Tracking HIV Prevention @ AIDS 2018

Welcome to the first in a series of AVAC updates ahead of and during the 22nd International AIDS Conference, which will be held in Amsterdam, The Netherlands, July 23–27.

In this update we highlight some events and activities AVAC and partners are leading on or active in (and hope to see you at!) as well as the sortable HIV Prevention Roadmap of relevant sessions and activities at the conference. To keep up with the latest, bookmark our AIDS 2018 page and check it often for updates from the conference!

HIV Prevention Roadmap

The International AIDS Conference includes hundreds of sessions, side events, marches and meetings—many focused on HIV prevention research and implementation. This Excel sheet allows you to sort by focus; the PDF version has everything mapped out day by day. If there are events that are not on the roadmap but should be, please email us.

Global Village Zones

Research Literacy Networking Zone and HIV Prevention Marketplace
AVAC, in partnership with AfNHi, EATG, NHVMAS, TAG, and Wits RHI, is excited to host the Research Literacy Networking Zone (Booth 523 in the Global Village) at AIDS 2018. The RLNZ brings together advocates, researchers, community educators and local community members to network and discuss ongoing and planned HIV prevention, cure, treatment and implementation research.

This year, the RLNZ is also partnering with the HIV Prevention Marketplace Zone, which is being hosted by a number of seasoned HIV prevention advocates from east and Southern Africa who are Alumni of or currently participants in AVAC’s HIV Prevention Advocacy Fellows program. This Marketplace Zone will be a space where HIV prevention advocates, delegates and community members can come together to network, strategize and have informal discussions on current and future HIV prevention strategies as well as rollout of new interventions. Join us at Booth 525 in the Global Village.

In addition to features like a Help Desk (come with all your questions about prevention research!) and recharging area (for mind, body and devices), there is a robust schedule of events at the Zones. We hope that you’ll include some of the Zone sessions in your plan for the week! Keep an eye on our AIDS 2018 page for the schedule of events.

Pre-Conferences and Satellite Sessions

Click for details on select pre-conferences and satellites that AVAC and partners are participating in!

Stay tuned for additional updates as the conference kicks off!

New Px Pulse is Up With Look at Cure Research

The June episode of Px Pulse is up!

In this episode, researchers and advocates debate the rationale, risks and ethics of interrupting treatment as part of cure research. This is known as analytic treatment interruption or ATI.

AVAC spoke with advocate Udom Likhitwonnawut about when and why treatment interruption might make sense. Two cure researchers—Dr. Steven Deeks and Dr. Dave Margolis—share their differing views on treatment interruption; Deeks is professor of medicine at the University of California, San Francisco, while Margolis leads the Collaboratory of AIDS Researchers for Eradication at the University of North Carolina at Chapel Hill. Finally, HIV advocates Flahvia Namwaya and Moses Supercharger Nsubuga talk about what a cure would mean for those living with HIV.

Listen to this episode to hear the hopes, scientific mysteries and doubts surrounding HIV cure research and ATI.

For the full podcast, highlights and resources, visit here. And subscribe on iTunes to catch every episode!

We Love the Jargon, We Hate the Jargon!

Angelo Kaggwa-Katumba is a Program Manager at AVAC and Kay Marshall is a Senior Communications Advisor.

Scientists spend most of their time in laboratories or classrooms, in clinics or at conferences, in front of computers or wherever their field of specialty takes them.

The two of us have worked in the biomedical HV prevention field for more than three decades combined. Over the years, we’ve seen how so many scientists we know prefer to remain far from the spotlight—especially the media spotlight.

“They don’t get it,” one researcher said to us of journalists at a recent conference. “They always misrepresent my facts so I stay away from them,” we heard from another.

For their part, journalists have shared their own complaints about dealing with scientists as sources.

“Scientists speak in tongues to sound smart. Why would anyone say ‘end-user’ when she can simply say ‘someone who takes aspirin’?”

But journalists and scientists need each other if the public is going to understand the importance of research and support it. Opportunities are rare for them to meaningfully interact with each other.

To bridge the gap between scientists and the media, and to enhance knowledge and appreciation of each group’s role in biomedical HIV prevention and rollout, we, along with other AVAC team members, have conducted workshops for editors, scientists and civil society. We have convened media trainings in Eastern and Southern Africa and at major conferences; provided support to global communications experts; and over the past four years, initiated the media science cafés program in key countries in Eastern and Southern Africa. These provide a less formal space for interactions among journalists, scientists, civil society and research communities.

These programs are a crucial link.

At a symposium in April, organized by AVAC and Internews in Gaborone, Botswana, we were reminded that advocates are instrumental to making these connections and helping them to thrive.

At the Avani Hotel on the outskirts of Gaborone, about 30 people gathered in the intimate dining room reserved for private dinners. Most of them were health journalists from one of seven Southern African countries where biomedical HIV prevention research or implementation is underway. Journalists were from Botswana, Malawi, Mozambique, South Africa, Tanzania, Zambia and Zimbabwe. Seasoned journalists from Kenya and Uganda also joined to share their experiences and expertise in covering the field. Also in attendance were a couple of scientists and policy makers, and a handful of HIV prevention advocates representing civil society organizations from these same countries.

The journalists were there to learn about the research taking place in their own backyard and how it was connected to sister studies across the region. It was also an opportunity for the journalists to interact with the scientists conducting the research and gain the kind of knowledge they need to share this amazing science in language that is clear and compelling to their audiences at home.

We know that failure to make these connections represents a risk in itself. If you asked us, we can’t think of a time when there was more biomedical HIV prevention research in the region, or even globally, and each of these countries is deeply immersed in different aspects of it. More than 573,000 research participants in Africa (representing about 82 percent of the global total) are involved in research on HIV vaccines, microbicides, pre-exposure prophylaxis, HIV cure, HIV treatment, multipurpose prevention options, antibody-mediated prevention and hormonal contraceptives and HIV risk, among other areas. Far too often, local and national health journalists may not even know this research is underway, or their editors don’t grasp the significance of these stories in their communities. The public cannot support this work if it doesn’t know it exists. Even worse, poorly reported pieces may lead to fear and misjudgment, or, as we’ve seen in some places, stop important research from starting or continuing.

Educating journalists about the value of research through accessible, accurate stories, that inform and provide context, is vital.

A trip to Botswana Harvard Partnership is a case in point. Generally, access to the spaces where scientists work is restricted. In part, this is to protect the privacy of research participants. As part of the April symposium, researchers opened their doors to their world-class laboratory and clinical trial site. Some of the journalists had never visited a clinical-site laboratory, or any laboratory for that matter. Peering into a state-of-the-art industrial freezer holding 20,000 samples of material such as blood, urine, tissue, cells, DNA and protein among others, at minus 100 degrees, the journalists learned about the scientific questions under investigation from the researchers working with these samples. Some of these questions included: whether a combination of HIV prevention measures could significantly reduce the number of new HIV infections within a community; whether antibody infusions are safe and could prevent HIV infection; and what is the burden of hepatitis B infection among pregnant women.

They journalists learned how this work will inform other studies going on throughout the region.

“It now makes sense,” said Malawian Journalist, Chimwemwe Padatha.

“For me, seeing this makes the science more credible, more real,” added Botswana journalist Mmapula Molapong.

But those terms listed above—microbicide, pre-exposure prophylaxis and the like—they represent one of the challenges. It’s both essential and difficult to break down the jargon. Journalists who understand the science, and the context around it, report more and better stories, deepening public trust and interest.

Gathered around several dining tables pushed together, notebooks out, PowerPoint slides up on the screen, the journalists struggled to follow one scientist as she gamely made a first attempt at explaining the basics of research on broadly neutralizing antibodies. Looking at the faces around the table, some distracted, some frowning, most curious, an advocate from Botswana, Kennedy Mupeli said, “Can I help?”.

Mupeli had just completed his one-year AVAC Advocacy Fellowship and had also just been to the 2018 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston in March, and steeped himself in this research.

“You or maybe your children have probably received fluids for dehydration via a syringe or IV, right? Now, imagine receiving the same IV but with fighter cells that protect your body from any sub-type of HIV.”

That’s the handy metaphor Mupeli used to make sense of a key prevention concept, which transformed a few frowns. The scientist nodded. She added a few details and continued to build off of Mupeli’s contribution, adopting less technical language modeled by Mupeli. The journalists leaned in to learn more. Later in the week, a whole session on the agenda was dedicated to the use and misuse of jargon, hence the birth of the most famous phrase at the symposium, “We love jargon, we hate jargon!”

Later in the session, a Zambian advocate, Chilufya Kasanda, showed how advocates hold a broad and deep level of knowledge about the context of research. She summarized the HIV prevention research ongoing in her home country. She could tell them the status of access to PrEP at trial sites in Zambia. She also explained the issue surrounding questions of standard of care at trial sites and why it’s generating debate among advocates and the research community right now.

Researchers tend to focus on their own studies. It’s not their job to maintain a bird’s-eye view on the whole landscape of HIV prevention. But the advocates know the science, they know the scientists, and they know the community.

The policy makers, scientists and journalists in the room took notice.

As the meeting concluded, Mupeli found himself surrounded by a group of journalists from Botswana. They wanted to start a coalition of health reporters, inspired by their counterparts in Kenya, Uganda and Zambia. Through the media science cafés, these journalists meet with advocates and scientists to network, get updates on research and implementation and spur each other on to better reporting. They share sources, learn new scientific concepts and talk craft.

Could Mupeli help them get this launched, they wanted to know. “I’m all yours,” said Mupeli.

We’ve since learned that the group, with Mupeli’s stewardship, had their second meeting early in June at the Botswana Harvard Partnership laboratory, a venue Mupeli secured through his links to them. A coalition has been formed and they are working on a plan to secure funding. Mupeli said, “But as we wait for the funds to come, we’ll do what we can with the resources we have: ourselves.”

May Episode of Px Pulse Podcast: HIV vaccine science, research, updates and advocacy

Check out the newest episode of Px Pulse on iTunes or at www.avac.org/px-pulse!

With HIV Vaccine Awareness Day (HVAD) in the spotlight earlier this month, AVAC’s May episode of Px Pulse features four experts steeped in HIV vaccine research. Together they help set expectations for where the field is now and where it is going.

Dr. Larry Corey, who leads the HIV Vaccine Trials Network (HVTN), explains how the AMP studies, HVTN 702 and HVTN 705 will each, in different ways, advance what the field knows about how to develop a vaccine for HIV.

Then, IAVI’s Dr. Kundai Chinyenze talks about efforts to ready for possible success, so that new tools work in the real world as well as they do in a clinical trial.

And two deeply experienced advocates, Bill Snow and Matthew Rose, talk about engaging with the science and preparing for research results.

For the full podcast, highlights and resources (including AVAC’s newest HIV Vaccine Awareness Day toolkit), visit here. Subscribe on iTunes to catch every episode!

HIV Vaccine Awareness Day 2018: Tools & more

HIV Vaccine Awareness Day, May 18, commemorates the vital and ongoing work to develop a vaccine against HIV. This work advances because of the ingenuity, courage and commitment of trial participants, host communities, funders, scientists and advocates. AVAC salutes the collective trust and sustained dedication to end the epidemic.

2018 is marked by great advances in research and important opportunities for advocacy. In addition to a host of tools AVAC updates annually to keep you current on this front, The Rise of Broadly Neutralizing Antibodies by AVAC founder and former Global HIV Vaccine Enterprise executive director Bill Snow offers a comprehensive look at antibody mediated prevention and its connection to vaccine research.

In case you missed it, check out the recording and slides from the May 17 webinar featuring Dr. Sandhya Vasan’s discussion on the legacy of RV144 and vaccine advocate Mark Hubbard’s take on today’s agenda for HIV vaccine advocacy.

The complete set of AVAC’s HVAD resources includes:

And add to the conversation on social media at #HIVvaccineAware and #HVAD2018.

The Rise of Broadly Neutralizing Antibodies

Bill Snow founded AVAC and is the former Global HIV Vaccine Enterprise Executive Director.

Research on broadly neutralizing antibodies (bNAbs) is taking the field of HIV prevention science in new directions, with implications for new prevention interventions and vaccine development. There’s much to know and much to learn about these powerful instruments of the immune system.

Since 2016, more than 2,700 men in Brazil, Peru, Switzerland and the US, and 1,900 women in Southern Africa have begun to enroll in clinical trials looking at antibody-mediated prevention, or AMP (see Figure 1). A collaboration between the HIV Prevention Trials Network (HPTN) and HIV Vaccine Trials Network (HVTN) (both funded by the National Institutes of Health), the AMP studies test the safety and efficacy of the broadly neutralizing antibody (bNAb) VRC01 when it is given every 8 weeks to reduce the risk of HIV infection. But how did this approach come about, why is it important and what may happen next with bNAbs for HIV prevention?


Click to enlarge.

What’s an antibody?

Antibodies are Y-shaped proteins produced by B cells to clear infected cells and pathogens in the bloodstream. B cells are part of what is known as the adaptive immune system, which mounts defenses aimed at specific invaders—like a cold virus or chicken pox or HIV. The innate immune system also defends against invaders, but its defenses are not so finely tailored to a specific pathogen. When a virus encounters the right B cell, the B cell begins cloning itself and produces antibodies designed to battle that virus. These antibodies circulate throughout the body looking for the virus, and they evolve continuously, becoming ever more precise and numerous.

The Antibody Hierarchy

Here are some terms that will help you follow this ongoing story:

  • Antibody: Proteins produced by B cells as a major part of the adaptive human immune defense against specific invaders.
  • Binding antibody: An antibody that attaches to a virus but doesn’t necessarily render it ineffective; can be driven by the innate immune system.
  • Monoclonal antibody: A bioengineered antibody made in a manufacturing facility by copying (cloning) one original antibody—selected for its potency and other characteristics.
  • Neutralizing antibody: Antibody that disables virus.
  • Broadly neutralizing antibody: An antibody that neutralizes many different genetic variants of HIV.
  • Passive antibodies: A dose of monoclonal antibodies that are infused or injected, rather than made by one’s own immune system.

HIV Vaccine Awareness Day: In May 2018, the story is…

HIV Vaccine Awareness Day (HVAD), May 18, is just a week away. Today, we’re bringing you AVAC’s annual HVAD Toolkit, a new advocacy resource—The Story Is…, and our HVAD webinar announcement!

AVAC’s HVAD 2018 webinar, to be held on Thursday, May 17, 9am ET, will tell the current story of HIV vaccine research from two perspectives. Dr. Sandhya Vasan of the Military HIV Research Program in Thailand will give her take on the world of HIV vaccine research since RV144: from where have we come, and where are we going? Mark Hubbard, a seasoned vaccine advocate and community representative for HIV research in Nashville, Tennessee will tell the story from a community and advocacy perspective: what are today’s current successes and challenges, and how are community members pushing the HIV vaccine agenda? Register now.

We’re especially excited in this year’s HVAD Toolkit to bring you a set of infographics that explain key aspects of vaccine research—trial participant and enrollment numbers, global funding, trials timelines, and more. We also have updated versions of old favorites you’ve come to expect each year, all available online at www.avac.org/hvad.

So, what is the story this year for HVAD? The story is the science, with an unprecedented level of vaccine and antibody clinical activity underway. But it’s not only the science—there are other important stories to tell as well, about global support for vaccine research in a time when there are many priorities in HIV prevention, and about stakeholder engagement in the current trial context. AVAC is publishing a special advocacy document, The Story Is…, which explores all this with an eye on primary prevention and the central role that research must play in it. Download it here.

As always, AVAC hopes these tools prove useful for HVAD events in your communities around the world. We know many of you are hard at work for HVAD, and we can’t wait to hear your stories, too.

New Issue! Px Wire: The prevention question cascade

In the new issue of Px Wire, AVAC gives our take on this year’s PEPFAR process for establishing the Country Operational Plans (COPs). These plans define what work will be done with PEPFAR money at the country level and how that work will be evaluated in each of the 63 countries that receive PEPFAR money.

The process has changed considerably since last year, allowing for deeper insights into what’s working and what’s not. In this issue, AVAC takes you through the good and bad of PEPFAR’s emphasis on index testing, analyzes crucial gaps in combination prevention, and lays out a series of questions to shape a powerful agenda for advocacy.

This issue’s centerspread takes a closer look at Zimbabwe’s data, and highlights amfAR’s detailed country factsheets that draw from PEPFAR’s giant data sets. Additional tools and information on influencing the COPs process are available from COMPASS partner Health GAP’s PEPFAR Watch.

Find the full issue Px Wire and the archive of past issues at www.avac.org/pxwire.

Px Pulse Podcast: From the trenches, advocates share their prevention priorities

Check out the April episode of Px Pulse on iTunes or at www.avac.org/px-pulse!

We bring you two different conversations, each throwing a spotlight on different aspects of HIV prevention advocacy today.

AVAC’s Manju Chatani-Gada talks with three advocates who attended AVAC’s African Advocacy Partners’ Forum in Johannesburg, where seasoned and new advocates came together to look at prevention priorities from every angle. In this discussion, you’ll hear how the forum brought key issues into focus and how these advocates are sharpening their strategies.

Then we turn to a global effort to accelerate prevention.

Christine Stegling, the head of the UK-based International HIV/AIDS Alliance joins us to talk about a new initiative led by UNAIDS and UNFPA to escalate and maximize HIV prevention in the 25 countries with the biggest number of new HIV diagnoses. Dubbed the Global HIV Prevention Coalition, we talk with Christine about how to know if it’s living up to its name.

For the full podcast, highlights and resources, visit here. Subscribe on iTunes to catch every episode!

Post-CROI Roundup and Webinar Series

[UPDATED: slides and audio from the webinars now available.]

The annual Conference on Retroviruses and Opportunistic Infections featured over 4,000 researchers, advocates, implementers—and a couple big snowstorms—along with a range of scientific findings of great interest to prevention advocates.

Join us to dig into the data with researchers and discuss with fellow advocates how these findings can inform our advocacy work moving forward.

Webinar Series

We will be adding additional webinars over the next couple of weeks, so please do stay tuned for additions to the schedule!

Conference Coverage

We’ve rounded up a selection of conference highlights, which are posted on our P-Values blog—check out it here!

For comprehensive coverage of the conference check out the excellent work from aidsmap. Resources from the UNAIDS and WHO co-organized update to staff and beyond on the Latest HIV science from CROI 2018 are now accessible.

CROI Program and Webcast

CROI provides a number of ways to review what happened in Boston: check out the full program; abstracts and e-posters; and webcasts of all sessions.