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 AudioSlides / 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 HIVMAPrEP4All and The Choice Agendathis 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

Recording / Slides / Resources

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.

Read the full press release here.

Developments in the HIV Biomedical Prevention Pipeline & PrEP Implementation Issues

An Update for Community Educators and Advocates

The European AIDS Treatment Group published a report covering two online discussions on the HIV biomedical prevention research & PrEP implementation issues for community educators and advocates. The report covers developments from the PREVENIR Cohort study, on long-Acting intramuscular PrEP, DoxyPEP, vaccine, as well as STI-PEP research. It also reviews challenges in the uptake of PrEP among women and in particular migrant women from sub-Saharan Africa and trans people.

Download the report. For more information and to see the recordings of the online discussions, click here.

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 AudioSlides / Resources / Audio Transcript (English/Ukrainian)

Avac Event

MOSAIC Global PrEP Learning Network – Building a Brand for PrEP: Positioning PrEP in the Hearts and Minds of Young People


With choice of PrEP products on the horizon – including oral PrEP, the PrEP ring, and injectable cabotegravir for PrEP (CAB PrEP) – PrEP marketing and demand generation must evolve with the availability of new PrEP products. Young people, in particular, need PrEP demand generation campaigns tailored to their needs and aspirations. In this webinar, we will hear from teams working to change the landscape of PrEP marketing by applying private sector approaches to brand the PrEP category. We will also hear how they are developing fresh, dynamic, and evidence-informed campaigns to increase PrEP awareness and encourage PrEP use among young people in Africa.

This webinar is being hosted by PEPFAR, USAID, and MOSAIC.

Cumulative PrEP Initiations

2016-2025

In 2020, the world missed the UNAIDS’ goal of reaching 3 million PrEP users. The updated target for 2025 is 10 million. Is the 2025 target achievable based on the current trends in PrEP uptake? Excerpted from an issue of PxWire.