Tracking PrEP Rollout & Learning Lessons

Accelerating the rollout of the full range of proven HIV prevention options depends on learning from what’s been done in the past and investing in coordination and innovation to put improved solutions in place. The Biomedical Prevention Implementation Collaborative (BioPIC) is doing just that. Over the last two years, BioPIC—a project led by AVAC with support from the Gates Foundation—has been gathering and sharing evidence on these critical lessons to ensure the next generation of HIV prevention products reaches everyone who needs and wants them with much greater speed and equity.  

What We’re Learning—Highlights from 2024 Convenings

An ongoing series of think tanks, convened by BioPIC and WHO since 2021, are generating key insights for people-centered product delivery. Below, read the latest reports from these think tanks that are informing decision-making on priorities for accelerating access to PrEP. Go to the BioPIC’s page on PrEPWatch to find reports on all think tanks since 2021.  

  • Early Insights from EBONI and PILLAR, February 2024: Early insights from ViiV Healthcare, the manufacturer of CAB for PrEP, from two CAB for PrEP implementation studies, EBONI and PILLAR. Conducted by ViiV in the US, these are among the first studies gathering data in real-world settings. Learn more
  • Taking Stock of PrEP Evidence, March 2024: An analysis of current data and priority evidence gaps. This inquiry was not focused on any one PrEP product, and its findings are informing the focus of future think tanks. Learn more
  • Linking Modellers with the Latest Implementation Science Evidence, March 2024: A consideration of the latest modelling data and insights on injectable cabotegravir (CAB) for PrEP. Read about the biggest takeaways from CAB for PrEP modelling here, and learn more about the big questions that require further inquiry here
  • Discussing Early Results from the SEARCH Dynamic Choice Study, April 2024: Professor Moses Kamya of Makerere University shares early insights from the SEARCH Dynamic Choice Study in Kenya and Uganda, which gave participants a choice between oral PrEP, PEP, and CAB for PrEP, and analyzes the role of choice in PrEP coverage. Watch here
  • PrEP and the Role of HIV Self-Testing, May 23: Highlights from the WHO guidance on use of self-testing (HIVST) as an innovative way to increase PrEP access and coverage and further simplify PrEP delivery. Panelists also share experiences with procurement, costing, rollout and scale-up. Watch Here

As other new biomedical HIV prevention products roll out, BioPIC will continue to hold strategic convenings, identify and address evidence gaps, and work to accelerate equitable product introduction. To learn more efforts to coordinate the introduction of CAB for PrEP, check out the JIAS article Shaping and coordinating the implementation science agenda for injectable cabotegravir for PrEP: the role of the Biomedical Prevention Implementation Collaborative (BioPIC). To learn what’s needed to better coordinate rollout for not-yet-approved products in Phase III clinical trials, check out BioPIC’s Adaptable Product Introduction Framework. 

We hope you will book mark these resources, and stay up to date on findings from future think tanks and webinars in 2024 on the BioPIC page of PrEPWatch.

Avac Event

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

Moderator:
Raniyah Copeland, Equity & Impact Solutions

Materials:
Recording / Ukrainian Audio / Slides / Resources / Audio Transcript (English/Ukrainian)

Remembering a Legacy and Celebrating AVAC Fellow Alumni

For over a decade, the AVAC Advocacy Fellows Program has played a role in shaping the landscape of HIV prevention by strengthening leadership skills and building a growing and evolving network of fierce and unstoppable advocates. Last year, AVAC released A Legacy of Impact: The power and reach of AVAC’s Advocacy Fellows to tell the story of the Fellows program and to share testimonies of impact from research to policy, and beyond.  

Today, on Martin Luther King Jr. Day, a day dedicated to the importance of advocacy to influence change, AVAC honors its nearly 100 Fellow alumni and applauds our most recent class which closed out their fellowship in December.  

Read on for testimonies from the AVAC 2022/2023 Fellows and explore their work in their individual pages. 

AVAC 2022/2023 Fellows in their words

Learn about Ruth’s work around the approval and rollout of the dual prevention pill (DPP) in Uganda here. 

Learn about Onward’s work with engaging religious institutions on adolescent sexual and reproductive health in Zimbabwe here.

Learn about Prince’s work ensuring access to injectable CAB for PrEP for trans people in Malawi here. 

Learn about Catherine’s work in the rollout and implementation of the dapivirine vaginal ring for adolescents and young women (AGYW) in Tanzania here. 

Learn about Natasha’s advocacy for the approval of the dapivirine vaginal ring and injectable CAB for PrEP in Zambia here. 

Learn about Peter’s work with differentiated service delivery of PrEP and expediting new PrEP tools in Lesotho here. 

Learn about Elizabeth’s work advocating for sex workers and people who use drugs (PUD) here. 

Learn about Liyema’s work on advocating and implementing the decriminalization of sex work in South Africa here.  

Get to know the full AVAC Fellows community by exploring the full alumni database and stay tuned to meet the 2024/2025 class to be announced in April! 

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! 

New on PrEPWatch

Modelling the Scale-Up of Injectable CAB for PrEP 

Our Biomedical Prevention Implementation Collaborative (BioPIC) teamed up with the HIV Modelling Consortium to produce this analysis of the potential impact of scaling up injectable cabotegravir (CAB) for PrEP, What can modelling tell us about the scale-up of CAB for PrEP? The findings can help implementers and policymakers understand what to expect and guide early policy decisions to maximize the impact of CAB for PrEP on the HIV epidemic. 

Country Pages 

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.

PEPFAR at 20: Keeping the promise (23:16)

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.

LGBTQIA+ Advocacy in Uganda: Facing down fear and fighting for justice (24:19)

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.

The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action (15:14)

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.

PPPR Advocacy 101: Find out what it means to you (19:05)

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.

Inclusion of Pregnant and Lactating People in HIV Research: What you need to know (34:28)

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? (21:23)

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! 

New Episode of the Px Pulse Podcast

The intersection of HIV research and pregnancy

AVAC’s Px Pulse podcast has a new episode: Inclusion of Pregnant and Lactating People in HIV Research: What you need to know. 

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 

Advocacy resources 

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.

Read the abstract below and the full published research article here.

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.

Global PrEP Tracker video / Integrated Study Dashboard video / Breaking the Cycle Toolkit video

Avac Event

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
  • Long Acting Therapeutics Patents and Licenses Database (LAPaL): LAPaL is the go-to resource to learn about long-acting therapeutics, their patent landscape, development and regulatory status
  • 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.

Recording / Slides

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.

REGISTER

October 31, Boo, Syphilis is Really Back!

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.  

REGISTER

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.  

REGISTER

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. 

REGISTER

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. 

REGISTER

November 15, HPTN 096: Building Equity Through Advocacy – An Integrated, Status-Neutral Approach for Ending the Epidemic Among Black Gay Men in the South

At 10:00am ET: Join The Choice Agenda and partners for a fascinating discussion about a novel, much-needed HIV prevention research study – HPTN 096. Currently in the field, the study addresses social, structural, institutional, and behavioral barriers to HIV prevention and care. Visit the study website here. See the speakers list here. Co-sponsored by PrEP in Black America and Federal AIDS Policy Partnership Research Working Group 

REGISTER