What’s New on AVAC.org and PrEPWatch.org

A few important new resources are up on AVAC.org and PrEPWatch.org. Read on for highlights and links.

Global Guidance

Don’t miss AVAC’s Take on Updated WHO Guidance on Hormonal Contraception and HIV Risk. You’ll learn “business as usual” is a grave concern in light of the World Health Organization’s (WHO) updated guidance on “Hormonal Contraceptive Eligibility for Women at High Risk of HIV”. The changed status of the hormonal contraceptive DMPA stems from a review that was prompted by the results of the ECHO Trial.

F/TAF and Women

In our blog, “A New Oral PrEP Strategy Is On the Horizon, But Who’s Going to Get It?” you’ll get the details on a potential new oral PrEP strategy using F/TAF, which inched a step closer to availability—though not necessarily for all people who need it. The blog provides information on what happened at an Antimicrobial Drugs Advisory Committee meeting on F/TAF for PrEP, convened by the US Food and Drug Administration—and what needs to happen next.

PrEP and the Challenge of Continuation

Watch the webinar, Identifying PrEP Continuation Challenges and Approaches to Support Success, to hear implementers from Kenya (Jhpiego/Jilinde) and Zimbabwe (PZAT) share PrEP continuation challenges, successes, and approaches. And learn more about findings from a recent think tank our Prevention Market Manager project co-convened with a number of partners on defining impact and success in the context of PrEP, and key considerations for measuring and monitoring continued and effective use.

Fellows in 2020

Apply to become an AVAC fellow, or send this application to someone who you know belongs in AVAC’s 2020 class of Advocacy Fellows. AVAC’s Advocacy Fellows Program has been supporting and expanding the capacity of advocates and organizations to accelerate, shape and monitor biomedical HIV prevention research and implementation since 2009. Our Fellows have gone on to become leaders in the HIV movement in their communities, countries and globally. Don’t miss your chance to join the next class—deadline is September 20th!

A New Oral PrEP Strategy Is On the Horizon, But Who’s Going to Get It?

Earlier this month, a new daily oral PrEP strategy using F/TAF (brand name Descovy), inched a step closer to availability—though not necessarily for all people who need it. It’s a mixed moment. More strategies are good, but it is unacceptable to skimp on research in ways that leave women or any other population out. The history of the AIDS epidemic is, in part, the history of moving ahead based on research in the bodies of people assigned male at birth—to the detriment of essential knowledge about what works for cis (and trans) women and transmen. This blog provides information on what happened at an Antimicrobial Drugs Advisory Committee meeting on F/TAF for PrEP, convened by the US regulatory body, the Food and Drug Administration (FDA)—and what needs to happen next.

What’s the New Strategy?

Gilead Sciences, the developer and patent holder for Descovy (F/TAF), submitted an application to license F/TAF as a daily oral PrEP strategy for HIV prevention. TAF and TDF (TDF is one of two drugs in the combination TDF/FTC that the FDA approved for PrEP in 2012) represent different prodrug versions of the same compound, tenofovir (TFV). A prodrug is a drug that works only after our bodies have processed, or metabolized, it. It gets activated as our bodies break it down. Many drugs just start working without this activation step, but tenofovir is not absorbed well without this step. TAF is similar to TDF in many ways, but TAF gets metabolized inside cells not the blood. Cells are where the drug needs to be to stop HIV from establishing infection. This difference—being activated at the site where protection is needed, versus in the blood—means that people need a lower dose of F/TAF compared to TDF/FTC to achieve protective drug levels. This also translates to a smaller pill for F/TAF.

How Is F/TAF Different from the Already-Approved TDF/FTC?

Gilead claims that the lower circulating blood levels for F/TAF (described above) might reduce the risk of some of the side effects seen with daily oral TDF/FTC for PrEP (as well as for treatment, for which both drugs have been approved). These include bone density loss and kidney function issues. While the side effect profiles of the two drugs are different, AVAC and other activists have pushed against any claims that F/TAF is “better PrEP”. We welcome strategies that reduce pill size and that may lower toxicities and side effects (less tenofovir in the blood could mean less risk of renal toxicity and bone density loss, both possible with long-term TDF use). But, we don’t want Gilead or anyone else to argue that F/TAF is “better” or “safer” PrEP unless the data clearly show that. As we wrote to the FDA, “Any claims of superiority of F/TAF are an overstatement of the data and, more importantly, will cause enormous confusion among both users and providers of PrEP… All labeling and marketing materials should clearly state these as equivalent daily oral PrEP options.” Click for more on concerns about how Gilead described F/TAF from AVAC, and the Treatment Action Group (TAG) and PrEP4All.

What Happened at the August 7th Hearing?

Gilead presented data from the Phase III DISCOVER trial of daily F/TAF as PrEP amongst men and transgender women who have sex with men. It showed that daily F/TAF is as safe and effective as daily TDF/FTC for HIV prevention in these populations. There is no similar efficacy trial amongst cisgender women, but Gilead did present data, including from a small USAID-funded pharmacokinetic study from research NGO CONRAD, that Gilead hoped would allow extrapolation of efficacy to support a PrEP indication for F/TAF in cisgender women. This CONRAD study of daily oral F/TAF in 72 HIV-negative cisgender women measured the levels of tenofovir (TFV) in the blood among participants. In that study, participants taking F/TAF for PrEP had protective levels of TFV in their blood. (This blood level—associated with a greater-than-90% reduction in risk of HIV acquisition—derived from efficacy trials of TDF/FTC in cisgender women.) The vaginal tissue concentrations in samples in the CONRAD study, though, did not allow the FDA to make any conclusions about protective levels for F/TAF. Since there is no consensus about which levels—blood or tissue—matter most in predicting efficacy, the FDA presentation found it could not conclude that this extrapolation was justified.

AVAC and partners, including TAG and PrEP4All, attended the Advisory Committee and submitted both written comments and presented during the open session of the meeting. The key points from AVAC’s testimony are at the end of this update; additional background materials from the meeting, including submissions from a number of organizations and individuals can be found here.

How Did the Committee Vote?

The Advisory Committee overwhelmingly voted to recommend F/TAF for PrEP in men who have sex with men (MSM) and transgender women by a vote of 16-2. But the committee split 10-8 against recommending F/TAF for PrEP in cisgender women. The panel’s recommendations are advisory to the FDA but are usually followed by the agency. This means that the FDA could approve F/TAF as PrEP for MSM and transgender women, without approving it for use in cisgender women. FDA is expected to announce its decision in early October.

What to Watch For

  • The FDA decision. Their decision is expected approximately two months from the time of the Committee meeting and vote. Advisory Committees provide the FDA with independent advice, but final decisions are made by FDA. The FDA could accept the Committee’s recommendation to approve F/TAF for MSM and transgender women (but not cisgender women), approve a label for all people at risk, or deny Gilead’s application altogether. Typically, the FDA accepts the Committee’s recommendation.
  • Regulatory filings in Europe and Africa, and WHO prequalification and guidelines. The DISCOVER study included sites in Europe, and Gilead will presumably be filing with the European Medicines Agency (EMA) for registration, and/or with national regulatory agencies in Europe.

    Will Gilead file for an MSM and transgender women indication for F/TAF in Africa, and would that make F/TAF use unsafe given the rampant homophobia and stigma still present in many communities?

    If registration will only be in Europe and the US, will Gilead file for WHO prequalification, which would allow F/TAF to be purchased by PEPFAR or the Global Fund? And how would WHO modify its PrEP guidance if F/TAF is approved by the FDA?

  • Safety and effectiveness data in cisgender women. Whether the FDA approves F/TAF for cisgender women or not, there is an urgent need to collect more data in cisgender women, as well as other populations that were not represented well or at all in the DISCOVER trial. AVAC has argued for full approval, with a clear requirement for Gilead to develop and implement a robust post-marketing research agenda to provide data on safety and effectiveness among cisgender women. Gilead has heard collective deep disappointment with their decision not to test F/TAF as PrEP in ciswomen—will they now act?
  • Pricing of F/TAF. Branded TDF/FTC, or Truvada, is shortly coming off patent in the US, finally opening the US market to generic TDF/FTC. What will this mean for pricing for branded F/TAF? The list price in the US for F/TAF is currently identical to TDF/FTC, but the generic price for F/TAF is unknown. It should be less expensive to produce F/TAF because it uses less active drug. Even so, Gilead will likely price it above, and possibly well above, the generic price for TDF/FTC. For public agencies, which still fund the majority of PrEP use either through programs like PEPFAR, national insurance schemes or health programs, any significant cost difference may lead them to stick with TDF/FTC. Gilead’s pricing of Truvada, which has limited PrEP uptake in the US, has been under criticism and legal challenge from groups like PrEP4All.

AVAC’s Bottom Line

  • The available data support approval of F/TAF as an additional non-inferior oral PrEP option. While Gilead representatives and researchers did present data at IAS 2019 that F/TAF was superior in safety and possibly in efficacy to F/TDF, claims of superiority of F/TAF are an overstatement of the available data and could cause confusion among both users and providers of PrEP. An indication that claims superiority could cause actual harm as potential TDF/FTC users delay initiation or current TDF/FTC users abandon PrEP use until F/TAF is later available. We were pleased that in their comments, the members of the Advisory Committee reinforced this view that if approved, F/TAF should not be marketed as superior to TDF/FTC.
  • We support labeling that includes cisgender women as a population that can benefit from F/TAF as PrEP. F/TAF and TDF/FTC represent different tenofovir prodrugs. Gilead did not plan an efficacy trial in cisgender women, hoping that bridging data would be sufficient. There are differing views about which biologic samples matter most in bridging across populations, but the data that were presented do, in our minds, support a label that includes cisgender women. While the Advisory Committee did not vote in favor of recommending F/TAF as PrEP for cisgender women, the comments from the committee members (irrespective of how they voted) did highlight the importance of requiring Gilead to collect this data in the most ethical and expeditious manner.
  • Any indication should be subject to specific post-marketing surveillance, Phase 4 studies and a robust Risk Evaluation and Mitigation Strategy (REMS). We know from earlier oral PrEP trials [of daily TDF/FTC] that efficacy in cisgender women can have wide confidence intervals. Recent data about lipid and weight-gain side effects of TAF compared to TDF, especially in women and individuals of African descent, make strict post-marketing surveillance critical. And, these post-marketing plans should also include other populations (e.g., adolescents and transgender men) that were not part of the DISCOVER trial.
  • Given the fundamental need for additional prevention options for cisgender women, AVAC believes the insufficient process for collecting data in Gilead’s product development plan for F/TAF thus far could be major setback in HIV prevention, and we join the chorus of advocates who are disappointed at Gilead’s lack of commitment to robust testing of this drug for PrEP in cisgender women. This is a unique situation, given that TAF is closely related to TDF, and not an entirely new product. Approving oral F/TAF for PrEP on the limited data is warranted in this case, but should not be the standard by which additional, novel PrEP options are tested and approved. We urge the FDA to hold product developers to a higher standard in drug development plans that will gain sufficient data across a range of populations in a timely and efficient manner, and in advance of regulatory submissions. Robust data across a range of populations at risk of infection must continue to be the standard, so that product development and regulatory approval can lead more seamlessly to acceptance, uptake and adherence by all populations who can – and should – benefit from innovation.

What’s New on AVAC.org and PrEPWatch.org

We don’t want you to miss a host of resources posted in recent weeks on AVAC.org and PrEPWatch. In case you missed them, these tools and resources will sharpen your take on the field.

Reporting on Global HIV Prevention

Check out these reports—recently published by AVAC and partners—for updates on funding trends in prevention and cure R&D, as well as a fresh look at places that have beaten back HIV with existing interventions:

Smarter Rollout

These articles and tools support advocates, implementers and decision-makers working on PrEP rollout today with an eye on future interventions tomorrow:

  • Reaching and Targeting More Effectivley: The application of market segmentation to improve HIV prevention programmes, by AVAC’s Anabel Gomez and others, and published in the Journal of the International AIDS Society, explores how to leverage the power of market segmentation for the promotion and uptake of primary prevention.
  • Just updated in July, AVAC’s Global PrEP Tracker on PrEPWatch.org provides the latest data on programs, number of enrollments by country, regulatory status and more.
  • A User’s Guide to PrEP Tools offers a handy table to navigate the many tools produced by different organizations to support policy makers, implementers, providers and others on PrEP access, uptake and continuation. Use this table to learn more about these tools, who they’re designed for, and when to use them.
  • The PrEP4Youth video series of public service announcements encourages adolescent girls and young women in South Africa to consider PrEP as an HIV prevention method. Created by the OPTIONS Consortium in collaboration with the South African National Department of Health, these videos feature popular actresses and put young women at the center with short empowering messages.

Apply to be an AVAC Fellow in 2020

AVAC would like to remind you that our call for applications for the 2020 class of AVAC Fellows is open until September 20. We encourage you to learn more about the program and share this information with your network!

AVAC Comments to Antimicrobial Drugs Advisory Committee and FDA re: TAF/FTC (Descovy) as PrEP

AVAC comments submitted to the Antimicrobial Drugs Advisory Committee and FDA re: TAF/FTC (Descovy) as PrEP, which encourage the Advisory Committee to recommend, and the FDA to approve, the supplemental indication for daily oral PrEP with F/TAF for adult men and women at risk of sexually acquired HIV-1 infection – with the appropriate requirements for labeling, post-marketing surveillance and REMS as described in the letter, and as per the FDA’s own updated guidance on REMS and access posted earlier this year.

Follow the Money: HIV R&D Resource Tracking Reports 2018

Two new reports tracking resources for investment in HIV research and development are hot off the presses. The Resource Tracking for HIV Prevention R&D Working Group, a collaboration among AVAC, IAVI and UNAIDS, has launched its 15th annual report, HIV Prevention Research & Development Investments: Investing to end the epidemic, detailing overall 2018 investment and analysis of funding trends. And the Cure Resource Tracking Group, a collaboration between AVAC and the International AIDS Society, has also released its annual report, Global Investment in HIV Cure Research and Development in 2018.

These two reports represent powerful tools for advocacy. Both reports can be used to advance advocacy for a host of issues directly impacted by financial investments: the prevention crisis in the global HIV response is insurmountable without cutting-edge research and development and the scale-up of existing interventions, while cure research spearheads crucial innovation, and offers hope and inspiration to the millions affected by the epidemic.

Read on for links to downloads and key findings from each report:

Key Findings in Prevention R&D Funding

The report indicates an uptick after five consecutive years of declining investment. In 2018, funding for HIV prevention R&D increased by a modest 1.2 percent or US$13 million from the previous year, growing to US$1.14 billion. While the increase is encouraging, it’s the smallest net increase since 2003. This incremental growth impacted the various prevention categories differently. Investment increased for pre-exposure prophylaxis (PrEP), female condoms and prevention of vertical transmission (PMTCT) but decreased for voluntary medical male circumcision (VMMC), preventive vaccines, microbicides and treatment as prevention (TasP).

Despite the significant variation among these categories, donor trends remained more or less the same. Public sector (79 percent of overall or US$900 million) and philanthropic sector (14.4 percent of overall or US$164 million) investments remained mostly unchanged from 2017, while the private sector saw a 30 percent surge in investment, rising to at least 6.6 percent of overall funding or US$74.7 million in 2018. Actual commercial investment levels are higher as not all private companies responded to the Working Group’s request for data.

While US and European investment remained steady in 2018 compared to 2017, these figures are still the lowest in over a decade at US$829 million and EU$57.5 million, respectively. Outside the US, increases came from Australia, Canada, the European Commission, Germany and the UK, while declines were observed from Brazil, France and Japan. Global philanthropic levels also saw no change in 2018 and the Bill & Melinda Gates Foundation (BMGF) remained the preeminent funder in that category at US$149.7 million or 91 percent of all philanthropic sector investment.

In 2018, the US public sector and BMGF accounted for 86 percent of all funding. Citing the promise of the current R&D pipeline, the report cautions against this funding imbalance and the resulting impact on the longevity and sustainability of the field. Much hope can be drawn from the latest scientific strides: the ongoing efficacy trials for long-acting injectable PrEP and antibody mediated-prevention; the planned Phase III trial of a novel HIV vaccine regimen; and the dapivirine vaginal ring – another potential option for women. All of the above is contingent on sustainable financing and a diverse donor base that cushions against priority shifts from large donors.

Key Findings in Cure R&D Funding

The report estimates global investments in HIV cure research, which includes therapeutic HIV vaccines (for treatment) shows US$323.9 million in 2018, representing a 12 percent increase over the US$288.8 million invested in 2017. Compared to the US$88.1 million invested since tracking began in 2012, this is a 268 percent increase. The public sector accounted for the majority of funding, with the remaining US$19.7 million invested by philanthropies such as Aidsfonds, amfAR, the Bill & Melinda Gates Foundation, CANFAR, Institut Pasteur, Sidaction and Wellcome Trust.

We hope these reports will serve as tools for advocacy and inform public policy that accelerates scientific progress. We thank all of the individuals who contributed data to the report and who gave time and effort as trial participants.

If your organization is a funder or recipient of HIV prevention grants and we don’t know you already please contact us at [email protected]!

Paving the Road for Rollout

Jeanne Baron is AVAC’s web editor and producer of Px Pulse.

This diverse set of some of the latest resources on PrEPWatch.org will help program implementers from a variety of contexts plan for the rollout and scale-up of PrEP. Added to the already extensive tools and resources available on PrEPWatch.org are: country-specific Situation Analysis for Kenya, South Africa and Zimbabwe; Health Care Providers’ Knowledge, Attitudes and Practices (KAP) Relevant to Oral PrEP Service Provision to AGYW in Zimbabwe; PrEP Costing Guidelines; The Common Agenda for the Dapivirine Ring, and The Dapivirine Ring Introduction Matrix.

Latest additions:

  • Country-specific Situation Analysis for Kenya, South Africa and Zimbabwe, have been developed to assess factors that are crucial to the expansion of PrEP rollout. Each report explores the strengths, challenges and progress to date on planning and budgeting, supply-chain management, the status of infrastructure and human resources places where people can obtain PrEP, and how people learn about PrEP and are supported in taking it.
  • Health Care Providers’ Knowledge, Attitudes and Practices (KAP) Relevant to Oral PrEP Service Provision to AGYW in Zimbabwe: This KAP study among health care providers in Zimbabwe explored questions about PrEP services for adolescent girls and young women. Health care providers serve as gatekeepers, encouraging or discouraging the use of new products or interventions. For example, providers report they have concerns about community backlash, or ambivalence about adolescent girls taking PrEP without their parents’ knowledge. They also report the need to balance concerns about adherence with the level of risk. The findings offer insights that can be applied to provider training and support. This report from Zimbabwe, and OPTIONS’ other KAP studies in Kenya and South Africa, may well be relevant to other places trying to enhance provider skills as part of the rollout of PrEP.
  • PrEP Costing Guidelines lay out the elements of estimating the cost of PrEP and how to adapt them appropriately and transparently for different objectives. These guidelines are written for individuals whose task it is to collect, evaluate and utilize cost data, and who may have differing levels of familiarity with economics.
  • Common Agenda for the Dapivirine Ring is for stakeholders working on aspects of planning for the introduction of the dapivirine vaginal ring, and summarizes key components for ring introduction, lists ongoing and planned efforts, and proposes next steps for streamlined and coordinated rollout.
  • The Dapivirine Ring Introduction Matrix shows the findings from a pilot discussion in Zimbabwe that explored how to integrate a new prevention product such as the ring into existing programs already focused on oral PrEP. The pilot discussion included policy makers, regulators, researchers, implementers and other partners. This resource explores where existing capacity could also support the rollout of the ring, and it suggests where additional planning and assistance would be needed. The matrix also highlights how ring introduction can strengthen other prevention efforts, especially oral PrEP.

These and other tools being developed by the OPTIONS Consortium (which is co-led by FHI360, AVAC and WITS RHI) can be used in the planning for future HIV prevention products as well. The OPTIONS Consortium is a major contributor to the growing body of technical resources for delivering PrEP options at scale in key countries, and complements work being done by many other efforts and partners, including the Prevention Market Manager project that looks to accelerate PrEP access and also improve the introduction of prevention options still in the research and development pipeline. These efforts dovetail with AVAC’s advocacy programs to close the multi-year gap from proven efficacy to access that has stalled the delivery of prevention in the real world.

Taken together this body of work found on PrEPWatch.org, can serve as case studies and templates to help implementers work swiftly, improve the quality of the delivery of prevention products and maximize their impact.

Statement on Gilead’s Announcement of PrEP Donation

Mitchell Warren is the Executive Director of AVAC.

Gilead’s donation is an acknowledgment that there is a huge issue with PrEP access in America, as in many parts of the world. We welcome this indication that the company grasps the gravity of the situation. However, we urgently need a lower price for all. It’s disappointing that even this small step has taken so long.

At nine years post demonstrated safety and efficacy of oral PrEP and seven years post-FDA approval, Gilead is making this announcement quite late in the process of trying to scale PrEP to achieve public health impact. And it is nowhere near enough. The donation offers PrEP to only 200,000 individuals, while the CDC estimates that 1.1 million Americans overall are at substantial risk for HIV and should be offered PrEP. Based on what we know about the generic costs of Truvada (FTC/TDF), this donation offers a mere $10 million per year in drug supplies—irrespective of the list price for the drug.

It’s important to remember that PrEP is not a pill—it’s a program that has to include regular HIV and STD testing, support to take the pills as prescribed, training providers in culturally competent care, and strategic demand creation effort. The availability of more pills, while welcome, is not enough to move PrEP to the public health intervention that is needed for it to have a real impact for individuals and communities.

Gilead’s offer—and the announcement from Secretary of Health and Human Services Alex Azar—leave many open and important questions. How will the CDC distribute this additional oral PrEP? And how will they ensure it does not replace current PrEP access, but rather is additive? Who will pay for these distribution costs, as “free donations” often come with costs? Will Gilead continue its Truvada for PrEP Medication Assistance Program (MAP)? Will CDC and NIH—which, along with the Bill & Melinda Gates Foundation, funded the trials that demonstrated PrEP is safe and effective—still act on their intellectual property rights to Truvada for PrEP and reinvest any profits that could be realized into PrEP programs that work?

The bottom line is that the price of Truvada (FTC/TDF)—and Gilead’s new, additional PrEP pill, Descovy (FTC/TAF)—is still too high. We need sustainable price cuts, and clear strategic programs, that will support long-term access to and use of the medicines needed for PrEP. We cannot afford to lose any more time, or money, in translating PrEP’s promise into public health impact.

PrEPWatch Redesign!

A redesigned PrEPWatch.org is now at your fingertips! The search engine is more powerful, the site navigation is cleaner and simpler, and you will continue to find the rich selection of resources that inform PrEP introduction around the world. Since 2006, PrEPWatch.org has been home to information on PrEP research, data, cost, access, implementation and advocacy around the world.

As the PrEP field evolves, so does PrEPWatch. Don’t miss these new and trusted tools and resources:

For a quick orientation to the site’s new look and feel, check out the short 5-minute video below. It provides a tour of the main navigation and dives a little deeper into a few of the powerful tools found on PrEPWatch.org.

Regulatory Status of TDF/FTC for PrEP

The TDF/FTC combination pill (brand-name Truvada) that has shown efficacy for PrEP is already used for Treatment U=U in HIV-positive people, and so is approved and licensed in many countries. One key step for this PrEP strategy is to ensure that the drug is licensed (and therefore available) and that it is approved for use for both prevention and Treatment U=U in each country. National guidelines for PrEP use are another key step.

What’s New?

Check out these new resources and updates on AVAC.org and PrEPWatch.org.

Pushing the Field Forward

Read Describing–and Doing–the Work: AVAC in print and in the streets, featured on our P-Values blog, for AVAC’s overview of articles featured in a special issue of Current Opinion in HIV and AIDS. AVAC staff members Emily Bass, Laura Fitch, Anabel Gomez and Maureen Luba Milambe joined collaborators in advocacy and human-centered design to co-author two important articles that each highlight our core business of bold, evidence-informed advocacy and action.

Doing It Right: Anatomy of an effective stakeholder consultation

What made the early stakeholder consultation for the Microbicides Trials Network study MTN-042, or DELIVER, such a powerful tool for meaningful engagement when so many other meetings under the name of “stakeholder engagement” are perfunctory occasions? Read our blog to find out!

Diving Deep into Demand Creation

The OPTIONS Consortium—a USAID-funded initiative to expedite and sustain access to antiretroviral-based HIV prevention products—has developed a five-part video series, featured on PrEPWatch.org, that explores key aspects of demand creation for PrEP. Watch them to learn more about what it means to generate useful insights, and how to apply those insights to reach the people who need PrEP the most. And be sure to check out the complementary PrEP Communications Accelerator to help fast track PrEP uptake through strategic communications and demand creation.

Putting Data to Use as Advocates

Listen to a recording of amfAR’s recent webinar Data To Win in the COPs to see its databases on PEPFAR Monitoring, Evaluation and Reporting (MER) come to life as a tool for advocacy. Created as part of the COMPASS Africa collaboration, this web tool gives HIV advocates access to a wide range of PEPFAR program data, such as district-level data with descriptions of what each indicator means, how the results are measured, and how the data can be interpreted. These data are presented in a variety of formats including data visualization, maps and downloadable PDFs.

PrEP Use Around the World: Global PrEP Tracker update

For details on the status of PrEP around the world, download the latest version of the Global PrEP Tracker available on PrEPWatch.org. It provides data on programs, number of enrollments, regulatory status and more—updated February 2019!

Making Our Px Pulse Podcast Even Better!

AVAC wants to hear from you! A year-and-a-half and 15 episodes later, we want to know how well Px Pulse serves your needs. Take this 10-minute survey, and we’ll apply what we learn to bring you insights and information about advocacy for HIV prevention research in the year ahead.

Announcing the 2019 Fellows

Early in February, we proudly announced our 2019 Fellows. These seven advocates, representing the 10th class of AVAC Fellows, will be taking on a variety of priority issues and engaging their communities and governments in Kenya, India, Malawi, Nigeria, South Africa, Uganda and Zimbabwe. We hope you’ll find ways to collaborate with them and with us as the field faces major challenges and opportunities in the year ahead from the results of the ECHO and DISCOVER trials to the evolving rollout of oral PrEP, the possible approval of the dapivirine vaginal ring, a new urgency around condom programming and more.