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.”
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.”
Here’s a friendly reminder for the HIV community: The HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) invites you to join us on January 27, 2021, for a stakeholder webinar on efforts to implement the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The EHE Stakeholder webinar will be held from 2:00 to 3:30 p.m. (ET).
This webinar is designed to:
Provide updates on major federal activities related to the implementation of the Ending the HIV Epidemic initiative
Highlight ways to improve HIV diagnosis, care and prevention outcomes for Black Women
Opportunity for question and answer from major stakeholders with federal officials
Registration is required for the webinar. This event is open to everyone, please note capacity is limited so register early! This webinar will be audio-recorded and slides will be publicly available for those unable to attend.
On October 1, I joined federal colleagues from CDC and HRSA in a virtual meeting with HIV and viral hepatitis program leaders from state and local health departments. The meeting, organized by NASTAD as the first part of their annual technical assistance meeting, provided an opportunity for sharing updates and engaging in dialogue with these key stakeholders in Ending the HIV Epidemic: A Plan for America (EHE). Much of the conversation focused on EHE as well as the broader response to HIV and other infectious diseases amid the pandemic.
As one of several Indian Health Service activities supported by the Minority HIV/AIDS Fund (MHAF) in Fiscal Year 2020, the Urban Indian Health Institute (UIHI) is currently leading a project focused on creating culturally attuned HIV education materials—including print, digital, and video formats—for both American Indian and Alaska Native patients and the healthcare providers who serve them.
UIHI , located in Seattle, Washington, works to provide information to and assist urban Indian-serving organizations to better the urban Indian community’s health nationwide. Seven out of 10 American Indians and Alaska Natives currently live in urban settings away from federally defined tribal lands. Since 2016, UIHI has led several projects that promote culturally attuned HIV prevention and treatment.
Among the new materials being developed under this project, in March 2020, UIHI released a short film, Positively Native , in which long-time HIV survivors Bill Hall (Tlingit), Shana Cozad (Kiowa), and Hamen Ides (Lummi) discuss their lived experiences with HIV stigma, discrimination, and advocacy. Along with the film, UIHI released an accompanying toolkit that includes a facilitator’s guide, discussion questions, and a presentation on the basics of HIV. The organization presented Positively Native to an audience of 38 people at the International Indigenous Pre-Conference on HIV/AIDS in July 2020.
Of all those who became HIV-positive, over a third (36 percent) were persistent meth users. Men aged 36-45 reported the most meth use, and those living in Western states had the highest incidence of the drug.
Persistent meth use is the biggest factor for seroconversion, researchers stated, followed by Black ethnicity and a syphilis diagnosis.
Researchers detailed the correlation between meth and HIV.
“Methamphetamine exacerbates HIV risk via increasing sexual libido while simultaneously reducing inhibitions,” the authors stated, according to AIDSMap. “Our findings highlight the need to address methamphetamine use and its associated risks among sexual and gender minorities, the likes of which may also serve to help end the HIV epidemic.”
Highlights from the Ryan White Clinical Conference on HIV.gov…
The promise of long-acting injectable formulations of HIV medications to maintain viral load suppression is closer to reality, according to Constance A. Benson, MD, Professor of Medicine and Global Public Health at University of California San Diego. She shared her assessment during a session at the 2020 Ryan White HIV/AIDS Program Clinical Conference, held online earlier this month for over 600 physicians, nurse practitioners, physician assistants, and other key clinical decision makers in HRSA’s Ryan White HIV/AIDS Program-funded clinics and programs.
Levels of sexual health screening among gay men taking PrEP fall well below recommended levels, investigators from the United States report in the online edition of Clinical Infectious Diseases. Rates of testing for sexually transmitted infections (STIs) in the rectum and throat – which can be asymptomatic – were especially low, so too testing coverage in south-eastern US states which have an especially high burden of HIV and STI infections among gay and other men who have sex with men.
“Consistency of STI screening at PrEP care visits was lower than recommended, especially for rectal and pharyngeal infections that are mostly asymptomatic,” write the authors. “Our findings also highlight the regional variation in gaps between recommendations and PrEP clinical practice overall, and raise concerns about whether comprehensive PrEP care as currently practiced would be effective for STI control.”
Tenofovir-based PrEP is highly effective at preventing infection with HIV but the treatment provides no protection against STIs. Pre-existing research shows elevated STI rates among PrEP-using gay men, probably the result of increased surveillance and sexual risk behaviour. The Centers for Disease Control and Prevention (CDC) therefore recommends that gay men taking PrEP should have comprehensive check-ups for bacterial STIs every three to six months. These sexual health screens should include tests for chlamydia, gonorrhoea and syphilis, with swabs or samples taken from the urethra, throat and rectum.
What is the AHEAD Dashboard?
AHEAD is a data visualization tool created to support the efforts of local health departments towards reaching the goals of the Ending the HIV Epidemic: A Plan for America (EHE) initiative.
Who Can Use the AHEAD Dashboard?
AHEAD allows jurisdictions, community organizations, and other stakeholders to monitor progress towards meeting the goals of EHE and use data to inform national and jurisdictional action.
AHEAD graphically visualizes data and targets for jurisdictions to track their progress on the six EHE indicators:
• Knowledge of Status
• Linkage to HIV Medical Care
• Viral Suppression
• PrEP Coverage
Over the next year, AHEAD will add additional features and expanded data sets to further to encourage progress towards EHE initiative goals.
Explore the AHEAD Dashboard today and view our progress towards ending the HIV epidemic in America
A new study has found that HIV screening every three months compared to annually will improve clinical outcomes and be cost-effective among high-risk young men who have sex with men (YMSM) in the United States. The report, led by researchers at the Massachusetts General Hospital (MGH), is being published online in Clinical Infectious Diseases.
“Young men who have sex with men account for one in five new HIV infections in the United States. Yet, more than half of young men who have sex with men and who are living with HIV don’t even know that they have it,” says Anne Neilan, MD, MPH, investigator in the MGH Division of Infectious Diseases and the Medical Practice Evaluation Center, who led the study.
“With so many youth with HIV being unaware of their status, this is an area where there are opportunities not only to improve care for individual youth but also to curb the HIV epidemic in the U.S. Despite these numbers, the Centers for Disease Control and Prevention previously determined that there was insufficient youth-specific evidence to warrant changing their 2006 recommendation of an annual HIV screening among men who have sex with men.”