The Presidential Advisory Council on HIV/AIDS (PACHA) will hold its 67th full Council meeting virtually on Monday, June 1 and Tuesday, June 2, 2020. Due to the coronavirus (COVID-19), the council members will each participate from home, presenters will join remotely, and stakeholders can view the meeting via livestream online.
During the meeting, the Council will:
Welcome a new member;
Discuss the impact of COVID-19 on the HIV response;
Engage with federal HIV leaders on the status of the Ending the HIV Epidemic initiative and the Federal responses to prevention and care access challenges resulting from COVID-19; and
Hear perspectives and lessons learned on HIV and COVID-19 from PEPFAR.
The Council will also hear public comments during the meeting. Individuals wishing to make a public comment must pre-register by emailing PACHA@hhs.gov. If you do not pre-register for public comment but decide you would like to submit a statement, please email your written statement to PACHA@hhs.gov by close of business Tuesday, June 9, 2020.
The meeting convenes on Monday, June 1 and Tuesday, June 2, 2020 from 2:00 PM to 5:00 PM (ET) each day. It will be livestreamed at www.hhs.gov/live. To register, please email Caroline Talev at PACHA@hhs.gov.
Learn more about PACHA on HIV.gov, where you can find links to previous meeting summaries and slides, including those from the February 2020 PACHA meeting held in Washington, DC.
Vaginal swab samples collected by patients performed similarly to lab-based molecular diagnostics for chlamydia and gonorrhea testing, therefore supporting the use of a new 30-minute point-of-case assay, according to findings published in JAMA Network Open.
Barbara Van Der Pol, PhD, MPH
“The new binx io CT/NG assay can facilitate a complete paradigm shift in how we offer testing for the two most commonly reported notifiable diseases in the United States — chlamydia and gonorrhea,” Barbara Van Der Pol, PhD, MPH, professor of medicine and public health at the University of Alabama at Birmingham and president of the American STD Association, told Healio. “Rates of infection with chlamydia and gonorrhea continue to rise, suggesting the need for additional tools in order to effectively reduce the burden of disease. Providers can now identify and treat infections (that are predominately asymptomatic) during a single office visit to prevent transmission and development of sequelea.”
[…] “Sample-first collection by clients seeking sexual health care (or who are eligible for routine screening according to the CDC guidelines) immediately upon arrival at the clinic can enable rapid, accurate results that allow the provider to offer both accurate treatment and appropriate counseling,” Van Der Pol said. “This is the first truly rapid molecular assay for chlamydia and gonorrhea. It is a breakthrough development.”
The Centers for Disease Control and Prevention (CDC) understands that its partners in HIV prevention are facing unprecedented challenges and demands as we continue to battle the COVID-19 pandemic together.
While some clinics and HIV prevention providers have adapted to changing circumstances by offering expanded phone triage and telehealth services, other clinics that provide pre-exposure prophylaxis (PrEP) services have had to reduce hours, eliminate or reallocate staff resources, or temporarily close.
CDC has developed guidance for providing PrEP when facility-based services and in-person patient-clinician contact is limited. For programs experiencing disruption in PrEP clinical services, CDC offers the following guidance for clinics to consider in the context of local resources and staff availability.
Among the principal reasons for recommending initiating antiretroviral treatment (ART) among pregnant patients who are HIV positive is to prevent transmission of the virus to their unborn children. This number was estimated at 1.3 million pregnant pregnant women, as of 2018. However, optimal treatment regimens remain unclear.
An international team of investigators published their study results earlier this month in Lancet HIV showing the superiority of ART containing raltegravir, an integrase inhibitor, compared with efavirenz, a nonnucleoside reverse transcriptase inhibitor. Both drugs are well established in their safety and efficacy for reducing the HIV viral load among nonpregnant patients, but the results of initiating them during pregnancy remain unclear. Is one superior?
As our country continues to battle the COVID-19 pandemic, we understand that our partners in HIV prevention are facing unprecedented challenges and demands. The Centers for Disease Control and Prevention (CDC) remains committed to working to protect the communities it serves and to providing timely and important data that can be used to help guide decision-making and advance progress toward ending the HIV epidemic in the United States. The CDC has published two new reports: Diagnoses of HIV Infection in the United States and Dependent Areas, 2018 (Updated) and Estimated HIV Incidence and Prevalence in the United States 2014–2018, as well as an AtlasPlus update that includes data from these reports. The reports and AtlasPlus update provide HIV diagnoses, diagnosed prevalence, and death data, along with estimated HIV incidence, prevalence, and knowledge of status through the year 2018. HIV prevention partners can use these reports, along with the data published in AtlasPlus, to help focus prevention efforts, allocate resources, monitor trends, and determine gaps and successes in HIV prevention.
August “Buzz” Pusateri played an integral role in the Pitt Men’s Study, a confidential research study of the natural history of HIV and AIDS. Not only did he believe in the importance of recruiting volunteers to help further research, he was one of the project’s first volunteers. Twice a year, sometimes more, Pusateri visited the clinic to give blood and answer detailed questions about his life. He also participated in special studies.
“Buzz got it across to the community … that this had to be done for them to defeat this epidemic of AIDS,” said Charles Rinaldo, a scientist and investigator of the Pitt Men’s Study. “He was central to it. He was always there. He was a tough guy, too.”
August “Buzz” Pusateri
Pusateri, a long-term HIV survivor, died on Monday, according to a tribute on the Pitt Men’s Study website. He was 81. Pusateri was a well-known community activist, a founding member of the Pitt Men’s Study community advisory board, and a volunteer with Shepherd Wellness Community. He had been involved in the Pitt Men’s Study since recruitment began in 1984.
“It’s just a horrible loss,” Rinaldo said. “He was our go-to person as far as connecting with the community. He was number one in making sure the community understood.”
Pusateri tested positive for HIV more than 30 years ago. He told the Tribune-Review in 2015 “it’s been an up-and-down battle.”
“Really, with this HIV, you never know what’s going to happen to you,” Pusateri said in 2015.
The Pittsburgh resident was the longest serving chair of the community advisory board, the direct link between the researchers and LGBTQ community, Rinaldo said.
The CDC recommends regular testing for bacterial sexually transmitted diseases (STDs) among all sexually active gay, bisexual, and other men who have sex with men (MSM) because they have a higher risk of infection. Chief among these STDs are gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Those most at risk also should be receiving recommended STD counseling services.
“Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner,” states the CDC.
Despite these guidelines, there has been a constant uptick in STDs over the past decade, particularly among HIV-positive MSM, even though they are receiving care for their HIV, according to the authors who investigated the receipt of STD testing and associated services among these individuals and published their results online today in Annals of Internal Medicine.
The primary outcome of their study was to determine both deficiencies in bacterial STD testing and what risky behaviors result in these deficiencies among HIV-positive MSM—especially because having an STD increases the risk of transmitting HIV.
HRSA’s HIV/AIDS Bureau recently announced five Notices of Funding Opportunity (NOFOs) for initiatives on HIV stigma reduction, implementing rapid ART initiation, and improving care and treatment for Black women with HIV. All five NOFOs are supported by the Minority HIV/AIDS Fund. Pre-application webinars begin this week.
HRSA-20-112: Reducing Stigma at Systems, Organizational, and Individual Client Levels in the Ryan White HIV/AIDS Program
This NOFO seeks applications for a training and technical assistance program to reduce stigma for people with HIV on multiple levels throughout the health care delivery system, including on an individual client level. The program will focus on implementing various stigma-reducing approaches, with an emphasis on cultural humility. The pre-application webinar will be held on May 5 from 2:00-3:00 PM (ET). Applications are due June 8. For more information and to apply.
HRSA-20-113:Building Capacity to Implement Rapid Antiretroviral (ART) Initiation for Improved Care Engagement – Evaluation and Technical Assistance Provider
This NOFO seeks applications to support a single organization that will conduct a rigorous multi-site evaluation on the implementation of rapid ART start interventions and facilitate technical assistance (TA) to a cohort of implementation sites (funded separately through HRSA-20-114, see below) to promote a “rapid start” connection or accelerated entry into HIV medical care and rapid initiation of ART for people with HIV who are newly diagnosed, new to care, or out of care. The pre-application webinar will be held April 29 from 3:00-4:30 PM (ET). Applications are due June 15. For more information and to apply.
HRSA-20-114: Building Capacity to Implement Rapid Antiretroviral (ART) Initiation for Improved Care Engagement – Implementation Sites
This NOFO seeks applications for awards to implement and evaluate “rapid start” or accelerated entry into HIV medical care, and rapid initiation of antiretroviral therapy (ART) for people with HIV who are newly diagnosed, new to care, or out of care. Awards will support organizations that have the capacity and infrastructure to support rapid start implementation, but have not yet been able to, with the goal of replicating and expanding successful rapid start models. The pre-application webinar will be held April 29 from 1:00-2:30 PM (ET). Applications are due June 15. For more information and to apply.
HRSA-20-115: Improving Care and Treatment Coordination: Focusing on Black Women with HIV – Evaluation and Technical Assistance Provider
This NOFO seeks applications for a single organization that will lead a multi-site evaluation and provide technical assistance (TA) to a cohort of demonstration sites (funded separately through HRSA-20-116, see below). The funded recipient will provide TA and capacity building to funded demonstration sites, work collaboratively with demonstration sites to implement a comprehensive multi-site evaluation, and disseminate successful models, findings, best practices, and lessons learned within the Ryan White HIV/AIDS Program (RWHAP) community. The pre-application webinar will be held on April 30 from 1:00-2:30 PM (ET). Applications are due June 15. For more information and to apply.
HRSA-20-116: Improving Care and Treatment Coordination: Focusing on Black Women with HIV – Demonstration Sites
This NOFO seeks applications for awards to design, implement, and evaluate bundled interventions, defined as a group of evidence-informed practices put together into a package that when implemented together produces better health outcomes than when the practices are delivered separately. Bundled interventions will address socio-cultural health determinants, expand the delivery and utilization of comprehensive HIV care and treatment services, support continuous engagement in care, and improve health outcomes for Black women with HIV in a culturally sensitive and responsive manner. Funded sites will collaborate with an Evaluation and Technical Assistance Provider (see HRSA-20-115, above). The pre-application webinar will be held April 30 from 3:00-4:30 PM (ET). Applications are due June 15. For more information and to apply.
The estimated award date for all five NOFOs is September 1, 2020.
More than 160,000 Americans with HIV are unaware they have the virus because they have not been tested and diagnosed. Yet we know that early diagnosis and treatment with ART are associated with better health outcomes for those with HIV. There are profound prevention benefits as well—a CDC analysis found that the nearly 15% of people with HIV whose infections are undiagnosed account for 38% of all HIV transmissions in the U.S. By finding ways to help more people get tested, we can prolong lives and prevent further transmissions.
That’s why HIV testing is a key strategy in Ending the HIV Epidemic: A Plan for America (EHE), the nation’s plan to reduce new HIV infections in the U.S. by 75% by 2025 and by 90% by 2030. The first of the Plan’s four strategies calls for diagnosing all people with HIV as early as possible after infection so they can begin care and treatment that can protect their health and prevent transmission of the virus to their partners.
Stakeholders across the country are exploring innovative ways to pursue this EHE strategy and seeking to make HIV testing more available to previously unreached populations, such as those who live far from the nearest testing site or who are concerned about confidentiality. One innovative model includes HIV self-testing programs, sometimes called “home HIV test giveaways.” These are programs in which city or state health departments advertise free self-test kits via the internet and/or dating apps, and distribute the kits by mail so that users can perform their own HIV tests in private.
The pandemic that has upended life in the U.S. could lead to increased STD rates and setbacks in the fight against HIV as public health resources are shifted to the coronavirus response.
Access to STD and HIV testing and treatment services are dwindling as local health departments shuffle staff to respond to COVID-19 and clinics reduce hours or close altogether and cancel outreach programs.
“We are seeing a complete disruption to STD prevention here in the United States,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD). “We expect to experience even higher STD rates as a result.”
