The FAPP AIDS Budget and Appropriations Coalition (ABAC) wrote letter urging Members of Congress to vote no on the House L-HHS Appropriations Bill (H.R. 5894), which includes $767 million in cuts and eliminations of domestic HIV programs.The letter also urges members to vote down two amendments which would eliminate funding for the Minority HIV/AIDS Fund and cut NIAID funding.
FAPP Letter: Vote NO on House L-HHS Bill to Continue Progress Against HIV/AIDS
Avac Event
Pandemic Accord Briefing for Civil Society & Community Partners
The Pandemic Accord negotiations are ongoing, and should come to fruition next year. What do they mean for your work, your country, and the future of global health?
On Tuesday, November 21, 8:00 to 9:30 AM EST / 2:00 to 3:30 PM CEST, advocates came together to discuss two years of talks and what’s next to progress global health equity.
DoxyPEP Implementation – All Systems Go?
On October 5, The Choice Agenda (TCA) and the National Coalition of STD Directors (NCSD) hosted a discussion on the roll out of Doxycycline as STI PEP for helping gay, bisexual, and other men who have sex with men and transgender women reduce bacterial STIs, including gonorrhea, chlamydia, and syphilis.
Speakers:
Dr. Taimur Khan, Fenway Health
Cait Shea, NCSD
Kendrick Clack, NP, Crofoot MD Clinic/Research Center
Lee Vaughn-Ogin, Bigger Blacker Book
Avac Event
Boo, Syphilis is Really Back!
Tuesday, October 31, 1:00 to 2:00 PM ET
Syphilis rates have increased drastically in recent years. Learn how others are addressing these rising rates and the techniques clinicians are using to detect, treat, and prevent infections.
Co-hosted with NACCHO and NNPTC.
Webinar Recording / Kimberly A Stanford Slides / Anne Rompalo Slides / Irene Stafford Slides
Three HLMs, A Host of Challenges and One Major Victory
For the last year, reforming the global health architecture in the hopes of delivering health more equitably has been top of mind. From the Pandemic Fund launch, to post-mortems on the ACT-A (the global body convened to develop COVID-19 interventions and ensure access to them), to the call for a new Pandemic Accord, a strong consensus had finally emerged that things need to change.
Accordingly, this theme ran throughout the health-related proceedings at the UN General Assembly in September where High-Level Meetings (HLMs) on universal health care (UHC), Tuberculosis (TB), and Pandemic prevention, preparedness and response (PPPR) took place.
Four key takeaways from the week stand out to AVAC:
Multilateralism is threatened.
Tensions between countries are incredibly high. Each day’s proceedings made clear that the spirit of diplomacy from previous years has waned. Given that there have already been UN Declarations on UHC and TB, advocates went into this year’s process thinking that stronger declarations would be relatively easy to negotiate. But countries were at odds during negotiations for all three health-related HLMs. Country representatives disagreed on a host of issues that will impact access to medical products, financing, and who is responsible for addressing health crises. These disagreements upended usual procedure. Typically, the Declaration is finalized weeks before the actual HLM; this year, a final decision on all three Declarations hung in the balance until the minute before the meetings began. Advocates must work hard in the coming year to bring countries together on key issues in the Pandemic Accord.
Access is THE issue.
By far, the question of access to medical products and tools dominated all three HLMs. Tensions around this issue sparked the most heated disagreements during negotiations. During the PPPR HLM, Member States speaking from the UN floor all mentioned their commitment to building more equitable access to medical countermeasures, but richer countries are unwilling to alienate the pharmaceutical industry by including access commitments in international agreements. And lower-income countries are refusing to permit open access to data on new pathogens without access commitments to the products derived from that data. The issue is so fraught it almost derailed any health Declarations at all. Right before HLM week, eleven countries that have been the target of ‘unilateral coercive measures’ (sanctions) sent a letter to the President of the General Assembly refusing to sign on to the declarations because the sanctions prevent them from accessing medical countermeasures — tools, medicines and equipment, needed in a health crisis. The Declarations ended up moving forward anyway with very limited commitments on how best to ensure access to medical countermeasures. It will be imperative for advocates to keep the issue of access front and center and help to navigate toward agreements that all countries can stomach.
Civil society engagement is going backward.
The PPPR HLM had no civil society formal engagement mechanism, and the process suffered because of it. Civil society was left out of the loop. They didn’t receive information about the status of negotiations, or details on sticking points. These updates would typically be funneled through a formal mechanism. In addition, the HLM process usually includes two to three days of Multistakeholder Hearings for each HLM to allow civil society to state their priorities and views ahead of negotiations on the draft Declaration. This year, each HLM had just one half-day, significantly limiting the number of civil society organizations and advocates that could get their views in front of Member States. Approvals for registration for both the Multistakeholder Hearings and HLMs came less than a month before the actual event, leaving many advocates too little time to get visas to the US. To add insult to injury, during the HLM, many civil society advocates did not get to make statements from the floor even though time was reserved for civil society – agencies such as Gavi and the Global Fund and pharmaceutical corporations spoke during these slots. Engagement with UN staff is needed to better define what constitutes civil society, and to protect these rare points of access and influence for those who speak for communities.
Policymakers are starting to understand the contributions HIV, TB, and malaria can make to pandemic preparedness.
As the furor to address huge gaps in pandemic preparedness and response capacities ramped up in 2021, it was a slog to get policymakers new to the space, who had not traditionally been involved in health negotiations, to understand the underlying infrastructure and movements that the global responses to HIV, TB, and malaria have built. However, this year’s UN General Assembly showed that advocates have made a lot of progress. The Coalition of Advocates for Global Health and Pandemic Preparedness, of which AVAC is a co-founder, pushed hard for inclusion of these ongoing pandemics in the Declaration on PPPR to great success – two clauses recognizing the existing infrastructure from these responses that can be leveraged for pandemic preparedness and committing to continue the fight to end these ongoing pandemics made it into the final Declaration text. Much more needs to be done to harmonize the PPPR and HIV/TB/malaria architecture, saving advocates and everyone involved in pandemic preparedness extensive time and resources, but the recognition of the interconnectedness of future and ongoing pandemics represents a huge win.
At AVAC, we have put a lot of hope in the processes of the Pandemic Accord, the UN High-Level Meeting (HLM) on Prevention, Preparedness, and Response (PPPR), and the development of a medical countermeasures (MCM) platform. To understand how these three efforts fit together, see AVAC’s Advocate’s Guide to PPPR.
And check out these other important resources:
- AVAC’s Executive Director, Mitchell Warren along with partners from the Coalition of Advocates for Global Health and Pandemic Preparedness penned an essay to make the case of meaningful investment in Pandemic Preparedness while referencing continued failures of the COVID-19 pandemic.
- Sam Rick authored a piece, Who’s Driving this Ship, which takes a critical look at the issues challenging Global North governments in creating a system that is equitable and aims to prevent health threats everywhere and prepare everyone.
- Our Take: Is the UN Declaration on PPPR and the Pandemic Accord going in the right direction? AVAC’s blog explored the drafts of the Pandemic Accord and the UN Declaration on PPPR—and their implications for equity in global health.
- PPPR Advocacy 101: Find out what it means to you: For a deep dive on the diverse initiatives aimed at preparing for the next pandemic. Learn what they commit to, how much they will spend, and how well these plans incorporate equity as a principle.
- The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action: In this episode of Px Pulse, Chris Collins, the CEO and President at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, talks about what’s at stake in efforts to re-think the global architecture of pandemic response, which policy-makers get it, why this year matters so much, and what advocates can do.
Avac Event
DoxyPEP Implementation – All Systems Go?
On October 5, The Choice Agenda (TCA) and the National Coalition of STD Directors (NCSD) hosted a discussion on the roll out of Doxycycline as STI PEP for helping gay, bisexual, and other men who have sex with men and transgender women reduce bacterial STIs, including gonorrhea, chlamydia, and syphilis.
Speakers:
Dr. Taimur Khan, Fenway Health
Cait Shea, NCSD
Kendrick Clack, NP, Crofoot MD Clinic/Research Center
Lee Vaughn-Ogin, Bigger Blacker Book
PEPFAR at 20: Keeping the promise
Our latest episode of Px Pulse is out, PEPFAR: Keeping the promise.
PEPFAR is one of the greatest US foreign policy and global development achievements of the century. The program has saved upwards of 25 million lives since it launched in 2003. But as PEPFAR marks its 20th anniversary, it’s also fighting for its future.
The US Congress needs to reauthorize PEPFAR for another five years by September 30 and reaffirm its commitment to this lifesaving program. Until a couple of months ago, most in global health and development expected smooth sailing for a five-year reauthorization of the program, as has happened throughout the past 20 years. PEPFAR has enjoyed deep and broad bipartisan support since its founding. Evangelical Christians, staunch conservatives and progressive liberals, Democrats and Republicans, HIV activists, civil society advocates and public health leaders have all championed PEPFAR, year in and year out. But a handful of Republicans, including past PEPFAR allies, are pulling reauthorization into high-stakes partisan politics.
In this episode, Px Pulse talks to some of the people who put PEPFAR dollars into action and to global health leaders who explain why PEPFAR’s approach has been so effective, and what’s at stake in this debate.
Tune in to hear:
Ilda Kuleba from Mothers 2 Mothers talks about the impact of PEPFAR on their work across 10 countries, training and employing HIV positive mothers as peer healthcare workers.
Dr. James Mukabi of World Vision’s Kenya program talks about how this Christian relief organization has changed the lives of thousands of orphans and other populations who are vulnerable to HIV.
Tom Hart, President of the ONE Campaign, which was co-founded by the rock star Bono, to be an early champion of PEPFAR and other poverty fighting efforts talks about PEPFAR’s accomplishments at the global level and what’s next as Congress debates reauthorizing the program.
PEPFAR’s supporters have a job to do, to make sure everyone understands that the world has a lot to lose if PEPFAR is weakened and so, so much to gain if US policymakers unite in their support. We hope you will listen and pass on the episode, download the resources and, most especially, add your voice in support of PEPFAR.
Announcing the New AVAC.org and Digital Resources
We are delighted to share the new and improved AVAC.org! On our new site, you can easily access all the great data, policy analysis, tools and resources that you’ve come to expect from AVAC, including our much-loved infographics, podcasts, Weekly NewsDigest and Pandemic Watch, webinars, research literacy materials and so much more!
The updated AVAC.org also reflects the expanded vision and practice of our dynamic programs. AVAC will always work to accelerate ethical development and equitable delivery of effective HIV prevention options. But, we also know that responding to HIV and preparing for future pandemics requires a comprehensive, integrated, and sustained response that is rights-based, people-centered and evidence-informed.
To AVAC, this means connecting the dots between HIV prevention, sexual and reproductive health and rights, pandemic preparedness, strengthened health systems, research engagement and community leadership. It means recognizing that resilience in global health requires us to confront the threats posed by disparities in access, entrenched stigma, discrimination, criminalizing key populations and inadequate responses to other sexually transmitted infections.
Visit the new AVAC.org for resources, tools and analysis that make these connections as we continue to track and translate the field, including:
- Information on the entire pipeline of biomedical prevention strategies being investigated today
- Our projects, which showcase the incredible partnerships and collaboration that underpin everything we do
- Our podcast, PxPulse, which will deepen your knowledge and help you “check the pulse” of this fast-paced field and the urgent challenges still ahead
- PxWire our quarterly update on where we are in biomedical prevention research
- Our HIV clinical trials database, where you can find details on all biomedical prevention trials and our broader resource database containing fact sheets, infographics, blog posts and more on HIV prevention and the broader issues surrounding global health equity
- Links to our newsletters—Pandemic Watch, Weekly NewsDigest, and our Advocates Network
And be sure to check out three vital AVAC resources that give you all the information you need on PrEP access, STI vaccine and diagnostics R&D and HIV prevention R&D funding.
We are immensely proud to share these resources with you. We hope these tools and analyses will help to power your advocacy, accelerate ethical development and equitable delivery of effective HIV prevention options, and advance global health equity.
From Brisbane to Chicago: A look at STIs, HIV and global health
Late July saw two nearly simultaneous conferences on the future of research and advocacy for HIV and sexually transmitted infections (STIs). IAS 2023 in Brisbane and the 2023 STI and HIV World Congress (also known as ISSTDR) in Chicago are landmark annual events. Both conferences bring together civil society, advocates, policy makers, donors and scientists to share the latest scientific findings and discuss where advocacy is needed to both advance research and ensure equity informs every aspect of the development process, from basic science to delivering new interventions. There may be two gatherings, but it’s one vital conversation. HIV and STIs are inextricably linked, affecting the same communities, who face the same barriers to care and prevention against these health threats. At AVAC, we see the links and we are making the connections. Below we offer highlights from these two all-important world gatherings, and check out our recent webinar linking these conversations, Tales from Two Cities: HIV and STI research highlights from Brisbane and Chicago.
AVAC at IAS
Taking prevention to the next level: Packaging PrEP with primary health care services as a pathway to achieving 2030 HIV prevention and universal health coverage goals
This satellite, co-sponsored by PATH, IAS, WHO and AVAC, put a spotlight on integrated, person-centered care, a central theme of the 2023 UNAIDS report launched at IAS 2023, The Path That Ends AIDS. UNAIDS reports that investing in person-centered priorities such as community-led services, integrating primary health care with HIV services, and a strong health workforce brings down incidence. And the pressure to scale up these approaches remains essential. According to the latest statistics in the report, only 42% of districts in African countries with very high HIV incidence are covered by prevention programs. Even more chilling, 4,000 adolescent girls and young women acquire HIV every week.A presentation in this session by former AVAC Fellow and CASPR partner Chilufya Kasanda from Zambia’s TALC put a face and a voice to this story. In Zambia, youth friendly services are scarce or non-existent, high rates of mental health issues are utterly neglected, and donors “flock to a few locations and leave out those who are most in need.” She said community advocates are too often dismissed as “people just making noise.” But, said Chilufyia, it’s young people who must receive support, their leadership must be nurtured and funded, and messages should be tailored just for them. “Young people need to know that pleasure, not only risk, is attached to sex. To get to pleasure, you need to be safe, that is the message.” Another AVAC Fellow, Elizabeth Onyango from Kenya’s Coast Sex Workers Alliance, called for accelerating access to the dapivirine vaginal ring. “Why is the ring not in our vaginas? Male condoms even come in different flavors! This is a women-first product and it needs more investment.”
Regaining lost ground for HIV prevention: Acting on lessons learned from oral PrEP scale-up new PrEP method mix
Prevention will fail if the HIV response remains narrowly focused on products. Oral PrEP has brought invaluable lessons we have yet to learn about how to get programming right so that effective products actually reach those who need them. As AVAC Executive Director Mitchell Warren said at the conference, reflecting on the status of PrEP uptake since FDA approval in 2012- “Only 4m global PrEP initiations in 12 years is an epic failure. Science has given us products that work, but our policies and programs have failed to meet the needs.”
This session featured presentations from AVAC on a package of tools called, Getting Rollout Right and the work of the Coalition to Accelerate Access to Long-Acting PrEP. Daniel Were of Jhpiego talked about lessons from the Jilinde project, Kenya’s ambitious program to deliver PrEP. The project adapted in real time to reach more people by recognizing that peer networks are essential, that stopping and starting PrEP is common, and that provider attitudes can be difficult to change. Daniel stressed the importance of focusing deeply on the people who need to use these products.
HIV Cure & Immunotherapy Forum
This preconference forum on HIV cure research featured innovative presentations tracking the progress toward an HIV cure. AVAC Senior Program Manager Jessica Salzwedel participated in a panel discussion on the importance of increasing diversity throughout HIV cure research from trial participants, to advocates, to researchers. The session also featured the release of a new resource on community preferred language for HIV cure.
bnAbs: From prevention to cure
This session covered the potential for research on broadly neutralizing antibodies (bNAbs) to inform strategies for both prevention and cure. AVAC partner Maureen Luba joined the panel discussion to applaud collaboration among the bNAb researchers working in prevention and cure, and she called for the same collaboration with communities. She said research budgets for community engagement should reflect the importance of community leadership right from the beginning, to ensure success in the future. Maureen added “thinking about cost and choice is the elephant in the room. The resource envelope for HIV prevention is not expanding enough. Countries will be asking ‘where will we get the money [for bNAbs].’ We have to think about cost effectiveness now.”
Next Gen HIV Prevention research: Clinical Trials in an era of highly effective standards of care
Investigators and advocates discussed innovative methods to test how new interventions compare to oral PrEP, and how to also make comparisons to HIV incidence in a given community. Models of community engagement were just as important in the conversation. Ntando Yola of APHA described robust programs that brought community members along as these complex new trial designs were developed. Investing in Good Participatory Practicemeans investing “in the platforms that equip and empower communities and advocates,” said Ntando. And for more on how trial design is evolving, check out AVAC’s Evolving Designs for HIV Prevention Trials.
AVAC at the STI & HIV World Congress
The STI Prevention Pipeline: Where Are We, and What Will It Take to Move Forward Faster?
This session on the state of the field offered updates on how STI prevalence and incidence rates are estimated, STI vaccine acceptance, STI test development, and information on the first US STI National Strategic Plan and Federal Implementation Plan. The session included discussions about advocacy priorities in each of these areas, with discussions continuing in the Advocacy Zone throughout the conference (see below). For more on the STI pipeline, check out the resource pages on STIwatch.org.
Setting Up a Remote/Home Testing STI Programme: A Practical Toolkit
This session explored the power of remote testing to curb STI acquisitions. Remote and home-testing brings many benefits. It’s convenient, overcomes barriers from stigma, offers privacy, reflects trauma-informed principles, and can overcome structural barriers. For the status of testing for several STIs go to the pathogen pages on STIwatch.org.
Symposium: New Vaccine Approaches to STI Prevention, STI Vaccine Acceptance, and Equity
This symposium shared progress on STI vaccine research and examined the question, “what factors could influence acceptance of STI vaccines and how do we ensure equitable access to these vaccines”. AVAC’s Dr. Alison Footman referenced the disparities in the COVID-19 vaccine and how vaccine access can differ due to income, health insurance, and region. Considerations around equity, access, vaccine hesitancy, vaccine confidence, and vaccine awareness must be confronted as an integrated part of the advocacy for STI vaccine development. This session provided a platform for framing these issues and developing an agenda for advocacy.
ISSTDR Advocacy Zone
AVAC hosted an Advocacy Zone at the conference, which bubbled with activity throughout the meeting. Advocates used this space to weigh in on questions and share perspectives on how the STI field can grow and how advocacy can equitably advance the field. Overall themes included the need to normalize sexual health, center pleasure in STI conversations and the urgency for increased funding to support STI prevention and research.
Spotlight on WHO News at Both Conferences
The WHO made headlines from Brisbane and Chicago, with major announcements and research findings that will be shaping global health for years to come.
U=U and Zero Risk
In a policy brief released at IAS 2023, the WHO directly affirmed zero risk of HIV transmission from people living with HIV who have an undetectable viral load using any WHO-approved test and who adhere to treatment. The brief, The role of HIV viral suppression in improving individual health and reducing transmission, also emphasizes the importance of expanding viral load testing, particularly in low and middle-income countries (LMICs) where access to testing falls far short of the need. The Lancet also published the WHO’s systematic review of the data behind this finding, championed since 2016 by the U=U campaign (undetectable=untransmittable).
A Call to Expand HIV Self-testing
Also from Brisbane, the WHO announced new HIV testing guidelines, calling for countries to expand use of HIV self-testing (HIVST) and to promote testing through social networks. In a July 22 press release, the WHO said, “These recommendations are issued at a moment of unique opportunity, when self-care and self-testing are increasingly being recognized as ways to increase access, efficiency, effectiveness and acceptability of health care across many different disease areas, including HIV.”
Surveillance of Mpox
The WHO presented their mpox surveillance data in Brisbane, building on findings reported at the Conference of Retroviruses and Opportunistic Infections that showed mpox severely impacts people living with HIV (PLHIV) who have a very low CD4 T-cell count. The WHO analysis draws from a larger set of data than was presented at CROI, and it found PLHIV with advanced immunosuppression were twice as likely to be hospitalized than people who are HIV-negative. See the aidsmap article for details.
Guidance on STIs
WHO called for better access to testing and diagnostic services at the STI & HIV World Congress. Its new guidance on testing and diagnostics includes: target product profiles (TPPs) for point-of-care tests for STIs, to diagnose syphilis, chlamydia trachomatis, neisseria gonorrhoeae and trichomonas vaginalis; and an updated edition of The diagnostic landscape for sexually transmitted infections featuring tools to scale up screening for syphilis, chlamydia, gonorrhoea, trichomoniasis, mycoplasma, herpes, and human papillomavirus (HPV) in LMICs. Earlier this year, the WHO approved its multi-year implementation strategy for HIV and STIs. For more information on the status of diagnostics and vaccines for STIs, go to STIwatch.org.
HIV Research Highlights
Women Want CAB for PrEP as a Choice in HIV Prevention
Researchers presented findings from the open label extension study of HPTN 084 studying injectable cabotegravir (CAB) for PrEP, among individuals born female. Among 2500 participants in seven African countries, nearly 78% chose injectable CAB and 22% preferred oral PrEP. And a related study, HPTN 084-01, also found CAB for PrEP was generally acceptable to a small study of cisgender adolescent women in a study conducted in South Africa, Uganda and Zimbabwe. 92% opted to continue use of CAB for PrEP in the open label extension. The study also found that engagement of parents or guardians could be pivotal, providing young women with the support they need to make choices with confidence. The HPTN’s Erica Hamilton said the study reinforces how much choice matters. “The efficacy of CAB for PrEP was reassuring, but some participants still preferred the oral tablet [which also has very high efficacy] for various reasons.”
New Data on VMMC Among Gay Men and Other Men Who Have Sex with Men (MSM)
A small but noteworthy study from eight cities in China showed VMMC offered protection against HIV transmission among MSM. Researchers say this first randomly controlled trial demonstrating efficacy among MSM should be followed up by larger trials.
Tracking the Inclusion of Transgender People in Research
The launch of AVAC and the Office of HIV/AIDS Network Coordination’s (HANC) Clinical Trial Scoring Tool, provided an initial analysis of the inclusion of transgender people in HIV research and a tool for tracking inclusion in the future. This tool generated great excitement during the poster session. The score card evaluating HIV research since 1991 found less than 1% of participants in 41 key HIV studies included transgender populations. “Dozens of attendees from Harare to Montreal to Hyderabad had questions and expressed interest in using the scorecard and applying it to other populations, too.”
Cure at IAS 2023
The “Chicago Patient” was first presented at CROI 2023 and is the first known case of rebound from a bone marrow transplant where the donor did NOT have a critical and rare mutation to what is called the CCR5 receptor, which is found on certain human immune cells. The individual decided to go back on therapy after two consecutive detectable viral loads. This case is interesting because it suggests that reservoir cells may persist even after extreme clearance measures that are part of a stem cell transplant.
The “Geneva Patient” is the potential sixth cure for HIV. This individual received a bone marrow transplant from a donor with wild type CCR5 — meaning they did not have natural immunity to HIV. The individual experienced severe graft vs. host disease, a complication where the new immune system attacks the host. No virus can be found 20 months off therapy using the most sensitive assays. The medication used to stop the effects of graft vs. host disease promotes latency, meaning the reservoir cells have a harder time reactivating. Researchers are excited about this case because it provides clues on the role of the immune system in clearance and potential pathways toward an HIV cure.
The 5 cases of pediatric control were presented by Gabriela Chaumet of University Kwa Zulu-Natal. This longitudinal study followed 281 mother-infant pairs with in utero transmission. The children were started on ART soon after birth and about 92% were exposed to ART in utero through the placenta. Five of the children, all male at birth, who were not adherent to ART were able to control the virus below detectable levels without therapy. However, Only 40% of the infant cohort was male. The study suggests the importance of the virus itself and indicates the need to further understand the impact sex & gender may have on future HIV cure strategies.
STI Research Highlights
GPP on the STI Map
From two different sessions in Chicago, a GPP champion and San Francisco’s Bridge HIV medical director Dr. Hyman Scott called out the power of Good Participatory Practice. In sessions on Biomedical Prevention for STIs and HIV and Addressing the HIV and STI Syndemic, Hyman’s presentations called for GPP to be implemented broadly. “I am really glad to see AVAC at this conference. We need GPP to hold us accountable,” said Hyman. CASPR partner Zinhle Sokhela of Wits RHI also gave background on GPP during the session Centering Equity, Inclusion and Diversity in STI/HIV Research and referenced a Cameroon and Cambodia PrEP trial that ended prematurely due to lack of effective community engagement. “The [GPP] guidelines help prevent misunderstanding and miscommunication among researchers and stakeholders.”
Antimicrobial Resistance and New Drugs in the Pipeline
Resistance to existing antibiotics for different STIs is spurring a hunt for alternative drugs. The conference presented encouraging early findings on new interventions for herpes simplex virus (HSV) and mycoplasma genitalium (M. genitalium), which cause urethritis and other diseases. A retrospective review of data from 165 patients found minocycline cured 2/3 of the resistant cases of M. genitalium. Phase II studies of pritelivir demonstrated superiority over the standard of care for resistant cases of HSV.
Women and DoxyPEP
Dr. Jenell Stewart presented additional data on the DoxyPEP study out of Kenya and found, from hair testing analyses, that 44% of women assigned to DoxyPEP may have not taken any of the medication. This could be one reason why DoxyPEP has not shown efficacy among women, from data that was previously presented at CROI 2023. Watch this space for more data coming out of the D-PEP Kenya study, including a look at the correlation between PrEP and DoxyPEP adherence, as well as conversations about future research of DoxyPEP in cisgender women.
The Promise of Self-Testing
A presentation by Preventx, a UK-based supplier of self-testing kits, featured their analysis that remote/home-testing led to the diagnosis of a similar number of STIs as those diagnosed in the clinic. Preventx shared that out of 2.2 million kits ordered over a given period of time, they saw a high rate of return, with 1.8 million kits returned.
This cross section of research, advocacy and innovation in STIs and HIV should be a call to action for all of us who see how equity and sexual health cannot be siloed.
P.S. In case you missed it, AVAC recently launched the latest HIV Prevention and Cure Resource Tracking Reports. Find all the details here.
Press Release
AVAC Applauds the Selection of Dr. Jeanne Marrazzo as New Director of NIAID
Wednesday, August 2, 2023
AVAC enthusiastically applauds the selection of Jeanne Marrazzo, MD, to serve as the new director of the NIH’s National Institute of Allergy and infectious Disease (NIAID). Dr. Marrazzo brings unparalleled leadership and research expertise to this pivotal role at NIAID, which oversees some of the largest investments to advance research on HIV and sexually transmitted infections in the world, at such a critical moment in global health science and politics.
“Jeanne has been a pioneer in both HIV prevention and STI research and advocacy for many years. This news of her selection as NIAID Director just does not get any better,” said Mitchell Warren, AVAC’s Executive Director. “Given her distinguished career, NIAID’s selection signals a commitment to pursuing a research agenda that is aimed squarely at defeating HIV while safeguarding principles that advance global health equity. Moreover, her appointment reflects the important intersection of science, policy, communications and advocacy that has defined her career thus far.”
“Perhaps most importantly, her longtime championship of community engagement and person-centered research provides a fantastic foundation for this role,” said Manju Chatani-Gada, AVAC’s Director for Partnerships & Capacity Strengthening. “She has always been accessible and provided time, mentorship and support to civil society advocates in breaking down and interpreting science. Ultimately, it is not just what science gets supported at NIAID, but how the science happens and how it is communicated, and Jeanne is the right leader at the right time to build on Dr. Fauci’s legacy.”
Dr. Marrazzo’s research included landmark investigations of pre-exposure prophylaxis (PrEP) for cisgender women as well as discovery and implementation science research focused on complex issues including hormonal contraception and HIV, antimicrobial resistance in gonorrhea, and other efforts especially as they effect women’s health and livelihoods and exacerbate the impact of infectious diseases. She provided pioneering leadership of the Microbicide Trials Network’s groundbreaking Vaginal and Oral Interventions to Control the Epidemic (VOICE) study, one of the most complex HIV prevention studies ever designed and conducted.
“Jeanne is a remarkable physician, researcher and advocate. We are so optimistic about her ability to connect the dots—between HIV prevention, sexual and reproductive health, and pandemic preparedness, and help solve for the threats of disparities in access, stigma, discrimination and criminalization of key populations,” Warren added.
Dr. Marrazzo will be the first new director of NIAID in nearly 40 years and the first woman in this position. She will also be the first openly gay director of any institute at the NIH. The position was held by Dr. Anthony Fauci, whose vision, passion and commitment to ending the AIDS epidemic and advancing global health research has been an inspiration to AVAC and to so many. Dr. Marrazzo is expected to assume the post as NIAID Director later this year.
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About AVAC: AVAC is an international non-profit organization that leverages its independent voice and global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity. Follow AVAC on Twitter @HIVpxresearch; find more at www.avac.org and www.prepwatch.org.