New data on twice-yearly lenacapavir for HIV prevention announced at HIVR4P 2024

 New data on twice-yearly lenacapavir for HIV prevention announced at HIVR4P 2024

By Hope Mafaranga 

New data from the PURPOSE 2 study of twice-yearly lenacapavir for HIV prevention are  among the scientific highlights at HIVR4P 2024, the 5th HIV Research for Prevention Conference, taking place in Lima, Peru, and virtually from 6 to 10 October.

At the official HIVR4P 2024 press conference today, PURPOSE 2 principal investigator Colleen Kelley of Emory University announced new efficacy, safety and demographic data from the trial, in which only two HIV acquisitions occurred among 2,184 trial participants who were randomized to receive subcutaneous lenacapavir every six months (for details, see the press release issued today by Gilead Sciences, which developed lenacapavir). Kelley will formally present these data at HIVR4P 2024 on 8 October at a session starting at 11:00 Peru time (PET).

PURPOSE 2 enrolled HIV-negative cisgender gay, bisexual and other men, trans women, trans men and gender non-binary individuals in Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the United States who have sex with partners assigned male at birth. 

Last month, topline results from an interim analysis indicated that lenacapavir reduced HIV acquisitions by 96% compared to background HIV incidence and demonstrated superiority to daily F/TDF for HIV prevention. Prior to that, the PURPOSE 1 study demonstrated that lenacapavir reduced HIV acquisitions by 100% and demonstrated superiority to daily F/TDF among cisgender women in Africa. Gilead Sciences has said it will begin a series of global regulatory filings by the end of 2024.

“These findings confirm that lenacapavir for PrEP has the potential to transform the global HIV prevention landscape for people of all genders,” Beatriz Grinsztejn, the President of IAS – the International AIDS Society – said. “All stakeholders must work together now, ahead of regulatory approvals, to plan for a rapid, equitable global rollout of this important new prevention tool.”

“The IAS commends Gilead for signing voluntary licensing agreements with generic manufacturers to increase access to lenacapavir in high-incidence, resource-limited countries,” Grinsztejn added. “However, we’re highly concerned that these agreements do not cover large parts of the world, including the majority of countries in Latin America.”

Grinsztejn is also a member of the PURPOSE 2 study team, an HIVR4P 2024 Organizing Committee member and the Director of the HIV/AIDS Clinical Research Unit at the Evandro Chagas National Institute of Infectious Diseases – FIOCRUZ in Brazil.

Other scientific highlights at HIVR4P 2024 include:

• Evidence that the three-month dapivirine vaginal ring is pharmacokinetically superior to the monthly ring
  
  
• A PrEP choice study finding moderate uptake of the dapivirine vaginal ring among women in Africa
  
  
• A study finding no pharmacologic interactions between long-acting cabotegravir for HIV prevention and hormonal contraceptives
  
  
• A drug-agnostic transcutaneously refillable subdermal implant that provides ultra-long-acting delivery of antiretrovirals for HIV prevention
  
  
• Data showing that an innovative dosing strategy improves early immune responses to an experimental germline-targeting HIV vaccine

Hosted by the IAS, HIVR4P is the only global scientific conference focused exclusively on the rapidly evolving field of HIV prevention research. It brings together the global scientific community to address the biggest challenges and opportunities in HIV prevention, including vaccines, microbicides, PrEP, treatment as prevention and biomedical interventions, as well as the social and behavioural implications of these advances.

This year, the conference is being held in Latin America for the first time, creating an opportunity to highlight HIV prevention needs in the region.

“We hope that by holding the conference in Lima, we can help draw attention to the urgent need to scale up HIV prevention efforts across Latin America,” Grinsztejn said. “Ours is one of the only regions in the world where HIV is on the rise. It’s alarming that new HIV acquisitions in Latin America increased by 9% between 2010 and 2023 despite broadly expanded access to antiretroviral therapy. Unfortunately, the scale of powerful new prevention tools like PrEP remains significantly limited.”

Three-month dapivirine vaginal ring for HIV prevention shows promise

Efficacy of the three-month dapivirine vaginal ring (DVR) is likely to be "at least equal" to that of the monthly DVR, according to a study from South Africa.

The monthly DVR, which is the world's first woman-controlled HIV prevention product, has been approved for use in 11 African countries. When inserted into the vagina, it slowly releases dapivirine, an antiretroviral drug, over a one-month period, helping to reduce the woman’s likelihood of acquiring HIV. After a month, it must be replaced for continued protection.

While research has shown that the monthly DVR is appealing to many women, a longer-lasting version will have a lower annual cost and may be more convenient to users.

The new study, IPM 054, is a Phase I, open-label, randomized crossover trial investigating the relative bioavailability of a three-month (100mg) DVR compared with the one-month (25mg) DVR. A total of 124 HIV-negative women enrolled in the study. Based on dapivirine concentrations in plasma after women used each type of ring, the study team determined that the three-month DVR is pharmacokinetically superior to the monthly DVR.

According to presenter Jeremy Nuttall of the Population Council’s Center for Biomedical Research, the three-month DVR will expand options and choice for women to protect their health and accelerate global efforts to end the HIV epidemic. By increasing convenience to women, the three-month ring may also increase acceptability and adherence, which may lead to increased effectiveness.

Abstract and session: Pharmacokinetic superiority of a 3-month dapivirine vaginal ring (100 mg) compared to the 1-month dapivirine vaginal ring (25 mg), HIVR4P 2024 late-breaker selection (2343)

PrEP choice study finds moderate uptake of dapivirine vaginal ring among women in Africa

A study conducted in five African countries found that when given a choice between different types of PrEP for HIV prevention, many women selected the dapivirine vaginal ring (DVR) – also known as the PrEP ring – although most chose daily oral PrEP, according to presenter Elizabeth Irungu of Jhpiego.

The CATALYST study, which is funded by PEPFAR and USAID through the MOSAIC project, aims to characterize an enhanced service delivery package for informed PrEP choice for women at public health sites in Kenya, Lesotho, South Africa, Uganda and Zimbabwe. Of 3,967 participants enrolled, 45% were aged 24 years or younger, 26% reported sex work, 9% were pregnant, 12% were breastfeeding and 68% had never taken PrEP.

At enrolment, 66% of participants chose oral PrEP, 30% chose the DVR and 4% chose no PrEP method. DVR uptake was 15% among pregnant women and 21% among breastfeeding women, where allowed.

In multivariable analysis among those who had choice, those having multiple sex partners in the past three months and those currently using a contraceptive method were more likely to choose the DVR instead of oral PrEP. Participants under the age of 25, new PrEP users and participants who were pregnant or breastfeeding were less likely to choose the DVR.

Participants who chose oral PrEP said they did so because it is easy to use (59%) and works well (32%); those who chose the DVR did so because it is easy to use (57%) and does not require swallowing pills (53%). According to the study team, women are taking advantage of PrEP choice. The results demonstrate moderate uptake of the DVR when offered within existing real-world PrEP programmes, and the findings will inform implementation of PrEP choice in the region.

The CATALYST study is ongoing and will soon produce evidence of how patterns of PrEP use change with choice of oral PrEP, the DVR and long-acting cabotegravir for HIV prevention.

Abstract and session: PrEP choice for women in Africa: Uptake of oral PrEP and PrEP ring, Delivering on the promise of PrEP choice (257)

HPTN 084 finds no pharmacologic interactions between long-acting cabotegravir and hormonal contraceptives

A sub-study of HPTN 084 observed no pharmacologic interactions between long-acting cabotegravir (CAB-LA) and hormonal contraceptives, according to presenter Mark Marzinke of the Johns Hopkins University School of Medicine.

HPTN 084 reported in 2020 that CAB-LA, injected once every eight weeks, was well tolerated and significantly reduced the likelihood of HIV acquisition in women compared to daily oral TDF/FTC. During the blinded phase of the trial, participants were required to use long-acting reversible contraceptives.

The sub-study assessed potential pharmacologic interactions between two types of PrEP (CAB-LA or TDF/FTC) and three hormonal contraceptives: etonogestrel, norethindrone or medroxyprogesterone acetate (MPA).

A total of 190 participants consented to take part in the sub-study across both study arms. Plasma CAB concentrations were evaluated from enrolment through study week 73; plasma tenofovir concentrations were measured at enrolment and study weeks 25, 49 and 73. Plasma concentrations of etonogestrel, norethindrone and MPA were also evaluated at enrolment and weeks 25, 49 and 73 for participants using each reported contraceptive type.

Post-enrolment contraceptive concentrations were comparable between study arms for all three contraceptive types. The percentage of participants with concentrations above thresholds associated with ovulation suppression was high and did not differ between arms. CAB concentrations were comparable across contraceptive types. However, tenofovir concentrations were unquantifiable for most participants, irrespective of contraceptive agent; this was attributed to low adherence to TDF/FTC among participants included in this analysis.

The study team concluded that while interactions between CAB-LA and etonogestrel, norethindrone and MPA were not observed, associations between TDF/FTC and hormone concentrations could not be effectively evaluated due to low adherence to TDF/FTC.

Abstract and session: Evaluation of potential pharmacologic interactions between CAB-LA or TDF/FTC and hormonal contraceptive agents: a tertiary analysis of HPTN 084, PrEP in pregnancy and lactation (719)

Drug-agnostic transcutaneously refillable subdermal implant provides ultra-long-acting delivery of antiretrovirals for HIV prevention

Alessandro Grattoni of Houston Methodist Hospital presented preclinical data on a subdermal implant designed for ultra-long-acting delivery of antiretrovirals for HIV prevention.

The implant consists of a titanium casing and a silicon nanochannel membrane that controls drug release. Unlike traditional implants, it can be refilled through the skin with a minimally invasive injection.

Tests in nonhuman primates showed that when loaded with islatravir, an antiretroviral drug, the implant was safe and tolerable, sustained drug release for 29 months without fluctuation, and provided 100% protection against rectal and vaginal SHIV exposures. When loaded with MK-8527, a different antiretroviral drug, the implant was also tolerable and sustained drug release. 

The study team concluded that the implant offers safe, effective and long-lasting protection against HIV with minimally invasive transcutaneous refillability that "extends release potentially throughout the recipient’s lifespan".

The team anticipates that the implant could serve as a "multiprevention technology" because it could deliver one or more antiretrovirals for PrEP or HIV treatment, potentially in combination with contraceptives. They also estimate that a drug-loaded implant could be produced at a low cost, making it a viable option for low-resource countries.

Abstract and session: Drug-agnostic transcutaneously-refillable subdermal implant for ultra-long-acting delivery of antiretrovirals for HIV prevention, Prevention advances: PrEP, DoxyPEP and MPTs (2159)

Innovative dosing strategy improves early immune responses in HIV vaccine study

A vaccination strategy called "fractional escalating dosing" improves early immune responses to an experimental germline-targeting HIV vaccine, according to research presented by William Hahn of the Fred Hutchinson Cancer Institute.

Vaccines are typically delivered through a single “bolus” administration. However, in preclinical models, HIV vaccination strategies, pioneered by Darrell Irvine, Shane Crotty, Dennis Burton and others, that mimic the sustained antigen load that the immune system experiences during acute infection have produced a more robust immune response. This study tested the effectiveness and tolerability of fractional escalating dosing, a strategy based on these concepts.

HVTN 301 is a first-in-human, double-blind, placebo-controlled trial evaluating an HIV immunogen nanoparticle (426.Mod.Core-C4b) adjuvanted with the TLR7 agonist 3M-052 AF/Alum intended to expand CD4-binding site bnAb lineage B cells. The study compared 426.mod.Core administered as a single 100mcg bolus dose versus a fractional escalating dose – a series of smaller, incremental doses that also totalled 100mcg, given over three weeks in the priming phase.

Testing in 53 HIV-negative adults showed that the vaccine was safe and tolerable with either bolus or fractional administration. Four weeks after the initial prime, fractional escalating dosing led to enhanced antibody, B cell and CD4+ T cell responses.

According to the study team, these results establish proof of concept that sustained antigen/adjuvant exposure can improve immune responses for preventive HIV vaccines intended to elicit broadly neutralizing antibodies during the priming phase. Additional research is needed to identify strategies based on this concept that can be more readily translated into clinical practice.

Abstract and session: Vaccination with a novel fractional escalating dose strategy improves early humoral responses with a novel germline targeting HIV vaccine (426.mod.core-C4b): preliminary results from HVTN 301, Emerging data from recent human clinical vaccine trials (225)

The summaries above are based on submitted abstracts; in some cases, presenters have provided updated information. Final data presented at the conference may change.

IAS calls for global access as Gilead announces lenacapavir licensing

 the International AIDS Society – applauds moves by Gilead Sciences to make generic injectable lenacapavir for HIV prevention widely available, but cautions that the current agreements still leave out millions around the world.

Gilead announced on 2 October 2024 that it had signed royalty-free, non-exclusive licensing agreements with six generic manufacturers to increase access to lenacapavir for HIV prevention in 120 high-incidence, resource-limited countries.

“The licensing agreements enabling generic versions of the HIV prevention drug, lenacapavir, in certain countries is an important step forward, but large parts of the world remain excluded, including countries where trials were conducted,” IAS President Beatriz Grinsztejn said. “We are hopeful that the speed with which these agreements were reached will be maintained, and that the rest of the world will soon benefit from similar agreements to make lenacapavir more affordable and offer a further potent option in the HIV prevention toolbox.” 

Three of the generic manufacturers have their operations in India, one in Egypt, one in Pakistan and one in the US. Gilead added that the agreements were signed “in advance of any global regulatory submissions to enable these countries to quickly introduce generic versions of lenacapavir for HIV prevention” once they receive regulatory approval.  

This will substantially reduce the time to market. However, many countries with high HIV incidence are not included in the licensing arrangements, which will slow access. 

Six-monthly injections of lenacapavir showed 100% protection against HIV acquisition among more than 5,000 cisgender women in South Africa and Uganda in the Phase 3 PURPOSE 1 trial, presented at AIDS 2024, the 25th International AIDS Conference. 

The results of the PURPOSE 2 trial released in September 2024, showed that 99.9% of the 2,180 cisgender men and gender-diverse participants in the United States, South Africa, Peru, Brazil, Argentina, Mexico, and Thailand who received the injection did not acquire HIV. New data are due to be released at HIVR4P 2024, the 5th HIV Research for Prevention Conference, taking place on 6-10 October 2024.  

The IAS calls on stakeholders to put people first and ensure fast and equitable access to lenacapavir for all those in need.  

NSSF members get 11.5% interest on savings.

 NSSF members get 11.5% interest on savings.

By Hope Mafaranga

National Social Security Fund (NSSF) members have received 11.5% on their savings in the last financial year (2023/24).

The finance minister made the announcement during the fund's 12th annual general meeting in Kampala on September 20, 2024.

Last year, NSSF declared a 10% interest rate, which translated to about sh1.591 trillion in total.

“Given the improved performance, I am confident that the fund will pay a competitive interest rate for the financial year 2023/24 as will be declared by the Minister of Finance,” NSSF managing director Patrick Ayota said.

NSSF reported a 15% increase in earnings to sh2.53 trillion for the financial year ended June 30, 2024, driven by growth in interest, dividends, and real estate income.

NSSF’s total assets under management grew 19.2% to Sh22.13 trillion, exceeding its 2025 target. Member contributions grew 12.2% to sh1.93 trillion.

“Income from all three asset classes we invest in increased this last financial year compared to the previous one. Interest income increased from sh2 trillion to sh2.34 trillion, dividend income from our listed and unlisted equities increased from sh145.1b to sh175b, and income from our real estate investments also increased from sh11.9b to sh13.3b,” Ayota said.

Global Fund Report Highlights Major Strides Against HIV, TB and Malaria, Lowered Prices for Essential Medicines

 Global Fund Report Highlights Major Strides Against HIV, TB and Malaria, Lowered Prices for Essential Medicines

 

• Death rate from the three diseases cut by 61% since 2002; 65 million lives saved.
• Sustained progress against HIV, TB and malaria in 2023, with significant price reductions and wider access to key health products across the three diseases.
• Data reveals Global Fund investments in HIV freed up capacity in health care facilities, allowing better response to other diseases.
• Climate change, conflict and threats to human rights impact progress.

 Investments in the fight against HIV, tuberculosis (TB) and malaria have saved a total of 65 million lives and cut the combined death rate from the three diseases by 61% since 2002, according to a new report by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

 “Those are not mere numbers,” said Peter Sands, Executive Director of the Global Fund. “Each of the 65 million lives saved by our partnership is a family member, a friend, a neighbor, a teacher, a worker. Every life saved, and every infection averted, has a multiplier effect across families, communities and entire nations.”

 

Over the last two decades, the impact achieved by the Global Fund partnership has led to dramatic improvements in life expectancy: Global inequality in life expectancy across countries declined by one-third between 2002 and 2019. Half of this decline is due to reduced mortality from AIDS, TB and malaria.

Progress vs. challenges

 

In 2023, Global Fund-supported programs to fight HIV, TB and malaria achieved a complete recovery from the disruptions caused by COVID-19, the report shows.

 

On the HIV front, the Global Fund partnership sustained progress in rolling out HIV treatment, with a record 25 million people now on antiretroviral therapy. In 2023, the partnership also conducted 53.8 million HIV tests, and reached 17.9 million people with HIV prevention services.

 It supported increased access to effective prevention options, including oral pre-exposure prophylaxis (PrEP) and the dapivirine vaginal ring. However, human rights barriers like punitive laws, policies and practices such as stigma, discrimination and violence, including gender-based violence, persist and prevent people in many regions of the world from having access to HIV prevention, testing, treatment and care.

 

“The fight against diseases is as much a fight for justice and equity as it is a biomedical fight,” said Sands. “Even the most innovative biomedical tools will fail if those who most need them can’t get them.”

 

TB programs supported by the Global Fund recorded a complete recovery from COVID-19-related disruption. By leveraging innovative tools and novel approaches, including mobile diagnostic units and artificial intelligence (AI) capabilities in screening, such as AI-powered computer-aided detection software and digital chest X-rays, more people with TB were found and treated than ever before. 

Over 7.1 million people with TB were treated, 121,000 received treatment for drug-resistant TB, and 2 million people exposed to TB received preventive therapy. Yet drug-resistant TB – one of the largest causes of antimicrobial resistance-related mortality – is a growing threat.

 

On malaria, the Global Fund accelerated the equitable deployment of tools for prevention, testing and treatment. Main achievements include the distribution of 227 million mosquito nets, the testing of 335 million suspected malaria cases, and the treatment of 171 million malaria cases. 

A total of 44.6 million children received seasonal malaria chemoprevention. Malaria remains a daunting global health challenge, as conflict, climate change and increasing resistance to insecticides are jeopardizing the significant gains made against the disease over the last two decades.

 

Stronger health and community systems

 

The report also illustrates the transformative contribution of the Global Fund partnership, beyond the three diseases, to strengthening health and community systems, reducing global health inequities, and accelerating progress toward universal health coverage (UHC).

 

For example, it demonstrates – for the first time – how Global Fund investments in HIV over the last two decades have kept millions of people healthy, freeing up 1.66 billion hospitalization days that would have otherwise been used for HIV-related activities and averting 1.36 billion outpatient visits, generating US$85 billion in cost savings.

 

“Where the three diseases absorb over 50% of health system resources, the impact of reducing their burden on overall health system performance can be dramatic,” said Sands. “It means lower infant and maternal mortality and fewer deaths from acute trauma and other conditions. In addition, our continued investments in community health workers, labs, supply chains, disease surveillance systems and other health system components better prepare countries to prevent, detect and respond to other diseases like mpox or future pandemics.”

 

In 2023, the Global Fund invested the highest amount ever in a year – US$1.8 billion – to strengthen health and community systems. Between 2024 and 2026, the Global Fund plans to invest up to US$6 billion in health and community systems to support countries to improve health outcomes across all diseases, build pandemic preparedness and work toward achieving UHC. 

 

Market-shaping impact

 

The Global Fund is committed to driving equitable access to quality-assured health products and innovations. It uses its scale to shape markets by encouraging manufacturers to meet global quality requirements, to secure increased supply capacity for low- and middle-income countries, and to lower health product prices.  

 

In 2023, those efforts resulted in major price reductions for key commodities across the three diseases, enabling countries to increase coverage and reach more people. For HIV, the Global Fund and partners secured a 25% price reduction for TLD, the preferred first-line HIV treatment. For TB, the partnership reduced prices by 20% for diagnostic test cartridges, by 30% for 3HP, the short-course TB preventive treatment, and by 55% for bedaquiline, the main treatment for drug-resistant TB. Leveraging the newly created Revolving Facility, the Global Fund accelerated the scaled introduction of new dual active ingredient insecticide-treated mosquito nets by achieving sustainable pricing for this new net, which is >45% more effective against malaria than existing insecticide-treated nets. 

Colliding crises, deepened partnerships

 

In 2023, the world was again hit by multiple crises, including climate change, conflict, and attacks on human rights, gender equality and civil society. These crises have a direct impact on the fight against HIV, TB and malaria.

 

In response, the Global Fund adapted its interventions to provide agile support through grant flexibilities, reprogramming and provision of emergency funding. For instance, it has reprogrammed its grants to better serve communities caught up in the intensifying conflicts in Sudan, Ukraine and the Middle East. To support countries to adapt to the impact of extreme weather and climate events, it restructured grants as well as offered access to emergency funds in countries such as Zambia, Kenya and Somalia. The Global Fund invests 70% of its funding in the 50 most climate-vulnerable countries. To tackle human rights and gender-related barriers to accessing health services, the partnership expanded the Breaking Down Barriers initiative, ensuring inclusivity and equity in health care delivery.

 

“Our model is anchored by a partnership that thrives on inclusive governance, making us a global movement of civil society, governments, private sector partners, technical partners and communities affected by the three diseases in more than 100 countries,” said Sands. “That partnership came to count enormously as we responded to the many challenges we faced in the year.”

 

The Global Fund is committed to maximizing the collective impact of global health efforts, especially as the world confronts a host of colliding crises. It has already established several wide-ranging workstreams with partners, including Gavi, the Vaccine Alliance and the Global Financing Facility, and will continue to work closely with long-standing partners such as the World Health Organization, the World Bank, Unitaid and others to save more lives and accelerate progress toward Sustainable Development Goal 3 of health and well-being for all.

 

IAS announces 2024 Me and My Healthcare Provider Campaign Champions to honour outstanding stigma-free services

 IAS announces 2024 Me and My Healthcare Provider Campaign Champions to honour outstanding stigma-free services

The 2024 Me and My Healthcare Provider (MMHCP) Campaign, supported by Gilead Sciences for the third year running, honours 18 frontline workers providing exemplary inclusive and stigma-free HIV services in Brazil, Hong Kong, Mexico, Taiwan and now, Türkiye. 

11 July 2024 – IAS – the International AIDS Society – with local partners, today honoured 18 Me and My Healthcare Provider Champions from Brazil, Hong Kong, Mexico, Taiwan and Türkiye. This award celebrates the tireless efforts of frontline healthcare workers who navigate the challenges of stigma and discrimination to provide high-quality HIV prevention, treatment and care to key populations.

Despite a decrease in new acquisition rates, stigma and discrimination remain significant challenges in HIV care. According to the People Living with HIV Stigma Index 2.0 Global Report 2023, while 93.5% of respondents were receiving HIV treatment, a majority reported experiencing internalized stigma associated with their HIV status.

Additionally, 3% of respondents faced stigma and discrimination from health facility staff and 27% interrupted or stopped their HIV treatment. These findings indicate that we are far from achieving the Global AIDS Strategy’s target of reducing stigma and discrimination to below 10% by 2025 and highlight the need for collaborative action to establish stigma-free HIV care environments globally.

Since 2021, the Me and My Healthcare Provider Campaign, supported by Gilead Sciences, has been running in Brazil, Hong Kong, Mexico and Taiwan in partnership with Gilead and local partners, GESTOS – HIV, Communication and Gender, Hong Kong AIDS Foundation, Inspira Cambio A.C, Taiwan AIDS Foundation, and Pozitif-iz Association Türkiye. This year, marking its third year of collaboration, the campaign has expanded to Türkiye, signifying a crucial milestone in the global response against HIV-related stigma and discrimination. This expansion underscores our unwavering commitment to promoting health system sustainability and advancing people-centred care at a global level. 

Driven by key populations affected by HIV, the Me and My Healthcare Provider Campaign serves as a platform to honour the contributions of healthcare providers who have positively influenced their lives. It goes beyond recognizing the dedication and passion of the frontline workers; it also encourages replication and empowers others to confront and challenge the stigma that continues to hinder progress in the HIV response.

This year’s Healthcare Provider Champions (in alphabetical order) are: 

•    Andréa Carla Almeida de Araújo, CTA/SAE Jaguaribe in Brazil
•    Richardson Barroso, Otávio de Freitas Hospital in Brazil
•    Eline Gomes, Lactário de Caruaru in Brazil
•    Patricia Holanda, UDM de Cajazeiras in Brazil 
•    Alex Siu Wing Chan, The Hong Kong AIDS Foundation in Hong Kong
•    Sze Nga Chan, Queen Elizabeth Hospital in Hong Kong
•    Grace Cy Lui , The Chinese University of Hong Kong in Hong Kong
•    Bonnie Chun Kwan Wong, Hong Kong Society for HIV Medicine in Hong Kong
•    Carlos Batalla, Positivxs Morelos in Mexico
•    Yuliana Italia López Bueno, Mexican Institute of Social Security in Mexico 
•    Hsin-Yen Ku, Taoyuan Hospital in Taiwan
•    Chia-Wen Li, National Cheng Kung University Hospital in Taiwan
•    Yu-wen Tang, National Cheng Kung University Hospital, inTaiwan
•    Meng-Tzu Wu, Taiwan Love and Hope Association in Taiwan
•    Ayşe Akaltun, Ankara Çankaya Municipality Volunteer Counseling and Testing Center in Türkiye
•    Metin Sinan Elmalıoğlu, Renk Pharmacy in Türkiye
•    Cansu Ecem Kesgin, Querencia Psychology in Türkiye
•    Hüsnü Pullukçu, Ege University Faculty of Medicine, Department of Infectious Diseases, in Türkiye

“Addressing HIV-related stigma is a crucial part of creating a world in which HIV no longer presents a threat to public health and individual well-being,” Birgit Poniatowski, IAS Executive Director said. “Our MMHCP Champions and like-minded partners are paving the way towards that goal. They are fostering equitable access to care and empowering people living with HIV to seek support and treatment without fear of discrimination – ensuring that everyone can enjoy their rights to health and well-being.” 

“Gilead is committed to creating a healthier world for all people – no matter where they live or who they are. A key component to achieving this vision is putting people at the centre of everything we do to help reduce barriers to care, including stigma and discrimination. We are proud to support this year’s MMHCP Champions who share our vision and work passionately every day to improve health in their communities,” Janet Dorling, Gilead Senior Vice President, Intercontinental Region and Gilead Patient Solutions, said. 

Visit the IAS website to learn more about the Me and My Healthcare Provider Campaign.

About the Me and My Healthcare Provider Campaign 

Established in 2016, the Me and My Healthcare Provider Campaign, supported by Gilead Sciences, recognizes frontline healthcare workers who deliver quality HIV prevention, treatment and care and other services to key populations, often in the face of stigma and discrimination. The campaign aims to build better understanding of what motivates these healthcare champions to provide inclusive and stigma-free services, amplify their stories to encourage replication, and empower others to confront stigma. 

IAS calls for stepping up HIV vaccine R&D after PrEPVacc halts its vaccine arm

 PrEPVacc announced today that it "has stopped further vaccinations as there is little or no chance of the trial demonstrating vaccine efficacy in preventing HIV acquisition". Its pre-exposure prophylaxis (PrEP) trial is set to continue.

While IAS – the International AIDS Society – is disappointed at this outcome, we believe that this provides us with lessons to drive HIV vaccine research and development (R&D) with urgency.

“We cannot and will not lose hope that the world will have an effective HIV vaccine that is accessible by all who need it, anywhere,” IAS Executive Director Birgit Poniatowski said. “A vaccine remains one of our most powerful tools to reach and change the lives of vulnerable communities and key populations in the most affected parts of the world.” 

PrEPVacc, an African-led, European-supported HIV prevention study, has been running in four sites in Uganda, Tanzania and South Africa since 2018. With 1,513 participants (men and women aged 18-40 years), it has been testing two experimental vaccine combination regimens to protect against acquiring HIV and a new form of PrEP. 

The PrEPVacc sites are in eastern and southern Africa, the region most heavily impacted by HIV. It is home to almost 21 million of the 39 million people living with HIV globally: 500,000 people in the region acquired HIV in 2022, and 61% of them were women and girls.

HIV prevention is often approached through a combination of methods, including condoms, antiretroviral therapy (ART) and behavioural interventions. A successful HIV vaccine could provide long-term protection with a single or limited number of doses, simplifying adherence and reducing the need for ongoing interventions. 

A vaccine could help reduce the stigma associated with HIV by normalizing prevention practices. Importantly, it could ease the burden on key populations, including gay men and other men who have sex with men criminalized by some of the world’s harshest anti-gay laws in parts of the PrEPVacc study region. 

An HIV vaccine could alleviate healthcare costs and contribute to the economic well-being of communities in affected regions. Also, the pursuit of an HIV vaccine drives scientific innovation and contributes to our understanding of the immune system and infectious diseases: a case in point is the rapid development of vaccines for COVID-19, which drew heavily from HIV vaccine research. 

At the IAS, we believe that even when efficacy studies have not shown the desired outcomes, they offer valuable lessons and data that researchers can use to refine their approaches. Understanding why certain strategies are unsuccessful is crucial for making informed adjustments and moving us closer to an effective vaccine. 

The IAS is committed to ending HIV as a threat to public health and individual well-being, and we call on all stakeholders, including in Europe, to step up HIV vaccine R&D to make that a reality.   

Europe must not abandon the quest for an effective HIV vaccine

 On this HIV Vaccine Awareness Day, IAS – the International AIDS Society – calls for the re-engagement of all stakeholders, especially in Europe, in funding HIV vaccine research and development (R&D). 

After more than 40 years since HIV was discovered, there have been breakthroughs in curbing acquisition through pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART). However, 1.5 million people acquired HIV in 2021 – one million above the 2020 global targets for ending the AIDS epidemic – and a quarter of the 38.4 million people living with HIV globally do not have access to treatment. A vaccine remains the most effective prevention method and is still elusive.  

Between 2019 and 2020, funding globally for HIV preventative vaccine R&D decreased by 5.5% or USD 46 million. In comparison, European funding decreased by 31%, significantly undermining pathways to an effective vaccine. 

“We call on Europe to not abandon the quest for an effective HIV vaccine. The role of an effective HIV vaccine in the global HIV response cannot be underestimated, especially in low- and middle-income countries where HIV prevalence is still high,” Marlène Bras, IAS Director, HIV Programmes and Advocacy, said. “An effective and accessible vaccine will make it much more likely that we will meet our global targets.” 

The IAS Global HIV Vaccine Enterprise notes that the goal of HIV vaccine development is to give long-lasting protection with the fewest number of doses, ideally a single dose. Introducing PrEP in 2012 has proven to be an effective prevention mechanism. But it requires consistent use, and inequities in access and stigma linked to taking HIV medication persist.  

An HIV vaccine would save the world billions just in ART provision. Treatment remains expensive relative to a vaccine. In Europe, 2.3 million people are living with HIV, and almost 300 people were diagnosed with HIV every day in 2021; the estimated yearly cost per client is EUR 11,638 in Spain, EUR 32,110 in Germany, EUR 14,821 in France, and EUR 6,399 in Italy.  

Discontinuation of the Mosaico efficacy trial due to lack of efficacy offers lessons to build on, and there is still hope for an HIV vaccine. Strategies being pursued include the induction of broadly neutralizing antibodies and dendritic cell-based immunotherapy. HIV vaccine research played a crucial role in facilitating the development of COVID-19 vaccines. A therapeutic HIV vaccine is feasibly the key to finding a cure with remission of the virus.  

The progress and the intersection of the latest HIV cure and vaccine R&D will be explored in the 2023 HIV Cure & Immunotherapy Forum at IAS 2023, the 12th IAS Conference on HIV Science, in Brisbane, Australia, this July.  

The IAS is committed to ending HIV as a threat to public health and individual well-being, and we call on all stakeholders to commit to funding the development of an HIV vaccine to make that a reality.