Px Wire September 2023

Volume 13, Number 3

Advancing Choice in HIV Prevention

In recent weeks, important new resources for advancing choice in HIV prevention have been announced. Don’t miss these highlights from the field. They point to an HIV response in transition, and help to define the role advocacy must play. As policy, practice and budgets strive to keep up with advances in research, advocacy around choice becomes a cross-cutting priority—so that the promise of new options in HIV prevention won’t be squandered in siloed programs, or by poorly-planned supply chains, or because of disconnected policy decisions. People have diverse needs and face complex challenges; ending HIV depends on finding the option that works best for each individual.  

The Choice Manifesto 

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The African Women’s HIV Prevention Community Accounability Board (AWPCAB) launched the HIV Prevention Choice Manifesto, calling for increased political and financial support to ensure every proven method of HIV prevention is integrated into the HIV response, so that all women who need prevention will have access to the options that will make prevention possible for them. At the launch event in Kampala, UNAIDS Executive Director Winnie Byanyima gave a keynote address in support of the Manifesto’s call for all stakeholders to commit to the budgets and strategies that will make choice possible.  

“I congratulate you for the HIV Prevention Choice Manifesto. It’s about pushing everyone towards people-centered, women-centered and women-led approaches to HIV prevention. You have fought with your lives to get here. You are fearless feminists. Women must lead for themselves.” – Winnie Byanyima, UNAIDS Executive Director

Learn more about the HIV Prevention Choice Manifesto and other advocacy resources for choice in our latest AVAC blog, Reclaiming Choice: The launch of the HIV Prevention Choice Manifesto and what that means.  

The Dual Prevention Pill (DPP) 

The DPP Consortium created a multiyear strategy to frame priorities and next steps in the development and delivery of the dual prevention pill (DPP), which is being developed to prevent HIV and unintended pregnancy. This multipurpose prevention technology (MPT) combines oral PrEP with an oral contraceptive. The updated strategy consolidates two years of progress toward preparing the field for new MPTs. The strategy addresses additions to the MPT pipeline, the potential role of the private sector in delivering a future DPP, recommendations for provider counseling on the use of the DPP, market research on potential DPP users, the latest analysis on cost, and more.

Stay tuned for more resources and updates to come on the DPP, the Choice Manifesto, and tools for connecting choice to HIV prevention, ending the epidemic and the role of choice in global health equity in HIV, and beyond.

DPP Audience & Provider Insights for the DPP Research and Marketing Plan: Phase 1 Research Findings

This report, by M&C Saatchi World Services, AVAC, and partners, highlights learnings from Human-Centered Design Research undertaken in 2022 to understand the values and motivations of potential users and influencers of the Dual Prevention Pill (DPP) in Kenya, South Africa, and Zimbabwe.

Frequently Asked Questions About the Dual Prevention Pill (DPP)

This factsheet provides answers to the most frequently asked questions about the Dual Prevention Pill (DPP), including what it is, who might use it, and how it can be rolled out.

Dual Prevention Pill: Market Preparation and Introduction Strategy

This strategy, updated in August 2023, is intended for donors, governments, implementing partners and civil society to inform priorities and planning for DPP rollout. The strategy describes activities required to build a cohesive body of evidence and recommends an approach to DPP introduction to focus efforts. Where possible, activities will be embedded into existing programs to consolidate and leverage resources.

Reclaiming Choice: The launch of the HIV Prevention Choice Manifesto and what that means

The African Women’s HIV Prevention Community Accountability Board (AWCAB) launched its HIV Prevention Choice Manifesto in Kampala, Uganda on September 8, 2023. This document, and the advocacy behind its development and release, marks a historic milestone in the power of community-led leadership and prioritization of choice in HIV prevention.  

“The toolbox for HIV prevention products is still falling short. More options are needed to suit everyone at different stages of their lives including an effective, accessible, and safe HIV vaccine if we want to see an end to the epidemic”. – Joyce Ng’ang’a, WACI Health, Accountability Board Member and Communications Lead

The AWCAB is a coalition of women and girls living and working in Africa who are united in calling for continued political and financial support for more choice in HIV prevention through the HIV Prevention Choice Manifesto. This comes at a time when political will and financial investment are critical to deliver new prevention options such as CAB for PrEP and the dapivirine vaginal ring to meet the needs of women and girls in Africa. In 2023, over four decades in the epidemic, a vast array of biomedical tools to prevent HIV acquisition exist, but these tools are only effective in their purpose if there is universal access, if communities know they exist and are able to choose from all the available options. The manifesto serves as a declaration of what could happen if African women and girls not only had a seat at the table, but led the response and advocacy efforts that shape healthcare for HIV prevention.  

“We have come a long way in the fight to secure choice in HIV prevention for women and girls. We are at a watershed moment to ensure we close the gap for new infections among women and girls. The launch of the Choice Manifesto is the beginning of the work ahead of us as we call on key players to sign onto the manifesto and become part of the change.” – Yvette Raphael, Advocacy for Prevention of HIV and AIDS (APHA), Accountability Board co-chair

Most notable was the presence of UNAIDS Executive Director, Winnie Byanyima, who delivered the keynote address and publicly endorsed and signed the Manifesto. Key stakeholders in HIV prevention participated in the launch and affirmed their commitments to choice. This included leadership from UNICEF, UN WOMEN, ViiV, PEPFAR, USAID, Global Fund, Ministry of Health, Uganda, Population Council/ IPM, Aidsfonds, FHI 360 and other civil society organizations. The commitments leadership and key stakeholders signed were focused on elevating national and global dialogue, ensuring resources to prevention options were accessible and sustainable, and bolstering support for local manufacturing of prevention products. Following the launch of the Manifesto, UNAIDS released a feature story on its website HIV Prevention Choice Manifesto for Women and Girls in Africa launched, highlighting the commitment to choice. 

Explore resources, tools, and takeaways from the launch including the full HIV Prevention Choice Manifesto.  

“The Choice Manifesto is an important and timely advocacy tool. It will help advocates lobby for resources and political will towards making HIV prevention options available for women and girls in Africa. We need commitment and actions from all stakeholders including funders and governments towards CHOICE-based HIV Prevention Programming”. – Grace Kumwenda, AVAC, Accountability Board Member

AVAC stands in solidarity with the Accountability Board, and congratulates the group on this major advocacy win! AVAC reaffirms its ongoing commitment to support the Accountability Board as part of the Coalition to Accelerate and Support Prevention Research (CASPR) and to champion the cause of ensuring choice in program implementation, access to and procurement of prevention options; and to advocating that the prevention agenda is shaped by women and girls who seek and want these essential tools. 

“We are not asking for much! Let us stop being comfortable with shameful statistics of alarming new HIV infections among adolescent women and girls and start providing options for HIV prevention that meet their needs. Their lives matter!” – Lillian Mworeko, International Community of Women living with HIV Eastern Africa (ICWEA), Accountability Board co-chair

As advocates continue to track and translate HIV prevention tools on the horizon, including already existing and revolutionary long-acting medications, it is important to listen to those who are leading the fight for equity and center choice in all of our implementation efforts.  

For more information on the Manifesto, please reach out to Yvette Raphael (yvette@apha.org.za), Lillian Mworeko (lmworeko@icwea.org), or Joyce Ng’ang’a (joyce@wacihealth.org).  

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.

PrEP That Booty: The latest on rectal microbicide research for the back door

Thursday, June 29 at 9:00 AM–10:30AM ET

Most of what we hear about regarding the HIV prevention pipeline is about long-acting, longer-acting, and even longer-acting products that deliver drug throughout the body and require a trained clinician to deliver. However, these attributes are not desirable to many folks, and communities want a range of choices. Researchers and advocates for years have been working on HIV prevention products specifically for the back door (rectum) to provide protection during anal intercourse. These products are user-controlled, non-systemic (the drug stays in the booty and only the booty), and are short-acting, so you don’t have to commit to having a prevention drug in your body for a year or longer. Join us for a dynamic discussion regarding the latest research on Booty PrEP – aka rectal microbicides – with our multi-talented panel.

Speakers include: Jonathan Baker, PA, Laser Surgery Care, Dr. Craig Hendrix, Johns Hopkins, Juan Michael Porter II, The Body, and Dr. Sharon Riddler, University of Pittsburgh

Recording / Slides / Resources

Avac Event

SCOPE Community E-meeting: Developments in the HIV and STIs biomedical prevention pipeline

The European AIDS Treatment Group, along with European and local organizations are coming together for a virtual meeting via Zoom e-meeting on Wednesday, May 24 at 6:00 to 7:30 AM ET (12:00 – 13:30 PM CET).

This interactive e-meeting for community educators and advocates will provide an update on the latest developments in biomedical HIV and STIs prevention research and implementation, new approaches and future challenges. Participants will learn from each other and discuss community preferences, uptake and access issues, as well as advocacy efforts to overcome policy and financial barriers at local, regional and European level. Live interpretation in English and Russian will be provided. This meeting is part of the SCOPE Project.

Avac Event

STI & HIV World Congress (ISSTDR) 2023

The STI & HIV World Congress (also known as ISSTDR) kicks off in Chicago, Illinois, USA and AVAC will be there. This is the first major face-to-face meeting of STI & HIV professionals since 2019 and one of the only spaces the global STI community comes together to promote ongoing STI research efforts and exchange information on current investigations. This is also the first time AVAC is attending ISSTDR in hopes of expanding STI advocacy and community engagement.

STI & HIV World Congress Resources 

Visit STIWatch.org, a new resource for the sexual and reproductive health and rights (SRHR) community to better understand and advocate for STI vaccine and diagnostics research, development and rollout.

STI & HIV World Congress 2023 Roadmap

Check out some AVAC-featured sessions below.

The STI Prevention Pipeline: Where Are We, and What Will It Take to Move Forward Faster?
Monday, July 24 11:00 AM to 2:00 PM in the Cadmium Room
Join us to explore the current development and implementation stages of STI vaccines and diagnostics and identify ways to accelerate research through advocacy.

Symposium: New Vaccine Approaches to STI Prevention STI Vaccine Acceptance and Equity
Tuesday, July 25 2:30 PM to 4:00 PM in Chicago 6
Join AVAC’s Alison Footman to dive into the topic of STI vaccines and equity as new interventions come into reach.

Setting Up a Remote/Home Testing STI Programme: A Practical Toolkit
Thursday, July 25 11:30 AM to 1:00 PM in Sheraton IV/V Room
Join us to explore the power of remote testing to affordably curb STI acquisitions.

Community Happy Hour 
Monday, July 24, 6:00 to 8:00 PM at Lizzie McNeill’s
Join AVAC and partners for a no frills happy hour for the STI community. All are welcome! 

ISSTDR Advocacy Zone 
Monday, July 24 to Thursday, July 27 at the Exhibit Hall
Visit the Advocacy Zone, a space to ask important questions, connect with fellow STI advocates, and begin to chart next steps in advancing STI R&D.