Px Pulse: A season of listening

As we look ahead to 2024 and the vital work AVAC and partners will be carrying forward, the conversations from 2023 offer guidance and insights. Px Pulse, AVAC’s podcast on critical issues facing HIV prevention research, hosted several not-be-missed conversations in 2023 that will reverberate into the year ahead.  

From a stalled PEPFAR reauthorization to LGBTQIA+ voices fighting persecution in Uganda; from efforts to bring equity to a new global architecture for pandemic readiness to advances in HIV vaccine science and advocacy to include pregnant people in research—we hope that all of these conversations can inform our advocacy in 2024. Click on the episode for both recordings and resources.

PEPFAR at 20: Keeping the promise (23:16)

Considered one of the greatest US foreign policy and global development achievements of the century, the program has saved upwards of 25 million lives since it launched in 2003. But PEPFAR is marking its 20th anniversary while fighting for its future. LISTEN HERE.

LGBTQIA+ Advocacy in Uganda: Facing down fear and fighting for justice (24:19)

In March 2023, the Ugandan Parliament moved forward broad-reaching legislation to further criminalize LGBTQIA+ people. This podcast features Ugandan advocates and AVAC partners discussing the specifics of how these attacks have gained momentum and their ties to US-based religious extremists. The advocates discuss what needs to happen next. LISTEN HERE.

The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action (15:14)

Health leaders around the world are in the midst of creating a new architecture to deal with pandemics. Chris Collins, the CEO and President at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, talks about what’s at stake, which policymakers get it already, why this year matters so much, and what advocates can do about it. LISTEN HERE.

PPPR Advocacy 101: Find out what it means to you (19:05)

Over the coming months, global leaders will make key decisions about several initiatives to prepare for the next pandemic. This podcast explores what they commit to, how much they will spend and how well these plans safeguard equity. LISTEN HERE.

Inclusion of Pregnant and Lactating People in HIV Research: What you need to know (34:28)

AVAC’s Manju Chatani-Gada takes us through conversations with a trial participant who became pregnant, researchers, policymakers and donors to understand why this population gets excluded, the impact it has and what to do about it. LISTEN HERE.

Evolving Strategies for an HIV Vaccine: One researcher explains where the field is going and why? (21:23)

Evolving Strategies for an HIV Vaccine: One researcher explains where the field is going and why? Dr. Katy Stephenson explores the implications of recent trial results, the big questions driving next generation vaccine development, and new strategies underway in early phase research. LISTEN HERE.

Happy listening—and let us know what topics you want to hear more about in 2024! 

Press Release

The Search for an HIV Vaccine Must Continue

Field Will Learn for Halted PrEPVacc Arm

New York, 6 December 2023 – Today the PrEPVacc trial team announced at a special session at the International Conference on AIDS and STIs in Africa (ICASA) in Harare, Zimbabwe, that they were stopping vaccinations in the study following a review by an independent data safety committee that determined there was little chance the vaccines being tested could stop HIV acquisition. The oral PrEP arms of the study will continue. 

PrEPVacc was testing two different vaccine strategies against a placebo: one regimen combining a DNA vaccine with a protein-based vaccine (AIDSVAX), and another regimen combining DNA, MVA and a protein-based vaccine (CN54gp140). 

“We always hope for a positive outcome in HIV prevention trials, and this news is disappointing,” said Mitchell Warren, AVAC executive director. “We look forward to seeing the full PrEPVacc data in 2024 and hope it will add to the body of evidence that is helping scientists understand how to develop better vaccine candidates that will one day protect against HIV.”  

“The PrEPVacc outcome underscores yet again that the science of HIV vaccine development is extremely challenging,” he added. “Now is not the time to step back from vaccine research. There are several promising strategies in early-stage research that must continue, along with research for other HIV prevention options. We will not end HIV without ensuring that everyone who is vulnerable to HIV infection has a choice of effective and desirable prevention options.”  

Importantly, PrEPVacc’s PrEP arms will continue. The study is testing two different formulations of daily oral PrEP, looking to see if a new formulation – F/TAF (also known as Descovy) – is at least as good in the trial population at protecting against HIV acquisition as F/TDF (also known as Truvada and the most widely used version of PrEP). The trial will provide the first data for F/TAF among cisgender women (who make up 87% of the just over 1,500 PrEPVacc trial participants). F/TAF is approved for use in the US and UK, but not for those individuals who have receptive vaginal sex, since previous trials regrettably did not enroll cisgender women. 

The PrEPVacc study is scheduled to conclude in 2024 and data from all arms of the study are expected to be reported in the last half of 2024. 

“The PrEP arms of PrEPVacc will provide important insights into the potential of expanding access of F/TAF for PrEP to women in East and Southern Africa who need additional options to protect themselves from HIV. Equitable access to new interventions should be a goal of every research program,” said Stacey Hannah, AVAC’s director of Research Engagement. 

“PrEPVacc is a complex, innovative trial design, and, while the vaccine result today is disappointing, the trial team has worked from the outset to implement the Good Participatory Practice (GPP) Guidelines. The team’s hard work on the front-end to apply GPP to this trial is paying off especially now in the ability to deliver complex, disappointing results to trial participants, advocates, policymakers and other key supporters of PrEPVacc and of HIV prevention broadly.” 

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About AVAC  

AVAC is an international non-profit organization that provides an independent voice and leverages global partnerships to accelerate ethical development and equitable delivery of effective HIV prevention options, as part of a comprehensive and integrated pathway to global health equity. Follow AVAC on Twitter @HIVpxresearch; find more at www.avac.org and www.prepwatch.org.

AVAC Commemorates World AIDS Day

This World AIDS Day we at AVAC are reflecting on remarkable gains and increasing threats to progress against AIDS. Our latest issue of PxWire, tracking trends in research, development and delivery of HIV prevention options, speaks to this important progress: 

However, as we look to 2024, all these gains could be imperiled by political and financial choices facing leaders today.

The answers to these questions will require donors and political leaders to do the right thing, and it will depend on us, a global movement of advocates with a track record of world-changing achievements, to stay the course and build the road to reach everyone one of these goals. Below are a few key resources to support your work. 

From the Lab to the Jab

A series of advocates guides on key issues to ensure equitable access to safe, effective, and affordable vaccines.

Learn more.

Call to Action for Voluntary Medical Male Circumcision

A report on next steps to advance the role of VMMC in ending the epidemic.

Learn more.

Good Participatory Practice: Body of Evidence

An online package of resources to support advocacy for GPP as an international standard for clinical trials.

Learn more.

The HIV Prevention Choice Manifesto

A historic milestone in the power of community-led leadership and prioritization of choice in HIV prevention.  

Learn more.

Progress Against HIV and AIDS is Fragile

POZ Magazine’s interview with Mitchell Warren, with a comprehensive look at the status of the fight against HIV/AIDS and the scientific breakthroughs to date and still needed to end the epidemic.

Read more.

The Anti-HIV Jab is Coming to South Africa

Bhekisisa’s Mia Malan and AVAC’s Mitchell Warren breakdown what it will take to get injectable CAB for PrEP to everyone who needs it.

Listen here.

A Call to Action: Scale Up HPV Vaccination in People Living with HIV

In a new call to action, Mitchell Warren and Heather White, executive director of TogetHER for Health, argue that the time is now to invest in efforts to ensure that people living with HIV can live their lives without the threat of cervical cancer.

Read more.

At AVAC, we believe it’s up to all of us to make sure the world does not squander another decade in slow, fragmented rollout of life-saving innovation in HIV prevention or risk underfunding research and development. If we work together to build equity into the rollout of options that exist already and support the promise of expanding choices in the near future, the world will at long last bend the curve of HIV.  

Call to Action for Voluntary Medical Male Circumcision

The Job Is Not Done Yet

In the pursuit of a future without HIV and AIDS, voluntary medical male circumcision (VMMC) remains an integral component of the arsenal in HIV prevention, offering a cost-effective and scientifically proven intervention that holds immense potential in curbing the acquisition of HIV.

A two-page summary document is also available.

AVAC and Partners at ICASA 2023

Join AVAC and partners for the biennial International Conference on AIDS and Sexually Transmitted Infections (ICASA), in Harare, Zimbabwe December 4-9. More than 30 of our partners will convene at the meeting to champion community leadership and amplify their role in shaping local, national and global responses and delivering impactful advocacy. Community leadership on a range of issues are instrumental to: 

  • Accelerate and expand access to proven prevention options that people want and need. 
  • Dismantle the structural barriers to health faced by key populations. 
  • Intensify demands for robust domestic and global funding for health. 
  • Integrate HIV services with sexual and reproductive health. 
  • And much more. 

Scroll down for a roadmap to ICASA’s prevention program, and details on sessions and events that you won’t want to miss. 

Sessions of Interest

Sunday, December 3

  • Biomedical Prevention Forum 
    9:00-15:00 GMT 
    The Biomedical Prevention Forum will be held as a hybrid event bringing together advocates, civil society representatives, researchers, government officials and front-line providers to explore and discuss the latest advancements, challenges, and opportunities in biomedical HIV prevention, while emphasizing the importance of choice and its transformative impact on HIV prevention efforts. This is an open event. Register here. 
  • Key Populations Preconference 
    9:00-15:00 GMT 
    The Africa Key Populations Experts Group (AKPEG), African Sex Workers Alliance (ASWA), the African Network of People Using Drugs (AfricanPUD) and African Queer Youth Initiative (AQYI) Advocates for Prevention of HIV and AIDS in Africa (APHA), Global Black Gay Men Connect (GBGMC) and partners will host a safe platform to deliberate on the state of the HIV epidemic among Key Populations and to determine the stumbling blocks for progress on the path that ends AIDS for Key Populations.

Monday, December 4

Tuesday, December 5

  • Advancing Integrated Biomedical Prevention: Best Practices from Zimbabwe (Session 2) 
    8:45-09:30 GMT
    This satellite session will discuss best practices and lessons learned from the delivery of biomedical HIV prevention and Voluntary Medical Male Circumcision services as we work to further universal health coverage and robust health systems. Partners will launch a global call to action to unite, mobilize, and advocate for continued prioritized funding, sustained commitment, and strategic integration of VMMC into national and global prevention strategies.
  • Catalyzing a sustainable HIV prevention agenda: Approaches to expand local action on global commitments
    10:45-11:30 GMT
    Leveraging new strategic plans for HIV prevention, including the PEPFAR’s 5-year Strategy and UNAIDS’ Prevention Road Map, this satellite session will discuss combination prevention in the context of a sustainable HIV response and highlight a variety of approaches and models that leverage country and stakeholder-led innovations to meet the challenge.
  • Coordinating Implementation Science for CAB for PrEP: BioPIC’s Implementation Study Tracker 
    12:25-12:35 GMT
    In this oral abstract session, AVAC will present a new dashboard, which reflects all currently known activities relating to implementation research, modelling, clinical research, and landscaping for new late-stage biomedical HIV PrEP options, including cabotegravir for PrEP and the dapivirine vaginal ring.
  • Policy, Politics and HIV Management 
    13:05-13:50 GMT
    In this oral abstract session, Princess Mharire from Pangaea Zimbabwe AIDS Trust (PZAT) will present, Beyond Metrics: How the Simple Participatory Assessment of Real Change (SPARC) Tool Provides a Holistic Approach to Advocacy Measurement, and Joseph Njowa of PZAT will share the COMPASS MERL model in a presentation, Innovative tools for planning, monitoring, and evaluation of advocacy campaigns. 

Wednesday, December 7

Friday, December 8

  • Strengthen integration for better SRHR outcomes 
    10:45-11:30 GMT
    This concurrent session will feature Advocates for Prevention of HIV and AIDS in Africa’s (APHA) Yvette Raphael and will explore linkages between unintended pregnancies, unsafe abortion, and HIV.
  • HIV Prevention-Right Place, Right time 
    13:05-13:50 GMT
    This concurrent session will feature Maureen Luba of AVAC, Definate Nhamo of PZAT and Yvette Raphael of APHA. 

AVAC and Partner Poster Presentations

Tuesday, December 5 

  • Maximizing private pharmacies for PrEP delivery to increase uptake: Lessons learnt from the Community Retail Pharmacy Distribution Point, Ruth Akulu 

Wednesday, December 6 

  • Journalist Training: A Key Advocacy Strategy, Catherine Madebe
  • Perceptions on the new biomedical HIV prevention methods among adolescent girls and young women in tertiary institutions in Zimbabwe, Cleo Makura
  • Lessons from Crisis Response from TaNPUD in Enhancing Harm Reduction from 2015 to 2018, Marineus Mutongore
  • Implementing Community led Monitoring for improved quality of HIV services in Tanzania, Mathew Kawogo
  • Impact of social media exposure on HIV services uptake among Tanzanian Young people: Implications for enhancing the HIV response, Marineus Mutongore
  • Effective Strategies for Operating COWLHA support groups of Adolescents Living with HIV: Case of Mangochi and Chikwawa Districts of Malawi, Harry Madukani

Thursday, December 7 

  • Understanding Choice of HIV Prevention Options among Adolescent Girls and Young Women (AGYW) in Zambia, Natasha Mwila
  • Leveraging HIV to Build a Global Health Research and Development (R&D) Equity Advocacy Agenda, John Meade
  • Championing advocacy for domestic resource mobilization for health research and development in Africa, Ethel Makila

Friday, December 8 

  • Rural Youth: Underserved and Unsafe When Seeking Care, Liyema Somnono
  • Redefining Coalition Governance and Leadership in Support of Decolonizing Global Health: The Evolution of the COMPASS Coalition, Roberta Sutton
  • Collaborative Monitoring & Evaluation to Support Learning and Strengthen Advocacy Coalitions: The MERL Hub, Grace Tetteh
  • Realities faced by street children predisposing them to HIV and STIs in Dodoma and Dar es Salaam Cities in Tanzania, Simon Shilagwa 

Spotlight on New PrEP Tools and Data: From R&D to access

Tuesday, November 28

Between the recent accelerated growth in global PrEP initiations, and the introduction of new PrEP products like cabotegravir and the dapivirine vaginal ring, the field of PrEP data has never been more exciting or more complex. Staying on top of the latest advances is key for advocates, researchers, funders, and others working in HIV prevention to do their job effectively—but how can you navigate the vast amount of PrEP data online? AVAC, the Medicines Patent Pool (MPP), and Unitaid presented information on three important online PrEP resources and understand how they can support and enhance your work:

  • PrEPWatch.org: the one stop shop for PrEP resources to support introduction and scale-up, including the PrEPTracker, the only place to find information on global PrEP initiations online
  • Long Acting Therapeutics Patents and Licenses Database (LAPaL): LAPaL is the go-to resource to learn about long-acting therapeutics, their patent landscape, development and regulatory status
  • Access to Medicines Tracker: the go-to place for quarterly-updated insights on regulatory filings, regulatory approvals, and product supplies of MPP-licensed generic medicines at the country level.

Recording / Slides

Access Enablers

This graphic presents key strategies for advocates to improve vaccine access, highlighting actions like influencing WHO guidelines, community education, addressing intellectual property barriers, and establishing voluntary access mechanisms.

From the Lab to the Jab

This graphic shows all the steps to cross or overcome in the development of a new product — research & development, intellectual property barriers, registration with regulatory bodies and the implementation of products — along with the important role can advocates play.

Vaccine Manufacturing is a Multi-Stage Process Often Requires Extensive Collaboration

This graphic highlights the extensive and complex process of vaccine production, encompassing initial design, drug development, large-scale manufacturing, the creation of administration devices, and finally, distribution.

Excerpted From the Lab to Jab series.

Getting the COVID-19 Vaccines We Need

As of March 2023, the World Health Organization reported that there are 199 COVID-19 vaccines in pre-clinical development, and 183 in clinical trials. Most are injectable; but 16 candidates are intranasal, 5 are oral, 2 are inhalable, and 1 is an aerosol.