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23 December 2016 VOLUME 17 ISSUE 51

Media Coverage

  • If asked to pick one word to sum up the latter portion of 2016, “uncertainty” would be as good as any and better than most....One of the biggest questions for people working in HIV is whether commitments to funding will be honoured and renewed in the future, and the greatest doubt hangs over The President's Emergency Plan for AIDS Relief (PEPFAR).

    January 1, 2017
    The Lancet
  • The United States is the pillar of global health aid, donating billions of dollars annually — more than any other country — to fighting disease in the world’s poorest countries. But even as the faltering battles against AIDS, tuberculosis and other diseases hang in the balance, advocates for the poor, health experts and government officials admit that they have no idea what direction the incoming Trump administration is going to take.

    December 29, 2016
    NY Times
  • Simplification and optimization of antiretroviral therapy for HIV, wider use of pre-exposure prophylaxis (PrEP), a growing appreciation that people with undetectable viral load do not transmit HIV, and an expanded armamentarium of treatments for hepatitis C were among the top HIV and viral hepatitis headlines this year. Here's a look back at some of our biggest news from 2016.

    December 22, 2016
    HIV and Hepatitis
  • This latest step in a global effort to develop an effective HIV vaccine builds on a legacy of failure, hubris, and reinvention. Each stage of this history has much to teach us about the development of preventive vaccines in general.

    December 21, 2016
    Health Affairs
  • A huge global trial has begun of a long-acting injectable form of the investigational antiretroviral cabotegravir as pre-exposure prophylaxis (PrEP) against HIV....The Phase III trial....will determine whether long-acting injectable cabotegravir given every eight weeks protects against HIV as well as daily oral Truvada.

    December 21, 2016
    POZ
  • As 2016 winds to a close, we look back at the stories that made headlines, including the viruses reminding us that progress against infectious diseases is never easily won or maintained.

    December 21, 2016
    Bhekisisa
  • The first major clinical trial began Tuesday for an injectable drug to prevent HIV....The drug would be injected once every eight weeks, and if effective, will be made available as an alternative to the only other form of PrEP on the market, the once-a-day blue pill Truvada....Truvada has been shown to be roughly 99% effective in preventing new infections, for those able to stick to its once-a-day regimen. But not everyone is able to maintain the daily habit.

    December 20, 2016
    BuzzFeed
  • Mercy has been struggling....The few months she spent outside the hospital were hell....At work her bosses have on several occasions fell short of firing her due to absenteeism.... At home life is not easy. Her own relatives shun her....This was the face of HIV and AIDS 36 years ago. But Malawi through the Ministry of Health together with different stakeholder has managed, through civic education, to reduce HIV related stigma and discrimination.

    December 20, 2016
    MBC
  • Earlier this year, the International Partnership for Microbicides (IPM) announced results of two large phase 3 clinical trials demonstrating that a monthly vaginal ring containing the antiretroviral drug dapivirine can help protect women from HIV....IPM is seeking regulatory approval and conducting open-label studies, enabling trial participants to continue using the ring as IPM collects additional data. The dapivirine ring is the only long-acting, female-initiated HIV prevention tool to have proven successful in phase 3 clinical trials.

    December 20, 2016
    GHTC
  • Researchers have used CRISPR to identify five genes that appear to be used by HIV to infect T cells, but which cells can survive without. The new research, published in Nature Genetics, suggests that wiping out the genes could potentially block infection, although further study is needed to know what other effects that might produce. STAT chatted with Tim Wang, a graduate student at MIT and one of the authors of the work.

    December 20, 2016
    STAT
  • Listerine was first invented in the late 19th century, and as early as 1879, manufacturers claimed the disinfectant was effective at both cleaning floors and curing gonorrhea. Now, 137 years later, scientists have published the first ever randomized controlled trial testing Listerine’s gonorrhea claim in the medical journal Sexually Transmitted Infections. The verdict: the bad-breath mouthwash does indeed kill gonorrhea bacteria, both in petri dishes and in people’s throats.

    December 20, 2016
    Huffington Post
  • This should not be a partisan issue, and in the past, it hasn’t. In 2003, George W. Bush created... PEPFAR,...which has offered antiretroviral drugs to almost 11.5 million people in sub-Saharan Africa....Obama continued that legacy....When asked whether he would commit to doubling the number of people receiving treatments through PEPFAR, [Trump] said, “I believe strongly in that and we are going to lead the way.” Then again, he also mentioned Alzheimer’s, so it’s possible he...didn’t actually know what PEPFAR is.

    December 20, 2016
    The Atlantic
  • GSK’s approach is a departure from the three-med combos rival Gilead Sciences is cooking up, and some industry watchers say a two-drug success could help the British pharma giant poach share from its market-leading nemesis. Taking one drug out of the picture reduces the side-effect burden patients bear, and it may also result in cost savings potential payers like the sound of....At least one analyst isn’t worried about Gilead ceding its lead, though.

    December 20, 2016
    Fierce Pharma
  • 2016 is fast winding down and for many people the thought is: this year can't be over quickly enough. It's been a wild one. Human rights and health care seem more imperiled than ever as a result of political changes in many parts of the world, including here in the US where the core AVAC team is located.

    December 20, 2016
    The Body
  • Is President-elect Donald Trump behind the curve on making his science appointments? More than two dozen US scientific organizations have written urging him to act quickly....Trump doesn’t have to fill some top science jobs if he likes the incumbent. At the National Science Foundation, France Córdova’s 6-year term as director runs until March 2020. And some Republican senators and research community leaders are urging Trump to keep Collins at NIH.

    December 19, 2016
    Science
  • A systematic review and meta-analysis has confirmed that individuals who are homeless or in transient housing are more likely to have sub-optimal adherence to antiretroviral therapy (ART). But, the results of separate studies were mixed and, when analyzed together, the magnitude of the effect was small....The authors of the new review question this: "Given the results of the meta-analysis, the recommendation that ties ART-readiness to housing should be reconsidered."

    December 19, 2016
    TheBodyPRO
  • It is unclear whether the effects of chronic inflammation can be reversed, even if a functional cure of HIV can be found or eradication of the virus can be achieved, notes an introduction to the "Persistent Inflammation in Treated HIV Disease" supplement in Journal of Infectious Diseases. Articles in the supplement address strategies for reducing the risk of cardiovascular problems, how nutritional status in those living with HIV affects inflammation, and the mechanisms by which chronic inflammation continues, among other issues.

    December 16, 2016
    TheBodyPro
  • Malawi on Thursday launched Africa's first drone-testing corridor as developing countries explore how drones could be used during humanitarian crises such as floods, or to deliver blood for HIV tests. The project, which will cover up to 40 kilometres (25 miles) around the administrative capital Lilongwe, will be fully operational by April in a collaboration between Malawi and UNICEF.

    December 15, 2016
    AFP

Published Research

  • On December 1, the National Health Service announced roll-out of pre-exposure prophylaxis in England.... The news is long overdue, but will be welcomed by the various organisations that have campaigned...since the results of the PROUD trial were announced 2 years ago....However, many questions remain about the implementation of this trial. The most urgent being when will it start? The next key question surrounds eligibility.

    January 1, 2017
    Lancet HIV
  • From June 11, 2014 to June 22, 2015, we enrolled 9812 participants....HIV prevalence was 59·8% in women aged 25–40 years, 40·3% in men 25–40, 22·3% in women younger than 25, and 7·6% in men younger than 25....Sexual partnering between young women and older men, who might have acquired HIV from women of similar age, is a key feature of the sexual networks driving transmission. Expansion of treatment and combination prevention strategies that...address age-disparate sexual partnering is crucial.

    January 1, 2017
    The Lancet
  • In response to our Comment, Chika Uzoigwe and Luis Sanchez Franco accuse us of sophistry in reporting the best available evidence, which suggests that the promotion of abstinence and fidelity does not prevent HIV, sexually transmitted infections or unwanted pregnancies....Uzoigwe and Sanchez Franco fail to grasp a basic distinction in epidemiology between efficacy and effectiveness [and]...present some spurious arguments.

    January 1, 2017
    Lancet Global Health
  • By inactivating any one of five human genes, scientists can prevent HIV from entering and growing in immune cells....Bruce Walker at the Ragon Institute of MGH, MIT and Harvard in Cambridge, Massachusetts, and his colleagues screened the genome of human T cells and identified five genes not essential to cell survival whose inactivation protected cells from HIV infection....The authors say their approach could also be used to find drug targets for other pandemic viruses.

    December 21, 2016
    Nature
  • At the July 2016 International AIDS Conference, efforts focused on primary HIV prevention among adolescent girls and young women were abundantly on display,...typically aimed at providing age-appropriate preventive services and products,...increasing HIV knowledge, and promoting gender-equitable norms. However, despite passionate calls to action to reduce gender and age related HIV risk, there was palpable silence about the importance of addressing the family planning needs of HIV-positive adolescent girls and young women.

    December 21, 2016
    The Lancet
  • While 90-90-90 has been widely emphasized and adopted....the focus thus far has largely been on increasing access to ART....A similar emphasis on achieving UN HIV prevention targets and adequate funding for meeting these is essential, alongside treatment, in order to reduce population-level incidence and change the trajectory of the HIV epidemic over the long term.

    December 19, 2016
    JIAS
  • At its best, the health community can offer hope at moments of despair. In 2017, we will discover what a US Presidency led by Donald Trump actually means. Will it be as apocalyptic as some predict? Or will he be a model of business-like pragmatism? As 2016 draws to a close, it is perhaps worth reflecting on the unifying power of health. 2017 is likely to need that kind of optimism more than ever.

    December 17, 2016
    Lancet
  • Men who have sex with men and transgender women (n=195) were enrolled from 8 sites in the United States, Thailand, Peru, and South Africa with mean age of 31.1 years. Rectal application of RG TFV gel was safe in MSM and TGW. Adherence and product use likelihood were similar for the intermittent gel and daily oral FTC/TDF regimens, but lower for the daily gel regimen.

    December 16, 2016
    Clin Infect Dis
  • Kent Buse and colleagues (September, 2016) make a compelling argument for HIV prevention initiatives to abandon educational interventions based on fidelity and abstinence. This approach is potentially hazardous and antithetical. It is important not to conflate the efficacy of the message with the persuasiveness of the messenger. The evidence is unquestionable that abstinence and fidelity reduce HIV transmission.

    December 12, 2016
    The Lancet
  • In The Lancet HIV, Steve Kanters and colleagues identify several practical and effective adherence interventions for antiretroviral therapy regimens. Specifically, they report that supportive and behavioural strategies...improve adherence (and in some cases viral suppression)....However, the observed benefit is probably limited because we often do not know who needs them or when they need them....Answers to these questions come through actionable adherence monitoring.

    November 15, 2016
    The Lancet
  • We obtained data from 85 trials with 16≥271 participants. Short message service interventions were superior to standard of care in improving adherence for all study settings. Multiple interventions showed generally superior adherence to single interventions, indicating additive effects. For viral suppression, only cognitive behavioural therapy and supporter interventions were superior to standard of care. For all study settings, the time discrepancy was an effect modifier..., suggesting that the effects of interventions wane over time.

    November 15, 2016
    Lancet

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