PLOS Publication Correlates Key Policies with PrEP Uptake

New research published in the journal PLOS today from AVAC and COMPASS partners shows the importance and value of an enabling policy environment to increase the uptake of HIV prevention services, including for PrEP.

Using data from 194 countries gathered by the HIV Policy Lab and AVAC’s Global PrEP Tracker, the team analyzed the impact of a series of policies: broad PrEP eligibility, HIV self-testing, and lowered age of consent to HIV testing and treatment services. Each was found to be correlated with increased PrEP uptake. The results show:

● A significant and positive correlation between countries authorizing HIV self-testing and cumulative number of PrEP initiations in-country.

● A significant and positive correlation between countries authorizing lowered age of consent to HIV testing and treatment and cumulative number of PrEP initiations.

● Similarly, and not surprisingly, policies authorizing broad PrEP eligibility also show significant and positive correlations with PrEP uptake.

These findings suggest that HIV self-testing is a vital step towards increasing access to PrEP, and support existing evidence that HIV self-testing serves as a gateway to PrEP uptake. They also suggest that young people may be motivated to access PrEP and that countries with policies that expand PrEP eligibility may see a strong benefit, with greater adoption of PrEP by people who need it. With these findings in mind, it’s vital to remember that inequities in PrEP access across populations and settings, based on complex social factors such as stigma and discrimination, can begin to be addressed by enabling policies, but require comprehensive strategies that build on that environment. The right policies cannot do the job alone. Community leadership in every aspect of the HIV response from local to national and to international levels is needed.

Read the full publication here: Correlations Between Oral Pre-Exposure Prophylaxis (PrEP) Initiations and Policies that Enable the Use of PrEP to Address HIV Globally.

New Products Are Needed But a New Paradigm is Essential

With all the talk about new HIV prevention products such as the dapivirine vaginal ring or injectable cabotegravir for PrEP (CAB for PrEP), what’s little understood is how to match proven products with the programs, policies and political will needed to get them to the people who need them. This episode explores the shifting landscape in HIV prevention and how this moment gives the world a chance to finally reimagine how to DELIVER prevention.

We go from big picture to grass roots, and dig into what it’s going to take to reach global targets. There’s a new road map out from the Global HIV Prevention Coalition with a big vision and a new target of less than 370,000 new infections by 2025. And PEPFAR’s new Strategic Direction talks about a target for ending the epidemic as a public health threat by 2030, but how are we going to get there?

This episode brings three perspectives together:

PEPFAR Ambassador Dr. John Nkengasong describes a model to scale up prevention in 5 countries and show impact in 1-2 years.

Executive Director of HEPS-Uganda, and former AVAC Advocacy Fellow, Kenneth Mwehonge talks about the commitments needed from a range of stakeholders to bring the Coalition’s new roadmap to life, and hit 2030 targets.

Lilian Benjamin Mwakyosi, the Executive Director of DARE and former AVAC Advocacy Fellow, talks about the day-to-day obstacles faced by young women who need prevention, what’s working now and what needs to change in HIV prevention programs.

Highlights

  • Listen to the ambassador’s appeal for an aggressive strategy to scale up combination prevention, including injectable cabotegravir for PrEP.

Resources

Press Release

Thousands Sign Letter Calling for National PrEP Program

Movement for Equitable PrEP Access Gains Momentum Ahead of World AIDS Day

Contact

Jeremiah Johnson, [email protected]
Rachel Klein, [email protected]

November 29, 2022. Washington, DC—Over 6000 individuals and 300 organizations representing all fifty states, Washington DC, Puerto Rico, and the US Virgin Islands have signed on to a letter calling for the establishment of a national PrEP program. The letter builds on months of advocacy from a large national coalition of HIV/AIDS advocacy organizations calling for federal fiscal year (FY) 2023 funding for a PrEP program that will increase access to medications, labs, and direct services for uninsured and underinsured individuals; expand a provider network including nonclinical sites and telePrEP; and create demand through both national and local campaigns.

“Nearly 400,000 new HIV transmissions have occurred in the United States since PrEP was first approved by the Food and Drug Administration (FDA) on July 16th, 2012.” states the letter. “Over those ten years, Black, Latinx, and queer communities have continued to bear the brunt of this devastating epidemic. It is critical that the nation address this long-standing crisis by creating a national PrEP program to expand access to PrEP so that it reaches every person in need.”

The letter–promoted by PrEP4All, AVAC, The AIDS Institute, NMAC, the National Coalition of STD Directors, NASTAD, and AIDS United—notes that of the 1.2 million Americans estimated by the CDC to be most in need of PrEP only 9 percent of Black individuals and 16 percent of Latinx people had PrEP prescriptions in 2020 compared to 66 percent of White individuals.

“This persistent, never-ending crisis has come at great financial cost to our healthcare system. A national PrEP program would avert many of these costs while improving the lives and health of thousands of people nationwide,” the letter continues.

The letter is being delivered to the White House and Congressional leadership as Congress moves to finalize appropriations for FY23, providing a key opportunity for appropriators to invest critical funding toward a national PrEP program. A downpayment on a national PrEP program in FY23 is a necessary first step to promote equitable access to this proven HIV intervention that prevents new HIV infections that are costly to both personal health and healthcare systems.

We call on Congress and the Administration to fund a national PrEP program now so that we can advance this critical intervention and realize the bipartisan goal of ending HIV as an epidemic in the US. A decade has been too long to wait. We need a #NatlPrEPProgramNow.

logos of sign on organizations

###

MTN 017

HPTN 067 (ADAPT)

MTN 016 (EMBRACE)

IPERGAY

Bangkok Tenofovir Study (BTS) Follow-Up

TMC278-MWRI-01

Nigerian National Agency for the Control of AIDS