The Vagina Dialogues – Day 3 at AIDS 2016 

July 19, 2016

We head into day three of the Durban Diaries a little deafer than we were before from the unceasing din of the Global Village—a beat that breaks down into equal parts information, activism and celebration of all the shapes and sizes and colors of our lives. Between the pink-peacock-feather-clad dancers in the condom area and the music of Ugandan singer Moses Supercharger on the Global Village mainstage, it’s a feast for all five senses, and a reminder of the beauty of the bodies we live in every day.

Over in the main conference building, the beauty of those bodies was in and out of focus today in a series of sessions focused on women, HIV risk and HIV prevention. At its best, the dialogue was led by and for women and centered on rights, realities and engaged discussion on the whole body, from head to toe and heart to mind. In some fascinating sessions, the vagina seized center stage and all but lost the head and heart that go with it. Today, in our update, we’ll try to put the pieces together and so, of course, the theme is: The Vagina Dialogues.

The morning’s plenary featured a number of powerful women who reminded delegates of the role of gender in the global response to the epidemic. Eminent Kenyan scientist and advocate Elizabeth Bukusi, of KEMRI, reminded the audience that, “HIV operates in a gendered world and it thrives because of that.”

What exactly is going on in that gendered world? Some insights came from a special session, New Evidence: Why Do Young Women in Africa Have High Rates of HIV Infection?. It started out with a presentation on the “direction” of transmission in a South African community—in other words, who is passing on the virus to whom, by gender and age-bracket. By sequencing viruses and grouping them according to their genetic relatedness, researchers established that the majority of young women [16–24 years old] are acquiring HIV from significantly older men—an average of 11 years older, in fact. The age disparity between male and female partners decreases as young women age. But many of them are getting HIV from older male partners so that by the time they are 24, they are also in a position to transmit HIV to their male partners, setting up a cycle that looks like this.

The session also presented data drawn from women who participated in the CAPRISA 004 trial of a 1% microbicide gel. This investigation explored the presence of specific vaginal bacteria (the flora that live in all women’s vaginas) and how it might increase HIV risk and affect the absorption of the tenofovir gel. The good news is that there is no evidence these findings apply to the use of oral PrEP.

This session provided great food for thought including this comment—voiced in the follow-on session on women’s rights and health: “We heard all about vaginas. But vaginas are attached to people…” The challenge will be to put these important scientific findings into practice in ways that explore young women’s practices in relation to their vaginal health, and their whole bodies—all while treating and PrEPing as needed.

Speaking of vaginas, another study presented today focused on new analyses of data from the ASPIRE dapivirine vaginal ring study. While initial data were presented at CROI, new analyses showed that individuals with high levels of adherence achieved extremely high levels of protection.

Back in the Global Village, no surprise here, women’s bodies and lives were fully present in all sorts of sessions; a vibrant discussion in the Women’s Networking Zone ensued from a project documenting the experiences and perspectives of women living with HIV and undergoing treatment. Women at the session, who were primarily from sub-Saharan Africa, found the findings from this project personally resonant and were eager to obtain the full report as an advocacy tool. Download the four-page summary here.

Wednesday at the Research Literacy Networking Zone

In addition to having a Help Desk (have a question about prevention research or looking for a resource—stop in!) and a comfortable space to rest your feet, come check out all the programming in the RLNZ (Global Village, Booth 606). See Wednesday’s schedule below:

  • 11:00 – 12:30 – Safer Conception for HIV-affected Individuals and Couples: Synopses of Findings (HIVE)
  • 12:45 – 13:45 – Addressing Known Causes of Poor Participation by Black MSM in HIV Prevention and Treatment Research (APEB, PxROAR)
  • 14:00 – 15:00 – Advancing PrEP Advocacy Opportunities and Challenges in Settings Where it Has Been Approved and Where it Has Not (IRMA)
  • 15:30 – 16:30 – Hope vs. Hype in Reporting HIV Cure Research (AVAC, TAG, UNC)
  • 17:30 – 18:30 – Ask the Researcher: Preventive HIV Vaccine Research (HVTN)

A Few Sessions We’ve Starred

See below for a highly selective list of sessions for all the data geeks out there! Check them out in-person or find them on the webcast archive the following day.

  • 8:45 – 10:55 – What is our goal?, Session Room 1, Wednesday’s plenary features AVAC team member Micheal Ighodaro speaking on the role of young people leading in the response
  • 11:00 – 12:30 – Making PrEP Real for Those Who Need It Most: Optimization Strategies, Session Room 1, Data from IPERGAY and HPTN 073 and Partners Demo studies and SEARCH test and treat study in Uganda and Kenya
  • 13:00 – 14:00 – Accelerating the Decline of the Burden and Incidence of HIV in Sub-Saharan Africa Special Session, Session Room 1
  • 13:00 – 14:00 – Circumcision: Where to, How to, Who to?, Session Room 5, Oral poster discussion on VMMC uptake, barriers, new devices and more
  • 13:00 – 14:00 – Prevention for Women: The Need for Multidisciplinary Approaches, Session Room 8, Oral-poster session including additional qualitative data from FACTS 001, preferred PrEP formulation in ASPIRE sub-study, vaginal bacteria and its relation to increased risk of HIV, and more

Follow along in real-time on Twitter, and look for the next update in your inbox tomorrow!