West & Central Africa Oral PrEP Initiations, 2023

As of Q3 2023, the top five West and Central African countries for PrEP initiation have surpassed 10,000 initiations; Cameroon, Cote d’Ivoire, Democratic Republic of the Congo (DRC), Ghana and Nigeria. Nigeria has marked almost 550,000 cumulative initiations as of this quarter, ranking it second, behind South Africa, worldwide. These milestones can be credited to targeted PEPFAR investments. But despite these successes, West and Central Africa make up only 14 percent of PrEP initiations recorded in Africa, compared to 85 percent reported by East and Southern Africa. These same countries are home to two thirds of all people living with HIV in West Africa. There is vital work to be done to close the gap.

West and Central Africa can and must continue to leverage this recent growth in oral PrEP by making additional HIV prevention options available. In September, Nigeria’s regulators approved injectable cabotegravir (CAB for PrEP)—approving the first new biomedical HIV prevention option in a West and Central African country since oral PrEP. But at this time, only one other CAB for PrEP application has been submitted in the region, in Côte d’Ivoire, and none for the dapivirine vaginal ring (DVR). Only one CAB for PrEP implementation study is planned for the region.

Excerpted from PxWire Volume 13, Issue 4.

PEPFAR Support for PrEP in 2023

PEPFAR’s role has been instrumental to accelerating global uptake of PrEP to date. In 2023, four countries started providing PrEP for the first time, and seven countries exceeded 70,000 new PrEP initiations, most of which are attributable to PEPFAR. This lifesaving, uniquely effective, program must see continued full funding and a 5-year reauthorization to carry on this work and help to put the world on track to control the epidemic.

Excerpted from PxWire Volume 13, Issue 4.

PrEP Resources Showcase

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

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

November 15, 10:00 to 11:30 AM ET

The Choice Agenda and partners hosted a fascinating discussion about a novel, much-needed HIV prevention research study – HPTN 096 on November 15. Currently in the field, the study addresses social, structural, institutional, and behavioral barriers to HIV prevention and care. Visit the study website here.

Speakers (list in formation):

Prof. LaRon E. Nelson. Yale School of Nursing; HPTN 096 Protocol Co-Chair
Christopher Hucks-Ortiz, HPTN Black Caucus Chair
Dr. Cedric Pulliam, HPTN 096 Community Strategy Group
Abraham Johnson, HPTN 096 Research Advisor

Moderators:
Riko Boone, Treatment Action Group
John Meade, AVAC

Co-sponsored by PrEP in Black America and Federal AIDS Policy Partnership Research Working Group

Recording / Slides / Resources

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 

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

Community Manifesto for HIV Long-Acting Injectable PrEP in Europe

This document stems from a March 2023 consensus meeting in Paris involving regional and international HIV prevention organizations and activists. Four main pillars were identified to promote new PrEP technologies and expand access to long-Acting injectable PrEP in Europe. These pillars should be implemented simultaneously and also aim to broaden PrEP accessibility beyond LA-CAB.

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.