Meet Octavio Vallejo, A Friendly Rectal Microbicide Advocate

Check out this interesting mini-bio of  Octavio Vallejo, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Octavio is one of five new bios posted this week.

Octavio Vallejo
Los Angeles, California, USA

Octavio Vallejo has been working in the HIV prevention field for more than 22 years. As an HIV+ gay Latino man, Octavio has long recognized the need for additional methods of protection for young gay men and other men who have sex with men. His involvement with rectal microbicides came through his interactions with scientists such as Dr. Ian McGowan and Dr. Ross Cranston. Their passion for this issue was contagious and soon Octavio became involved with IRMA's active body of passionate researchers and advocates.


Octavio was drawn to IRMA by its spirit of inclusion and the resolve, resilience, and passion shown by the advocates connected with IRMA. He works for the Capacity Building Assistance program at AIDS Project Los Angeles as a Biomedical Prevention Specialist. This role have given Octavio more opportunities to share evidence-based information to all parties interested in changing the course of the HIV epidemic and educate them about the new generation of prevention tools and approaches.

Currently, Octavio and his fellow staff members are in the process of creating the platform to bring microbicide advocacy to the forefront of all their trainings, educational endeavors and prevention discussions.

Thank you Octavio for your continued dedication to HIV/AIDS prevention advocacy! 

------------------- *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. -------------------

Meet Hailey Gilmore, A Friendly Rectal Microbicide Advocate

Find out a little about Hailey Gilmore in her interesting mini-bio, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Hailey is one of five new bios we are featuring.
 

Hailey Gilmore
San Francisco, California, USA

Hailey Gilmore studied international development in college and was always interested in sexual health promotion and education. While in school she interned at a local non-profit and developed a sex-ed workshop for youth in trade school. During this time she also became a volunteer HIV test counselor. This introduction to sexual health work opened the door for her current position as the Assistant Director of HIV Prevention Intervention Studies at Bridge HIV at the San Francisco Department of Public Health. She has been with Bridge HIV, supporting and coordinating clinical trials, for over four years.

Her organization conducts HIV prevention clinical trials testing HIV vaccines and pre-exposure prophylaxis (PrEP), and soon, rectal microbicides. Bridge HIV also studies behavioral interventions.

A little over a year ago, her organization was approached by the Microbicide Trials Network about conducting MTN-017, a phase II safety and acceptability study of rectally applied tenofovir gel among gay men, men who have sex with men, and transwomen in the US, Peru, Thailand, and South Africa. Hailey and her colleagues are incredibly excited for the MTN-017 launch later this year.

Hailey is also busy with the HPTN 069 study, or NEXT-PrEP, which is looking at the safety and tolerability of four daily oral regimens of PrEP. She is also analyzing qualitative data about people's motivations to take PrEP to better address advocacy strategies.

Hailey and her group will also soon be hosting a screening of "The Rectal Revolution is Here" in July to engage the San Francisco community on the topic of rectal microbicides.


Hailey would like to encourage IRMA to continue to find additional community allies to partner with - rectal microbicides are just too exciting to not talk about!

Thank you Hailey! 

------------------- *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. -------------------

Meet Rig Rush - A Friendly Rectal Microbicide Advocate

Check out this interesting mini-bio of Rig Rush, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Rig is one of the six new bios just posted the other day, including individuals from Thailand, Kenya and the US.  Each will be featured on the blog, and you can read all of them here right now.


Rig Rush
Los Angeles, California

"By promoting affirming messages that reinforce normalizing overall sexual health and awareness, you can inspire individuals who engage in anal sex to take ownership and accountability of their own behaviors; making confident and informed decisions. In my fierce opinion, that is the basis for HIV and STD prevention."

Originally from Pittsburgh, Rig just moved across country to Los Angeles to become the new Community Mobilization Coordinator at the Black AIDS Institute. He has several interests including going to movies, amusement parks, and taking extremely long walks. He loves meeting different types of people and creating pleasant memories. He also happens to be one of the stars of the soon-to-be-released IRMA video called "The Rectal Revolution is Here: An Introduction to Rectal Microbicide Clinical Trials" being produced in collaboration with the Microbicide Trials Network and Population Council. In the video, Rig relates his experiences as a participant in a rectal microbicide trial with wit, warmth, and passion.

He believes that STD information, brochures and presentations focus on "drips, itches and stenches". Based on the available information, Rig felt he was the only individual who passionately enjoyed receptive anal sex. He also found the small amounts of health-related information regarding anal health/enjoyment highly offensive. Given his frustration, Rig was overjoyed when he heard about the research study that "celebrated the bottom perspective" - the study he talks about in the video.

He acknowledges that "men love sex, and they love unprotected sex, but most men do not think about risk when the moment arises." Condoms protect only when used consistently and correctly. However the concept of rectal microbicides "truly takes prevention and puts it where the rubber meets the road." He finds microbicides in general (both rectal and vaginal) to be the best modern step to fighting the HIV/AIDS epidemic that isn't gay specific. Rectal microbicides have the potential to have a vast and appealing impact on the community collectively.

Rig's advice for IRMA is to remain consistent and committed to promoting awareness and education about rectal microbicides and health. He feels that "the information one obtains from IRMA is very beneficial for the collective gay community."

He will soon be a featured speaker in the satellite session "Rectal Microbicides: Making HIV Prevention Gel" at the International AIDS Conference in Washington, DC with other members of IRMA and allies. The session is taking place in the afternoon on Sunday, July 22, 2012. More info on this event can be found here.

He works to motivate, inspire and unite gay black men and other men who have sex with men around a variety of issues, and continues to support and celebrate black gay men regardless of their HIV status. He strives to help others live productive, informed and authentic lives filled with healthy connections and relationships.

Rig's mother has had the deepest impact on his life. She is his symbol of strength, compassion and authenticity, which shaped Rig into the man he is today. His mother's fearless, positive and audacious appreciation for life ignited a fire that continuously resonates.

Thank you Rig 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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Many HIV/AIDS Advocates Support the FDA to Approve PrEP for HIV Prevention

via PRNewswire

In public comments submitted this week, a group of 14 leading HIV/AIDS and health organizations stated their support for Food and Drug Administration (FDA) approval of emtricitabine/ tenofovir disoproxil fumarate (TDF/FTC or Truvada®) as pre-exposure prophylaxis (PrEP) to prevent HIV infection in adult men and women. Their comments, submitted in advance of a May 10 FDA Advisory Committee meeting, pointed to compelling evidence on the efficacy of TDF/FTC as PrEP and highlighted the unique potential of this intervention to help slow the HIV epidemic in the U.S.

With PrEP, HIV-negative individuals who are at risk for HIV take anti-HIV medications in order to reduce their chances of becoming infected if exposed to the virus. At the May 10 hearing, the FDA will consider data from clinical trials showing that TDF/FTC reduced the risk of sexual transmission of HIV in populations including men who have sex with men (MSM) and heterosexual women and men.

"The U.S. and international AIDS community overwhelmingly supports FDA's priority review of this potentially game-changing new tool to prevent HIV," said Mitchell Warren, executive director of AVAC. "The evidence is increasingly clear that daily PrEP can help reduce HIV risk in women and men who take it consistently as prescribed. While no single tool will be enough to stop the spread of HIV, PrEP could be a vital part of a comprehensive, global strategy to end the AIDS epidemic."

Despite some progress in reducing HIV incidence using other available methods, approximately 50,000 people become newly infected with HIV every year in the United States, and 2.6 million people were newly infected with HIV worldwide in 2010. Globally, half of all people infected with HIV are women and girls. In the United States, HIV infection continues to take a disproportionate toll on African Americans and Latinos; MSM, including transgender individuals; and the poor. Driving down HIV infection rates is a primary objective of the U.S. National HIV/AIDS Strategy, and is at the core of global efforts to end the AIDS epidemic.

Read the Rest.



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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.

*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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Rosie the Riveter Can No Longer Represent the Face of Microbicide Research: Lessons from M2012

by IRMA member Morenike Ukpong

Rosie the Riveter is a cultural icon of the United States, representing the American women who worked in factories during World War II, many of whom produced munitions and war supplies. These women sometimes took entirely new jobs replacing the male workers who were in the military. Rosie the Riveter is commonly used as a symbol of feminism and women’s empowerment. Rosie’s picture came to represent the objective of microbicide research – an empowering tool that will enable women to have a HIV prevention option they could control, in their hand.

The microbicide research movement was actually initiated as a women empowerment movement. Women asked for a tool that they can control independently to help reduce their own risk of HIV infection. Women activists led by Lori Heise, started making a case for a women controlled option for HIV prevention. This movement was in response to a call made by an African woman on the need to have something to protect herself, Lori Heise often recalls. The earliest movement was focused on the development of a vagina application that could ensure women can use the product discretely if and when they choose too.

Trials in many African countries continue to suggest that discrete use of a microbicide may not be feasible – male involvement in the implementation of microbicide trials and its use by women engaged in the trials is important so as to ensure participant retention and prevent other potential social harm. However, Mitzy Gafos in her presentation titled ‘What have men got to do with it: the role of men in reproductive and sexual health in a predominantly rural are of KwaZulu-Natal, South Africa’ showed that women in South African can actually take decision about the use of the microbicide independent of their male partners. I would want to assume that this is the same in South West Nigeria where women are quite independent and are better able to negotiate the use of condom with their male sex partners.

With increasing discussion on anal sex and rectal microbicide, the objective of developing a microbicide seems to have shifted. It is less so about developing a tool that will empower women to have control over her sexual and reproductive health in a way that will enable her protect herself from HIV infection. More and more attention is being paid to public health needs that are larger than women focused issue.

Rosie the Riveter can no longer represent the face of microbicide research. Current research is looking at bioavailability of microbicide gel in the rectum and vagina and its efficacy in preventing HIV infection in both the vagina and the rectum at the best. This means a microbicide product can be used by men, women and transgenders.

The message about microbicide is no longer one of empowering women in Africa. The message is now about health and access to health product in African. Structural issues that will facilitate the uptake and use of microbicides are being discussed everyday. This includes the need to strengthen health systems so as to ensure product access, human right issues so as to ensure access by MSMs. The peculiar issues related to women, women access, women empowerment, has quietly fallen off the table. The events at the M2012 make this very clear.

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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.

*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 FDA Evalutes the Decision on PrEP for HIV Prevention

via The New York Times, Denis Grady

An advisory panel to the Food and Drug Administration is expected to vote Thursday on whether a drug already used to treat H.I.V. infection should also be approved to prevent it. Such a recommendation, if made, would mark the first time that government advisers have advocated giving antiviral medicine to healthy people who might be exposed through sexual activity to the virus that causes AIDS.

Studies have shown that people who take the medicine, Truvada, every day have a greatly reduced risk of infection.

The F.D.A. usually accepts the advice of its advisory panels, which are made up of outside experts, mostly from medical schools.

On Thursday morning, the panel evaluated studies of the once-a-day pill and heard scientific presentations about whether Truvada should be prescribed for people at high risk of infection, like gay men who have multiple sex partners, especially those who do not always use condoms, and people in relationships with someone who is H.I.V.-positive. Young black men who have sex with other men are at highest risk.

The drug is meant not to replace condoms and other safe-sex measures, but to be used with them for added protection.

Experts say better methods of prevention are needed because there are 50,000 new H.I.V. infections a year in the United States. Several speakers emphasized on Thursday that that number had not budged in 15 to 20 years. Counseling and condoms are not doing the job, they said, and many of the newly infected are men whose sexual partners do not realize they are H.I.V.-positive.

Read the Rest.


------------------- *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. *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. -------------------

Studies Search for "User Friendly" Microbicides for HIV Prevention

via Voice of America, by Joe DeCapua

In 2009, researchers completed a study that showed a microbicide gel could protect women from HIV infection. The gel, known as CAPRISA 004, was nearly 40 percent effective in reducing the risk of infection during sex. The encouraging findings have led to follow-up studies. But just because a microbicide can block HIV, does not mean that women will use it.

Top ranking health officials called the CAPRISA 004 study historic. They said it showed that a microbicide could empower women to protect themselves from HIV/AIDS. It was something they could use without asking a man’s permission. But would women use it outside of a clinical trial?

That’s what a U.S.-funded study called Project LINK is trying to find out. Dr. Kathleen Morrow is leading a team of researchers at The Miriam Hospital in Providence, Rhode Island.

“It’s actually the first study to my knowledge to link those physical, chemical and rheological properties and performance characteristics of a gel to the user experience - the actual sensory perceptions and experiences of the person using the product,” she said.

Not all gels are alike

Morrow is a staff psychologist at The Miriam Hospital and associate professor of psychiatry and human behavior at the Warren Alpert medical school at Brown University. Morrow and her team are not studying whether the microbicide actually works. Instead, they want to know how women react to the gels themselves.

“If my clinical counterparts, who are actually developing the pharmaceutical sides of things – the drug side of things – the drug that they will actually put into the gel or ring or whatever they’re going to put it into – if they do that and they do that well, and we have a product that will actually reduce HIV infections, the reality is it will only do that if people use it. So if people don’t use it, it will sit on a shelf and will have no impact on the HIV pandemic,” she said.

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.]

U.S. Policy Addresses HIV Epidemic in the LGBT Community

via HuffPost, by Charles Stephens

We finally are starting to scratch the surface of the depth of the HIV crisis among young black men who have sex with men (MSM). Late last summer the Centers for Disease Control and Prevention (CDC) announced the most recent HIV incidence numbers, indicating that young, black MSM were the only population in the United States that showed an increase. In the three-year period between 2006 and 2009, there was an almost 50-percent increase in HIV incidence in that group.

This information was startling. Those of us working in the field had suspected that the HIV incidence numbers among young, black MSM would be disproportionately high. But to know it, to hear it confirmed, was shocking. For a few months after the updated HIV incidence numbers were announced, there seemed to be a collective gasp, even as we struggled to crank out solutions. And since then there has been a persistent conversation among many sectors of the HIV prevention realm about next steps. Just what are we going to do next?

So it was this spirit of persistence to find answers that many of us brought to the White House LGBT Conference on HIV/AIDS in Atlanta, Ga. on April 19. Held at the Morehouse School of Medicine, the conference was as well attended as it was ambitious. On the campus of a historically black college, in a historically black community, the symbolism was as rich as it was breathtaking. Those of us who attended assembled dutifully, with both grace, because we were called, and urgency, because of the calling. Several White House officials, including Dr. Grant Colfax, the new director of the Office of National AIDS Policy, as well as numerous HIV experts, gathered to talk about the HIV epidemic today in LGBT communities.

Two groups that entered almost every conversation were young MSM and transgender populations. Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, shared his insights about the social and structural drivers of HIV, particularly among vulnerable populations and sexual minorities. He affirmed the commitment of the CDC to LGBT communities and announced some of the agency's next steps, including a roll-out of additional social marketing campaigns.

Homophobia must frame how we think about the devastating impact of HIV. This was a key insight to the entire conference. Anti-gay stigma, HIV stigma, and environments that dehumanize and demean sexual minorities and gender-nonconforming people create a perfect storm for HIV and other public health disparities. Young, black MSM and transgender people are vulnerable in a variety of ways, including to physical and psychic homophobic violence, familial and community rejection, discrimination, and a litany of other kinds of social stigma. These vulnerabilities fuel health disparities, particularly with regard to HIV. As Dr. Patrick Sullivan, an Emory University professor and researcher, stated, "homophobia is a public health hazard." In this sense, the scientific and social, negative health outcomes and human rights and, by extension, sexual rights, are not separate spheres but are intricately connected within a wider spectrum of issues we must work on together, and not separately.

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.]

Digital Technologies Changing the face of HIV Prevention

via Advocate.com, by By Gurmit Singh & Christopher S. Walsh

Why are we so fixated on finding a medical solution when, as social networks revolutionize sex in our community, gay men are successfully using new technology to combat HIV?

More and more gay men are hooking up online. The explosion of “Gaydar culture” through Xtube, Manhunt, Adam4Adam, and Grindr can increase risky sexual behavior, spawning fears of a new wave of HIV infections, particularly among young gay men. Yet, as new digital technologies change the way we enjoy sex and experience relationships, they are also changing the face of the AIDS response in remarkable ways.

In recent years, the global AIDS establishment has become fixated on medical approaches to HIV prevention. The success of antiretroviral therapies and new clinical trials on pre-exposure prophylaxis (PrEP) have transformed the field, and “Treatment as prevention” is now promoted by the US PEPFAR, UNAIDS and the WHO.

The prospect of ending the HIV epidemic with a simple pill is seductive – but falsely so.

Fuelled by disparity and discrimination, HIV slams communities on the margins of society. Gay men have experienced this since the beginning of the epidemic, yet the medical establishment continues to advocate for chemical “quick fixes” to an exceedingly complex social problem. We cannot let these medical – albeit important – scientific advances distract us from what social science researchers have been telling us for years: the roots of this epidemic lie in the lack of health and human rights for gay men, other men who have sex with men (MSM) and transgender people in the developed and developing world.

Fortunately, just as we did at the beginning of the AIDS epidemic, our communities are taking the lead in tackling these fundamental challenges. As digital technologies become integral to our lives, they have become equally central to innovative HIV education, prevention and care efforts. These technologies enable us to work together in ways never before possible, offering unprecedented opportunities to tackle the many barriers that make our communities vulnerable to HIV.

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.]

Cost Issues of PrEP Evaluated as HIV Prevention

via Pharmalot, by Ed Silverman

Late last year, Gilead Sciences took a widely anticipated and controversial step by seeking FDA approval to market its Truvada HIV pill to prevent infection, which is also known as pre-exposure prophylaxis or PrEP. The move was both welcomed and criticized by AIDS activists, reflecting a spectrum of views on making a preventive pill available on a large-scale basis.

To some, FDA approval would offer needed assistance in containing HIV and possibly clarify the extent to which such preventive measures are useful. To others, FDA approval raises the specter of creating a form of resistance to HIV due to widespread use, which would undermine effectiveness for existing Truvada patients and, therefore, diminish prevention efforts. In particular, critics worry people without HIV who take a preventive pill may engage in risky behavior.

A related issue, of course, is cost. Truvada carries a price of $26 a day, or roughly $10,000 a year, which may inhibit widespread usage. However, a new study suggests there is, indeed, value. Prescribing Truvada to men who have sex with men in the US would cost $495 billion over 20 years, but targeting only those at highest risk would lower costs to $85 billion, according to the study published in The Annals of Internal Medicine (here is the abstract).

Over the next two decades, the researchers calculated a total of 490,000 new infections if prevention is not undertaken, but if 20 percent of gay men take the pill daily, there would be nearly 63,000 fewer infections. And if just 20 percent of high-risk men took the drug, 41,000 new infections would be prevented over 20 years at a cost of about $16.6 billion.

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.]

Researchers Report that PrEP May Be Accepted as HIV Prevention in UK's Gay Men

via AIDSmap.com, by Roger Pebody

Pre-exposure prophylaxis (PrEP) would be an acceptable HIV prevention strategy for large numbers of gay, bisexual and other men who have sex with men in major UK cities, according to two studies presented to the British HIV Association (BHIVA) conference in Birmingham this week.

The conference also heard details of a small pilot PrEP study, likely to start recruiting later this year.

A cross-sectional survey of 842 HIV-negative gay and bisexual men, recruited at bars, clubs and saunas in London, suggested that half the respondents would be interested in taking PrEP.

Respondents were given information about pre-exposure prophylaxis and asked: “If PrEP were available, how likely is it that you would take a pill (oral dose) on a daily basis to prevent HIV infection?”.

Half said yes, with 16% saying they were likely to take PrEP and 34% saying they were very likely to. Men interested in PrEP were slightly more likely to be under the age of 35 (AOR adjusted odds ratio 1.58), have attended a sexual health clinic in the past year (AOR 1.59) and to have previously taken post-exposure prophylaxis (PEP) (AOR 1.96). After statistical adjustment, various measures of risky sex were no longer associated with interest in PrEP.

In this survey, 17 men (2.1% of those answering the question) said that they had previously taken antiretroviral drugs to reduce their risk of HIV infection.

Secondly, clinicians at the Manchester Centre for Sexual Health surveyed HIV-negative men attending their service who reported unprotected receptive anal intercourse. Of the 121 men who responded, 36% said they would be “very willing” to take PrEP while only 14% said they would not take the treatment. Daily dosing was perceived as a better option by four fifths of respondents – just one fifth would prefer taking a dose before sexual activity.

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.]

PrEP Project Initiative Starting Throughout California

via California HIV/AIDS Research Program

In April 2012, the California HIV/AIDS Research Program (CHRP) of the University of California awarded grants totaling $11.8 million to three collaborative teams of investigators to test a potential HIV prevention medication among high-risk HIV-uninfected persons in several communities throughout California. The studies also will examine new strategies to engage and retain HIV-infected persons in care and treatment. Both of these strategies are expected to help curb the HIV epidemic in California.

Two of the collaborative teams of investigators will offer PrEP (pre-exposure prophylaxis with antiretroviral drugs) to high-risk uninfected men who have sex with men (MSM) and to transgender women (male to female transgendered persons) located in Los Angeles, San Diego, and Long Beach over the next four years. These investigators also will assess the implementation of TLC+ (testing and linkage to care plus treatment), a strategy to locate, engage, and retain HIV-infected persons in care and start them on life-saving treatment for their HIV infection

A third grantee consortium will not fully implement PrEP or TLC+ at the present time, but will instead plan and pilot PrEP/TLC+ implementation strategies for young MSM of color located in Oakland, Richmond, Berkeley, and other East Bay Area locations.

PrEP involves the provision of antiretroviral drugs and risk reduction counseling to high risk uninfected persons to prevent future HIV infection among those who potentially may be exposed to the virus. Previous international research trials have shown that PrEP has been very effective in preventing new HIV infections among MSM and selected other risk populations, but only when taken as prescribed in addition to ongoing risk reduction counseling. Recent studies have suggested that the mixed results found for some populations may be due to a lack of consistent adherence to the medication, leading to suboptimal or ineffective levels of drug in the body. In addition, other studies have suggested that identification and rapid institution of antiretroviral therapy for people infected with HIV not only improves survival of those treated, but also lowers the level of HIV virus in the community and might ultimately reduce HIV transmission rates.

This will be the largest PrEP/TLC+ demonstration project initiative in the U.S., and will be the first to test PrEP in several communities throughout California. In these demonstration projects in California, PrEP will be delivered as part of a comprehensive prevention package including risk reduction counseling, sexually transmitted infection screening, and other components. Daily Tenofovir/FTC (Truvada®, a tenofovir/emtricitabine two-drug combination pill manufactured and distributed by Gilead Sciences, Inc. of Foster City, CA) based PrEP will be offered to eligible uninfected high-risk men who have sex with men, as well as to transgender women. Gilead Sciences will provide the drug product (brand name Truvada®) to support these studies. The studies will adhere to safety and implementation guidelines issued by the Centers for Disease Control and Prevention.

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.]

The Challenges that Arise When Using ARV's as HIV Prevention

via AIDSmeds, by Tim Horn


Excerpt:

A key question from HPTN 052 is whether the results can be generalized to other contexts, Cohen and his colleagues explain. Examples include heterosexual couples with CD4 counts lower and higher than those studied in HPTN 052; high-risk heterosexual individuals, notably sex workers and their clients; men who have sex with men (MSM); and injection drug users (IDUs).

With regards to MSM and IDUs, the authors note, a World Health Organization expert committee concluded that there is no reason to presume that treated, HIV-positive MSM will not be rendered less contagious as a result of ARV therapy. “However,” Cohen and his colleagues write, “the biology of HIV transmission is sufficiently different in IDU and MSM as compared to heterosexual transmission, warranting further consideration and study.

“For example, the number of HIV variants acquired and the efficiency of transmission are higher in MSM and IDU than in heterosexual transmission,” they note in recalling one study. “Additionally, whether [ARV therapy] reduces infectivity through anal sex by the same order of magnitude as for vaginal sex remains uncertain. Although such an effect is widely assumed, this is a key missing piece of evidence.”

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.]

Microbicides Conference Changing to a More Integrated HIV Prevention Conference

via AIDSmap.com, by Gus Cairns

The International Microbicides Conference held in Sydney this week will be the last of its kind, delegates were told in a closing plenary today.

From 2014 onwards, it is planned, a single biennial conference on all aspects of HIV prevention will be held.
Globally, the two largest funders of HIV prevention research are the US National Institutes of Health's Office of AIDS Research and the Bill and Melinda Gates Foundation. Gina Brown of the Office of AIDS Research and Stephen Becker of the Gates Foundation shared the podium to make a joint speech outlining the reasons for no longer funding separate conferences, and instead convening a programme committee to plan a biennial global HIV prevention conference.

They said they were proposing an "integrative prevention meeting" in recognition of the fact that no one HIV prevention method is likely to end the epidemic and that different methods can be synergistic. Stephen Becker said that the demand for a more integrated approach to HIV prevention “was being voiced from the ground up", by community advocates and NGOs, as well as by donors who wished to see more efficiency and less duplication of effort within the field.

Cross-cutting dialogue between specialists pursuing different areas is more likely to generate combinations of prevention approaches than individual approaches being pursued in neighbouring research 'silos', Becker added.

There was duplication of effort in some areas. Much of the animal-model and mucosal-immunity work being done in the HIV prevention technologies underlay HIV vaccine development as much as it did microbicide development. he said. And, he added, the social and behavioural research that underpinned prevention technology research by helping to understand which populations need what HIV prevention methods formed the same backdrop, whether what was being developed was a vaccine, a microbicide or the roll-out of a circumcision programme.

Gina Brown said that a world HIV prevention conference planning committee would be convened immediately, comprising experts from all fields including social sciences and community advocacy. In common with the international microbicides conferences, which have been held biennially since 2002, the last of the the annual AIDS Vaccine conferences, which started in 2000, will be held in 2013 in Barcelona. Other prevention conferences, such as next week's second international Treatment as Prevention Workshop in Vancouver, will also no longer receive funding as separate events.

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.]

AVAC Presents A Research Literacy Database as a Resource for HIV Prevention

AVAC is pleased today to launch the Research Literacy Database at www.avac.org/researchliteracy, an important new resource for the biomedical HIV prevention field.

The Research Literacy Database is the first central portal for educational resources on biomedical HIV prevention including:

• Global and country-specific materials;

• Resources specific to given prevention interventions including AIDS vaccines, ARV-based prevention and voluntary medical male circumcision; and

• General information on clinical trials and the research process.

The tools featured in the database were developed by a range of stakeholders worldwide to meet specific needs. We will continue to expand the database and encourage our users to share their favorite materials on an ongoing basis. The database focuses on materials that won’t necessarily change substantially over time; for trial updates, timelines, recent results and their implications and current issues, please see other areas of the AVAC website.

Using an innovative design, the database allows users to search for what they need based on key criteria. For example, a journalist in South Africa who wants to learn more about the basics of microbicide research can use the database to find relevant fact sheets, e-learning courses and other helpful tools. Research organization staff members who need tools for training and outreach to wider audiences can use the database to get a tailored toolkit according to location, audience and specific content.

We all know that the science behind HIV prevention research is challenging. AVAC believes that building
basic research literacy among key stakeholders is fundamental to effective advocacy, to moving research forward as quickly and ethically as possible, and ultimately to getting new prevention options to people who need them. Whether you are a researcher, advocate, journalist, policy maker or someone interested in learning more about clinical trials and new ways to prevent HIV, we hope this database will make learning and outreach efforts easier and more effective.

The database is an iterative tool, and will be constantly updated with new materials and other user input. We need your help in ensuring that useful materials are available and used! Please contact us at researchliteracy@avac.org with any and all feedback you have as you use the database—and we are especially keen to receive additional relevant resources to be shared with the field.



[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.]

High HIV Prevalence Found Among Ugandan Sex Workers

via New Vision, by Joyce Nyakato

New research published in The Lancet, an international medical journal, has revealed that commercial sex workers in Uganda have one of the highest rates of HIV infections in the world.

Some 99,878 female sex workers in 50 countries (14 in Asia, four in Eastern Europe, 11 in Latin America and the Caribbean, one in the Middle East and 20 in Africa), were subjects in the study conducted between January 1, 2007 and June 25, 2011. Results of the study, which was led by Dr. Stefan Baral of the US-based John Hopkins School of Public Health, were released on Thursday.

The study, which assessed the burden of HIV compared to that of other women of reproductive age, found that the burden is disproportionately high and concluded that there is an urgent need to scale up access to quality HIV prevention programs for sex workers.

State minister for ethics and integrity Fr. Simon Lokodo agrees that like all Ugandans, sex workers have a right to HIV treatment and attention.

“However, giving them the leeway to operate as a business is too much to ask from the Government,” he said.

The four-year survey funded by the World Bank and the United Nations Population Fund ranked Uganda as one of the countries where sex workers had a higher HIV prevalence than other women.

Women who sell sex came sixth among the 20 African countries after Malawi, Zimbabwe, South Africa, Kenya and Benin.

An average of four sex workers in ten will have HIV.

This rate is about five times more than other women of reproductive age, who have 7.7% prevalence, according to the recent AIDS indicator survey released by the Ministry of Health last week.

In addition, the likelihood of new HIV infections among sex workers stands at 15%.

“These findings suggest an urgent need to scale up access to quality HIV prevention services among female sex workers because of their heightened burden of disease and the likelihood of onward transmission through the high number of sexual partners as clients,” Stefan wrote.

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.]

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.]

Researchers Present the Impact of Serosorting as an HIV Prevention Strategy

via AidsMap.com, by Gus Cairns

An meta-analysis of HIV-negative gay men’s sexual behaviour and HIV incidence rate in four HIV prevention studies, presented earlier this month at the 19th Conference on Retroviruses and Opportunistic Infections (CROI), has found that attempting to ‘serosort’ by restricting unprotected sex to partners known to be HIV negative does have efficacy as an HIV prevention strategy, when compared with using no strategy at all.

Serosorting is, however, considerably less effective in reducing the chances of acquiring HIV than four other strategies: 100% condom use, monogamy, only having insertive sex, or ‘seropositioning’ (only taking the bottom role with partners known not to have HIV and being top with partners of positive or unknown status). Interestingly, 100% condom use was the least effective of these other four strategies.

‘Seroadaptive’ behaviours include any method of attempting to reduce the risk of HIV acquisition or transmission by altering one’s sexual behaviour according to the HIV status of partners. The term ‘serosorting’ has been used in various different ways. Most commonly, it means restricting unprotected anal sex to partners known to have the same HIV status as yourself. When unprotected sex between HIV-negative men is confined to a primary relationship, with condoms used in all other encounters, this has been called ‘negotiated safety’.

 

While some studies have found serosorting in HIV-negative men to be effective, others have not. Attempted serosorting by HIV-negative people has an inherent drawback that serosorting by HIV-positive people lacks: people can only be certain of their status up to the first time they risk exposure to HIV after their last negative HIV test. Research indicates that a large minority of people in high-risk communities who assume they are HIV negative in fact have HIV, and that a large proportion of men who ‘know’ their partner’s HIV status have, in fact, tried to guess it.

 

The meta-analysis

 

Nonetheless, though serosorting is fallible, a recent meta-analysis of studies presented at CROI found that serosorting halved the likelihood of acquiring HIV compared to having no strategy at all.

The study pooled behavioural data and HIV incidence rates from four different studies in gay men:

• The HIVNET 001 Vaccine Preparedness Study (VPS), an observational study that took place in eight cities in the US between 1995 and 1997. 
• VAX 004, the first phase III efficacy trial of a candidate HIV vaccine, which took place at 61 sites in the US, Canada and the Netherlands between 1998 and 2001.
• The EXPLORE study, a randomised controlled trial of a behavioural HIV-prevention intervention that took place in six US cities between 1999 and 2003. 
• The STEP study, a phase III trial of another candidate vaccine, which took place in North and South America and Australia between 2004 and 2007.

There were a total of 12,705 HIV-negative gay men from North America included in these trials, of whom 663 (5%) acquired HIV.

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.]

Johns Hopkins: Studies Show the Likelihood of HIV Infection in Female Sex Workers

via Johns Hopkins School of Public Health

Female sex workers in low- and middle-income countries are nearly 14 times more likely to be infected by HIV compared to the rest of country’s population, according to an analysis by researchers at the Johns Hopkins Bloomberg School of Public Health. The findings suggest an urgent need to scale up access to quality HIV prevention programs in these countries. The study was published online in The Lancet Infectious Diseases.

“Although female sex workers have long been understood to be a key affected population, the scope and breadth of their disproportionate risk for HIV infection had not been systematically documented,” said Stefan Baral, MD, MPH, MBA, lead author of the study and associate director of the Bloomberg School’s Center for Public Health and Human Rights. “In addition to antiretroviral treatment and ongoing HIV prevention for sex workers, considerations of the legal and policy environments in which sex workers operate, and the important role of stigma, discrimination, and violence targeting female sex workers globally will be required to reduce the disproportionate disease burden among these women.”

For the study, Johns Hopkins conducted a meta-analysis of 102 previous published studies representing almost 100,000 female sex workers in 50 countries. Overall, HIV prevalence in female sex workers in low- and middle-income countries was found to be about 12 percent, which equated to an increased risk of infection for sex workers 14 times that of other women in these countries. In 26 countries where background levels of HIV were considered “medium” to “high,” approximately 31 percent of the female sex workers were found to have HIV and were 12 times more likely to be infected compared with women from the general population. Sex workers in Asia had a 29 percent increased risk for HIV infection compared to other women, which was the greatest disparity among the regions studied. Sex workers in Africa and Latin America were 12 times increased risk compared to other women in these regions.

This analysis was conducted as part of a larger project entitled, "The Global Epidemics of HIV among Sex Workers: Epidemiology, prevention, access to care, costs, and human rights" led by Johns Hopkins researchers Deanna Kerrigan, PhD, MPH, and Chris Beyrer, MD, MPH. The larger project assesses not only the epidemiology of HIV among sex workers in low- and middle-income countries, but also documents the current state of HIV prevention interventions and the social context surrounding sex work in different settings, and uses mathematical modeling and cost-effectiveness analysis to assess the potential impact and resources necessary to scale up of comprehensive HIV prevention, treatment and care services among sex workers.

“Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis” was written by Stefan Baral, Chris Beyrer, Kathryn Manning, Tonia Poteat, Andrea L. Wirtz, Michele R. Decker, Susan G. Sherman, and Deanna Kerrigan.

 
[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.]

Dr. Grant Colfax: New Director of White House Office of National AIDS Policy

via PR Newswire

San Francisco AIDS Foundation applauds President Obama's selection of Dr. Grant Colfax to become director of the White House Office of National AIDS Policy. Dr. Colfax is uniquely suited to continue the momentum established under his predecessor, Mr. Jeffrey Crowley, in advancing the ambitious goals outlined in the president's National HIV/AIDS Strategy and moving us closer to an AIDS-free generation.

"Dr. Colfax has been instrumental in the decline of new HIV infections in San Francisco in recent years," said San Francisco AIDS Foundation CEO Neil Giuliano. "His unique blend of experience serving on the front lines of the epidemic, implementing the national strategy at the local level, working as a direct service provider within the Ryan White CARE system, and conducting cutting-edge research makes him the right person at the right time to lead the Obama administration's efforts to end HIV/AIDS in the United States."

The Office of National AIDS Policy provides essential leadership in addressing the U.S. HIV/AIDS epidemic. As director, Dr. Colfax will be required to take a fresh look at how resources can be targeted to reduce HIV infection rates, increase access to treatment, and decrease HIV-associated health disparities related to sexual orientation, race, gender, and socio-economic status in hard-hit communities across the country. His track record in San Francisco demonstrates he is well suited for this challenge.

"Dr. Colfax will play a critical role over the next several years to ensure the implementation of the Affordable Care Act and HIV service integration to address the health care needs of people living with HIV," said Ernest Hopkins, director of legislative affairs at San Francisco AIDS Foundation. "Having worked closely with him on complex issues and having seen his consensus-building skills among diverse populations, including communities of color, I am confident that the AIDS community will have a strong advocate within the administration. I know Dr. Colfax will work to ensure that the coming changes to our health care system are made thoughtfully, carefully, and with a strong focus on improving the health status of the most vulnerable people."

As director of the HIV Prevention and Research Section at San Francisco Department of Public Health, Dr. Colfax elevated the role of community-based health research in local planning and funding decisions and instituted innovative, evidence-based HIV prevention tools, such as measuring and mapping community viral load and enhancing HIV testing and linkage to care, making San Francisco's HIV prevention planning and service system a model for jurisdictions across the nation. When developing the city's most recent HIV prevention plan with diverse stakeholders, Dr. Colfax was mindful to ensure its consistency with the emerging National HIV/AIDS Strategy. Throughout his career, he has maintained his role as a physician at Ward 86 at San Francisco General Hospital, the nation's first HIV/AIDS-specialized clinic.

San Francisco AIDS Foundation stands ready to work with Dr. Colfax, the White House, and other community partners across the country to reduce new HIV infections, increase access to care for all people living with the disease, and reduce HIV-related health disparities.



[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.]