The More We Know: Evolving our understanding of PrEP for cisgender women
Science and real-world experience continue to demand a re-assessment of our collective understanding of the safety and effectiveness of PrEP options for women, including oral, vaginal ring, and injectable options. For instance, a new paper in the Journal of the American Medical Association by Dr. Jeanne Marrazzo (HIV Pre-Exposure Prophylaxis with Emtricitabine and Tenofovir Disoproxil Fumarate Among Cisgender Women) challenges the notion, baked into policies, programs and “conventional wisdom”, that cisgender women need to be “super-adherers” to achieve protection utilizing oral PrEP. In this webinar, we discussed this important paper and more.
Speakers: • Dr. Jeanne Marrazzo, National Institute of Allergy and Infectious Diseases • Joyce Ng’ang’a, WACI Health
The 31st annual Conference on Retroviruses and Opportunistic Infections (CROI) kicks off this weekend, and runs from March 3-6 in Denver, Colorado. CROI is the go-to forum for groundbreaking science in the HIV field, and this years’ program is full of exciting new research.
At AVAC, we’re tracking data and discussion on long-acting, injectable PrEP; the dapvirine vaginal ring (DVR) in pregnancy; doxycycline as post-exposure prophylaxis (DoxyPEP) to prevent sexually transmitted infections (STIs); and the latest in HIV cure and control. We’re also very excited for this year’s Martin Delaney Presentation – Unveiling the Power of Uganda’s LGBTIQ Advocacy in Shaping HIV Response and Health Care Access – that will be delivered by Frank Mugisha of Sexual Minorities Uganda (SMUG) in Uganda and couldn’t be more timely. Be sure to check out the conference program.
AVAC and partners have worked to follow and explain the research presented at CROI for many years, making the science more accessible, connecting the findings to community priorities, and ensuring civil society and affected communities are represented within the program, and ultimately the research. For those attending or not, this email shares ways to follow along and join in the discussion and debate.
Follow Along Be part of the conversation by following AVAC on X (Twitter) at @hivpxresearch for real-time updates using the conference hashtag #CROI2024, and be sure to sign up and follow our partner, Aidsmap, who will be reporting from the conference.
Community Breakfast Clubs (CROI registration not required Join the CROI Community Liaisons, AVAC, the European AIDS Treatment Group, and partners for daily Community Breakfast Clubs. These virtual webinars feature researchers and advocates discussing some of the most consequential science being presented at CROI. They are open to all, CROI registrants and non-registrants alike.
Monday, 4 March, 7:00am – 8:00am MT (Click here to determine the time in your location.)
Looking forward to seeing you at the daily Breakfast Club sessions and to working together to unpack the research and be sure it is applied!
Best, AVAC
New Year, New PrEPWatch Resources
In 2024 we look forward to continuing to provide advocates with tools to support our collective work to ensure access to PrEP in all its forms to all who can benefit from it.
PrEPWatch.org has grown significantly in the past year, reaching a growing number of implementers, policy makers and advocates with continually updated tools and information that are instrumental to delivering the growing range of HIV prevention options. Throughout 2023, visitors from every country in the world have used PrEPWatch.org, a one-stop online clearinghouse of data, guidelines, tracking tools and other resources to help the global community speed the delivery of every proven method of PrEP to everyone who needs it. Check out what’s new and updated on PrEPWatch.org!
PrEPWatch has added 35 new country pages where you can find the status of drug registration for PrEP products, data on PrEP initiations by product, country-level PEPFAR targets, and links to key policy documents and guidelines.
The Integrated Study Dashboard
Produced under the BioPIC project, the Integrated Study Dashboard tracks all currently known activities relating to implementation research, modelling, clinical research, and landscaping for new biomedical HIV PrEP options, including CAB for PrEP and the dapivirine vaginal ring (DVR), and has been recently expanded to include links to study results and study websites. The dashboard is updated in real time, and links to results will be added as they become available.
More Essential Resources on PrEPWatch.org
Tracking Country Planning for Product Introduction
The Country Planning for Product Introduction Matrix tracks key indicators for the introduction of injectable CAB and the DVR by country, including regulatory status, late-stage clinical trials and implementation research, procurement plans, and recent oral PrEP provision.
Training PrEP Champions
Among the most popular resources on PrEPWatch, the HIV Prevention Ambassador Training Package and Toolkit prepares potential and current PrEP users to be leaders – and “Ambassadors” – in the rollout of PrEP for HIV prevention in their communities. Developed as part of the MOSAIC project, it includes a training manual and resources for Ambassadors to use in peer outreach and community education.
Trends in PrEP Initiations
The Global PrEP Tracker provides quarterly updates on global trends in PrEP initiation by geography, delivery models, and more. The Global PrEP Tracker has become an indispensable resource for following the state of the field in delivering PrEP.
We hope these tools, created through strong partnerships and joint effort, support your work to accelerate the delivery of HIV prevention options. We are always interested in collaboration to ensure needed resources are developed and up to date. If you have information to share or resource needs, please let us know by reaching out to janki@avac.org and catherine@avac.org.
Px Pulse: A season of listening
As we look ahead to 2024 and the vital work AVAC and partners will be carrying forward, the conversations from 2023 offer guidance and insights. Px Pulse, AVAC’s podcast on critical issues facing HIV prevention research, hosted several not-be-missed conversations in 2023 that will reverberate into the year ahead.
From a stalled PEPFAR reauthorization to LGBTQIA+ voices fighting persecution in Uganda; from efforts to bring equity to a new global architecture for pandemic readiness to advances in HIV vaccine science and advocacy to include pregnant people in research—we hope that all of these conversations can inform our advocacy in 2024. Click on the episode for both recordings and resources.
Considered 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 PEPFAR is marking its 20th anniversary while fighting for its future. LISTEN HERE.
In March 2023, the Ugandan Parliament moved forward broad-reaching legislation to further criminalize LGBTQIA+ people. This podcast features Ugandan advocates and AVAC partners discussing the specifics of how these attacks have gained momentum and their ties to US-based religious extremists. The advocates discuss what needs to happen next. LISTEN HERE.
Health leaders around the world are in the midst of creating a new architecture to deal with pandemics. Chris Collins, the CEO and President at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, talks about what’s at stake, which policymakers get it already, why this year matters so much, and what advocates can do about it. LISTEN HERE.
Over the coming months, global leaders will make key decisions about several initiatives to prepare for the next pandemic. This podcast explores what they commit to, how much they will spend and how well these plans safeguard equity. LISTEN HERE.
AVAC’s Manju Chatani-Gada takes us through conversations with a trial participant who became pregnant, researchers, policymakers and donors to understand why this population gets excluded, the impact it has and what to do about it. LISTEN HERE.
Evolving Strategies for an HIV Vaccine: One researcher explains where the field is going and why? Dr. Katy Stephenson explores the implications of recent trial results, the big questions driving next generation vaccine development, and new strategies underway in early phase research. LISTEN HERE.
Happy listening—and let us know what topics you want to hear more about in 2024!
Years Ahead in HIV Prevention Research: Time to Market
This timeline shows the potential time points when the next-generation of HIV prevention options might find their way into new programs.
People who are pregnant or lactating (PLP) have historically been excluded from research because of concerns for the developing fetus. But this has led to a dearth of data on new interventions against health threats for this population. In the case of HIV, pregnancy raises the risk of acquiring HIV by up to three times, but providers often do not have the data to know whether a new intervention is safe or how it will work for pregnant patients. As a result, PLP and their physicians are left to make difficult decisions around the use of proven HIV prevention products as they await more data specific to pregnancy and lactation.
But change is in the air. Champions for the inclusion of PLP in research are paving the way for a paradigm shift— one that will redefine this population from needing protection from research to being better protected through research. In this episode of Px Pulse, AVAC’s Manju Chatani-Gada takes us through conversations with a trial participant who became pregnant, researchers, policy-makers and donors to understand why this population gets excluded, the impact it has, and what to do about it.
Tune in to hear
Dr. Anne Drapkin Lyerly, Principal Investigator of the PHASES Project to advance equitable inclusion of pregnant women in HIV research and its follow-on project, PREPARE, focused on ethical HIV research in adolescents who are pregnant.
Elisia Madende, Trial participant in the HPTN 084 trial in Zimbabwe
Dr. Ashley Lima, Health Science Specialist and Lead Technical Advisor for Socio-behavioral Research – USAID Office of HIV/AIDS Research Division
Dr. Takunda Sola, HIV Prevention and Key Populations Medical Officer- Zimbabwe MoH AIDS/TB Unit
Frontiers in Reproductive Health: How might we motivate uptake of the Dual Prevention Pill?
Findings from human-centered design research with potential end users, male partners and healthcare providers
AVAC’s Wawira Nyagah and Kate Segal co-authored a comprehensive manuscript on a demand generation approach for the DPP (Dual Prevention Pill) including findings from research with potential users, male partners, and healthcare providers.
Multipurpose prevention technologies (MPTs) combining contraception with HIV prevention offer a promising solution to uptake and adherence challenges faced with oral pre-exposure prophylaxis (PrEP). The Dual Prevention Pill (DPP), which combines oral PrEP with an oral contraceptive pill (OCP), could address unmet need for family planning (FP) and HIV prevention. This study aimed to identify barriers and motivators for DPP uptake to inform the development of a DPP demand generation strategy and broader introduction efforts for MPTs.
Avac Event
PrEP Resources Showcase
Monday, November 20, 8:00 to 9:30 AM ET
This dynamic, workshop-style showcase was the first of a series that featured multimedia presentations that took participants through key PrEP resources including: A toolkit to ensure programs related to sexual and reproductive health (SRH) and HIV prevention are well designed to reach and support adolescent girls and young women. Comprehensive databases for tracking PrEP uptake, Implementation research and other critical data by product, country, and population.
Small groups had opportunities to take deep dives into each of the above resources, and explore how they might use these in their work. Additionally, participants provided input on what resources are still needed, collaborate on how to improve and disseminate what exists, and support the development of evidence and networks to advance HIV prevention.
Spotlight on New PrEP Tools and Data: From R&D to access
Tuesday, November 28
Between the recent accelerated growth in global PrEP initiations, and the introduction of new PrEP products like cabotegravir and the dapivirine vaginal ring, the field of PrEP data has never been more exciting or more complex. Staying on top of the latest advances is key for advocates, researchers, funders, and others working in HIV prevention to do their job effectively—but how can you navigate the vast amount of PrEP data online? AVAC, the Medicines Patent Pool (MPP), and Unitaid presented information on three important online PrEP resources and understand how they can support and enhance your work:
PrEPWatch.org: the one stop shop for PrEP resources to support introduction and scale-up, including the PrEPTracker, the only place to find information on global PrEP initiations online
Access to Medicines Tracker: the go-to place for quarterly-updated insights on regulatory filings, regulatory approvals, and product supplies of MPP-licensed generic medicines at the country level.
Vital Conversations in October and November: So many webinars, so little time!
The October and November calendar of webinars offers a wealth of conversations on cross-cutting issues facing advocates who care about global health equity and HIV prevention. From discussions on PEPFAR reauthorization, to an evolving picture on sexually transmitted infections, to case studies on new interventions at the intersection of HIV prevention and family planning, to research on barriers to care and health priorities for Black gay men in the US; it is a season for advocates to engage in shaping an agenda for 2024.
Scroll down for details and see you online!
October 26, Practicality over Panic: What happens if PEPFAR isn’t reauthorized?
At 11:00 AM ET: Join the Global AIDS Partnership (GAPP) for a candid assessment of the current landscape around PEPFAR, including the implications for work on the ground. It is intended to redirect anxiety into action and provide a reality check: PEPFAR is not going anywhere any time soon.
At 1:00 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.
November 7, Results from STI Landscaping Analyses in East and Southern Africa—Part 1
At 9:00 AM ET: Hear results from STI landscaping projects conducted by AVAC partners in seven different East and Southern African countries that explored needs for STI vaccines and diagnostics.
November 9, Results from STI Landscaping Analyses in East and Southern Africa—Part 2
At 8:00 AM ET: Hear results from STI landscaping projects conducted by AVAC partners in seven different East and Southern African countries that explored needs for STI vaccines and diagnostics.
November 9, Pioneering Self-care Solutions to Drive Access to HIV Prevention and Family Planning
At 8:00 AM ET: This session will amplify lessons from five self-care interventions in family planning and HIV prevention — with case studies on specific interventions— DMPA-SC; the Caya Diaphragm; the Dual Prevention Pill; HIV self-testing; and Triggerise; an mHealth platform. Learn more about how these successful self-care strategies can be applied across diverse settings and join the discussion on the future of self-care in sexual and reproductive health. This session is part of the 2023 Self-Care Learning and Discovery Series. Learn more here.
November 15, HPTN 096: Building Equity Through Advocacy – An Integrated, Status-Neutral Approach for Ending the Epidemic Among Black Gay Men in the South
