Getting Set to Defend and Advance Sex Workers’ Rights in 2017 and Beyond

Lindsay Roth, MSSW is a long time community organizer working with people who use drugs and sex workers. Lindsay is now with the Woodhull Freedom Foundation, a Washington-D.C-based NGO that works to affirm sexual freedom as a fundamental human right. She also organizes with the Sex Workers Outreach Project-USA, a collective of sex workers and allies committed to ending stigma and violence towards those in the sex trade.

Everyone’s worried about the dangers that lie ahead. Is there any good news from 2016?

Well, yes. California voters said “No” to Proposition 60 (Prop 60) this past Election Day, a controversial law that, if passed, would regulate the use of condoms in the porn industry. As stakeholders in the fight against HIV, we should celebrate this victory. We recognize the effort behind this proposed law is but one instance in a systemic disenfranchisement of people in the sex trade, both globally and nationally. And all too often, initiatives like this one are backed by NGOs who claim to serve them but actually do more than good.

In the case of Prop 60, the AIDS Healthcare Foundation (AHF), under the leadership of Michael Weinstein, poured millions of dollars into lobbying for the proposed law, which would have undermined health, safety and self-determination of porn performers. And Weinstein has funded other anti-sex initiatives. In 2012, AHF funded the campaign for Measure B, which called for mandated condom use and eye protection (e.g., goggles—yes, goggles) to protect from bodily fluids on set. California’s Prop 60 would have gone further, encouraging costly and invasive lawsuits against anyone financially tied to a porn production if the condom rule was violated. Weinstein’s work is driven by sex-negative values, and a blatant disregard of science, and other NGOs claiming to serve the interests of sex workers are just as suspect.

Instead of legislating, mandating and criminalizing people over condom use, sex workers need strong worker rights. They need respect and they need access to healthcare. Real HIV prevention depends on sex workers being able to access a range of options from PrEP and condoms to testing and treatment. With that access sex workers can fully protect their health and their human rights.

Stigma against sex work is at the heart of anti-sex worker legislation like Prop 60, Measure B and other problematic legislation that not only makes sex work more dangerous, but drives funding and attention from one of the key drivers of the global HIV crisis: economic inequality. Instead, laws like Prop 60 keep coming.

Prop 60 is a variation on an old theme. It basically expanded on Measure B for all porn production in California, which was voted down by Occupational Safety and Health Standards Board after protests by adult film performers. Prop 60 went beyond mandatory condoms and eye protection and has a number of statutes that put individuals at risk. The sex worker-led site, Free Speech Coalition, articulates the dangers of Prop 60 in detail.

In short, Prop 60 mandated that condoms are visible in every scene of pornographic films made in California—even homemade movies. It would have given all California citizens the ability to sue anyone who has a “financial interest” in the film if the condom rule is violated. Pro-Prop 60 campaigners said this would have held producers accountable for dangerous working conditions for performers, however activists worried this vague language would make performers, especially independent performers who often are also producers, vulnerable to expensive and invasive lawsuits. Prop 60 would have incentivized lawsuits by allowing civilians to profit from them, and made public the legal names and personal information of porn actors in the process of conducting those suits. Additionally, state employees from the Occupation Safety and Health Administration (OSHA) would be paid to watch porn films and ensure condoms are being used. Beyond continuing an anti-sex, anti-worker campaign, this bill, authored under Weinstein’s direction, included a clause requiring the state of California to hire Weinstein to take over enforcement efforts if he determined state efforts were insufficient.

Regulation of the pornography industry is one issue—what are some others?

Michael Weinstein and AHF are but one example of seemingly infinite attacks on the work, lives and safety of sex workers under the guise of helping them. I confronted this often as the Director of Project SAFE in Philadelphia, a peer-led harm reduction organization that provided direct services to women working in underground economies. We worked with the Coalition of Labor Union Women to fight PA HB262, a bill that would mandate a registry of exotic dancers including their eye color, tattoos, home address and personal history of victimization. The work of Project SAFE and many other sex worker-led organizations remains underfunded, as the struggle for the basic human rights, health and safety of people in the sex trade is so often dominated by a “Rescue Industry” that neither understands nor respects our lives and labor.

The “rescue industry” generates hysteria, pulls money from sex worker advocacy and increases HIV risk

Local Republican leadership worked with the Pennsylvania Family Institute, a Christian organization that fights for “traditional” marriage, to create HB262. They claimed it was an effort to “fight human trafficking” as well as reduce HIV and other health risks for exotic dancers. There is no evidence that registries can accomplish any of these goals. But they do put sex workers at greater risk of experiencing violence and exploitation by exposing personal information of a stigmatized workforce. The publication of sex workers’ personal information has led to stalking and “outing,” such as in Seattle, where exotic dancers brought legal action to stop a local court from releasing information to serial offender, Robert Hill. Porn performers in California worried the same would happen to them.

How do these US issues relate to global developments?

Legislation like this laws described above is typical of a global trend. “Anti-trafficking” organizations pressure governments to pass laws that make sex work more dangerous, often in the name protecting people in the sex trade, including victims of human trafficking. The “rescue industry” includes professionals, policy makers, religious leaders and advocates who seek to abolish the sex industry by regulating or criminalizing it out of existence. Most notoriously, the Somaly Mam Foundation, like AHF, used lies to generate hysteria and significant income for its founder, Somaly Mam. Watch-dog groups and journalists have investigated Somaly Mam for an array of abuses including misidentifying sex workers as victims of trafficking, and receiving big sums from donors while doing very little to empower sex workers to lead free and independent lives.

Indeed, saving sex workers, voluntary or trafficked, has become a cause célèbre. But the “rescue industry” often creates more chaos, suffering and stigma for sex workers. The recent proliferation of anti-sex worker organizations has displaced successful sex worker-led programming and interrupted efforts in HIV treatment and prevention, among other important initiatives. For instance, the Young Women’s Empowerment Project in Chicago, a direct service and anti-violence organization for youth of color with ties to the sex trade, lost critical funding to the misleading “end demand” campaigns. “End-demand” campaigns lobby to increase criminal charges for people accused of patronizing sex workers (catchphrases include “no demand, no supply”. Advocates for sex worker rights oppose this type of legislation.

Researchers at DePaul University in Chicago found that end-demand legislation empowered law enforcement to disproportionately profile and arrest Black and Latino men. They also found transgender women accounted for an alarming 10 percent of all arrests during this campaign, suggesting sex sellers were misidentified as sex buyers. Transgender women had their photos, government names and home addresses published in local newspapers as a part of a “John” shaming campaign. This tactic is humiliating and disruptive to anyone’s life, especially transgender women, who are disproportionately the target of violent crimes.

Certain funding policies from the US President’s Emergency Plan For AIDS Relief (PEPFAR) provide yet another example of anti-sex work policies driving funding away from sex workers’ self-advocacy. Despite being found unconstitutional by the US Supreme Court, the Anti-Prostitution Loyalty Oath, established in 2003, forces global recipients of PEPFAR funding to actively oppose prostitution. Efforts to criminalize sex work contradict recommendations from the World Health Organization, the World Bank, the Lancet, Amnesty International and many others, which call for the decriminalization of sex work as fundamental to the human rights of sex workers and instrumental to decreasing the transmission of HIV.

How can HIV Prevention and Sex Worker advocates work as allies?

Sex workers are stakeholders in the fight to end HIV

There is little data about sex workers and HIV in the United States. Transactional sex continues to be excluded from the National HIV/AIDS Strategy, a point that has been protested by activists, as this lack of visibility implies that sex workers are not considered stakeholders in national efforts to end HIV.

In low- and middle-income countries we have more data: sex workers are at elevated risk. HIV prevalence is estimated to be 12 percent of all sex workers – with variations among countries and regions. In several Sub-Sahara African countries, prevalence is as high as 37 percent. Where rates of HIV among sex workers is especially high, only 60 percent have received an HIV test in the past 12 months. In addition, sex workers report difficulties accessing condoms and lubricant, and report other unmet health needs in over 165 countries as a result of criminal laws and/or stigma against them and their work.

Alongside these figures, let us remember that sex work, like all work, is motivated by economic need. The struggle to make sex work safer should not be about mandatory condoms, registries or client-shaming; rather it should address the unequal distribution of wealth in the United States and globally in which so many individuals, especially women, have limited choices for survival.

Stop the stigma—let’s fix the real problems

Wealth inequality, punitive laws and access to health care are but a few of the issues that influence HIV-exposure and other risks that sex workers face. Efforts to end HIV would be far more effective if sex workers were empowered to keep themselves safe, instead of being criminalized, harassed and further isolated from prevention methods or other health care services.

It seems that just about anyone will be entrusted with the safety of sex workers—except sex workers themselves.

We must stay vigilant about the rights of all people in the sex trade. How are sex workers included or excluded in your work? Learn how to be an ally to sex workers here. Consider including sex worker-led organizations in your holiday giving. Only through solidarity can we neutralize the harm of people like Michael Weinstein—and continue to stand up to those who attack the work and the lives of people in the sex trade.

Not To Be Missed: New report on funding for prevention research

The span of a decade—that interval that’s neither too long nor too short to bring innovation—is one that’s often used in the HIV prevention research space, usually to convey optimism. Back in 1997, then President Bill Clinton called for a national commitment to develop an AIDS vaccine within ten years. Just this week, Bill Gates said, “With the right leadership and investments over the next decade, we can discover and deliver a vaccine for HIV.”

The success of these forward-looking claims has always depended on sustained funding. Note, in both cases, the emphasis on commitment and leadership. No one is promising a vaccine with anything less. A look back at the last ten years provides a warning on this front. Released today, the Resource Tracking for HIV prevention R&D Working Group’s latest annual report on global investment into biomedical HIV prevention reports that overall funding for HIV prevention research and development (R&D) has remained essentially flat for over a decade.

Close followers of the annual “RT” report take note—a preliminary version was released at AIDS 2016 in Durban in July. The final version contains slightly updated data and the same overall messages: with a slight fall from US$1.25 billion in 2014 to US$1.20 billion in 2015, overall funding for HIV prevention research and development (R&D) has been more or less level for the past ten years.

And what a decade it’s been! Consider the developments in PrEP, the pipeline of injectable ARVs for prevention and treatment, the continued advance of the ARV-containing vaginal dapivirine ring, and the insights and advances that have come from sustained scientific inquiry related to the search for an HIV vaccine. These are exciting times. And the fact that all of this happened in the context of flat funding for research doesn’t mean that flat funding will get us where we need to go next. As Tom Hope, PhD (Northwestern University) stressed at an opening plenary of the HIV R4P conference where the report was launched, the fact that funding is declining concurrent with new discoveries is a major challenge for the field.

The report notes that preventive vaccine research funding constituted the bulk of all investments, followed by investments in microbicides, TasP, PMTCT, PrEP, VMMC and female condoms. With the exception of vaccines and female condoms, every other HIV prevention option tracked by the working group experienced a decline. These trends are somewhat reflective of the cyclical nature of large-scale clinical trials—when trials end, funding drops off. Likewise, as some interventions enter full scale rollout, like VMMC and TasP, research in this arena can be expected to slow down. Nevertheless, the overall trends bear close watching and strong advocacy to ensure that research continues.

The right products need to be tested in the populations who need them most. The report is also a powerful reminder that this isn’t necessarily how research works. It provides information on the demographic breakdown of almost 900,000 participants in ongoing HIV prevention trials in 2015, with the majority of these volunteers residing in sub-Saharan Africa, most notably Uganda, Kenya, and South Africa. Only one in eight trial participants in 2015 belonged to a population most affected by HIV, including MSM and transgender women, injection drug users, and cisgender women.

These sobering facts come in the context of a vigorous period in research and development. It’s a time of growing recognition from the global community that research has to be part of the long-term fight to end the HIV epidemic. Taking stock of all that’s been accomplished with ten years of flat funding, now is the time to support continued progress with additional, well-targeted resources.

The Resource Tracking Working Group hopes that this tool provides strong facts for advocacy and supports efforts to assess public policy and its role in accelerating scientific progress. We thank all of the individuals who contributed data to the report and who gave time and effort as trial participants.

Check out the report, share it with your fellow advocates, and be sure to let us know if your organization is either a funder or recipient of HIV prevention grants or if you have further questions or information about resource tracking at all!

Press Release

A Decade of Flat Funding Could Imperil Progress of the HIV Prevention Research Pipeline

Contacts

AVAC: Kay Marshall, kay@avac.org, +1-347-249-6375
IAVI: Arne Naeveke, anaeveke@iavi.org, +1-212-847-1055

A PDF version of this press release is also available.

Report released at HIV Research for Prevention Conference highlights funding trends, opportunities and challenges for HIV prevention R&D

Chicago – A new report released today at the second HIV Research for Prevention Conference in Chicago documents 2015 funding, highlighting a decade of flat funding and its potential impact on continued innovation in the HIV prevention research and development (R&D) field.

The Resource Tracking for HIV Prevention R&D Working Group’s (RTWG) 12th annual report, HIV Prevention Research & Development Investments, 2000-2015 Investment priorities to fund innovation in a challenging global health landscape, finds that funding for R&D of new and emerging prevention options decreased slightly in 2015. This was due in part to decreases from the US public sector and a downswing in global philanthropic funding.

Steady progress in R&D for AIDS vaccines, microbicides, pre-exposure prophylaxis using antiretroviral drugs (PrEP) and treatment as prevention (TasP) confirms science’s critical role in providing solutions to end the HIV/AIDS epidemic. Yet research for these badly-needed solutions is in danger of being slowed or even sidelined by inadequate funding.

“It is critical that investments into HIV prevention innovations, science and technology are scaled up to put us firmly on the Fast-Track to ending AIDS by 2030,” said Luiz Loures, Deputy Executive Director, UNAIDS.

In 2015, funders invested a total of US $1.20 billion across R&D, down from US $1.25 billion in 2014, across eight key areas: preventive AIDS vaccines, microbicides, PrEP using antiretroviral drugs, TasP, HSV-2 vaccines and operations research related to voluntary medical male circumcision, female condoms and prevention of vertical transmission.

The report also finds that investment is being made along all phases of the research pipeline but remains concentrated among a few large investors. A more diverse base of funders would increase the stability of R&D financing and cushion the impact if any of the major funders were to reduce their investments. To improve continuity, RTWG calls for a more balanced funding base, especially through support of new investment by European and low- and middle-income countries. The US public sector (primarily via the National Institutes of Health) remained the largest global contributor at US$850 million, accounting for 70 percent of total funding. Together the US government and the Bill & Melinda Gates Foundation, the largest philanthropic funder, accounted for 81 percent of all funding in 2015.

“There is now very strong momentum in research and development, and we need to expedite the development of vaccine strategies and other new, biomedical prevention options that promise to be safe, accessible and effective for use throughout the world,” said Mark Feinberg, President and CEO of IAVI. “There must be adequate and sustained investment at all stages from early laboratory research and to clinical testing if we are to truly be able to contain the HIV pandemic and approach and end to AIDS.”

This is indeed a time of great optimism for HIV prevention research. Daily oral PrEP is gaining traction as a new prevention option in an increasing number of countries; an antiretroviral-based microbicide ring that showed modest efficacy earlier in 2016 will be further evaluated to determine its viability as a prevention option for women; large-scale efficacy trials of an AIDS vaccine candidate and an injectable form of PrEP are slated to begin soon and a novel proof-of-concept trial of antibody-mediated prevention is underway in several countries. Many more promising candidates in earlier stages are progressing toward pre-clinical and clinical evaluation.

Importantly, 2015 saw increasing investment in the science of delivery – or implementation research – primarily focused on delivery of TasP interventions. Such investments will become even more important to help ensure new prevention options move quickly and efficiently into prevention programs and begin to have an impact on HIV infection rates. There is also an increasing understanding that research must understand and integrate the needs and desires of people who will eventually use new prevention options. Ensuring that the perspective of those for whom new prevention options are being developed is included from the beginning of the research process can help ensure that safe and effective products can be rolled out swiftly and be more fully accepted.

“Innovative science needs innovative funding,” said Mitchell Warren, AVAC Executive Director. “We need an expanded and more diverse global cadre of funders who will be involved in and dedicated to advancing HIV prevention R&D, including product delivery. And these investments need to ensure that new options like daily oral PrEP, and potentially the dapivirine vaginal ring, do not sit on the shelf unused because we don’t know how to effectively deliver them, and that future R&D better meets the needs and wants of those for whom products are developed.”

The report and infographics on prevention research investment are online at www.hivresourcetracking.org and on social media with #HIVPxinvestment.

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Since 2000, the Resource Tracking for HIV Prevention R&D Working Group (formerly the HIV Vaccines & Microbicides Resource Tracking Working Group) has employed a comprehensive methodology to track trends in research and development (R&D) investments and expenditures for biomedical HIV prevention options. AVAC leads the secretariat of the Working Group, that also includes the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). This year’s report is additionally made possible by the support of several donors, including IAVI, UNAIDS, the Bill & Melinda Gates Foundation and the American people through the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID). The contents are the responsibility of AVAC and the Working Group and do not necessarily reflect the views of PEPFAR, USAID or the United States Government.

Global HIV Prevention R&D Investments by Technology, 2000-2015

In 2015, global funding for HIV prevention R&D declined slightly, from US $1.25 billion in 2014 to US $1.20 billion in 2015. This continues a decade of roughly flat funding. The US public sector remained the largest global contributor at US $850 million, and together with the Bill & Melinda Gates Foundation, the largest philanthropic funder, constituted 81 percent of all funding.

New! AVAC Report 2016 Big Data, Real People: The annual state of prevention advocacy

If you’re packing for Durban, we hope you’ll pause right now and add to your bag AVAC’s annual state of the field, Big Data Real People. The full PDF, Executive Summary and graphics are available here.

As always, AVAC Report is our annual advocacy analysis, with an agenda that spans the next 12 months—and beyond. We’ve designed it be a clear, succinct, actionable statement of the strengths and weakness of HIV prevention data today—and we hope you’ll join us in amplifying these messages at next week’s gathering.

Even if you’re not heading to Durban, we hope that this year’s Report will top your packing list for the journey through the next 12 months of advocacy and action.

In the Report, we argue that the state of HIV prevention data collection in 2016 is poor. One part of the solution lies in the adoption of “HIV Prevention Data Dashboards”. This tracking tool could bring the same specificity and accountability to non-ART prevention services that the “treatment cascade” of diagnosis, initiation, retention and virologic suppression does for antiretrovirals for people living with HIV.

The world cannot even pretend that ending AIDS is possible without action on non-ART prevention. We need to roll out what we have, continue R&D on what we still need, as well as scale up ART for all people living with HIV. That’s what the new UNAIDS Prevention Gap report says. That’s what AVAC has said for years. That’s what we hope you’ll say in Durban and over the coming year.

Here’s the Report, a roadmap for the coming year. Please read it, join us on the journey, let us know what you think!

Advocating Female Condoms: A reflection on stakeholder commitments & trends in support for female condoms

Produced by the Universal Access to Female Condoms consortium, this document analyzes policies, programs and budgets of organizations working on female condoms; looks at trends in expenditures on female condoms; provides an overview of emerging trends relevant for female condom advocacy, programming and procurement; and formulates recommendations for the future of female condom advocacy.

AVAC on World AIDS Day: We’re 20. We’re not giving up.

When AVAC was founded in 1995, we were called the AIDS Vaccine Advocacy Coalition. Our singular goal was to advance swift, ethical research for a vaccine that was then — and is today — essential to bring the epidemic to a conclusive end.

Twenty years later, AVAC is still focused on swift and ethical research, but our scope has expanded. Along with vaccines, we advocate for PrEP, microbicides, voluntary medical male circumcision and more.

Through it all, our message has been the same: prevention is the center of the AIDS response. Not just any prevention but smart, evidence-based, community-owned, rights-based strategies.

We do this work because it’s essential. We are able to do it because of our robust partnerships worldwide. We will keep doing it — with your help — until the epidemic has, finally, come to an end.

We’ve experienced 20 years of breakthroughs and disappointments in prevention research. A vaccine that many had given up on was the first to provide modest protection. One microbicide everyone hoped for didn’t pan out. Male circumcision and PrEP studies overcame skepticism and, together with antiretroviral therapy, paved the way for a prevention revolution.

Through it all, AVAC has worked with partners to maintain the field’s focus and press for continued research into an AIDS vaccine, a cure and more.

When AVAC was founded, the only biomedical HIV prevention options for adults were male and female condoms. The pathway for introducing any new strategy was largely unmapped. No one knew where the gaps would be—between trial result and country action, between guidance and financial support. Now we do.

Over two decades, AVAC has not only identified the gaps; we’ve worked to bridge them, so that products reach people in programs that work — without delay.

Twenty years ago, advocacy for HIV prevention hardly existed. So AVAC helped build a global network of advocates equipped with effective advocacy strategies and the latest evidence.

With our support, they are putting prevention on the agenda in countries and communities around the globe.

When the world lacked a plan for ending AIDS, we helped create one.

Now we’re holding global leaders accountable for results — demanding the resources, policies and evidence-based plans needed to deliver all of today’s prevention options to the people who need them, and to plan for the rapid rollout of new options as they emerge.

Communities’ support for prevention research can never be taken for granted — it has to be earned. For 20 years, we’ve helped build trust between researchers, funders and communities to speed the ethical development and rollout of new prevention options.

And when controversy threatened to derail those efforts, AVAC provided leadership and resources to help get them back on track.

Your gift to AVAC will support our efforts to accelerate the development and delivery of HIV prevention options to men and women worldwide. With your help, we can continue to convene, collaborate and communicate a strong, clear and cohesive vision for HIV prevention today, tomorrow and to end the epidemic.

It will take all of us working together to end AIDS. Please join us.

Breaking Regulatory Barriers for Greater Female Condom Access

A variety of safe and effective female condoms currently exist. However, regulatory hurdles limit new products from entering consumer markets. With the pipeline of new receptive-partner initiated condoms growing, advocates must understand how regulatory issues determine product introduction and approval in their country.

Receptive partner-initiated condoms in development
Link between regulatory environment and female condom access
Current regulatory issues and obstacles
Unique advocacy opportunity to break barriers to existing female condoms and pave the way for emerging internal condoms

You can watch the webinar here.

New Report on HIV Prevention R&D Investment Highlights 2014 Global Funding Trends

The recent UN Report on the Millennium Development Goals (MDGs) calls out the 40 percent reduction in new HIV infections since the MDGs were established in 2000 as a singular MDG achievement1. That progress reflects 15 years of HIV research in many forms—from female condoms and voluntary medical male circumcision, to new strategies for preventing vertical transmission to the scale-up of ART. Over the years, this progress has been supported by investments from many government, philanthropic and private sector funders of HIV prevention research.

The 11th annual report on the state of HIV prevention research investment, HIV Prevention Research & Development Funding Trends 2000–2014: Investment Priorities To Fund Innovation In An Evolving Global Health and Development Landscape, suggests that this work is still on the agenda for funders, albeit with a small cohort supplying the bulk of the resources.

The new report, released in Vancouver at the IAS 2015 conference, was prepared by the HIV Vaccines & Microbicides Resource Tracking Working Group (RTWG), led by AVAC, in partnership with the International AIDS Vaccine Initiative and UNAIDS. HIV Prevention Research & Development Funding Trends 2000–2014: Investment Priorities To Fund Innovation In An Evolving Global Health and Development Landscape documents that absolute funding levels have been stable over the past few years. This reflects an overall decline in real spending given biomedical research inflation.

In 2014 funders invested a total of US$1.25 billion in research and development (R&D) for HIV prevention—representing a decrease from the 2013 funding level which totaled US$1.26 billion.

In 2014, the US public-sector and the Bill & Melinda Gates Foundation account for 83 percent of all HIV prevention R&D funding and the number of philanthropic funders engaged in HIV prevention research has continued a steadily decline since 2010. Thus, the report points to the need for a broader funding base.

Despite the slight decline in funding, HIV prevention R&D is still delivering important advances. The 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention in Vancouver July 20-22, will showcase results for a range of groundbreaking research that has been supported over the past several years, including the Strategic Timing of Antiretroviral Treatment (START) trial, the HPTN 052 treatment as prevention trial and several groundbreaking oral PrEP trials.

Results from studies of a vaginal ring containing the antiretroviral dapivirine are expected in the next 12 months. Several different HIV vaccine candidates, neutralizing antibodies and long-acting injectable ARVs are currently in trials that could lead to multiple efficacy trials starting over the next two years.

While the report focuses on financial resources, in also highlights the essential role of individual trial participants. In 2014, there were over a million participants in HIV prevention research trials globally. With continued human and financial investment, the 40 percent reduction in new HIV infections attributed to the MDGs is hopefully only the beginning.

For more information on the HIV Vaccines & Microbicides Resource Tracking Working Group, the full report, executive summary, graphics and slides visit www.hivresourcetracking.org.

1 The MDGs consist of eight global goals, with goal six to combat HIV/AIDS, malaria and other diseases. For more information on the MDGs see: www.un.org/millenniumgoals/aids.shtml.

Press Release

With future of HIV prevention “on the line,” AVAC calls for sharper, bolder strategy to end the epidemic

Contacts

Mitchell Warren, mitchell@avac.org, +1-914-661-1536

Kay Marshall, kay@avac.org, +1-347-249-6375

New York — In a report issued today, AVAC warned that global HIV prevention efforts are in jeopardy due to an absence of strategic targets, resources and specific implementation plans to translate science, slogans and goals into action. The report calls for a robust set of global HIV prevention targets tailored to specific interventions and demands action in several key areas of the global AIDS response, including expanded rollout of daily oral pre-exposure prophylaxis, or PrEP, and alignment of science and human rights-based agendas.

“We’re at a make-or-break moment and the future of HIV prevention is on the line,” said Mitchell Warren, AVAC’s executive director. “Advances in HIV treatment and prevention research have made it possible to contemplate ending the AIDS epidemic in our lifetimes, but that will only happen with smarter planning, increased resources and greater accountability.”

The report was released ahead of the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle (Feb. 23-26), where researchers are expected to present data from several major HIV prevention trials, including studies that could help drive global implementation of PrEP, as well as a key study of a tenofovir-based vaginal gel for women.

Report calls for smart, realistic goals and targets for HIV prevention

Today’s report, entitled Prevention on the Line, takes a close look at global goals for HIV prevention and what it will take to make them a reality. UNAIDS recently adopted the broad goals of reducing new HIV infections worldwide from 2.1 million in 2013 to 500,000 and eliminating stigma and discrimination, both by the year 2020.

Drawing upon lessons from WHO’s “3 x 5” HIV treatment initiative and other case studies, the AVAC Report concludes that ambitious prevention goals are critical – but that they will only work if they’re feasible, well-defined, measurable and supported with adequate resources and political commitment. In the case of the new UNAIDS prevention goals, the report points to a critical need for more specific, interim targets that can be tracked between now and 2020; for better data and monitoring approaches; and for resource allocations that are directly tied to achieving those targets.

“The UNAIDS prevention goals for 2020 are ambitious and inspiring,” said Warren. “But something important is missing from this picture: how to get there. We need a clear path forward, including short-term targets, so we don’t wait five years to see if the world is on track. And new targets won’t be met – and may even be irrelevant – if we fail to close the growing global funding gap for HIV prevention.”

Bold action needed to advance AVAC’s agenda to end AIDS

The report also recommends key actions to advance AVAC’s three-part agenda to end AIDS. First issued in 2011, the agenda calls for sustained efforts to deliver proven prevention tools, demonstrate and roll out new options such as PrEP and develop long-term solutions such as long-acting ARV-based prevention, vaccines and cure strategies.

Key recommendations for 2015 include:

1. Align high-impact HIV prevention with human rights and realities. Research has demonstrated the potential of high-impact prevention strategies, including biomedical approaches like HIV treatment for people living with HIV and voluntary medical male circumcision (VMMC). But these strategies won’t succeed in the real world if we give short shrift to human rights concerns, or if we fail to involve affected communities in designing and implementing prevention programs. Recent experience with treatment and VMMC, in particular, has shown that community buy-in is an essential ingredient of successful rollout and scale-up.

2. Invest now to scale up access to PrEP. Landmark trials have shown that daily oral PrEP is a powerful HIV prevention tool, and studies at next week’s CROI meeting could provide additional support. But the pace of rollout remains far too slow. Demonstration projects are small and disconnected, funding is limited and policy makers are not yet heeding growing demands for access. Funders should invest now in large-scale targeted implementation of PrEP, linked to national programs. National regulatory authorities and health ministries should prioritize licensure and rollout.

3. Accelerate research into long-term solutions. We must sustain and accelerate research on solutions such as an effective AIDS vaccine, long-acting antiretroviral prevention and treatment and a cure. Just like the rest of the AIDS response, this research needs its own short-term targets, aligned to long-term goals.

The new report and related resources, including downloadable graphics, are available now at www.avac.org/report2014-15.

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About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.