A cure must be a cure for all: why more HIV cure research in Africa is needed

Only one in eight HIV cure studies are being conducted in sub-Saharan Africa, but a few important studies have got off the ground in recent years. The studies were discussed at a pre-conference meeting on cure held before the 24th International AIDS Conference (AIDS 2022) in Montreal, as well as at the conference itself.

Community-led monitoring of HIV services leads to investment and policy change

Community-led monitoring is an emerging model in which communities take the lead on the routine monitoring of a specific issue that matters to them, in any place where they are the end user. At the conference, Solange Baptiste of the International Treatment Preparedness Coalition presented a look into community-led monitoring.

Zambian patients on dolutegravir and recycled tenofovir regimens have high risk of TB even after switch

A study conducted among people on regimens of dolutegravir and recycled tenofovir in Zambia shows tuberculosis remains a deadly threat in the months after switching treatment and is a risk factor for poor viral suppression. The study presented at AIDS 2022 reaffirms the need for regular screening.

Giving antibodies to prevent vertical transmission in Africa would be cost-effective or even save money, study finds

If broadly neutralising antibodies are 70% effective at preventing transmission via breast milk after birth, and cost US $20 per dose, then they would be cost-saving if given to the babies of mothers known to have HIV before delivery in several African countries. In South Africa they would be cost-effective even if given to all newborn infants, regardless of the mother’s HIV status.

Long-term Canadian study shows HIV-exposed children have worse health outcomes

Findings from a study which has followed the children of mothers living with HIV who remain HIV-free in Montreal since 1988 make the case for continued clinical follow-up of this group. Dr Fatima Kakkar said that children who are “uninfected are not unaffected” and that assuming this has created missed opportunities to support these children.

Community organisations have formed the backbone of the HIV response in Ukraine

Despite the devastating impact of the Russian invasion, many people remaining in Ukraine have been able to continue to receive HIV, TB and drug dependency services with limited disruptions, the conference was told. However, people living with HIV in Ukraine and the services that support them face immense challenges as winter approaches.

Long-acting cabotegravir and rilpivirine may be feasible for people without viral suppression

Long-acting cabotegravir and rilpivirine injections may be an option for people with HIV who have been unable to achieve viral suppression due to suboptimal treatment adherence, according to a study presented at AIDS 2022 and published in Clinical Infectious Diseases.

Social support can buffer the effects of stigma on suicidality among young people living with HIV

HIV-related stigma and mental health challenges were associated with suicidality among young people living with HIV in two separate studies from South Africa and the United States presented at the conference. The South African study showed that social support was protective, while the US study identified other risk factors, including systemic racism, sexual minority status and pregnancy.

Package of person-centred care improves viral suppression for young people living with HIV in Kenya and Uganda

Discussing what is going on in patients’ lives, giving them a say in how they receive clinic services, returning viral load results within 72 hours and giving clinicians a WhatsApp group to discuss difficult cases significantly improved outcomes for 15-24 year olds living with HIV in rural Africa, the conference heard.

The challenges integrating U=U into HIV care around the world

Advocates from around the world came together at the U=U Global Summit at AIDS 2022 to share successes and challenges that continue to hamper full-scale integration of the ‘Undetectable = Untransmittable’ (U=U) message in diverse global contexts.

Rate of neural tube defects is no higher on dolutegravir

Dolutegravir treatment around the time of conception is not associated with an increased risk of neural tube defects in infants exposed to the drug at the time of conception, the most recent surveillance report from Botswana’s Tsepamo study has concluded. There were fewer neural tube defects in infants exposed to dolutegravir than in earlier surveillance periods.

We still have no HIV cure. But we have a better strategy for finding one

There are many pre-conference meetings that lead up to each International AIDS Society conference. One of the most eagerly awaited, by researchers and treatment activists alike, is run by the Towards an HIV Cure research consortium. This year's meeting was titled 'Pathways to an HIV cure: Research and advocacy priorities'.

Broader hepatitis C treatment not leading to more reinfections in people with HIV

Broader access to direct-acting antivirals has been accompanied by a decline or stabilisation in the rate of hepatitis C reinfection in people with HIV and there is no evidence that reinfection is undermining efforts to eliminate hepatitis C in this population, researchers reported at the conference.

Injectable PrEP is just as effective for transgender women as it is for gay men, study analysis finds

A poster presentation at AIDS 2022 shows that the efficacy of long-lasting injectable PrEP was as high among the transgender women who took part in the HPTN 083 study as it was among the gay and bisexual men.

Listed above are all the news stories from AIDS 2022 that were published after our final conference bulletin on 9 August. You can find all our news stories from the conference, as well as our summary bulletins, at www.aidsmap.com/conferences/aids-2022

Gay social and sexual norms are shifting in the PrEP era

While cost remains the biggest barrier to accessing PrEP for gay and bisexual men in Canada, they also felt pressure to take PrEP and have sex without condoms, with younger men tending to feel less anxious about HIV transmission, according to recent qualitative research.

South African women in long-distance relationships are choosing on-demand PrEP

Proximity to male partners, having a mobile lifestyle and feelings about pregnancy and motherhood are some of the factors that influence continuity of PrEP use among South African women, a study has found.

Many monkeypox cases among men living with HIV, but no sign yet of poorer outcomes

Almost four months into the current outbreak, we now know that a substantial proportion of people with monkeypox are living with HIV. While people with well-controlled HIV and a high CD4 count do not appear to have more severe monkeypox illness, this might not be the case for those with more advanced HIV disease. What’s more, HIV-positive people may not respond as well to monkeypox vaccines, suggesting they should receive the most effective regimen possible.

European Commission approves first twice-yearly HIV medication

Last month, the European Commission became the first regulatory agency to approve Gilead Sciences’ long-acting HIV capsid inhibitor lenacapavir, to be marketed as Sunlenca. The twice-yearly antiretroviral is indicated for treatment-experienced people with multidrug-resistant HIV who cannot otherwise construct a fully suppressive regimen.

Vitamin D and calcium supplements suggested to avert bone disease in people taking tenofovir-based ART and PrEP

A systematic review and meta-analysis found use of vitamin D and calcium supplements prevented bone disease and, in some cases, led to a significant recovery of bone mineral density among people taking tenofovir disoproxil fumarate based antiretroviral therapy (ART) or pre-exposure prophylaxis (PrEP).

Why do people with HIV delay hepatitis C treatment?

Greater efforts by healthcare providers to build trusting relationships with people with HIV and hepatitis C, together with a greater focus on overcoming concerns about treatment side effects, are likely to be needed to encourage people reluctant to start treatment to take hepatitis C medication, according to the findings of a US interview study.

Simple changes in clinic processes can yield big improvements in viral load testing, Malawi study shows

An intensive quality improvement exercise in one clinic in Malawi lifted viral load testing coverage among patients above the 80% target in just over a month by re-organising patient flow and assessment in the clinic, researchers report in the journal PLOS One.

Community monitoring uncovers gaps in HIV and hepatitis services in Indian state hard-hit by HIV, sparks reforms

A review by people living with HIV and those who inject drugs of HIV and hepatitis services in the Indian state of Manipur highlights gaps in these services, and has also shaped an evidence-based advocacy agenda.

Study shows the spectrum of monkeypox symptoms

The ongoing global monkeypox outbreak differs in several ways from historical transmission patterns and typical symptoms previously seen in countries in Africa where the virus is endemic, according to the largest case series to date, published in the New England Journal of Medicine.

HIV criminalisation continues with over 270 arrests recorded in 39 countries in the last three years

Since the first reported HIV-related prosecution in 1986, HIV criminalisation has occurred in at least 81 countries, according to a global report published by the HIV Justice Network.

Monkeypox: not enough vaccine available, one in ten may end up in hospital

As of 20 July, the number of confirmed cases of monkeypox globally, according to the US Centers for Disease Control and Prevention is 14,268, with a large increase in the US to 2107 cases. Spain remains the country with the highest number of cases both absolutely and per head, with 3125 now confirmed, the UK with 2137, and Germany 2033.

How often should PrEP users be tested for STIs?

Dutch researchers have found that 79% of STIs diagnosed during PrEP users’ routine three-monthly checkups were asymptomatic. They also found that over half (52%) of these infections would have remained undiagnosed, and untreated, for an additional three months if they had only done STI testing every six months.

Nationwide Australian data shows PrEP has largely neutral effect on STI incidence

The largest study ever of the incidence of bacterial STIs among gay and bisexual men who start HIV pre-exposure prophylaxis (PrEP) has found slight but statistically significant declines in chlamydia and gonorrhoea cases in the first couple of years after they started PrEP, but an increase – also slight but significant – in syphilis cases.

Gay men in Australia report various reasons for not using HIV prevention, including trust and familiarity with partners, misbeliefs about HIV and pleasure

Familiarity and trust with partners, pleasure, substance use and expectations that partners were on PrEP were among the factors linked with little to no use of HIV prevention strategies among gay men in Australia. Awareness of Undetectable = Untransmittable (U=U) and incorrect information about HIV also affected decisions around using condoms or PrEP, according to a study published in the Journal Archives of Sexual Behavior.

Better PrEP retention strategies are needed, as increasing numbers of ex-PrEP users are diagnosed with HIV

A quarter of gay and bisexual men diagnosed with HIV in 2021 had used PrEP at some time before their diagnosis, clinicians in Seattle report. This number had hugely increased 2014, when it was only 2%. Furthermore, over half of the men were diagnosed less than six months after stopping PrEP.

“I am bewitched”: understanding diagnostic delays for HIV-associated Kaposi sarcoma in Kenya

A qualitative study sought to understand the barriers and facilitators to diagnosis of HIV-associated Kaposi’s sarcoma in Kenya. The results revealed that both health providers and people with Kaposi’s sarcoma lacked awareness of the disease, so it was frequently diagnosed at an advanced stage.

HIV treatment adherence may be another casualty of climate change

Drought may cause HIV-related morbidity and mortality, pose a threat to national HIV treatment programmes, heighten risk of transmission and increase the likelihood of drug resistant HIV, according to a paper published in The Lancet Planetary Health.

Monkeypox may be infectious when asymptomatic, Belgian study finds

Researchers from the Institute of Tropical Medicine in Antwerp, Belgium, have found three cases from May of men who tested positive for monkeypox in the absence of any symptoms at all.

The population of people injecting drugs in the UK is getting older

The median age of people who inject opiates and crack cocaine is increasing in England, Wales, Northern Ireland, and Scotland, according to a new study published in the journal Addiction. The age of people currently injecting drugs, their age when they first started injecting drugs, and the number of years they had been injecting drugs have all increased.

NAM news & opinion: Supporting members of parliament to uphold sexual and reproductive rights

The European Parliamentary Forum for Sexual and Reproductive Rights (EPF) brings together parliamentarians from across Europe who are interested in improving sexual and reproductive health care and who understand the importance of upholding sexual and reproductive rights. We spoke to Marina Davidashvili, Head of Policy and Research, about EPF’s work supporting parliamentarians to make positive change in sexual and reproductive health and rights.

People with HIV describe how cognitive impairment impacts their quality of life

Research from the UK gives new insight into the impact of cognitive impairment on people living with HIV. The study shows the ways cognitive impairment impacts day-to-day life, sense of agency and social connection. This is the first qualitative study directly exploring health-related quality of life in people with HIV experiencing cognitive impairment.

UK rolls out vaccines for gay and bisexual men at high risk for monkeypox

An outbreak of monkeypox continues to spread in the UK and worldwide, and cases have now been reported in dozens of countries where the virus is not known to be endemic. While anyone can get monkeypox through close personal contact, most cases identified so far have been among gay, bisexual and other men who have sex with men.

Person-centred practices help Black and Latina women living with HIV stay in care and on treatment

A qualitative study among Black and Hispanic women living with HIV in South Florida explored how medical case managers and clinical providers helped the women stay in care and adhere to their HIV treatment through a patient-centred lens. The study found that having a provider who knew and respected them as a person was a key theme.

'Real-world' study finds PrEP may be stopping 60% of HIV infections in French men at high risk of HIV

A study in France that matched new HIV diagnoses in adult men who had been taking PrEP with diagnoses in men at similar risk who had not been taking it, has found that the overall effectiveness of PrEP in stopping infection in this high-risk population was 60%.

Why people living with HIV should not be criminalised for donating blood | HIV Justice Network

Thirty-seven jurisdictions in 22 countries maintain laws that criminalise people with HIV for donating blood. Notably, 15 jurisdictions in the United States have laws which specifically criminalise blood donations by people living with HIV.

Botswana shows remarkable progress in HIV response | Be In The Know

Results of national HIV survey demonstrate Botswana’s progress towards achieving HIV epidemic control.

Monkeypox is a sexually transmitted infection, and knowing that can help protect people | Scientific American

Naming who is being affected and how transmission is happening is not homophobic or racist. Rather not naming, researching, preventing and addressing how transmission is happening will keep people from understanding how to prevent infection, allow unnecessary worry, and exacerbate racist and homophobic social determinants of health.

Anthony Fauci, face of coronavirus response, to retire in December | The Washington Post

Anthony S. Fauci, the nation’s preeminent infectious disease expert who achieved unprecedented fame while enduring withering political attacks as the face of the coronavirus pandemic response under two presidents, plans to step down in December after more than a half-century of public service, he announced.

US: Far-right's 'morality war' now has its sights set on PrEP access | Plus

In the shadow of Roe v. Wade being overturned in June, the architect of a controversial Texas abortion law – a man who has already targeted marriage equality – is setting his sights on preventative HIV care. If he gets his way, Texans and other Americans could lose access to PrEP.

HIV medicines: India patients say hit by drugs shortage | BBC News

Members of an HIV activist group have been protesting in front of the Delhi office of the National AIDS Control Organisation (Naco) – the federal agency that procures drugs from pharmaceutical firms by issuing tenders. They allege that there is a critical shortage of essential drugs, including the recommended dolutegravir 50mg.