Allocation of Non-Commercial CAB for PrEP Supply in Low- and Middle-Income Countries, 2023-2025
Biomedical HIV Prevention Summit and PrEP in Black America Summit: AVAC Highlights
Last Week, 1,000+ community advocates, researchers, policy experts, federal public health leadership, medical and service providers from around the US and Puerto Rico attended the NMAC annual Biomedical HIV Prevention Summit in Seattle, Washington. The discussion and debate on PrEP access, especially for racial and ethnic minorities and key populations, PrEP research, care, policy and community-based programs are ones to follow. AVAC’s John Meade (Senior Program Manager, Policy), Jessica Salzwedel (Senior Program Manager: Research Engagement) and Kenyon Farrow (Communications Director) presented in workshops and satellite sessions at the Summit and at the PrEP in Black America preconference
The Summit included sessions that updated community advocates on the latest in biomedical research for new diagnostics, PrEP, PEP, STIs and vaccines. Meade co-presented a Clinical Trials 101 for community advocates to learn more about the research process. Farrow presented an epidemiological overview on HIV and Disparities in the United States for NMAC’s Gay Men of Color Fellows.
All three AVAC staff contributed to the PrEP in Black America: The State of HIV Prevention Research in the Black Community pre-conference, organized by PrEP in Black America (PIBA). PIBA began in 2022 as a community-led effort to increase Black community mobilization and engagement in PrEP research, policy and access programs. Farrow and Meade are PIBA cofounders, and Meade facilitated the day’s agenda, with more than 200 attendees focused on identifying the research gaps that need to be addressed to increase knowledge, access and use of PrEP. Data shows that while Black people in the U.S. make up 42% of all new HIV diagnoses in 2021, they were only 14% of all PrEP users. By comparison, white Americans are 65% of all PrEP users, but only 26% of all people diagnosed with HIV in the same year.
Salzwedel co-led the closing consensus session at PIBA, a discussion where attendees named research priorities to be later released as part of a National Black-Centered Biomedical HIV Prevention research agenda. One of the most important priorities named, however, goes beyond singling out the right research questions. Attendees showed strong consensus that the research process itself needs to change. Attendees expressed a need and desire for more investment and commitment to community-led research, that can reflect non-traditional ways of gathering data and designing trials and ending the extractive approach that characterizes conventional researcher/community relationships.
To stay up to date with PrEP in Black America, follow them on Instagram and Facebook.
Join AVAC, The Choice Agenda, PrEP4All and HIVMA on Friday, April 26 for a special follow-up webinar, We Can’t End HIV in the United States Without Equitable PrEP Access: Strategies for success. Register here.
Avac Event
PrEP and the Role of HIV Self-Testing
HIV self-testing (HIVST) is a safe, accurate, and effective alternative to provider-administered testing that many users prefer for its convenience and confidentiality. At IAS 2023, WHO issued a new recommendation to offer HIVST for PrEP initiation and continuation as an innovative way to increase PrEP access and coverage and further simplify PrEP delivery. However, many implementers still have questions on how to effectively roll out and scale up this important self-care intervention. Join AVAC and WHO on 23 May to learn more about WHO guidance on use of HIVST and hear directly from a panel of experts on their experiencing rolling out HIVST for PrEP, guidance on procurement and costing, and more.
For Us by Us: PrEP in Black America – A Master Plan for HIV Prevention in Black America
In the spirit of seeking change to ameliorate the devastating impact of HIV in Black communities through biomedical HIV prevention, Black leaders convened the “PrEP in Black America (PIBA) Summit” virtually and in person on September 13, 2022, in Atlanta, Georgia. Attendees have included Black activists, researchers, scientists, providers, and policymakers from across the country representing more than 50 organizations. Following the event, PIBA generated a report summarizing the event and key recommendations entitled, “For Us by Us: PrEP in Black America – A Master Plan for HIV Prevention in Black America.”
Read the full report, “For Us by Us: PrEP in Black America – A Master Plan for HIV Prevention in Black America” here.
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)
Rhoda Msiska
Rhoda is currently employed by Copper Rose Zambia. She was a 2023 AVAC Advocacy Navigator focused on lowering the age of consent for access to HIV prevention services. She holds a bachelor’s degree in gender studies from the University of Zambia where she was awarded best graduating student of her class and school of humanities and social sciences BA programme. As an AVAC 2024 Advocacy Fellow Rhoda will focus on the successful introduction of the Dual Prevention Pill with the goal of increasing women-controlled HIV prevention options in Zambia.
Mokone Rantsoeleba
Mokone is a community educator and advocate for people in prisons. He has supported demand creation and provided health information to increase incarcerated people’s knowledge on HIV/AIDS and improve their uptake of HIV services. He is a qualified Teacher and holds Bachelor of Education. As an AVAC 2024 Advocacy Fellow Mokone aims to streamline PrEP services in prisons. This project will create a beautiful vision in which there are no new HIV infections in Lesotho prisons.
Avac Event
We Can’t End HIV in the United States Without Equitable PrEP Access: Strategies for success
A collaboration between HIVMA, PrEP4All and The Choice Agenda, this webinar assessed some of the key challenges to delivering PrEP in the United States equitably, including cost, the complexities of our health care system, and other factors that inhibit uptake amongst the most vulnerable communities. Strategies to address these challenges were offered included a Q&A, discussion and much-needed debate.
Speakers:
• Dr. Lorraine Dean, Johns Hopkins University, Department of Epidemiology
• Dr. Rupa Patel, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
• Dr. Patrick Sullivan, Rollins School of Public Health, Emory University
Moderator:
Dr. Greg Millet, amfAR
Pamela Fuzile
Pamela has over a decade of experience working in HIV prevention and implementation programs. She is currently a research administrator for FAST PrEP, an implementation science project providing differentiated PrEP (oral, vaginal, and injectable) delivery to adolescent and young people in South Africa. She played a significant role in the design of a Youth Reference Group (YRG) in the FAST Prep project in 2020. And, notably, Pamela was involved in the development of youth centered delivery of STI partner notification. As an AVAC 2024 Advocacy Fellow, she aims to create a youth prevention advocacy platform.
Press Release
Funding for HIV Survives Extreme Cuts Proposed By House Republicans
Final FY24 Bill Includes Calls for HHS/CDC to Increase PrEP Access
21 March 2024 – PrEP4All, AVAC, HIVMA, and the PrEP in Black America coalition celebrate Congress’ decision to both fund domestic HIV programs at the same level as last year and to lift up calls for a National PrEP Program. The final 2024 Health and Human Services bill rejects extreme cuts to HIV funding proposed by House Republicans in July of last year. The organizations have led the charge on the #SaveHIVFunding campaign following efforts to eliminate $767M in critical funds to end HIV as an epidemic. We additionally thank House and Senate LHHS Appropriations Subcommittee leaders Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) and Representatives Robert Aderholt (R-AL) and Rosa DeLauro (D-CT) for working to ensure an effective and ultimately bipartisan outcome.
“Our movement for a National PrEP Program and to end HIV as an epidemic remains strong,” says PrEP4All Executive Director Jeremiah Johnson. “The final bill ultimately shows strong bipartisan support for HIV funding, including PrEP, and rejects the flawed effort by some House Republicans to zero out the Ending the HIV Epidemic Program. We created the #SaveHIVFunding campaign in collaboration with AVAC, HIVMA, and PrEP in Black America knowing that everyone in Congress needed to hear from community advocates in order to be successful in fighting these unnecessary deep cuts. Without this work and the concerted and brilliant efforts of so many HIV organizations within the Federal AIDS Policy Partnership, this win would not have been possible.”
The outcome means that a previous $25M increase going toward CDC’s efforts to improve equitable PrEP access will be preserved, which is critical as advocates continue to engage with CDC on ways to establish a foundation for a National PrEP Program using existing funds. Congress also included final report language directing CDC to increase access to PrEP and cited previous calls from the Senate to establish the “building blocks of a national program to increase awareness of PrEP, increase access to PrEP medication, [and] laboratory services…”
“This outcome is a win for Black communities across the nation who are disproportionately impacted by HIV. Making life-saving treatment and prevention a reality for Black Americans is a possibility because of our relentless advocacy work to #SaveHIVFunding,” says Raniyah Copeland, Founding member of the PrEP in Black America Coalition and Founder of Equity Impact Solutions.
“This has been a long process, and we are grateful to have an outcome that leaves us on firm footing to realize the vision of a National PrEP Program,” says Andrea Weddle of HIVMA. “However, the fight for FY25 is already upon us following this prolonged budget process; meaning that advocates will have to remain vigilant, fight to protect our existing funding, and continue to ensure a clear, immediate, and fully funded pathway toward equitable PrEP access.”
“This is very encouraging news for PrEP advocates, especially following the President’s reintroduction of his proposal for a National PrEP Program last week.” Explains John Meade, Senior Program Manager for Policy at AVAC . “Combined with HIV/AIDS housing advocates’ victory in achieving an FY24 funding increase, I am so proud of our movement and our ability to rally in the face of these threats.”
A National PrEP Program would be a cost effective means to achieve our national goal of Ending the HIV Epidemic by 2030. Pre-Exposure Prophylaxis (PrEP) is a 99% effective use of medication to prevent HIV. Unfortunately 64% of people who could benefit from PrEP do not have access to it. A new study shows that states with the highest PrEP coverage showed an annual percentage decrease in HIV diagnoses of 8% from 2012 – 2021. In contrast, states with low PrEP coverage increased 2% annually. A National PrEP Program will increase access among people who could benefit and address major disparities in access related to race, gender and geographic location. “In the current political environment, this Congressional action is especially noteworthy. But we must never confuse this progress with success; our fights for funding, equity and impact in treating and preventing this epidemic must continue, and funding and implementing a national PrEP program at scale and with urgency remains a huge priority,” said Mitchell Warren, Executive Director of AVAC.