Long-term monitoring of people with HIV with an undetectable viral load has shown that viral suppression is rarely lost, enforcing the validity of ‘U=U’ (Undetectable equals Untransmittable) messaging, according to Italian research published in the online edition of AIDS. The study involved over 8000 HIV-positive individuals taking antiretroviral therapy (ART) and with viral suppression (a viral load below 200) at baseline. Regular monitoring of viral load (at least twice a year for most) showed that viral load remained suppressed 97% of the time.
However, some groups, including women, people who inject drugs and those with a past history of ART failing to control viral replication spent more time with a viral load above 200. The investigators suggest that people with these characteristics may need more support to maintain viral suppression.
“We found that in our population of people with HIV the ‘U’ status was maintained on average, for 97% of the following ten years of observation and the proportion of [time] spent in ‘U’ status showed a trend for an increase in recent years,” write the authors. “This data reassuringly suggests that U=U is an appropriate message to communicate to help decrease stigma and increase motivation to remain virally suppressed.”
Injectable long-acting cabotegravir (CAB LA) has been proven safe and highly effective in preventing HIV infection among cisgender women, according to interim results from a major study announced in late January. The findings complement previously established strong results for cabotegravir-based injectable pre-exposure prophylaxis (PrEP) in cisgender men who have sex with men (MSM) and transgender women who have sex men, adding to evidence that injectable PrEP could ultimately have greater real-world efficacy than daily oral PrEP in many populations, thanks to better adherence.
The new data come from HIV Prevention Trials Network (HPTN) Study 084, interim results of which were presented at the biennial HIV Research for Prevention (HIVR4P) conference, which took place virtually this year in late January and early February. “These results complement data from HPTN 083, and confirm cabotegravir as the first safe and effective injectable PrEP agent for cisgender women,” said Sinead Delany-Moretlwe, MBBCh, Ph.D., the protocol chair and director of research at the Wits Reproductive Health and HIV Institute within the University of the Witwatersrand in Johannesburg, who presented the study. “We hope that these results will lead to the expansion of HIV prevention options for at-risk cisgender women globally, and ultimately reductions or elimination of HIV acquisition.”
Please join Human Services Center Corporation in honoring National Women and Girls HIV/AIDS Awareness Day on Tuesday, March 9 at 5:00PM via Zoom. We will discuss women’s sexual health, women and HIV, and healthy living with HIV. RSVP here. If you have questions, please contact firstname.lastname@example.org or 412-436-9537.
The Pennsylvania Department of Health, in partnership with the Pennsylvania Expanded HIV Testing Initiative (PEHTI) and the HIV Prevention and Care Project (HPCP), has introduced HIV Self-Testing (HST) for individuals who reside in Pennsylvania (excluding Philadelphia County). The goal of the getmyHIVtest.com program is to help people get tested who wouldn’t otherwise go to their doctor or to a testing clinic.
Tests are available from the website getmyhivtest.com. Individuals are asked to read the information on the website and answer a few questions in order to receive an FDA-approved, OraQuick home HIV test kit mailed to the address they provide. Support for clients who request and administer the HIV self-test is available through OraQuick and the HPCP, as noted on the website.
Individuals who reside in Philadelphia County should visit PhillyKeepOnLoving.com to order the HIV Self-test kit and for additional information about testing from the Philadelphia Department of Public Health.
The U.S. Department of Health and Human Services (HHS) recently enhanced mail-order delivery options for participants to receive PrEP HIV prevention medication at no cost to eligible individuals without prescription drug coverage. Ready, Set, PrEP participants can choose to have their PrEP medication sent directly to their home or healthcare providers (in participating states) when they enroll or continue to use the more than 32,000 participating co-sponsoring pharmacies.
The option of having PrEP delivered to a preferred location is not only convenient for participants, but it also allows Federally Qualified Health Centers (FQHCs) and Indian Health Service (IHS) facilities, Tribal Health Programs, and Urban Indian Organizations to provide “one stop shopping” for potential enrollees. They can now get tested, receive their PrEP prescription and get the prescription sent via mail in one visit by enrolling with a healthcare provider’s assistance through GetYourPrEP.com or the call center by calling 855-447-8410.
“This option allows our IHS, Tribal and Urban facilities the ability to provide a wholly integrated service inclusive of HIV testing, PrEP prescriptions and now the ability for our healthcare providers to offer mail-order for Ready, Set, PrEP enrollees,” said Darrell LaRoche, director of the Office of Clinical and Preventive Services at IHS. “The convenience of getting tested, enrolled and prescriptions mailed in one visit, sent to their home or a healthcare provider, is particularly important in Indian Country where a health center or pharmacy may be hours away.”
As 2020 draws to a close, we asked David Alain Wohl, M.D., a professor of medicine in the Division of Infectious Diseases at the University of North Carolina and a highly respected HIV clinician-researcher, to take stock of the year’s most momentous research developments and other critical events. In this exclusive series of articles, Wohl calls attention to 10 such developments that have tremendous short-term implications for our day-to-day efforts to improve HIV prevention, treatment, patient care, and policy in the U.S., and analyzes each development with his trademark wit and clinical savvy.
“Looking for something we can rely on. There’s got to be something better out there,” Tina Turner sings in her 1980s pop hit “We Don’t Need Another Hero.” That song jumps into my head when I think about new HIV therapies, but in my mind, it’s framed as a question: Do we need another hero?
For those with few antiretroviral options, who are downing multiple pills to keep multidrug-resistant virus from replicating, the answer would be yes: We do need another antiretroviral hero.
Fortunately, the number of people living with HIV who are heavily treatment experienced and have few remaining antiretroviral options is fairly small. Among over 27,000 HIV-positive people in the U.S. who were treatment experienced and in care at one of the HIV clinics contributing to the U.S. Centers of AIDS Research Network of Integrated Clinical Systems (CNICS) cohort from 2000 to 2017, just 916 had limited treatment options (LTO)—a status defined as having two or fewer available antiretroviral classes, as well as two or fewer active drugs per class as determined by resistance testing. After 2007, the proportion of people with LTO fell; it has since remained less than 1% of the cohort’s antiretroviral experienced patients.
Still, for that 1%, things can be rough. Many are straddled with antiretroviral regimens that include pharmacological boosters, inconvenient dosing, and side effects. Some may even still fail to achieve virologic suppression. Therefore, U.S. Food and Drug Administration (FDA) approval of fostemsavir (brand name: Rukobia), an HIV attachment inhibitor, in July is welcome news to these patients and their providers.
For more than 30 years, Gaétan Dugas was blamed for bringing the AIDS epidemic to the United States. A French-Canadian who died in 1984, Dugas was thought to have carried the disease to America and transmitted it to scores of sexual partners while working as a flight attendant.
But this week, scientists finally cleared the name of the man who, in the history of the AIDS epidemic, came to be known as “Patient Zero.”
In a study published in the journal Nature, the researchers found that blood sampled from Dugas in 1983 contained the same strain of HIV that was infecting men in New York City as early as 1971 — three years before he arrived in the U.S. as an employee for Air Canada.
“In short, we found no evidence that Patient 0 was the first person infected by this lineage of HIV-1,” the researchers wrote.
The study builds on decades of research that has sought to answer the medical mystery of how exactly AIDS made its way to the U.S.
The SASH study (Impact of Poor Sleep and Inflammation on the Adenosine Signaling Pathway in HIV Infection) seeks to understand how sleep can affect the health of people living with HIV.
Study participants complete questionnaires before and after getting a watch-like device similar to a Fitbit. Subjects wear the device for two weeks, to track their sleep patterns. Subjects also answer a few questions in a diary each morning about their sleep.
The study involves two visits to Montefiore Hospital. Each visit is about one hour in length. Participants will receive up to $100. Parking vouchers and/or bus fare will also be provided.
Researchers from Duke University School of Nursing in Durham, N.C., are turning to a ubiquitous locale — beauty salons — to help raise HIV prevention awareness among Black women in the South. Salons are often considered safe spaces for intimate conversations.
The numbers highlight the stark need: Black women, who make up 13% of the U.S. population, account for 64% of new HIV infections among U.S. women. They also make up 69% of all new HIV infections in the South, according to the Centers for Disease Control and Prevention.
Schenita D. Randolph, PhD, MPH, RN, CNE, and her research partner, Ragan Johnson, DNP, APRN-BC, both assistant professors at Duke University, developed a strategy to help prevent HIV spread in their region by focusing on Black women who have not been exposed to the virus.
The strategy involves training stylists to start conversations about HIV, educating women about HIV prevention, and linking them to prevention medication (pre-exposure prophylaxis or PrEP).
The research team received two-year funding from Gilead Sciences, which manufactures the HIV prevention medication Truvada, to put a pilot program in place.
Randolph explained that 44% of the people who could benefit from PrEP in the U.S. are African American (500,000). However, only 1% in that group have been prescribed PrEP, despite evidence that if taken once a day it can lower a person’s risk for getting HIV through sex by more than 90%.
In 2018, 37,968 people received an HIV diagnosis in the United States (US) and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among adults and adolescents. However, annual diagnoses have increased among some groups.
Gay and bisexual men are the population most affected by HIV, with Black/African American, Hispanic/Latino gay and bi men having the highest rates of new infections.
The number of new HIV diagnoses was highest among people aged 25 to 34.