This Week! Webinars on Mosaico Study and Trans Manifesto

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

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

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

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We look forward to virtually connecting soon!

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

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

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

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

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

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

AVAC’s statement on the Mosaico trial

Years Ahead in Biomedical HIV Prevention Research (Detailed)

Years Ahead in HIV Prevention Research (Simple)

A Review of Pipeline of New HIV Prevention Options

A Vaccine Factsheet

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

Mosaico HIV Vaccine Study Stopped Early for Non-Efficacy

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

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

Read the Janssen Pharmaceutical Company press release.

Read the HVTN press release.

Read the AVAC press release.

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

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

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

AVAC Launches the Advocacy Navigator!

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

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

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

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

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

Find the application and additional information at AVAC.org/navigator.

A Year of Action in 2023

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

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

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

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

Access Access Access

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

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

Funding: Innovation and Expansion

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

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

The Research Pipeline

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

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

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

People Centered Advocacy

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

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

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

Key Dates for January and February

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

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

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

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

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

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

Translating, Advocating and Catalyzing for HIV Prevention and Equity in 2022 & Beyond

This year was an incredible one of reflection, engagement, opportunity, and action. More than 40 years into the HIV epidemic – and in the midst of multiple other pandemics and persistent inequities – AVAC and its partners continue to reshape, reimagine and fight for effective HIV prevention.

We began 2022 with a new strategy reflecting an evolving field and critical opportunities for HIV prevention and for global health:

  • Research is accelerating, with more options available than ever before. But progress toward crucial targets has been far too slow, and these biomedical options are not yet real choices for the people who need them.
  • COVID accelerated science, but significant gaps in access underscored the necessity for smart, equitable, and people-centered pandemic preparedness, prevention AND response.
  • And a global movement for social justice continues to demand that we all reexamine critical questions of equity, including health equity.

As we close out the year, we’ve been asking ourselves, how have we done? And the answer, we hope, lays the foundation for bold action in 2023 and beyond.

Thanks to an incredible partnership network and committed donors and collaborators, I am proud to say that we’ve made significant progress. But, as Tony Fauci reminded us all last month when he and I had a chance to chat about history AND the future, “much accomplished; much more to do.”

In all that we do at AVAC, we keep three aims in mind. Track and translate the science so the research enterprise and the communities who need prevention most are working hand in hand. Advocate for evidence-based, high-impact, community-centered programs, products and policies. And catalyze the relationships, partnerships, coalitions, advocacy agendas, joint commitments and action plans that get it all done.

Here’s a look at just some of the work we’ve done to advance all three in 2022.

We served as a bridge between the scientific field and communities where research happens.

We deepened our investment in supporting the next generation of skilled and informed advocates with the belief that advocacy and action must be founded on principles of power-sharing.

  • Developed and continuously track our Plan for Accelerating Access and Introduction of Injectable CAB for PrEP to ensure time is not wasted and opportunity is not squandered, and importantly, that civil society plays a meaningful role.
  • Supported the African Women’s HIV Prevention Accountability Board and our CASPR and COMPASS partners in meeting with global leaders, including Winnie Byanyima of UNAIDS, Amb. John Nkengasong of PEPFAR and Atul Gawande and Han Kang of USAID, to make the urgent case for faster and more equitable access to both the dapivirine vaginal ring (DVR) and injectable cabotegravir – and to listening to and engaging with civil society before making decisions.
  • Welcomed the 12th class of the flagship Fellows Program with 8 new Advocacy Fellows working on access to the DVR, U=U campaigns, and integrating SRH with HIV services.
  • Established CureROAR to support a cadre of advocates to gain knowledge in the science and process of cure research, and to develop an advocacy agenda to ethically advance cure research.
  • Introduced The Choice Agenda (TCA), a global forum for advocacy on HIV prevention, with agenda-setting conversations, deep-dive webinars on key issues in the field and moderated passionate, highly-informed discussions with 1,000 advocates and experts across the field.
  • Launched an advocacy campaign with PrEP4All and other partners to ensure the US National PrEP Program reaches those who need prevention most – with a huge year-end victory this week when the US Congress included as part of its fiscal year 2023 budget a call for the Centers for Disease Control and Prevention (CDC) to expand equitable national PrEP access in order to end the HIV epidemic!

We expanded our work to cultivate and sustain dynamic partnerships that set a bold and innovative agenda for HIV prevention.

Yes, together we’ve been able to do so much this year. But there remains a long, unfinished agenda for all of us in 2023 and beyond, that no one organization can address alone. The challenges ahead can only be defeated by building global solidarity, sharing responsibility and accountability, and mobilizing a response that leaves no one behind.

Thank you to all of our partners, AVAC staff, board, donors, and the remarkable individuals and organizations around the world who allow us to continue this critical work as part of a comprehensive and integrated pathway to global health equity.

In solidarity and with enormous gratitude,

Mitchell Warren and all of us at AVAC

P.S. We are grateful for all forms of support and partnership. If you can, please do consider a financial contribution to AVAC to help keep this work moving, together.

AVAC Fellows Took Charge on World AIDS Day

World AIDS Day is a day to remember and reflect, but it can also be a day to intensify advocacy, which was the case for many of our 2022 AVAC Advocacy Fellows.

From broadcast interviews, to an open forum on religion and sexuality, to a symposium attended by the Prime Minister of Lesotho, AVAC Fellows took World AIDS Day to task with a day of conversation and advocacy. Check out highlights from the day below.

Ruth Akulu, who is hosted at ICWE/EA in Uganda, took on several broadcast interviews including Radio City and UBC TV to share perspective as someone living with HIV and to discuss the latest advances and opportunities in HIV prevention. These media appearances were supported by the Uganda AIDS Commission.

Pictured: Ruth Akulu and Radio City staff.

Onward Chironda, hosted by GALZ in Zimbabwe, organized a media cafe to launch a series discussing religion and sexuality, featuring religious leaders and members of the LGBTQ+ community. Read more about the event here.

Pictured: Reverend Maxwell Kapachawo in “Digital Conversation on: RELIGION, SEX & SEXUALITY”

Catherine Madebe participated in a panel discussion with the US Ambassador to the United Republic of Tanzania, Donald Wright, as they discussed youth priorities and challenges in HIV prevention and gender-based violence. Catherine offers perspective on where prevention is in Tanzania here.

Pictured: Catherine Madebe (second in on right) with Ambassador Wright and community members and PEPFAR leaders.

Prince Mikel Juao, hosted by Lesbians Intersex Trans and other Extensions (LITE) in Malawi, organized an event in Mzuzu to educate communities on new HIV prevention technologies such as injectable CAB for PrEP, the dapivirine vaginal ring, and HIV self test kits.

Pictured: A healthcare worker demonstrating how to use an HIV self-test kit.

Natasha Mwila and her host organization, The Network of Zambian People Living with HIV/AIDS (NZP+), commemorated World AIDS Day by distributing condoms and sharing information about additional HIV prevention strategies.

Pictured: Natasha Mwila (second in on right) and The Network of Zambian People Living with HIV/AIDS (NZP+) staff.

Pictured: Clever Chilende (2012 fellow), Esnart Sikazindu (2020), Chilufya Hampongo (2016 fellow), and Natasha Mwila (2022)

Peter Katleho Ntheri and his host, Lesotho Network of AIDS Service Organization (LENASO) collaborated with the National AIDS Commission and other AIDS-service partners for a World AIDS Day symposium in recognition of the community’s progress in ending the epidemic. Lesotho Prime Minister Sam Matekane attended this event!

Pictured: Lesotho King Letsie III and Prime Minister Sam Matekane attending the Lesotho Network of AIDS Service Organization symposium with LENASO Executive Director Mamello Makoae.

Elizabeth Atieno Onyango, who is hosted by the Coast Sex Workers Alliance in Kenya (COSWA-Kenya) collaborated with organizations such as Reachout Center Trust and HIV/AIDS People Alliance (HAPA-Kenya) to voice concerns around the lack of HIV prevention options in their communities. Their main message was saidia usiadhibu which means “support, don’t punish” in Swahili.

Pictured: Elizabeth Atieno Onyango at a World AIDS Day event in Kwa Khanyayo, Kenya.

Liyema Somnono hosted by Passionate Unlimited Peers in Action (PUPA) with the help of both government and non-governmental organizations hosted a World AIDS Day event in a hard-to-reach rural area called Kwa Khanyayo where community members were offered clinical services and HIV education. Liyema shared information on the dapivirine vaginal ring and held a Q&A session on PrEP.

Pictured: Community members in Kwa Khanyayo receiving HIV-related services and education.

To learn more about the AVAC Advocacy Fellows program and the work and achievements of our 2022 class as well as the past 11 years of Fellows, visit the AVAC Fellows page.

The Choice Agenda: 1000 Members Setting the Agenda

The Choice Agenda (TCA), a global forum for advocacy on HIV prevention, is just a few new sign ups away from the 1,000 member mark!!! It’s a milestone reminding us of what the TCA has achieved in such a short time, with agenda-setting conversations and deep-dive webinars on key issues in the field and a full program to come in 2023.

Since its launch earlier this year, The Choice Agenda has hosted monthly webinars and moderated passionate, highly-informed discussions with advocates and experts across the field. The Choice Agenda program, and all of its participants, representing over 40 countries, takes on a wide range of topics. Together, the TCA community drills into critical choices, including the need for short acting, non-systemic, user-controlled options, and a wide range of tailored implementation strategies that must define advocacy, the HIV response, and global health equity at large. Participants are also provided with links to a curation of exceptional resources to support further education and advocacy.

All these conversations and resources are here for you to follow, in the TCA archive of listserv discussions and webinar recordings, including:

● “PEP Needs Some Pep! Addressing PEP Neglect in HIV Prevention Research, Programming and Uptake” (Recording/Resources)

● “Doxycycline for STI prevention: Evidence and Current Research” (Recording/Resources)

● “RINGing the Bell for Choice: Actions and Solutions on Dapivirine Ring Access” (Recording/Resources)

● “Faster, Smarter and More Equitable – Accelerating Roll Out and Uptake of CAB for PrEP” (Recording/Resources)

● “The Research Says Yes, YES, YES – Just Like That”(Recording/Resources)

● “Efficacy is Not the Only HIV Prevention Attribute that Matters – Lessons from Contraception” (Recording/Resources)

Join the listserv to access the archive and participate in the discovery and debate of ongoing and emerging topics. And don’t miss the final TCA program of the year: More than Vessels: Pregnant people deserve inclusion in HIV prevention clinical and implementation research on Wednesday, December 14, 2022 at 9:00am-10:30am ET; 1:00pm-2:30pm GMT. Register Here

We’ll be announcing the 2023 TCA kickoff webinar shortly, which will include a series of convenings and webinars before and during February Conference on Retroviruses and Opportunistic Infections (CROI), including the beloved Margarita Breakfast Club offering daily research updates, all available whether you are attending the conference or not.

You won’t want to miss a thing!

PLOS Publication Correlates Key Policies with PrEP Uptake

New research published in the journal PLOS today from AVAC and COMPASS partners shows the importance and value of an enabling policy environment to increase the uptake of HIV prevention services, including for PrEP.

Using data from 194 countries gathered by the HIV Policy Lab and AVAC’s Global PrEP Tracker, the team analyzed the impact of a series of policies: broad PrEP eligibility, HIV self-testing, and lowered age of consent to HIV testing and treatment services. Each was found to be correlated with increased PrEP uptake. The results show:

● A significant and positive correlation between countries authorizing HIV self-testing and cumulative number of PrEP initiations in-country.

● A significant and positive correlation between countries authorizing lowered age of consent to HIV testing and treatment and cumulative number of PrEP initiations.

● Similarly, and not surprisingly, policies authorizing broad PrEP eligibility also show significant and positive correlations with PrEP uptake.

These findings suggest that HIV self-testing is a vital step towards increasing access to PrEP, and support existing evidence that HIV self-testing serves as a gateway to PrEP uptake. They also suggest that young people may be motivated to access PrEP and that countries with policies that expand PrEP eligibility may see a strong benefit, with greater adoption of PrEP by people who need it. With these findings in mind, it’s vital to remember that inequities in PrEP access across populations and settings, based on complex social factors such as stigma and discrimination, can begin to be addressed by enabling policies, but require comprehensive strategies that build on that environment. The right policies cannot do the job alone. Community leadership in every aspect of the HIV response from local to national and to international levels is needed.

Read the full publication here: Correlations Between Oral Pre-Exposure Prophylaxis (PrEP) Initiations and Policies that Enable the Use of PrEP to Address HIV Globally.

Domestic Resource Mobilization (DRM) Learning Collaborative – Save the Date!

Coming off World AIDS Day, we are reminded of the importance of robust domestic investment in all aspects of the HIV response, including research and development (R&D), to see an end to the epidemic and build sustainable systems for health. This Thursday, December 8 at 15:00 PM EAT / 14:00 PM SAST/ 13:00 PM WAT / 7:00 AM EDT marks the launch of the inaugural Domestic Resource Mobilization (DRM) Learning Collaborative.

The collaborative builds on work with our partners in both the COMPASS and CASPR programs and will be a facilitated virtual space that brings together global health advocates, civil society organizations and other key stakeholders from Africa to engage in peer-to-peer learning and collaboration. We will explore priority topics, including: local investments in HIV services and other health infrastructure; pandemic preparedness; and research and development (R&D). And we will use the time to explore opportunities and frame what questions must be answered to develop a unifying advocacy agenda. This comes exactly a month after Africa Health Week where over 80 community members and leaders came together online each day to reflect on lessons learned and best practices in health R&D.

You won’t want to miss this opportunity to build on what was learned and brainstorm with community leaders and advocates on ways to advance health R&D investment in Africa.

Save the date and register here!