based decision-making, inform the development of targeted interventions, and strengthen the overall capacity of STI prevention advocacy programs in Zambia. Learn more about the Latu Human Rights Foundation on Facebook

Investing in these advocates and partner organizations and in this advocacy is an urgent priority at AVAC. Their essential work lays the foundation for drawing critical resources to STI prevention, and accelerating the development of new vaccines, diagnostics, and other prevention tools and strategies. Their work and their voices will be instrumental to strengthening STI programs and equity in sexual health. We hope you’ll join us in congratulating these partners and hearing from them in November about this important work.

Investment Trends for HIV Prevention and Cure R&D: Resource tracking reports

New Reports on HIV Prevention and Cure R&D Funding

AVAC and partners are delighted to share two new reports showing investments for HIV prevention and cure research and development (R&D) that were launched this week at the IAS 2023 Conference on HIV Science. Both reports explore a variety of factors influencing investment and detail how investment trends are changing.   

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In its 17th annual report, the Resource Tracking for HIV Prevention R&D Working Group, a collaboration among AVAC, IAVI and UNAIDS, documents 22 years of investment in biomedical HIV prevention R&D, including HIV vaccines, PrEP, microbicides, voluntary medical male circumcision (VMMC), treatment as prevention (TasP) or undetectable equals untransmittable (U=U), female condoms and prevention of vertical transmission (PVT).   

Key Findings and Analysis 

  • Overall, total 2021 investments (the latest data available) in HIV prevention R&D show an approximate 12% increase for HIV prevention R&D compared to 2020. Money for HIV prevention has not returned to the high-water mark seen in 2012, when total investment was US $1.31 billion, but the figures have inched back up, to $1.25 billion in 2023, from $1.09 billion in 2020.  
  • Investment in HIV vaccine research declined, but still represents a majority of all HIV prevention research. At approximately $794 million, it is 63.5% of total HIV prevention R&D.  
  • Funding for microbicides is down for the 7th year in a row, and by 20% from 2020. However, this is in part attributable to several funders shifting to consolidating the PrEP category to include all products using antiretrovirals, including topical microbicides.   
  • 2021 saw the launch of USAID’s MATRIX Consortium, supporting further research on microbicides and dual prevention options.   
  • Also launched in 2021, USAID’s MOSAIC program, focused on developing and accelerating women’s access to new HIV prevention products. MOSAIC investments, funded as part of USAID’s long-standing microbicide investments, will be recorded by the Working Group from 2022 onwards. 
  • PrEP investment saw a two-fold increase, the highest seen since the Working Group began tracking, hitting approximately $270 million in 2021.  
  • A 30% increase in VMMC in 2021 reversed a decline seen in 2020. 
  • Funding for PVT decreased from US$25 million in 2020 to US$14.3 million in 2021, the lowest level recorded by the Working Group. 
  • The ratio of public to philanthropic investment remained the same as 2020, at 81% and 12%, respectively.  
  • Global philanthropic funding levels increased 16% in 2021 to US$150 million.  
  • Though the US continues to shoulder the bulk of all funding at approximately $922 million, diversity by geography is on the up. European entities increased their investments by 40%, reaching $161 million. Diversifying the funding base is vital not only for the long-term sustainability of the field, but also to ensure that the research priorities are informed by a diversity of perspectives. 
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The 2021 report of the Cure Resource Tracking Group, a collaboration between AVAC and the International AIDS Society, showed an impressive 30% increase in funding for cure research.  The report also provides an analysis of the cure research agenda and the scientific questions shaping investment decisions.  

Key Findings and Analysis 

  • Total funding went from $337 million in 2020 to $439 million in 2021. This increase represents a five-fold increase since tracking began in 2012.  
  • Approximately $362 million comes from public funders, approximately $40 million comes from philanthropy. Approximately $36 million is invested by industry.  
  • Only 6% of research sponsors report participant data derived from trials conducted in African countries, even though Africa is home to 68 percent of people living with HIV. There is a growing recognition that research needs to be done among affected communities and conducted in African countries. The establishment of the HIV Cure African Acceleration Partnership (HCAAP) aims to enable stakeholder engagement.  
  • The US NIH-funded Martin Delaney Collaboratories for HIV Cure Research expanded in 2021 and now include ten collaboratories.  
  • 2021 data show sustained geographic diversity in cure R&D, with several countries joining the US to increase their funding, including Canada, Switzerland and the Netherlands. 

We hope these reports will serve as tools for advocacy and inform public policy. Funding priorities are instrumental to the decisions and commitments that allow scientific progress. All stakeholders need opportunities to understand these trends and advocate where change is needed.  

A special thank you to trial participants everywhere. Without their time and dedication, scientific advance would halt, full stop. Also thank you to the individuals who contributed data to the report.  

If your organization is a funder or recipient of HIV prevention or cure grants and we don’t know you already, please contact us at [email protected]!