FACTS 001 Cannot Mean the End for Women: How do we PrEP for this?

This post was written by Yvette Raphael in South Africa a few days following the announcement of the FACTS 001 microbicide gel trial results. Yvette is a 2014 AVAC Fellow working at Johns Hopkins Health and Education in South Africa. She is a leader in South Africa’s HIV prevention movement for young women.

For years women’s failure to protect themselves from HIV was exacerbated by their inability to navigate through young womanhood. I fell into that same cycle: I did not negotiate my first sexual debut and not using a condom was surely not my choice. I now know that I was coerced into not using one. I learnt the hard way that that his compliments on my beauty were to make me feel OK about having unprotected sex with someone who knew he was HIV positive but not virally suppressed.

In 2010 the CAPRISA 004 trial showed a microbicide is possible. It was just the news I wanted to hear even if this news was almost 10 years too late for me and a marketable product would be even much later. A microbicide gel was one of the many prevention methods being tested and all were at different stages but I was particularly excited about this one for many reasons. The research for this was happening in South Africa, my country. The women who were in the trial represented me at the age I got infected and they would have gone through the same struggles as I did. If the gel worked for them, it would work in the South African context and most likely work for woman elsewhere in the world. What was particularly exiting was the regimen, in which the gel is delivered by applicator before and after sex. I thought of this as a power tool for women—something women could put in their handbag, almost like a Taser, and protect themselves. I was excited that our government made an investment in the research and I was excited that the team of lead researchers were women who I looked up to.

I waited for the results of the FACTS 001 trial results like an excited toddler would wait for Santa Clause. Then, in February, the call came directly from fellow advocates attending the session where the long-awaited results were released at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle. The results were flat. A microbicide gel in an applicator used before and after sex did not work for women. That was certainly not the news I wanted to hear. My heart sank. I wanted to run away. I wanted to hide. So many women were looking forward to this. The emails started, the press releases, the commentary from all angles. Everyone had something to say except the women.

I was following CROI with keen interest mostly for the FACTS results. But like with soccer, when your team loses, you support your next favourite team. I started to follow what was coming out of CROI about PrEP.

The Partners Demonstration Project among discordant heterosexual couples showed that PrEP and treatment in couples reduced the negative partner’s risk of HIV by 96 percent. Both the PROUD study in the UK and IPERGAY in France, looking at PrEP in gay men, showed an 86 percent reduction in risk.

What does all this mean for women? Would PrEP be the option that will finally liberate young women and girls? How do we advocate for PrEP to be made available to women in South Africa—where HIV prevalence is nearly twice that of men?

The Dangers of False Science Reporting and Our Duty as Communicators

In December 2009, the trial known as MDP 301 released results that the microbicide gel known as PRO 2000 had not shown efficacy among women in Zambia, South Africa, Tanzania and Uganda. These results were not unique as many efficacy trials in HIV prevention and in other arenas have shown flat results, or at times even increased risk. However, what happened after the released results was unique. Blogs and online media framed the trial as “exploitation”, resulting in skepticism about future HIV microbicide trials. Six years later, the effects of that misleading reporting can still be felt. That’s why the recent Toronto Star article caught my eye.

On February 5th the Toronto Star published an investigative article on the HPV vaccine headlined “A wonder drug’s dark side”. The article focused on several young women who became sick after receiving Merck’s HPV vaccine, Gardasil. Although the article stated that the illnesses were not conclusively linked to the vaccine, the photos, front page headline and anecdotes likely led some readers to believe that the Star had uncovered the “truth” about the vaccine.

The Star removed the article a week later but not before it fell under heavy criticism by other media outlets:

The Washington Post quoted Vox Science writer Julia Belluz, “everything wrong with vaccine reporting in one dangerous package. These tales of suffering and death are awful. Stomach turning. But they are just that: stories.” JAMA also wrote “Not all reported events are systematically validated, and many may have only coincidentally followed vaccination,” the study said, adding that underreporting, inconsistency in the quality and completeness of reported data, stimulated reporting due to extensive news coverage and reporting biases could also skew these numbers.”

Global News quoted Dr. Jen Gunter, an OB/GYN, “Paragraph after paragraph is dedicated to detailing the terrible things that happened to these young girls and their families and in an Oprah-esque move the wealth of information detailing the vaccine’s safety was distilled to a few comments easy to ignore in among the trail of destruction allegedly due to the vaccine. It also quoted Julia Belluz, “In medicine, anecdotes are considered the least helpful type of evidence. They are biased, unrepresentative, and, as often as not, misleading,” wrote Belluz. “What’s worse, while the Star cherry-picked damning cases about the vaccine’s alleged harms, they ignored the reams of independent studies we have involving millions of women around the world that show the vaccine is safe.”

CBC quoted John Cruickshank, the Star publisher, from his As it Happens Interview: “”We failed in this case. We let down. And it was in the management of the story at the top,” It also brought to light how two Star staff lashed out at critics: Michael Cooke, editor-in-chief of the Star, responded to Vox’s Julia Belluz: “’Stop gargling our bathwater and take the energy to run yourself your own, fresh tub.’ Cooke also called a reader an ‘idiot’ on Twitter.” Columnist Heather Mallick from the Star also criticized Dr. Jen Gunter by writing: “Here’s a tip: don’t read a website run by a rural doctor whose slogan is ‘wielding the lasso of truth.”

The Los Angeles Times writes: “But has the damage already been done? The article should stay online, as a warning to readers — not of the purported dangers of a life-saving vaccine, but of the real perils of shoddy science reporting.”

After much criticism, the Star printed a commentary titled “Science shows HPV vaccine has no dark side”. They write: “The Star presented the stories of women who have suffered greatly. The article was engaging, dramatic and might have created fear. But study after study has shown that there is no causal link between the events the Star reported and the vaccine. About 169 million doses of the HPV vaccine have been administered worldwide. In any given large population, there will be illness and death. This is a statistical fact. To attribute rare devastating occurrences to a vaccine requires evidence of causation, of which the international scientific community and the Star article have none.”

Thankfully, in this case, there was a swift response to this misleading, “investigative” report that resulted in the take down of the report. Had it not, there could have been serious implications for the future of the HPV vaccine and/or other vaccines. Although my hope is that this is a solitary incident, I know that this is not the last time we will see misreported facts. But this highlights the important role science reporting plays, and especially in sharing new information about health research. The things that we write and say shape public perception — and they have consequences that can have long-lasting effects.

Prevention on the Line Webinar Series

AVAC is putting together a year-long series of web-based dialogues focused on HIV prevention research and implementation. This series, HIV Prevention on the Line, will delve into issues raised in our recent AVAC Report and engage with issues and priorities that emerge over the course of the year.

Slides, audio and animations from the first set of webinars are available below. Stay tuned to this page, or subscribe to our Advocates Network newsletter, for details on future webinars.

Vaccines in Vivo: Advances in AIDS Vaccine Research
This year brought the launch of long-awaited initiation of clinical trials building on positive results from the RV144 “Thai” trial. This effort is led by the Pox-Protein Public-Private Partnership (P5), including the the HIV Vaccine Trials Network, who joined the webinar to provide a status update of their current vaccine research and development program. We also featured Janssen, part of Johnson & Johnson, to provide an overview of the research program they are moving forward that focuses on a cross-clade vaccine product.

May 18, 2015 — Downloads: Slides (PDF) / Audio (MP3) / Animation (Flash)

New Frontiers in HIV Prevention, Treatment and Cure: An advocate’s webinar on passive immunization
This webinar focused on “passive immunization”—a scientific term for an expanding area of research that’s highly relevant to treatment, prevention and cure work. There are trials in humans happening in many regions of the world—and data are beginning to come in that advocates need to understand, analyze and consider.

This hour-long webinar featured Dr. Sarah Schlesinger (Rockefeller University) who provided an overview of recent developments across the field including new data from Rockefeller.

April 21, 2015 — Downloads: Slides (PDF) / Audio (MP3) / Animation (Flash)

Demanding Clarity on PrEP: Understanding recent data on oral PrEP

This webinar featured Jean-Michel Molina of the French research agency ANRS and Sheena McCormack of the UK Medical Research Council discussing the data from the IPERGAY and PROUD studies, respectively. Both trials evaluated oral TDF/FTC (brand name Truvada) as PrEP in gay men and other men who have sex with men, and both reported high levels of protection against HIV acquisition. PROUD prescribed a daily pill regimen; IPERGAY asked trial participants to follow an “event driven” regimen that involved a sequence of doses before and after sex. IPERGAY participants took an average of four doses per week—comparable to the estimated protective dose required in trials of daily oral PrEP.

March 12, 2015 — Downloads: Slides (PDF) / Audio (MP3) / Animation (Flash)

Follow the Money: Knowns and unknowns when it comes to cash transfers and financial incentives to improve health in people living with and/or at risk of HIV
This webinar featured Wafaa El-Sadr, principal investigator of HPTN 065, which evaluated the use of cash incentives in improving outcomes for people living with HIV in the United States.

March 11, 2015 — Downloads: Slides (PDF) / Audio (MP3) / Animation (Flash)

After FACTS: What’s next for HIV prevention in women?
Helen Rees, principal investigator of the FACTS 001 microbicide trial of vaginal 1% tenofovir gel, spoke of their findings of no evidence of protection overall associated with the vaginal gel. Jared Baeten, co-chair of Partners PrEP, discussed the Partners Demonstration Project finding that serodiscordant couples using oral PrEP and/or ART had ver low levels of HIV transmission. We discussed what these and other data meant for women, including young and adolescent girls.

March 9, 2015 — Downloads: Slides (PDF) / Audio (MP3)

Facing FACTS, and Just Getting On With It

Jim Pickett, Director of Prevention Advocacy and Gay Men’s Health at AIDS Foundation of Chicago and chair of IRMA (International Rectal Microbicide Advocates), is a long-time advocate for new HIV prevention technologies for men, women, and transgender individuals.

I’ve been a microbicide advocate before I could pronounce the term. And while I am associated closely with rectal microbicides, I was a vaginal microbicide advocate well before I had a clue there was any back-door research going on—and I still am.

The microbicide field has a lot of experience with trials that don’t yield the results we’ve all been hoping for, and working so very hard to achieve. We’re used to being sad, disappointed, heartbroken. We’ve learned to manage our expectations—not always an easy task. And we’ve wiped our tears, tended to our bruises and gotten right back in the game. We don’t wallow.

When I heard the FACTS results—I was sad. SAAAAAAAD. I felt heartbroken—reflecting on the 2,000+ African women who volunteered for this study in the hopes they could be part of HIV prevention history, and help change the trajectory in a setting that so, so, so desperately needs new protective strategies for women.

I felt frustrated for the hundreds of clinical trial staff who gave this thing their all. But microbicide researchers and advocates—a pretty fabulous, resilient, hard-core bunch—don’t tend to linger at the pity party. There is no time to wallow. Our communities don’t have the luxury of wallowing—and we don’t either. We’re learning a lot from FACTS, and I look forward to the qualitative research that comes out and helps us better understand the lives of young African women, so we can do better. We have to do better.

Meanwhile, we have Truvada as PrEP—proven to work with women. And we have two Phase III dapivirine ring studies (the Ring Study and ASPIRE) in the field. And a robust pipeline of films, fibers and multi-purpose technologies. We’re not stopping. We’re not giving up. FACTS hurt us—but it didn’t break us. We all have work to do—and we’re getting on with it.

Women Deserve to Know About HIV Prevention Medication Too

This originally appeared on RH Reality Check.

In 2012, the Food and Drug Administration (FDA) approved the use of the antiretroviral medication Truvada as the first form of PrEP (pre-exposure prophylaxis), a pill to protect against getting HIV. To date, the United States is the only country to give regulatory approval to PrEP for HIV prevention. The Centers for Disease Control and Prevention (CDC) then issued clinical guidelines for prescribing PrEP to adults at risk of HIV. PrEP has been proven to reduce the risk of acquiring HIV equally well in both men and women—with a protection rate of up to 96 percent when taken daily without interruption or missed doses. Yet three years later, PrEP-centric media campaigns and clinical prescriptions continue to primarily target men who have sex with men.

We at the US Women and PrEP Working Group, a national advocacy coalition of more than 100 women’s health advocates, health-care providers, researchers, policymakers and industry partners, believe that everyone has the right to affordable access to the tools they need to implement their sexual and reproductive choices. Full PrEP availability—for both cis and trans women—is both a reproductive justice and human rights issue. March 10 is National Women and Girls HIV/AIDS Awareness Day. So it’s a good time to ask the question: Why are women being excluded from this potentially life-saving medication?

Of the six oral PrEP studies completed to date, only one took place in the United States. It only enrolled men and a few transgender women who have sex with men. Two international studies that only enrolled women did not show PrEP as successful, but researchers attributed this to the fact that most of the participants did not take the pills daily as instructed. In still other studies involving heterosexual couples, women who did take PrEP consistently achieved a high level of protection—showing that PrEP does work well across the gender spectrum.

Even so, the success of the trial involving American men, combined with the lack of positive data from the trials enrolling women, generated domestic press coverage that generally implied PrEP is “for men,” thus making women invisible as potential PrEP users.

In the United States, about one in four people living with HIV is a woman. Black women, who make up only 13 percent of the female population, comprise nearly two-thirds (64 percent) of new HIV infections among US women. Yet when sociologist Judith Auerbach conducted focus groups in six US cities among 144 women at high risk of HIV on their thoughts about PrEP, she discovered they were overwhelmingly unaware of the effectiveness of the medication for women.

Fewer than 10 percent of the women had even heard about PrEP; those who had thought it was only a tool for men, not for women. The remaining 90 percent were “upset, frustrated and even angry that they had not learned of it before.” They saw the failure of health professionals to reach out to them with information about PrEP as a “societal devaluation” of their lives.

In addition to human rights concerns, this kind of low awareness of PrEP’s availability is also highly problematic for practical reasons. Gender-based differences in social and economic power can sometimes make it difficult or impossible for many women to insist on condom use, and consistent condom use is infrequent overall. In a 2010 national probability study, only 22 percent of men and 18 percent of women reported using male condoms during the last ten times they had vaginal intercourse—and cis women are twice as likely to acquire HIV during heterosexual vaginal intercourse without condoms than are their male partners. Finally, women with HIV in the United States are more likely to be living in poverty and have less access to health care than men living with HIV. All of these factors make access to effective HIV prevention, including the option of PrEP, crucial for women.

Advocates are, however, making inroads in ensuring that PrEP becomes part of the narrative for women at risk of HIV. With funding by the CDC Foundation and its partners, the Sustainable Health Center Implementation PrEP Pilot Study (SHIPP) is under way. As the first PrEP study enrolling women in the United States, this demonstration project is designed to show how PrEP provision can be implemented sustainably. SHIPP is enrolling 1,200 volunteers at four federally qualified health centers in Illinois, Pennsylvania, New Jersey and Texas. These volunteers select PrEP as a part of their sexual health and primary care services. SHIPP’s results—including the rates of PrEP uptake, consistency of use, and protection from HIV—are expected in 2017. To date, about 40 percent of enrolled SHIPP participants are women, a victory for the Working Group and other PrEP supporters across the country.

In the meantime, family planning clinics and private OB-GYNs are well situated to educate women about PrEP, since 99 percent of American women, at some point in their lives, have used contraception. Not surprisingly, cost is a key concern among women considering PrEP use; these facilities can also help patients affordably obtain the medication. At this point, Truvada is the only pill approved as PrEP; Truvada Track, an advocates’ project monitoring PrEP access, reports that it is routinely covered by insurers and Medicaid. Gilead, the pharmaceutical company producing Truvada, also has a patient assistance program that supplies the drug to those without coverage and assists with co-pays to cover the testing and other services associated PrEP access and monitoring.

To choose whether or not to use PrEP, women need information about the medication, clinicians need to be educated about its use for women, and the drug needs to be affordable and accessible. While we are monitoring the implementation of SHIPP, we will continue to pressure policymakers, health-care professionals and the CDC to reach out to women. In addition, we will continue to mobilize women to demand more.

Everyone deserves the right to HIV prevention tools that we can use without our partner’s participation—for the sake of our safety, health and well-being. In short, we are tired of asking permission to protect our own lives.

Decoding Cure Science: A CUREiculum webinar series

The CUREiculum is a suite of tools that provides simple, accessible information on HIV cure research. As part of the effort to increase research literacy around cure, the CUREiculum team, a collaboration of community educators, researchers and advocacy organizations, will be presenting a webinar series that focus on issue-specific topics crucial to understanding the research landscape.

Check out the first three webinars in the series!

Stakeholder Engagement in Cure Research
Friday March 13, 11 am ET
Watch a recording of the webinar!

This webinar, led by Jessica Handibode of AVAC, will discuss how the Good Participatory Practice (GPP) guidelines, developed by UNAIDS and AVAC, can be applied to HIV cure research. GPP provides trial funders, sponsors and implementers with systematic guidance on how to effectively engage with all stakeholders. Drawing from the literature and past HIV prevention trials, the webinar will explore the history and importance of engaging community stakeholders early in the research process.

Latency Reversing Agents
Thursday March 26, 4 pm ET
Watch a recording of the webinar!

This webinar will feature Dr. David Margolis, Principal Investigator of the CARE Collaboratory at University of North Carolina at Chapel Hill, and Dr. Sharon Lewin member of the DARE Collaboratory and Director of the Infectious Disease department at Monash University. Latency reversing agents are biological compounds used to “wake up” HIV infected cells from their resting state in the body. The drugs are used as the “kick”, the first in a two phase strategy often called “kick and kill”. Both researchers will discuss what latency reversing agents are and how the research might contribute to a combination curative strategy.

Early ART
Thursday April 2 at 11 am ET
Watch a recording of the webinar!

Dr. Jintanat Ananworanich, Associate Director for Therapeutics Research at the U.S. Military HIV Research Program (MHRP) of the Walter Reed Army Institute for Research (WRAIR), will present the scientific mechanisms of early treatment and explain how it relates to HIV cure research. Administering early antiretroviral therapy can have a significant impact on limiting the reservoir—the cells that contain non-replicating HIV—in an HIV-positive individual. Starting ART very early after HIV infection has been linked to very low viral loads and even to apparent “remission” (periods of no detectable viral load).

For more information, please contact Jessica ([email protected]) or Karine ([email protected]). The full schedule for the 2015 CUREiculum webinar series is available.

Presenting the First GPP Online Training Certificate Recipients

AVAC is pleased to announce the inaugural group of Certified GPP Implementers! In October 2014, AVAC launched the innovative GPP Online Training Course, in partnership with the Center for Learning and Innovation at the San Francisco Department of Public Health.

The following individuals have successfully completed all course requirements and have received a GPP Online Training Certificate as recognition of their achievement. Please join us in congratulating our GPP community members on their hard work and accomplishment!

  • Patchara Charuthamrong, Armed Forces Research Institute of Medical Sciences (AFRIMS), Thailand
  • Leader Kanyiki, Desmond Tutu HIV Foundation (DTHF), South Africa
  • John Mdluli, Aurum Institute, South Africa
  • Jauhara Nanyondo, Makerere University Walter Reed Project (MUWRP), Uganda
  • Siriporn Nonenoy, AIDS Research Center, Red Cross, Thailand
  • Laura Potter, Bridge HIV, San Francisco, USA
  • Pongpun Saokhieo, Research Institute for Health Sciences (RIHES), Thailand
  • Rona Siskind, Division of AIDS (DAIDS), Bethesda, USA
  • Catherine Slack, HIV AIDS Vaccines Ethics Group (HAVEG), South Africa
  • Marie Michelle Umulisa, Rinda Ubuzima, Rwanda
  • Mathias Wambuzi, Uganda Virus Research Institute-International AIDS Vaccine Initiative (UVRI-IAVI), Uganda

The GPP Online Training course is a 12-week interactive learning experience that aims to build participants’ understanding of the GPP Guidelines and strengthen application of stakeholder engagement approaches in individual, real-world contexts.

For more information about the next course offering, contact Stacey Hannah ([email protected]), Jessica Handibode ([email protected]), or Anne Schley ([email protected]).

Playing Tennis Without a Net

The American poet Robert Frost once said that writing “free verse” — poetry without a formal structure, like a rhyme scheme — was like “playing tennis without a net.”

Targets, goalposts and milestones are what give meaning and inspiration to the incredible work that the AIDS community is engaged in each day. They allow us to challenge ourselves and, equally important, comprehend how far the AIDS community has come. To work without targets is to play tennis without a net—and it seldom yields works of beauty, unlike free verse.

In 2011, US President Obama announced an evidence-driven agenda for US global AIDS programs focused on high-impact interventions including antiretroviral treatment (ART), prevention of mother-to-child transmission and voluntary medical male circumcision. He set specific targets for PEPFAR to reach by the end of 2013, including support for two million more people on ART by 2013 and 4.7 million more VMMC procedures.

By the end of 2013, both goals had been exceeded via the combined effort of PEPFAR, national governments, other funders and community stakeholders.

But since then, there have been no new targets — and PEPFAR has been playing tennis without a net.

Even more concerning, there may not be funding to develop ambitious targets. On February 2, the Obama Administration unveiled its proposed budget for Fiscal Year 2016 (FY2016, which begins in October 2015) that included flat funding for PEPFAR and reduced funding for the Global Fund reflecting the cap on US contributions set by Congress.

Also concerning is a recent Lancet article that suggests the absence of targets may have slowed treatment enrollment, which declined in 2014 by 35 percent. More recently, at last week’s Conference on Retroviruses and Opportunistic Infections (CROI), in a presentation on VMMC scale-up, PEPFAR staff showed a worrying slow-down in those programs in the absence of a target.

Targets in 2015 and restored PEPFAR funding for FY2016 are needed in order for the program to get back on the trajectory it needs to end the epidemic.

It is out of character for PEPFAR not to have targets. PEPFAR has often in its 12-year history identified critical goals and met them. From supporting 7.7 million people on ART treatment, to reducing the cost of treatment, and meeting ambitious male circumcision goals, PEPFAR and partners have shown they can rise to the challenge.

Where are new PEPFAR intervention targets? We had hopes that new treatment and prevention targets would be announced on World AIDS Day 2014, but that day came and went. With the UNAIDS making the call for “90-90-90” as a new target for 2020, primary prevention targets are especially critical now to stem the tide of new infections and to ensure a truly comprehensive response to the epidemic. As we said in our Report, Prevention on the Line, global targets, particularly for prevention, still lack precision and plans to turn them into reality.

Targets are risky. PEPFAR may not achieve them, or Congress may not fund them. But our greatest achievements have not always been fully achieved, and they were never sure bets. For targets to have impact they need some key attributes to turn a target into impact. Targets need to be resourced, audacious, achievable, measurable, accountable, politically supported and a collective priority. Targets without these attributes can be a focal point for frustration, criticism and cynicism — see Prevention on the Line for our “Anatomy of A Target” and an analysis of targets that have worked in the past.

Under PEPFAR 3.0, the Office of the Global AIDS Coordinator has aggressive plans to support targeted efforts to combat HIV/AIDS. The new $300 million PEPFAR Impact Fund will be allocated to countries with the greatest need and ability to realign resources based on evidence to reach epidemic control, increase their own share of HIV budgets, and take greater ownership of data collection and expenditure analysis. PEPFAR’s focus on impact is welcome and needed. Yet without treatment and prevention targets to assess that impact, PEPFAR may still be playing tennis without a net.

We hope and expect that within the next months, the Administration will work to set, and Congress will work to fund, bold new treatment and prevention targets for PEPFAR in the future.

Putting Prevention on the Line with New Webinar Series

AVAC is pleased to announce a series of three webinars next week, starting on Monday, March 9, that will provide advocates with the chance to hear and discuss data—released last week at the Conference on Retroviruses and Opportunistic Infections (CROI)—in dialogue with researchers and other stakeholders.

These webinars are the first in a year-long series of web-based dialogues focused on HIV prevention research and implementation. This series, HIV Prevention on the Line, will delve into issues raised in our recent AVAC Report and engage with issues and priorities that emerge over the course of the year.

We are also happy to note that this first set of webinars is being produced in partnership with IRMA and the HIV Prevention Justice Alliance. We look forward to working with IRMA and HIV PJA to bring this important information and discussions to a growing audience.

The webinar topics and times are below. Also, please note that the US will change to Daylight Savings Time on Sunday, March 8 so please double check the time in your area at www.timeanddate.com. As always each webinar will be recorded and available online at www.avac.org.

After FACTS: What’s next for HIV prevention in women?

Download slides and audio.

This webinar will feature Helen Rees, principal investigator of the FACTS 001 microbicide trial of vaginal 1% tenofovir gel. FACTS 001, which released data at CROI, found no evidence of protection overall associated with the vaginal gel. Partners Demonstration Project, which reported data at the same meeting, found that serodiscordant couples using oral PrEP and/or ART had very low levels of HIV transmission. What do these and other data mean for women, including young women and adolescent girls? Join the call to share your thoughts and learn more!

Prepare for the webinar with these talks from CROI and excerpts from AVAC Report 2014/15:

Follow the Money: Knowns and unknowns when it comes to cash transfers and financial incentives to improve health in people living with and/or at risk of HIV

Download slides, audio or view the Flash animation slideshow.

This webinar will feature Wafaa El-Sadr, principal investigator of HPTN 065 which evaluated the use of cash incentives in improving outcomes for people living with HIV in the United States, and David Wilson, the World Bank’s Global AIDS Program Director. Both speakers presented at the recent CROI conference. Cash transfers for young women and girls have also been highlighted in the recent UNAIDS “Fast Track” report and in their draft Prevention Targets released in November 2014. What do the data tell us—and what are the missing pieces? Is now the time to have a cash transfer target—as UNAIDS has proposed—or to articulate an agenda to learn more? Or to do both?

Prepare for the webinar with these talks from CROI and excerpts from AVAC Report 2014/15:

Demanding Clarity on PrEP: Understanding recent data on oral PrEP

Download slides, audio or view the Flash animation slideshow.

This webinar will feature Jean-Michel Molina of the French research agency ANRS and Sheena McCormack of the UK Medical Research Council to discuss the data from the Ipergay and PROUD studies, respectively. Both trials evaluated oral TDF/FTC (brand name Truvada) as PrEP in gay men and other men who have sex with men, and both reported at CROI, that there were high levels of protection against HIV acquisition. PROUD prescribed a daily pill regimen; IPERGAY asked trial participants to follow an “event driven” regimen that involved a sequence of doses before and after sex. IPERGAY participants took an average of four doses per week—comparable to the estimated protective dose required in trials of daily oral PrEP. So—is there now an “event-driven” regimen? How might these data affecting PrEP delivery and demand in Europe, US and beyond? Join us to explore these conversations—and more!

Prepare for the webinar with these talks from CROI and excerpts from AVAC Report 2014/15:

We look forward to welcoming you on these webinars and others as we move through the year!

Personal Reflections from the 2015 Conference on Retroviruses and Opportunistic Infections

John Curry is a peer educator working on HIV outreach services for Unconditional Love, Inc. in Brevard County, Florida and is a graduate of the Black AIDS Institute’s African American HIV University (AAHU): Community Mobilization College (CMC). He is also a member of the Melbourne, FL Chapter of the Black Treatment Advocates Network (BTAN).

Having a trip to Seattle Washington is a treat within itself. But to be a delegate to attend the premier scientific conference on HIV and other viruses and opportunistic infections, is way above the expectations of any individual working in the HIV arena, or personally impacted by the disease. All I can say is “Wow!” This could be a mind-blowing experience with just the two mention reasons above. If you add that first-hand knowledge on hepatitis C will be disseminated; those individuals dually diagnosed, will have the opportunity to gain real time life changing information that directly impact their life.

I fit the profile of the individual mentioned above. My physician just added ledipasvir and sofosbuvir, or Harvoni, to my medication regime, for the CURE of the hepatitis C virus, that’s been flowing in my bloodstream for 15 plus years; this brought tears to my eyes. It has been a privilege having the opportunity to hear from world-renowned researchers, doctors and scientists who worked toward the development and implementation of this medication for the world. I wanted to wait to start my HCV medication until after I return from Seattle, for two reasons: first, I did not want to experience side-effects if any, while attending this premier conference. Second, I’ll have all information I need regarding the medication from the world’s top researchers.

My HIV infectious disease specialist informed me of all information I needed to know but it was helpful to hear it again in a session on drug-drug interactions between anti-HCV regimen ledipasvir/sofosbuvir and ART. This session, by Dr. Polina German and associates, re-enforced the information installed in me at the onset of receiving a prescription for this life changing medication. I’m truly blessed!

My highlights from CROI 2015 have been: 1). Ebola update, 2). PrEP the PROUD study results, 3). on-demand PrEP, results of the IPERGAY trial, 4). FACTS 001 Phase III Trial of pericotal tenofivir 1% gel for HIV prevention in women, and 5). the drug-drug interaction between the hepatitis C drug, Harvoni, and antiretroviral medications. My plan is to present the findings with the engaged Black Treatment Advocates Network (BTAN) Chapter in Melbourne, Florida.

In addition to having my own personal experience with HIV and hepatitis C, I feel qualified to bring the information that I learned at CROI to my community as a peer educator working HIV outreach services for Unconditional Love, Inc. I’m also a double graduate of the Black AIDS Institute’s African American HIV University (AAHU): Community Mobilization College (CMC) and Science & Treatment College (STC), which is in collaboration with the University of California, Los Angeles (UCLA). With these qualifications I believe I can reach the community I’ve been serving for the past seven years. I feel like I’ve been charged to implement change, to the people residing in the most HIV prevalent area in Brevard County, Florida. This alone gives me purpose and perseverance for the calling, God has set before me.

The preparation webinars hosted by the Black AIDS Institute & AVAC helped to prepare us with the information being presented during the conference. The mentorship program has valuable qualities, but I wish we had more time to connect to one another during these meetings. I will add that God had his hands on me, by connecting me with an AAHU graduate, whom is a Licensed Registered Pharmacist for my mentorship during this conference. It was a win-win situation. As we sat through sessions together he was able to help me understand all concepts I didn’t fully grasp.

I must give thanks to the Black AIDS Institute, AVAC and God for giving me the opportunity to experience the life changing sessions during CROI. The residents of Brevard County, Florida will have first-hand knowledge of the new developments in HIV and other opportunistic infections. I’ll close by saying: I hope to see you next year CROI 2016, and remain blessed.