This week’s issue covers developments shaping access to HIV prevention and the future of US biomedical research, including new pathways to accelerate access to lenacapavir for HIV PrEP, calls for greater transparency around a proposed NIAID restructuring, and a new lawsuit challenging NIH’s screening of research grants. With today as the final day to comment on the NIAID proposal, make your voice heard. And read on for a provocative Lancet commentary on the challenges of trying to reform global health architecture.

Lenacapavir Access Pathway

Two new agreements from Gilead Sciences, the developer of lenacapavir, this week could expand access to lenacapavir for HIV PrEP (LEN), both for the current every six month injectable and a potential once-yearly option still in development. Gilead and the Pan American Health Organization (PAHO) announced new steps to establish a procurement pathway through PAHO’s Regional Revolving Funds that will allow 14 countries in Latin America and the Caribbean – including Argentina, Brazil, Peru and Mexico (all of which participated in one of the pivotal efficacy trials) – to procure twice-yearly LEN. This mechanism complements the 24 countries already covered in the region by Gilead’s existing voluntary licensing agreements. Gilead also committed to advance a technology-transfer process in Brazil, although timelines, prices, and volumes were not defined in the release. Separately, Gilead expanded its six royalty-free voluntary licenses for lenacapavir to include the investigational once-yearly formulation being studied in the Phase 3 PURPOSE 365 trial. This would extend once-yearly LEN generic plans for 120 high-incidence, resource-limited countries before efficacy results or regulatory approval.

IMPLICATIONS: These LEN announcements are a step forward in rolling out new HIV prevention options with speed and scale, but equity continues to remain a central issue. Advocacy partners, ITPC Global and Make Medicines Affordable, welcomed the PAHO mechanism as an important step for countries that were initially excluded from Gilead’s voluntary licenses. However, they warned that important details including price, volumes, supply commitments and delivery timelines remain unknown and that governments cannot plan national scale-up without that information.

At the same time, expanding voluntary licenses to the prospective once-yearly formulation while it is still in Phase 3 development is an important step forward in early access planning and could shorten the gap between approval and generic supply, should the once-yearly formulation prove safe and effective. This early licensing approach mirrors Merck/MSD’s recent licensing agreements for their investigational monthly oral PrEP option, alimatravir. AVAC’s projections of potential LEN supply and demand through 2028 illustrate the scale of the opportunity—and the gap that remains between potential demand and current commitments. Whether these two LEN access agreements translate into affordable, predictable supply that countries can actually finance and deliver at scale and speed will be the true test of equity.

READ:

• PAHO opens a new pathway to access lenacapavir for HIV prevention in Latin America and the Caribbean—PAHO  
• Unique partnership commits €32.5 million to EmpowHER Fund to expand HIV prevention for women and girls—Aidsfonds 
• Sign the letters for alimatravir’s access in Perú—Public Citizen 
• Why do women make up 71% of South Africa’s new lenacapavir users?—IOL 
• Want the six-monthly HIV jab? Here’s your nine-step clinic cheat sheet—Bhekisisa  
• Gilead Accelerates Global Access Planning for Investigational Once-Yearly Lenacapavir for HIV Prevention—Gilead  
• A pathway is not access: ITPC and MMA call for transparency on the Gilead–PAHO lenacapavir agreement—Make Medicines Affordable 
• Gilead and PAHO Announce Milestone Partnership to Accelerate Access to Twice-Yearly Lenacapavir for HIV Prevention Across Latin America and the Caribbean—Gilead  

NIAID Reorganization: Last Day for Public Comment 

Advocates led by the Save HIV Funding campaign, founded by PrEP4All, HIVMA and AVAC, are demanding more transparency and a withdrawal of the proposed restructuring of the National Institute of Allergy and Infectious Diseases (NIAID) to allow time for meaningful opportunities for the HIV community to provide input on the reorganization proposal. Last week, the National Institutes of Health (NIH) released a proposed reorganizational chart with public comments due today, September 18. The proposal would eliminate NIAID’s Division of Clinical Research and redistribute clinical research functions across the Institute. Little accompanying detail has been provided about the rationale for the changes, how responsibilities would be reassigned or what the restructuring could mean for NIAID’s domestic and international clinical research infrastructure.  
 
The Save HIV Funding campaign developed a template for comments for individuals and organizations that would like to comment on the NIH proposed reorganization of NIAID.

IMPLICATIONS: The proposed restructuring comes at a particularly uncertain moment for the HIV research infrastructure NIAID has built over decades. The long-delayed announcement for the next seven-year cycle of the trial networks creates the possibility of funding gaps that could disrupt ongoing trials, research sites, staff and study participants; infectious-disease groups have warned that lapses could destabilize research capacity that has contributed to advances across HIV, TB, hepatitis and other infectious diseases. With fundamental questions about the reorganization still unanswered, advocates are pressing NIH not to restructure that system without greater transparency and meaningful community input. The uncharacteristically shortened timeline for public comment and scant details available about the proposed reorganization has been criticized as obfuscating meaningful community engagement and involvement in NIAID processes. Furthermore, NIAID has provided little justification for eliminating pertinent divisions such the Division of Clinical Research – which provides substantial clinical and regulatory support for NIAID-funded studies.  

READ:

• Action Alert: Urge Congress to Protect & Fund Federal HIV Programs—Save HIV Funding  
• The NIH funding crisis that could reshape biotech for years to come—Drug Discovery News  
• New NIH research center on vaccine harms takes shape—Science  
• NIH Budget Cuts Threaten HIV Research—Think Global Health 

Global Fund Releases New Report: Treatment Sustained, Prevention Impacted

The Global Fund to Fight AIDS, TB and Malaria released its 2026 Results Report, which positions sustained progress against all three diseases in 2025 despite the decimation of global health foreign assistance and financing. In Global Fund invested countries, the report shows that 26.9 million people received antiretroviral therapy for HIV, which is an increase from 25.6 million in 2024. However, despite sustainability of treatment, the report also documents the effects on prevention where programs were scaled back or suspended altogether in some countries. Notably, the number of people receiving PrEP in Global Fund-supported countries fell from 1.4 million in 2024 to 1.1 million in 2025

IMPLICATIONS: These findings suggest a similar pattern across recent analyses of the global HIV response, including the recent UNAIDS report and latest PEPFAR data. HIV treatment programs have so far proved relatively resilient to the funding pitfalls, while HIV prevention has been much more severely disrupted. AmfAR’s Brian Honerman and co-authors, Jirair Ratevosian, KFF and AVAC’s own analysis of the latest PEPFAR data, all sound the alarm that the front end of the HIV response is weakening.

READ:

• Results Report 2026—Global Fund  
• Despite Funding Cuts, Global Fund Sustains Progress Against HIV, TB and Malaria—Health Policy Watch 
• New report: Global Fund partnership has saved 72 million lives since 2002—Friends of the Global Fight 
• Aid cuts hit disease prevention harder than treatment, Global Fund chief says—Reuters  

Scientists Sue NIH Over Grant Screening Process 

Seventeen US researchers filed a class-action lawsuit challenging a new National Institutes of Health (NIH) grant-screening process that they say unlawfully allows political considerations to override scientific merit. According to the complaint, NIH is using a computational tool to flag at least 235 terms—including “gender,” “health disparities,” “racist” and “climate change”—in new and existing grants, and in some cases requiring researchers to remove or change flagged language before funding can proceed. The lawsuit alleges that the process violates First Amendment protections against viewpoint discrimination as well as federal requirements governing how NIH awards and terminates grants. They are asking the court to halt the screening policy, restore terminated grants and reconsider applications denied under the process.  

IMPLICATIONS: The lawsuit represents a new legal challenge to the Administration’s efforts to reshape federally funded research. Following the mass grant terminations in early 2025, this evolution of political overstep is being played out in a new way. The 17 researchers argue that requiring scientists to remove terms related to populations or subjects they are studying can alter how research is described and, in some cases, undermine its scientific design. Because this lawsuit is filed as a class action, its implications could extend beyond their specific grants and to researchers around the country affected by the screening policy. This new challenge follows AVAC’s lawsuit, which unlocked the payment of millions of dollars of development assistance for work that was done in January and February 2025. 

READ:

• Researchers file First Amendment challenge to NIH grant screening—Science  
• Researchers Challenge NIH Screening of Grants for Disfavored Viewpoints—ACLU  
• NSF memo implementing Trump’s ‘golden age’ of science unsettles researchers—Science  

What We’re Reading

• Offline: The tragic fallacy of global health reform—The Lancet 
• After Global Health: Building the Next Era of Applied Public Health—With & For Substack 
• Honoring the Legacy of the HIV Epidemic—NEJM 
• 90% of LGBTQ+ groups have lost funding since 2025, new report finds—Devex 
• E&C Democratic Leaders Demand Answers from CDC Director Schwartz After Misleading Public on Recent Measles Deaths—Energy And Commerce Committee Democrats 
• HHS is asking what to call vaccine recommendations. You have 4 days to weigh in.—CIDRAP    
• UNAIDS, WHO and Unitaid bring manufacturers and governments together in Geneva as HIV financing enters a new era—UNAIDS  
• An X-File?: State’s Mysterious Plan for Global Health Funding in Mexico—To End A Plague Again…Substack  
• Senate Must Reject Nicole Saphier as Surgeon General, Defend Public Health Urges—Defend Public Health 
• The Doctor Pressuring African Leaders to Own the Ebola Response—New York Times 
• WHO Spots Some ‘Encouraging Signs’ in Congo Ebola Fight—Medpage Today
• Global health agrees on reform. Now, who will give up power?—Devex  
• All things alimatravir (AMI)—AVAC
• Trump settles some UN debts—Devex  
• Kennedy Assures Vaccine Skeptics That They Have a ‘Friend at the White House’—New York Times 

Scientific breakthroughs in HIV prevention depend on community engagement that drives successful research, development, acceptance and uptake of new products. In 2007, emerging from controversies that halted the first ever PrEP efficacy trials, AVAC and UNAIDS led a global partnership to develop the Good Participatory Practice (GPP) Guidelines, offering systematic guidance on how to engage stakeholders throughout HIV prevention trials. Almost twenty years later, GPP is the gold standard for engagement in HIV prevention research and beyond. This edition of the Impact Report celebrates two decades of GPP, and shares how AVAC and our research and civil society partners have effectively integrated GPP into HIV prevention research by:

• Clinical Trial Design Academy: Equipping Advocates to Shape HIV Prevention Research Decisions and Move the Research Agenda Forward
• Using a Transformative Human-Centered Design Approach to Co-Create Communication Materials for the Alimatravir Efficacy Trial, EXPrESSIVE-11
• Embedding Good Participatory Practice in PURPOSE 1

These stories illustrate how meaningful engagement – driven by good participatory practices – strengthens both the research process and the global impact of HIV prevention innovations. 

Clinical Trial Design Academy: Equipping Advocates to Shape HIV Prevention Research Decisions and Move the Research Agenda Forward

As clinical trial research becomes increasingly complex, and as innovative HIV prevention products advance through the pipeline, advocates with dual skillsets – deep contextual knowledge of their community’s needs and scientific and technical knowledge – are increasingly sought after to provide critical community input in research that aligns with GPP and holds researchers accountable.

AVAC’s Clinical Trial Design Academy (CTDA), established in 2019, equips advocates with the scientific knowledge and skillset to influence research – from priority setting to trial design and conduct, to results dissemination. Today, the Academy’s 27 members are highly sought after experts who are directly influencing HIV prevention research.

Using a Transformative Human-Centered Design Approach to Co-Create Communication Materials for the Alimatravir Efficacy Trial, EXPrESSIVE-11

Merck’s EXPrESSIVE program is investigating the efficacy of alimatravir (AMI) for monthly oral PrEP. With support from the Gates Foundation, AVAC works to ensure there is strong, consistent engagement with community representatives to influence the design and implementation of the trials, with an eye toward future rollout and access planning for AMI.  

Leveraging expertise in community engagement and human-centered design (HCD), AVAC worked in partnership with community-based organizations on three continents to co-create communications materials for the EXPrESSIVE-11 trial – conducted among men who have sex with men (MSM), transgender, and non-binary people – that are driven by community perspectives and lived realities. The result is a series of tailored, localized materials designed to foster community interest, awareness, and engagement in the trials and in the novel concept of a monthly oral formulation. This work represents a transformative approach to community engagement in materials development for clinical trials. 

Embedding Good Participatory Practice in PURPOSE 1

AVAC collaborates with partners around the world to embed GPP principles in advocacy strategies and partnerships and cultivates a diverse network of advocates, civil society organizations, journalists, researchers, and implementers who champion GPP and are equipped to engage with and influence HIV clinical trial research.

Gilead’s PURPOSE program investigates the efficacy of long-acting injectable lenacapavir (LEN) for PrEP among diverse populations. For PURPOSE 1 and PURPOSE 2, embedding GPP principles promoted accountability, transparency, and meaningful community engagement throughout trial design and conduct. AVAC staff and network of experienced advocacy partners participated as members of the Global Community Accountability Group (GCAG) helping to shape trial design and implementation, participant recruitment and retention, and discussions about product access.

Merck’s EXPrESSIVE program is investigating the efficacy of alimatravir (AMI) for monthly oral PrEP. With support from the Gates Foundation, AVAC works to ensure there is strong, consistent engagement with community representatives to influence the design and implementation of the trials, with an eye toward future rollout and access planning for AMI.

Leveraging expertise in community engagement and human-centered design (HCD), AVAC worked in partnership with community-based organizations on three continents to co-create communications materials for the EXPrESSIVE-11 trial – conducted among men who have sex with men (MSM), transgender, and non-binary people – that are driven by community perspectives and lived realities. The result is a series of tailored, localized materials designed to foster community interest, awareness, and engagement in the trials and in the novel concept of a monthly oral formulation. This work represents a transformative approach to community engagement in materials development for clinical trials.

Starting with communities

HCD is a participatory, iterative process that centers communities in the development of research, materials, processes, or services to understand and incorporate their perspectives, preferences, and lived experiences into the final product. HCD uses creative participation techniques to fully explore and understand community perspectives, rather than traditional survey methods. The co-creation process to develop the EXPrESSIVE-11 communication materials started before the trial began.

“What was different about this process was the timing”, says AVAC’s Senior Program Manager Kate Segal, who led this work. “We were really thinking about community engagement and awareness raising early on. Normally it happens when the product starts to go to market, but we had community realities shape the materials from before the trial began. Because the insights centered on their holistic lives and lived experiences, they can be a starting point to think about future demand generation much sooner instead of waiting for product rollout.”

The project focused on eight trial countries in three regions: Argentina, Brazil, and Peru in Latin America; Kenya and South Africa in Africa; and the Philippines, Thailand, and Vietnam in Asia. In each region, AVAC partnered with local organizations – Fundación Huésped and Fiocruz in Latin America, Matchboxology and NENDO in Africa, and APCOM in Asia – to engage local facilitators directly from the community who were trained on the methodology and recruited fellow community members for the HCD sessions. This approach ensured that the right participants were reached, fostered trust among participants, and generated more candid and honest insights.

“We partnered with local community organizations so that this work was really rooted in the community in terms of who was facilitating these workshops and how participants were recruited,” says Segal. “Organizations were already working with the focus populations, so they were able to recruit from communities where they already had relationships and trust. Community was front and center throughout the process.”

Partnering with communities, and allowing them to define the process, concept, and design ensured that materials directly reflected the people the study intended to engage. Looking back on the partnership with AVAC, Luciana Kamel, who leads the Community Education Team for HIV studies at Fiocruz in Brazil, said:

“What stood out most to me was the trust in our work and the respect for the process we have developed with the community. That trust gave us the space to build the materials in a way that was grounded in local realities and in the perspectives of the people we were working with.”

Focus group discussion held with community members for co-creation of EXPrESSIVE-11 communication materials

Turning community perspectives into recruitment materials

The process began with small group HCD immersions, or in-depth focus group discussions. These discussions created space for participants to explore how HIV prevention fits within their lives across four domains – Home, Heart, Health, and Hustle – what might make a monthly prevention option relevant to them, and how they wanted their communities to be represented in engagement materials.

“One thing that stayed with me,” recalls Fundación Huésped’s Gastón Devisich, “was how consistently participants pushed us away from images that felt too aspirational, overly symbolic, or disconnected from their everyday lives. They wanted to see themselves — not an idealized version of the community. That meant thinking about much more than gender or sexuality. It was also about body diversity, age, ethnicity, socioeconomic background, and the places and situations in which people actually live, socialize, connect, and make decisions about their health. In Argentina and Peru, this led us to deliberately recreate everyday moments of intimacy and social connection rather than relying on conventional representations of HIV prevention or sexuality.”

Insights from the local immersions informed two global campaign concepts which were then shared with community participants for feedback. After synthesizing feedback from each country and multiple rounds of review, a single global campaign with unified messaging and imagery that resonated with a broad audience was finalized. Then, the global materials were adapted to fit the local contexts of each region and ensure cultural relevance. The adaptations included language translations, visual adaptations, refined messaging, and other design elements that reflected local communities. Given the diversity of the communities represented among the potential EXPrESSIVE-11 trial participants, this was a critical step in the process to ensure local resonance.

Numan Afifi, Senior Policy and Research Officer at APCOM in Thailand, reflected on the value of locally adapting the materials and what it looked like in practice:

“For me, that was the strongest part of the process. The materials felt more relevant because they were shaped by local communities, languages, cultures and experiences. We were able to talk about how people in our own contexts understand HIV risk, stigma, privacy, and what might make a monthly pill feel realistic and useful in their lives.”

The final materials were shared first with EXPrESSIVE-11 trial sites, some of which sought local IRB approval to use as trial recruitment materials, and at the International AIDS Conference in July 2026. With the trial almost fully enrolled, the materials will be used for continued engagement around the trial.

Representation in the final product

This process showcases a practical application of Good Participatory Practice – meaningfully engaging communities in clinical trial design and conduct from the start. Throughout this process meaningful community engagement meant establishing trust and ensuring local ownership of the process.

Kamel shared: “The biggest lesson from this experience was the possibility of developing materials based on our own realities and cultures, without a predefined vision imposed by the funder… Above all, I think the partnership that was established between us and AVAC was fundamental. The trust, openness, and respect for our work with the community made it possible to move beyond simply producing recruitment materials and instead build something that reflected the people and contexts the study was intended to engage.”

In an unexpected outcome, some participants chose to become the faces of the campaign themselves, embodying their call for images to truly look like them and their communities.

Community members who participated in the development of communication materials also posed as models.

As Segal reflected, “A lot of participants opted to be the models in these materials. We didn’t plan it that way, but we really heard that feedback, and they were really excited to participate in that way.”

For Kamel, what made that representation meaningful was when those same participants saw the printed posters at the Global Village during the AIDS 2026 conference: “They were very happy and excited to see themselves represented. For me, that was also an important part of the process: the people represented in the materials could recognize themselves in them and feel that they were part of something they had helped shape.”

The final EXPrESSIVE-11 communications materials

Inclusivity not just in trials, but for product access too

The insights surfaced through the process can serve as a starting point for understanding how communities perceive a once-monthly oral PrEP pill beyond the trial, and what messaging is most likely to support demand generation if AMI is found safe and effective.

At the same time, this experience highlights that meaningful engagement cannot end once community input has been gathered or when the trial is complete. Merck/MSD’s recent voluntary licensing announcement, made while the trials are ongoing, represents a terrific opportunity in preparing for accelerated access to generics, although it also excludes most Latin American and some Asian countries from the voluntary license, reflecting recent roadblocks to accessing other PrEP products.

“I think it is important to be honest about both sides of this experience – how meaningful and powerful the co-creation process was, and also the uncertainty and concern about whether the people and countries who helped build this work will actually have equitable access to what emerges from it,” said Kamel.

Numan adds: “This is why I think community engagement needs to continue beyond the development of the materials. People should not only help shape how a product is introduced; their experiences and demands should also influence decisions around price, access, eligibility, and implementation.”

Kamel and Numan’s concerns highlight what needs to happen next. Creating materials that reflect people’s lives and priorities is valuable, but real-life impact is only achieved if the prevention products actually reach the communities they are meant to serve. Continuing the practice of GPP, intentional access planning well in advance of efficacy results by product developers, funders, advocates, communities, and other stakeholders will be critical to ensuring that meaningful community engagement translates into tangible access and impact.

“I think there is an important lesson in the timing of the process. This was the first time I have been involved in a process where communities were brought in this early to think about communications and demand generation for a product still in development, and that was a significant step forward. … So, while this represents progress compared with the usual timing of community engagement, it also shows how much earlier these processes need to begin if we genuinely want community input to shape implementation rather than simply prepare materials alongside an already-moving trial.” 

Gastón Devisich

Fundación Huésped, Argentina

“Developing these materials was an incredible experience, particularly because we were able to build something that reflected the real face and experiences of the community. As we have discussed in presentations, stigma and where people can actually access prevention are central issues.”

Luciana Kamel

Fiocruz, Brazil

“Overall, I found the process valuable because it built both useful materials and stronger relationships between AVAC and us. It showed what is possible when there is trust, openness, and genuine respect for community knowledge. I hope we can carry that approach into future work… and continue pushing to ensure that the communities involved can actually benefit from the products they helped shape.” 

Numan Afifi

APCOM, Thailand

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HIV prevention research must be conducted in collaboration with the communities it intends to serve; decisions about study design, participant populations and locations, conduct, and future access need to reflect community input. This engagement creates transparency in the process, builds trust, and facilitates future acceptance of trial results. The AVAC and UNAIDS Good Participatory Practice (GPP) Guidelines are a proven framework for early and sustained partnership between advocates and researchers throughout the research process. As clinical trial research becomes increasingly complex, and as innovative HIV prevention products advance through the pipeline, advocates with dual skillsets – deep contextual knowledge of their community’s needs and scientific and technical knowledge – are increasingly sought after to provide critical community input in research that aligns with GPP and holds researchers accountable.

Building a Skilled Network of Advocates to Influence HIV Research

AVAC’s Clinical Trial Design Academy (CTDA), established in 2019, equips advocates with the scientific knowledge and skillset to influence research – from priority setting to trial design and conduct, to results dissemination. Today, the Academy’s 27 members are highly sought after experts who are directly influencing HIV prevention research. Through immersive learning, ongoing skills strengthening, and direct engagement with research teams, product developers and funders, the CTDA has nurtured this growing pool of technically prepared advocates and community representatives who critically review and inform complex trial designs, ask critical questions, and ensure community priorities are reflected in research decisions and protocols.

For Academy members, this continuing education has changed how they engage with both researchers and the communities they represent. Rather than choosing between scientific expertise and community knowledge, they bring the two together; translating complex science for communities while bringing community priorities into spaces where research decisions are made. As one member reflected:

Academy members’ growing influence and technical knowledge is further reinforced through the strength of the CTDA network. The Academy connects advocates with each other as well as directly to the clinical trial researchers, product developers, regulators, and other experts who shape HIV prevention research. As a network of diverse stakeholders with varied experiences, CTDA members can come together to confront technical challenges, share lessons learned, and work together to advance community needs.

Translating Community Priorities into Research Decisions

CTDA members are using their technical knowledge, community expertise, and collective advocacy to not only engage on individual trials, but to define and advance community-centered research priorities for the field. Recently, CTDA members helped shape the development of the People’s Research Agenda (PRA), a community-led accountability framework that assesses the state of HIV prevention research across the pipeline and identifies community-driven priority actions for HIV prevention and vaccine research. CTDA members – and advocates in general – use the PRA to advocate for concrete recommendations, including the inclusion of transgender and non-binary people, people who inject drugs, and pregnant and lactating people; examining interactions with gender-affirming treatment and other medicines; improving adherence support; and building post-trial access, pricing and scale-up planning into research from the outset.

Together, the CTDA and PRA create an upstream engagement mechanism through which community priorities can influence research questions and agendas long before individual trials are designed and implemented. Those community priorities are then carried from the broader research agenda into the design and conduct of individual trials. Building on work pioneered during the PURPOSE trials of injectable lenacapavir, the CTDA participated in the very first consultation of any kind for what became Merck’s EXPrESSIVE program assessing the efficacy of a new monthly oral PrEP pill. Seven CTDA members then participated in follow-up protocol consultations. Because of this early engagement, community recommendations informed protocol development and major trial decisions. Merck has publicly recognized the role of community input, including the selection of daily oral TDF/FTC as the comparator in the EXPrESSIVE program. Their involvement is part of a broader approach to community engagement across the EXPrESSIVE program that has placed advocates at the center of trial planning, and six CTDA members serve on the trial’s Global Community Advisory Board, providing sustained community input as the trial moves forward.

The design and conduct of the EXPrESSIVE trials demonstrate what is possible when technically informed and empowered advocates are engaged early and consistently to inform decision-making. Academy members are also applying their knowledge to other research accountability structures, ensuring community engagement in defining upstream research priorities, informing trial designs, and sustained partnerships throughout trial implementation and product rollout planning. Currently, CTDA members are also represented in the Zambia Community Advisory Platform, the AIDS Clinical Trials Group Community Advisory Board (CAB), the Baylor College of Medicine CAB, FASTER Pediatric and Adolescent CAB, amongst others.

Preparing Advocates for What’s Ahead

Approaches like AVAC’s CTDA matters more than ever today: new and emerging HIV prevention technologies require increasingly complex trial designs, and communities are being asked to weigh in on scientific, ethical, and implementation questions, especially when there are no clear-cut answers. Without the CTDA and broader community engagement mechanisms, HIV prevention research risks becoming less connected to the people it is intended to serve. The field needs trusted mechanisms like the CTDA that prepare advocates to interrogate complex trial designs, identify ethical and implementation risks early, and ensure that scientific efficiency does not come at the expense of relevance, equity, acceptability, or future access. That preparation is ongoing with regular CTDA convenings where members are continuously supported to deepen their technical knowledge and engage with new developments in the field; the next CTDA convening will take place in October 2026. As resources shrink and trial designs become more complex, this combination of technical literacy, community accountability and sustained researcher–advocate partnership is more essential than ever.

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