Meet Ariel - A Friendly Rectal Microbicide Advocate from the United States

Check out this interesting min-bio of Ariel Watriss, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Ariel is one of six new bios just posted a few days ago, including individuals from Kenya, Thailand, the UK, India and Argentina.  Each will be featured on the blog, and you can read all of them here right now.

 

Ariel Watriss
Boston, Massachusetts, United States

"Rectal mircrobicides will help allow people take ownership of their sexual health and in the process empower them."

Ariel is a nurse practitioner certified in both adult primary care and women's health, and currently works at the biomedical research team at the Fenway Institute at Fenway Community Health Center. Sexual health is Ariel's professional passion, and she loves discussing awareness, ownership, and knowledge of her clients' sexual selves. Outside of working, Ariel enjoys reading, spending time with her friends and family, and cycling.

Ariel first became aware of IRMA through her current position at Fenway. She worked on multiple biomedical study teams and Microbicide Trials Network studies, where she was first introduced to the amazing world of microbicides. She works on HIV prevention studies looking at HIV vaccines (HVTN 505), PrEP (iPrEx OLE, and the upcoming HPTN 069) and a vaginal ring study looking at vaginal microbicide use (MTN 013/IPM 026).

Ariel believes microbicides are important among new HIV prevention technologies because they are applicable to real world users. "Offering a prevention measure in a product that is already used, such as lubricant, is so awesome. As a prevention tool, they are accessible and engage people in a direct, yet nonthreatening way."

Ariel's advice for IRMA is to continue to advocate and educate. All of IRMA's work is so important to help HIV prevention measures evolve and grow.

Inspiration and influence for Ariel comes from the people (patients, participants, etc.) who she has had a moment of connection and learning with around their sexual health. Ariel learns from teaching all the time, and continues to be inspired by others' learning.

Ariel is also one of the study clinicians in the upcoming MTN 017 trial (the world's first Phase II rectal microbicide trial), and will be working directly with participants in the study.

Thanks Ariel for all that you do!


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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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The Shamless Plug!

REGISTER FOR THIS CALL!

Raise your hand if you've ever felt uncomfortable talking about anal sex and anal health. Have you noticed that people sometimes tend to cringe from embarrassment when the word "rectal" is uttered? Or that they may laugh a little too much, or try to change the subject too quickly?

If you can identify with any of that - it means you're human - welcome to the club! Dealing with other people's reluctance to talk about anal sex, including our own reluctance, is common. But if we're going to be effective rectal microbicide advocates, let alone Rectal Rock Stars, we must get over our anal issues, and we must help others do the same. We must be absolutely shameless!

Enter Vanessa Marquez, a clinician at Fenway Community Health who has worked on several rectal microbicide trials, and uses a number of strategies to rectally disarm her patients and others to great effect. She will share her Shameless Plugs on this IRMA/AVAC teleconference - please join us for a really fun conversation.

You may follow along with Vanessa's slides on the ReadyTalk web interface, or you may download her presentation in advance from the IRMA website here: http://rectalmicrobicides.org/teleconf.php. They will be available no later than April 3.

The call is scheduled for 11am Eastern. Please convert the time for your location by following this link: http://www.timeanddate.com/worldclock/converter.html

The call will be recorded, and will be posted on the IRMA website after its completion here: http://rectalmicrobicides.org/teleconf.php.
 
 
 
[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

PrEP May Shape HIV Prevention Strategies

via The Boston Globe, by Sean Cahill

Initial results from clinical prevention trials of pre-exposure chemoprophylaxis (PrEP), in oral pill form indicate that PrEP could be the “game changer” needed to more effectively fight HIV. PrEP involves taking antiretroviral medications to prevent HIV.

PrEP has shown partial efficacy with men who have sex with men (MSM) and heterosexuals. Biomedical prevention interventions such as PrEP have great potential, especially if coupled with traditional prevention approaches, expanded testing, and linkage to treatment and care. Modeling demonstrates the most effective deployment of PrEP will be in combination with scaled-up HIV treatment of people who are known to be HIV-positive, as this was shown to reduce infections.

Guidance from the US Public Health Service and the World Health Organization is expected later this year. The Food and Drug Administration announced February 13th that it would review Gilead Science’s application to use FTC-TDF (brand name Truvada) for PrEP by June 15th. Demonstration projects to develop real world best practices for implementing PrEP are underway or set to launch soon in the United States and in sub-Saharan Africa. While the cost of PrEP in the U.S. would be substantial, private insurers and state Medicaid departments are open to providing coverage. Low-cost generic medications could enable access in low-income countries. The prioritization of highly vulnerable populations could increase the cost-effectiveness of PrEP. Providing PrEP is also much less expensive than treating someone for HIV over the course of a lifetime. Recent modeling of PrEP implementation coupled with scaled up treatment—focusing on MSM in San Francisco, the general adult population in Botswana, and serodiscordant couples in South Africa—predicts that PrEP could significantly reduce HIV incidence and prevalence.

In February 2012, The Fenway Institute released an analysis of PrEP implementation issues, titled Pre-exposure prophyalxis for HIV prevention: Moving toward implementation. This report summarizes the state of PrEP and microbicide research as of early 2012, looks at willingness to use PrEP among various populations, addresses concerns about PrEP that could present obstacles to implementation, offers strategies for effective implementation, and examines policy issues related to cost and how to make PrEP accessible to those most vulnerable to HIV. Based on a review of published research and interviews with policy makers, funders and other stakeholders, it examines regulatory developments and planning underway both within the U.S. and globally.

Read the Rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Fenway Releases PrEP Policy Paper

viaFenway Health

Pre-exposure chemoprophylaxis (PrEP)—taking antiretroviral medications to prevent HIV transmission—could be a “game changer” for HIV prevention. PrEP has demonstrated partial efficacy with men who have sex with men (MSM), transgender women, and heterosexuals in several recent studies. Recent modeling of PrEP implementation coupled with scaled up treatment predicts that PrEP could significantly reduce HIV incidence and prevalence. And if PrEP is accompanied by sustained care, behavioral interventions, and safety monitoring, PrEP need not lead to increased sexual risk behavior or drug resistance.

The latest Policy Focus from The Fenway Insitute summarizes the state of PrEP and microbicides research as of January 2012, looks at willingness to use PrEP among various populations, addresses concerns about PrEP that could present obstacles to implementation, offers strategies for effective implementation, and examines policy issues related to cost and how to make PrEP accessible to those most vulnerable to HIV.

The Fenway Institute’s analysis found that the most effective prevention interventions will be those that combine behavioral interventions, structural interventions, and emerging biomedical technologies, such as PrEP and microbicides. The analysis concludes with recommendations for implementation of PrEP, including:
■If the U.S. Food and Drug Administration (FDA), which is considering approving FTC-TDF for use as PrEP, feels that research on PrEP’s efficacy among heterosexuals is inconclusive, it should consider approving PrEP for MSM now separately and consider heterosexuals, IDUs and other populations in the near future as the science advances;

■The World Health Organization (WHO) should issue guidance on PrEP that takes into account the promising results of the iPrEx study, Partners PrEP, and the Botswana CDC study;

■Following the release of the Bangkok injection drug user (IDU) trial results, if appropriate the U.S. Centers for Disease Control and Prevention, the U.S. Public Health Service, and the WHO should issue guidance for PrEP with IDUs.;

■States should provide access to PrEP as a critical prevention service and prescription medication under the Essential Health Benefits provision of the Affordable Care Act;

■State Medicaid programs should also cover PrEP as a cost-saving measure that will improve public health and ultimately save money in health care costs;

■Provision of PrEP to MSM and transgender women should occur in a broader context of ensuring clinically competent health care to gay, lesbian, bisexual and transgender people.

Read the Full Report.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New recommendations to reach 2015 goals for AIDS response

Via unaids.org

Thirty years into the AIDS epidemic, investments in the AIDS response are yielding results, according to a new report released today by United Nations Secretary-General Ban Ki-moon.

Titled Uniting for universal access: towards zero new HIV infections, zero discrimination and zero AIDS-related deaths, the report highlights that the global rate of new HIV infections is declining, treatment access is expanding and the world has made significant strides in reducing HIV transmission from mother to child.

Between 2001 and 2009, the rate of new HIV infections in 33 countries—including 22 in sub-Saharan Africa—fell by at least 25%. By the end of 2010, more than 6 million people were on antiretroviral treatment in low- and middle-income countries. And for the first time, in 2009, global coverage of services to prevent mother-to-child transmission of HIV exceeded 50%.
 
“World leaders have a unique opportunity at this critical moment to evaluate achievements and gaps in the global AIDS response,” said Secretary-General Ban Ki-moon at the press briefing in the Kenyan capital. “We must take bold decisions that will dramatically transform the AIDS response and help us move towards an HIV-free generation.”  
 
“Thirty years into the epidemic, it is imperative for us to re-energise the response today for success in the years ahead,” said UNAIDS Executive Director Michel Sidibé, who joined Mr Ban for the launch of the report. “Gains in HIV prevention and antiretroviral treatment are significant, but we need to do more to stop people from becoming infected—an HIV prevention revolution is needed now more than ever.”

Mobilizing for impact  In the report there are five recommendations made by the UN Secretary-General to strengthen the AIDS response:

• Harness the energy of young people for an HIV prevention revolution;
• Revitalize the push towards achieving universal access to HIV prevention, treatment, care and support by 2015; 
• Work with countries to make HIV programmes more cost effective, efficient and sustainable;
• Promote the health, human rights and dignity of women and girls; and Ensure mutual accountability in the AIDS response to translate commitments into action.

Read the full report

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Q and A: Moving PrEP from Promising Trial Result to Practical, Public Health Prevention Intervention?

by Julie Davids, AIDS Foundation of Chicago, HIV Prevention Justice Alliance and IRMA member

As noted in these pages and press reports worldwide, the iPrex trial found that daily use of truvada protected gay men, other MSM and trangender women from HIV infection.

Updated data presented at this week's Conference on Retroviruses and Opportunistic Infections (CROI) showed the trial results held true through 144 weeks - nearly three years - and that the key challenge seems to be adherence. Those who took the drug most or all of the time (about 1/2 of the people in the study) had high rates of protection - over 90%. But because the other half took little or no drug at all (as confirmed by blood tests), the overal efficacy rate among trial participants was 44%.

After a long day at the conference, an eager crew of conference-goers - including researchers, people with HIV, White House officials and press - joined local community members here in Boston on Tuesday night in the auditorium of Fenway Community Health for ARV-Based Prevention: A Community & Research Forum on Recent Results and What Happens Next, sponsored by AVAC and Fenway.

At the end of the formal presentations, I asked the panelists (on behalf of the HIV Prevention Justice Alliance)

"What are one to three next steps that are vital to making PrEP [pre-exposure prophylaxis] effective at the community or public health level, rather than just a boutique intervention for a few individuals?"

I captured the responses, which cover a wide range of issues and strategies, and wanted to share them with you. Panelists, in order of response, were:

- Morenike Ukpong, New HIV Vaccines and Microbicide Advocacy Society, Nigeria
- Kevin Cranston, Massachusetts Bureau of Infectious Disease
- Cate Hankins, UNAIDS
- Salim Abdool Karim, CAPRISA
- Jared Baeten, University of Washington and Partners PrEP
- Robert Grant, Gladstone Institute of Virology and Immunology
- Jim Rooney, Gilead Sciences
- Mark Hubbard, Tennessee Association of People With AIDS



Q and A: Moving PrEP from Promising Trial Result to Practical, Public Health Prevention Intervention? from HIV Prevention Justice Alliance on Vimeo.