Research Fundamentals: An HIV Vaccine — What’s the challenge and what’s the science?

Some vaccines are easier to develop than others. COVID-19 vaccines were developed with unprecedented speed, taking a matter of months to become available. A measles vaccine took about 10 years to develop. But the field’s been working on an HIV vaccine for 40 years.

In this episode, AVAC’s Jeanne Baron and co-host immunologist Katharine Kripke of AVENIR Health explore why HIV is different with two experts on vaccine research: Caltech’s Pamela Bjorkman and IAVI’s Vincent Kioi.

Learn how HIV has evolved like no other virus today to escape detection by the immune system. Learn why the right target on HIV is so hard to reach and how scientists are tackling it all.

Previous Research Fundamentals

More Vaccine Resources

What Matters Right Now for Rolling Out the Ring and Injectable PrEP?

The HIV field has two new approved prevention options waiting in the wings, the dapivirine vaginal ring and injectable cabotegravir as PrEP. Until now, daily oral PrEP, first approved in 2012, has been the only drug-based strategy for HIV prevention.

So here we are: research has shown safety and efficacy for both the ring and injectable cabotegravir. Now it’s time to take the next steps to deliver these options and translate advances in science into real impact on the epidemic.

At AVAC, we’ve been calling for coordinated planning to introduce and rollout new products, while expanding access to existing options. These efforts must learn from the mistakes of the past, especially lessons from rolling out oral PrEP.

In this episode of PxPulse, Linda-Gail Bekker from South Africa’s Desmond Tutu Health Foundation and Lillian Mworeko from the International Community of Women Living with HIV East Africa (ICWEA) join host Jeanne Baron and AVAC’s Executive Director Mitchell Warren to discuss innovative models for scale-up and delivery. Taking the right steps now could mean HIV prevention options fulfill their life-saving, epidemic-ending potential, and to do so requires working faster and more efficiently than ever before.

We dive into what lessons the field has learned, what’s still off-track, and the steps advocates, policy makers, drug makers and funders should each take right now to turn efficacious options into effective choices.

Resources

Dapivirine Vaginal Ring
Cabotegravir
Ring and CAB

Research Fundamentals: What is an endpoint?

The next installment of our Px Pulse series Research Fundamentals, explaining key concepts in HIV prevention research, is up. In this episode, Px Pulse host Jeanne Baron and Matthew Rose, a veteran HIV advocate and now Director at Global Health Strategies, look at endpoints in research.

Endpoints are a crucial component in every clinical trial but they are not always well understood. In addition, advocates can and should play a role, reviewing endpoints and interrogating how well the trial will serve communities that need HIV prevention.

Joining us to explore all this are:

  • Dave Glidden, Professor of Epidemiology & Bio-statistics at UC San Francisco
  • Erica Lessem, Senior Strategist for NYC Dept. of Health and Mental Hygiene, former Deputy Executive Director, Treatment Action Group
  • Meagan O’Brien, Senior Medical Director of Early Clinical Development & Clinical Experimental Sciences at Regeneron

Listen to learn how endpoints are used in clinical research, why they change overtime, and what matters most about endpoints for advocates and researchers alike.

Special Interview with AVAC’s Micheal Ighodaro

This episode of Px Pulse, Special Interview with AVAC’s Micheal Ighodaro, goes behind the scenes of the new HBO movie, The Legend of the Underground. The film documents the lives of AVACer Micheal Ighodaro and other LGBTQ Nigerians as they confront enormous risks to ‘live out loud’. As the movie unfolds, individual stories of resilience are woven together into a tapestry that portrays a revolution for cultural change in Nigeria.

To End A Plague

This episode of Px Pulse takes a deep dive into PEPFAR, The President’s Emergency Plan for AIDS Relief, looking at its pioneering successes and its challenges. In this episode, AVAC’s former Director of Strategy and Content, Emily Bass, discusses her new book, To End a Plague: America’s fight to end AIDS in Africa.

Dive into the AMP Trials

Results from the AMP Trials, studying a broadly neutralizing antibody (bNAb) known as VRC01, were complex, with still unfolding implications for the field.

The AMP Trials, two Phase IIb studies, tested the safety and efficacy of an infusion of VRC01 received every eight weeks. HVTN 703/HPTN 081 enrolled 1,900 women in sub-Saharan Africa, and HVTN 704/HPTN 085 enrolled 2,700 men who have sex with men and transgender people in North and South America and in Europe.

The overall efficacy demonstrated in the trials was not protective. But when VRC01 was fighting strains of HIV that were highly sensitive to it, the antibody did provide partial protection. So what does that mean for the field, and what other questions have been raised by these pioneering trials?

In this episode of Px Pulse, AVACers Jeanne Baron and Daisy Ouya talk to leading bNAb researcher, IAVI’s Devin Sok; a veteran HIV research advocate Mark Hubbard who served on AMP’s protocol team; and a senior member of the HVTN’s community engagement team, a chief explainer of the AMP trails, Gail Broder. Together we explore why these findings point to the need for combination antibodies, the need for a better understanding of the types of HIV that are circulating in a community, the complicated implications of a key lab test, the TZM-bl assay and more.

Hosted and produced by Jeanne Baron.

Highlights

Resources

CAB-LA is a Highly Effective HIV Prevention Option; Now what?

Long-acting injectable cabotegravir (CAB-LA) is a promising new option for HIV prevention. In 2020, early results from two trials—HPTN 083 and HPTN 084—showed CAB-LA was safe and highly effective at preventing HIV when compared to daily oral TDF/FTC (Truvada) in men who have sex with men (MSM), transgender (TG) women and cisgender women. Now what? What questions remain unanswered and what support is needed now to make the growing range of prevention options feasible choices for people who may want and need them?

A Leap Forward For the Dapivirine Vaginal Ring, the Next Steps Are Critical

After decades of research and advocacy, the Dapivirine Vaginal Ring is now one step closer to becoming available as a discreet, woman-initiated HIV prevention option. In July, the European Medicines Agency (EMA) issued a positive opinion for the ring, allowing the next steps in the regulatory process to go forward. Download this podcast to hear five different perspectives on the ring, how it expands HIV prevention options for women, and the most important next steps to bring the ring to women who need it.

Research Fundamentals: What is partial protection?

AVAC is launching a new series on our podcast Px Pulse—Research Fundamentals. In addition to our regular schedule of programs covering advances and challenges in HIV prevention research, Research Fundamentals we’ll explore scientific concepts in research, one at a time.

In our debut episode we explore the concept of partial protection, with:

  • David Evans, science and advocacy consultant for AVAC, formerly of Project Inform
  • Penny Moore from South Africa’s University of the Witwatersrand and National Institute for Communicable Diseases
  • And Sandhya Vasan of the US Military HIV Research Program

Together we explore the meaning of partial protection. Whether it’s condoms, a flu shot, oral PrEP or the dapivirine vaginal ring, proven products fall short of 100 percent protection against disease, and there’s a lot to know about how and why an intervention may offer imperfect but still useful protection.

Listen

The Intersections of HIV and COVID-19 in Real-Time

As the COVID-19 pandemic rages on across the world, the latest crisis is markedly reminiscent of the early days of HIV. And while the HIV epidemic is far from over, unrelenting activism, strong community engagement, partnerships and innovation are to thank for the strides the field has made towards controlling the epidemic.

Now, the response to COVID-19 is drawing heavily from these successes, and at the same time, forcing even more innovation on the HIV front.

In this episode of Px Pulse, we’ve compiled excerpts from two April webinars that offer unique perspectives on how COVID-19 and HIV are shaping one another. First, Mark Feinberg, CEO of IAVI, and Helen Rees, Executive Director of the Wits Reproductive Health and HIV Institute (Wits RHI), speak to COVID-19 vaccine development, and the role of the Coalition for Epidemic Preparedness Innovation (CEPI) in spurring vaccine funding and collaboration. We then turn to community engagement experts Sinead Delany-Moretlwe, Director of Research at Wits RHI, Vincent Basajja of the Uganda Virus Research Institute, Jau Nanyondo from Uganda’s Makerere University Walter Reed Project and Philister Adhiambo from the Kenya Medical Research Institute, who explain how HIV prevention trials are adapting in the wake of COVID-19.

Listen