HIV & AIDS

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Why Relying on Someone Else’s PrEP Isn’t a Good Idea

It’s becoming even easier for gay and bi men to search for and find partners on PrEP. Many people talk to partners ahead of time about their PrEP use. Social networking apps, like Grindr, also allow users to find partners who use PrEP (or who use other HIV prevention strategies like treatment as prevention).

“A lot of people will list their HIV status in their profile, or their PrEP use in their profile. So it’s pretty easy—and I think pretty common—to serosort or PrEP-sort on apps,” said Kay Nilsson, health advocacy coordinator at San Francisco AIDS Foundation.

One word of warning, though, for people who rely on other people’s PrEP use as their primary HIV-prevention strategy:

“There are some potential drawbacks to this strategy, that may expose you to risk,” said Oliver Bacon, MD, MPH, an HIV clinician and PrEP providers in San Francisco. “One of the breakthroughs of PrEP is that it’s an HIV prevention tool that you have complete control over yourself. You take it, and it protects you regardless of what your partners are doing or not doing. Relying on someone else’s PrEP is not the same thing. In fact, it’s exactly the opposite.”

One such case was recently highlighted during HIV Grand Rounds at Zuckerberg San Francisco General Hospital. Last year, a person in San Francisco contracted HIV after seeking HIV-negative partners on PrEP.

“That was his risk reduction strategy. He himself was never on PrEP,” said Susa Coffey, MD. “This was failure of prevention in a guy who not only was high risk, but knew he was high risk.”

If you’re HIV-negative and worried that you may be at risk for HIV, it’s better for you to consider using PrEP yourself than to try to find HIV-negative partners on PrEP. In San Francisco, said Bacon, just about every person who wants to access PrEP should be able to afford it because of benefit programs that reduce or eliminate the cost. San Francisco City Clinic, where Bacon sees clients, offers drop-in same-day PrEP services. San Francisco AIDS Foundation offers free PrEP services in San Francisco at Magnet, its sexual health clinic in the Castro, and at its headquarters in the mid-Market area.

Learn more about PrEP & find PrEP services

PleasePrEPme.org is a website linking people seeking PrEP services to PrEP providers across the U.S. The site includes a searchable directory (by state, zip code or street address) for users to find PrEP clinics and PrEP clinicians with hours, contact information and health insurances accepted for each listing.

San Francisco City Clinic offers free and low-cost sexual health care to people in the Bay Area regardless of immigration or insurance status. They offer same-day PrEP enrollment during drop-in hours:

Monday, Wednesday, Friday: 8 am – 3 pm Tuesday: 1 pm – 5 pm

For trans people, San Francisco City Clinic offers PrEP services by appointment Thursdays from 8 am – 11 am or during the drop-in hours.

San Francisco AIDS Foundation offers free PrEP services at Strut (470 Castro Street in San Francisco) and at their main office (1035 Market Street in San Francisco). Find more information and make an appointment online.

The CDC offers more info about PrEP and videos about this HIV prevention option.

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UNAIDS Calls to Quicken the Pace of Action to End AIDS

The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.

The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.

However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030. In order to step up progress and achieve the global targets adopted in the 2016 United Nations Political Declaration on Ending AIDS, all partners need to fully implement their country Fast-Track strategy. Ending AIDS requires steadfast political leadership, commitment to action and accountability towards shared responsibility and reaffirmed global solidarity. Increased effective and efficient investments are, and will continue to be, an essential prerequisite for success. Elimination of stigma and discrimination and full recognition of human rights are cornerstones of sustainable progress.

“Leadership, partnership and innovation will transform the epidemic,” said UNAIDS Executive Director Michel Sidibé.

President Museveni was the first head of state in Africa to launch a presidential Fast-Track initiative on ending AIDS as a public health threat, known as “Kisanja Hakuna Mchezo”, or “no time for playing games”.

“I am confident that working together with you all, we shall attain an AIDS-free Africa. It is possible to end AIDS in our generation!” said President Museveni.

During the event, the speakers outlined the positive impact that the Fast-Track approach to ending AIDS is having on people, health systems and the broader Sustainable Development Goals in Africa and beyond. They noted that addressing HIV within the Sustainable Development Goals will pave the foundation of the AIDS response.

“We must build on the Fast-Track commitments. We cannot stop before we have reached the finish line,” said Jacquelyne Alesi, a civil society representative from Uganda.

Speakers made a strong call for political leadership, global solidarity and shared responsibility to build momentum and deliver on the goal of ending AIDS by 2030, highlighting the role that supporting strengthened health systems plays, not just in making progress towards the Fast-Track Targets, but also in addressing stigma and discrimination.

“I am not speaking of a vague hope, but of a willingness of the heart. I do not say “we could defeat AIDS,” but rather “we will end AIDS,” said Line Renaud, singer and AIDS activist.

Momentum is building, but has not yet reached a critical mass. When the United Nations General Assembly adopted the Political Declaration on Ending AIDS in June 2016, Member States committed to achieve global and regional Fast-Track Targets by 2020.

In 2016, UNAIDS estimated:

19.5 million people were accessing antiretroviral therapy

36.7 million [30.8 million–42.9 million] people globally were living with HIV

1.8 million [1.6 million–2.1 million] people became newly infected with HIV

1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

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IAS 2017: Progress on PrEP, treatment as prevention, and HIV cure science

While the world’s top HIV experts reported no earth shattering progress in preventing, treating or curing HIV at the 9th IAS Conference on HIV Science (IAS 2017), which took place in July in Paris, it did serve as an important marker of progress. HIV researchers revealed new data that further strengthened the case for PrEP and HIV treatment as prevention — and issued a resounding declaration that a person with full viral suppression is essentially incapable of passing on HIV to their sex partners.

On the other hand, a joint meeting of HIV and cancer scientists, just before IAS 2017, ended on a more somber note. Though noting the rapid progress in our knowledge of the underlying mechanisms that make both HIV-infected cells and cancerous cells so hard for the body to get rid of, experts there also acknowledged that while long-term viral remission — with HIV still present in the body — can likely be achieved in many people, completely eliminating the virus will remain rare.

Here are some key highlights from the conference.

HIV Treatment Scale-up, Treatment as Prevention, and U=U

Two presentations and one issuance of a declaration statement, when combined, demonstrated just how much progress we are making at simultaneously improving the physical, mental and social health of people with HIV and substantially reducing the number of new HIV infections around the globe.

In terms of the societal impact of HIV treatment scale up and viral suppression, a new study out of Swaziland in the Kwazulu-Natal province in South Africa found that doubling the number of people with HIV who had full viral suppression was accompanied by a 50% drop in new infections. Though previous studies in multiple countries and cities had demonstrated less directly that increasing the number of people with HIV on ART was associated with significant drops in new HIV cases, this study represents the most direct correlation between viral suppression and HIV incidence to date.

A second presentation took these data to a very personal level. The previously reported PARTNER study, which predominantly enrolled heterosexual mixed HIV status couples, found zero cases of HIV transmission between people with HIV who had fully suppressed virus and their HIV-negative primary partner, despite thousands of condomless sex acts. The PARTNER study did enroll couples where both partners were male and where condomless anal sex was the primary risk, but the numbers were so small it was not possible to derive firm conclusions other than that lower HIV levels did offer good protection.

The Opposites Atract study focused solely on male-male mixed HIV status couples, and also found zero new infections between positive and negative partners despite nearly 17,000 condomless sex acts, a fair number of them occurring when the HIV-positive partner also had a sexually transmitted infection. Combined with the original PARTNER study, the top experts who convened the IAS 2017 conference, and high level officials from the U.S. government issued a strong declaration in support of the Undetectable = Untransmittable (U=U) campaign from the Prevention Action Campaign, which stresses the critical importance for people with HIV and the communities they live in to be aware of the fact that when a person living with HIV is on ART with a persistently undetectable viral load there is a negligible risk that they can transmit HIV to their sex partners. Growing consensus around this statement, and gaining buy-in and support from medical societies and various branches of government could considerably improve the physical, emotional and social well-being not only of people with HIV, but others in their communities.

PrEP

Perhaps the most helpful presentation on pre-exposure prophylaxis (PrEP) came from a second look at data from the IPERGAY study, which took place in France and Canada a couple of years ago, and which studied intermittent rather than continuous daily PrEP. Though efficacy rates were very high in IPERGAY — an 86% reduction in new HIV infections overall, but zero new infections in people who actually took their medication as directed — a critical uncertainty remained. Since the protocol recommended PrEP just before, during and after sex, and because so many participants had a lot of sex, a lot of the guys in the study were essentially taking daily PrEP.

The re-analysis of data on the subset of people who did go for longer stretches between sexual encounters, and who therefore could be considered as truly taking intermittent PrEP, showed that they also had high levels of protection against HIV transmission. It thus seems pretty clear that intermittent PrEP is a reasonable approach for those who go for longer periods between having condomless anal sex (provided that it is taken similarly to the protocol used in IPERGAY). It also lends further weight to the argument that even daily oral PrEP is likely to be incredibly forgiving of missed doses in those whose HIV risk is from condomless anal sex.

Pathway to a Cure

Since approximately 2010, when the world’s top scientists and government agencies began openly using the word “cure” as an achievable goal in the fight against HIV, we have gone from an initial burst of exuberance to an attitude of more sober optimism — the result of repeated experiments documenting the stubborn persistence of the virus and its ability to surge back to life when ART is stopped, even when the most sensitive tests seeking a trace of it come up blank over months or years.

Interestingly, as the consensus among scientists is that total elimination of the virus from a person’s body is highly unlikely, but that a long-lasting remission free of ART might be, we are now most intensively utilizing drugs designed for another condition where the word remission is the key: cancer.

Because both HIV-infected and cancerous cells hijack the biological machinery that protects the immune cells from attack by most viral infections, the IAS 2017 organizers convened a small pre-conference devoted to exploring the commonalities and the ways that some of the newest cancer drugs might also be promising as part of a combination approach to achieving long-lasting suppression of HIV when people stop taking ART.

Predominantly, those drugs are focused on the molecular markers on the outside of CD4 and CD8 cells that communicate with other immune cells. These checkpoint markers can affect whether a cell that has been activated by the presence of a virus essentially goes to sleep and becomes invisible to the rest of the immune system. While this is a desirable ability if we want to retain cells that can immediately mount strong immune response if we are exposed to a virus a second time, it is a total liability if those cells harbor reproducible portions of genetic material that can lead to the reemergence of HIV disease or cancer.

The good news is that several of the immune check-point blockers are so much more potent against some cancers than previous drugs, also appear to enhance the immune system to recognize and eliminate cells that are latently infected with HIV. Unfortunately, the drugs approved so far stop or reverse tumor growth in only about half of people with cancer, and the drugs almost always lose potency over time. This is leading researchers to believe that immune-checkpoint blocker therapy for cancer is possibly going to look a lot more like modern ART — combinations of drugs used together over the course of a person’s life.

Though sobered by these realities, however, the two-day pre-conference ended on a note of determination to succeed with the same zeal that delivered the medications that are making ending the epidemic a plausible reality for many parts of the globe.

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NMAC Launches Campaign to Fight Proposed Cuts to HIV Services

Today, NMAC Launches “Save Our Services,” an innovative campaign created to empower Americans across the country in fighting the proposed federal budget cuts that would cause severe harm to vital HIV treatment and prevention services.

SOS will enlist the advocacy of community volunteers to contact their representatives in Congress both in their home offices during the August recess and on Capitol Hill for the official  “HIV/STD Action Day” on Sept. 6. This Day of Action will precede the opening of NMAC’s annual U.S. Conference on AIDS, which will run from Sept. 7 – 10. More information about “Save Our Services” can be found at nmac.org/sos.“We are at a critical point in the fight against HIV/AIDS. The real possibility of ending the epidemic is in sight but only if we continue to use and fund the current tools we already have.,” said Paul Kawata, Executive Director of NMAC. “Through methods like Treatment as Prevention and Pre-Exposure Prophylaxis, we have seen drastic reductions in new infections around the country. But that progress is threatened by the cuts proposed by this Administration to HIV/AIDS services. These cuts could lead to a resurgence of HIV in America just as we have found a path to potentially end it.

If passed, the president’s budget would:

  • Eliminate the Secretary Minority AIDS Initiative FUND (SMAIF), a program that provides over $50 million in funding that helps get and keep people of color in care.
  • Decrease funding to the Ryan White HIV/AIDS Program by $59 million thereby eliminating AIDS Education and Training Centers which would make it all but impossible for clients seeking HIV-related services to do so.
  • Cut $610 billion from Medicaid – one of the largest payers of insurance for people living with HIV.
  • Result in over one million fewer HIV tests each year, meaning thousands of people will be unaware of their status leading to over 30,000 more people becoming HIV-positive.

“These cuts would deprive communities of color – which are more greatly impacted by HIV – from vital treatment and prevention services,” said Kawata. “Make no mistake: these proposed cuts would lead to more people becoming sick, becoming HIV-positive, or even dying. We absolutely cannot back down in the fight against HIV/AIDS now that we are so close to a final victory in this decades-long fight.”

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FDA Application Accepted for HIV Drug with New Mechanism of Action

Theratechnologies Inc. (Theratechnologies) (TSX: TH) announced Friday that it has been notified by its partner, TaiMed Biologics, Inc., that the U.S. Food and Drug Administration (FDA) has accepted for review the Biologics License Application (BLA) for ibalizumab as a treatment for multidrug resistant Human Immunodeficiency Virus-1 (MDR HIV-1). If approved, ibalizumab will be the first antiretroviral treatment (ART) with a new mechanism of action to be introduced in nearly 10 years and the only treatment that does not require daily dosing.

“We are excited to be one step closer to potentially bringing an important new treatment, with a new mechanism of action, to patients whose virus has become resistant to therapies in multiple classes and have limited treatment options for the long-term management of their condition,” said Luc Tanguay, President and Chief Executive Officer, Theratechnologies Inc. “The granting of Priority Review status is important since it confirms that, if approved, ibalizumab would represent a significant improvement in the treatment of this serious condition,” added Mr. Tanguay.

The FDA has set a Prescription Drug User Fee Act (PDUFA) target action date of January 3, 2018, for the ibalizumab application. Priority Review status accelerates FDA review time from 10 months to a goal of six months from the day of acceptance. In addition, ibalizumab received Breakthrough Therapy designation from the FDA in 2015, which is given if a therapy may provide a substantial improvement over what is currently available to address a serious and life-threatening condition. The FDA also granted Orphan Drug designation in 2014.

The BLA, submitted on May 3, 2017, is based on data from the phase III TMB-301 study, a single arm, 24-week study of ibalizumab plus an optimized background regimen (OBR) in treatment-experienced patients who had high pre-existing levels of drug resistance and advanced clinical disease.

The ibalizumab Expanded Access Program (EAP), or study TMB-311, is ongoing and enrolling patients. For more information about TMB-311 (NCT02707861), please refer to the ClinicalTrials.gov website (www.clinicaltrials.gov[clinicaltrials.gov]) or the study website (www.ibalizumab-eap.com[ibalizumab-eap.com]).

As HIV multiplies in the body, the virus may mutate to produce drug-resistant strains. Viral mutations may mean that HIV medicines that previously controlled a person’s virus are no longer effective, causing treatment to fail. There are approximately 20,000 to 25,000 Americans with HIV-1 that are resistant to at least one drug out of the three different classes of antiretroviral therapies. Up to 12,000 of these patients experience a virological failure over a period of 48 weeks of treatment, requiring their physician to modify their treatment.

About ibalizumab

Ibalizumab is an investigational humanized monoclonal antibody being developed for the treatment of MDR HIV-1 infection. Unlike other antiretroviral agents, ibalizumab binds primarily to the second extracellular domain of the CD4+ T cell receptor, away from major histocompatibility complex II molecule binding sites. It potentially prevents HIV from infecting CD4+ immune cells while preserving normal immunological function.

Ibalizumab is active against HIV-1 resistant to all approved antiretroviral agents.

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AIDS United Releases Statement for Providing Trans-affirming HIV Medical Care, Support Services and Funding

In a community-created consensus statement released today, AIDS United provides critical guidance for clinical providers, funders and social service providers to strengthen their understanding of how best to engage and support transgender communities. The statement provides concrete and measurable steps organizations can take to improve their approach to HIV work in transgender communities and was drafted by 12 transgender leaders at a think tank convened by AIDS United and generously supported by Janssen Therapeutics, Division of Janssen Products, LP.

The transgender community is critically affected by HIV and faces unique challenges accessing HIV care. A landmark 2013 study estimates that 22 percent of transgender women in the United States are living with HIV. This makes transgender women the most heavily affected group in the United States, relative to their population size. This disproportionate risk is fueled by pervasive violence and discrimination faced by transgender and gender non-conforming individuals in areas such as housing, education and when accessing health care.

“Our recent survey shows 41 percent of the respondents reported lapses in health care for longer than six months. This speaks to the need to meaningfully involve trans people living with HIV in cultural competency training and program designs. Trans people are experts of their experiences and this consensus statement puts the expertise of trans people front and center,” said nationally recognized leader in civil rights and trans equality Cecilia Chung.

 

“Twelve trans leaders from across the country came together to create concrete recommendations so that funders, health care providers and social services organizations can serve our communities with the dignity and respect we deserve. There is power in this—and the best practices we outlined are critical for improving trans health and justice in this country,” said Chung.

 

Due to these factors, it is critical that clinics and support services are welcoming, inclusive and competent in serving transgender people. Additionally, funders must ensure that funding strategies and decisions are community informed to yield the greatest impact.

“We can no longer ignore the needs of the transgender and gender-nonbinary community. Our consciousness of their presence has been raised, but our services have not stepped up to meet their unique needs,” said AIDS United President & CEO Jesse Milan, Jr. “We cannot allow transgender people to be left out or left behind or we will not fully achieve our national goals.”

The Consensus Statement and the newly launched Transgender Leadership Initiative, also funded by Janssen Therapeutics, are programmatic efforts by AIDS United to better partner with transgender leaders to address the dire HIV epidemic in transgender communities, to improve transgender health outcomes and to solidify transgender power in our society. Proposals for support from the Transgender Leadership Initiative are due by Jun 14, 2017 at www.aidsunited.org.

“This statement is a foundational tool that every provider and HIV advocate can use. It is the newest tool in our toolbox for ending the HIV epidemic in this country and AIDS United is proud to release it to everyone,” said Milan.

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PleasePrEPMe.org seeks to expand access to PrEP within California

 

HIVE (hiveonline.org) and Project Inform (projectinform.org) are pleased to announce the hiring of three key positions for supporting PrEP services within California and nationally through expanded navigation services at PleasePrEPMe.org (PPM). The launch date of these free new services is being planned for early April.

“HIVE launched PleasePrEPMe.org in 2015 to provide consumers a search engine to find PrEP-friendly clinicians within California,” stated Shannon Weber, Director at HIVE. “This year, with a grant from the state department of health, we’re excited to be expanding the original site to include an online chat function as well as provide navigation assistance by phone, email and text services in English and Spanish.”

Charlie Romero comes to the program as PleasePrEPMe’s State PrEP Navigator from Children’s Hospital Los Angeles where he supported adolescents’ access to care and prevention, including PrEP, for the last four years. He brings incredible compassion and commitment to people of diverse backgrounds along with his real-world clinic experience to support individuals in accessing the care they need. Charlie is based in Los Angeles and is eager to help bring a true state-wide vision and network to PPM efforts.

Laura Lazar very recently started as PleasePrEPMe Coordinator and is based in San Francisco. Laura joins PPM from AVAC (avac.org) where she was Program Coordinator of Research and Data Analytics, reporting on HIV prevention R&D investments and managing their HIV prevention study database. She previously worked at the HPV and Anal Cancer Foundation running the database that matched applicants for peer-to-peer support. With her strong organizational skills, analytical mind and ability to connect, Laura will assure our work processes and communications make PPM a product that is maximally useful for all.

Reilly O’Neal recently joined PleasePrEPMe as State Resources Coordinator. Previously, Reilly was the editor of San Francisco AIDS Foundation’s BETA Blog and more recently has been a freelance writer and editor for UCSF and Gilead. Reilly will work with us to develop state-specific resource pages, helping us develop a sustainable infrastructure to support states in PrEP rollout nationally.

Although additional strategies are in clinical study, currently PrEP is taken as a daily pill by HIV-negative individuals at risk for the virus. The State Department of Health estimates that between 221,528 and 238,628 Californians are eligible for PrEP, though far fewer than that are currently on PrEP. In contrast to these figures nationally, only 80,000 prescriptions have been written since the FDA approval in July 2012.

“PleasePrEPMe is looking forward to further help Californians understand PrEP and how to find and maintain their prescriptions,” remarked Alan McCord, Director of Education at Project Inform. “It’s exciting for us to help enhance individuals’ sexual and general health, and our new star staff are eager to begin this journey throughout the state.”

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HRC Announces Fellowships for 10 Young Nonprofit Leaders Working to End HIV in America

 

Fellowship ProgramThe Human Rights Campaign (HRC) Foundation announced the selection of ten outstanding, young leaders for the second year of its fellowship program focused on elevating the work of young people on the front lines of the HIV and AIDS epidemic.

The HRC Foundation’s HIV 360° Fellowship Program, made possible with the generous support of the Elton John AIDS Foundation (EJAF), provides individualized training and support to innovative young professionals and nonprofit leaders as they tackle the challenges facing communities hit hardest by HIV, including Black and Latino gay and bisexual men, transgender women of color, and LGBTQ people living in the U.S. South.

“We are honored to welcome ten talented young leaders to the second class of HRC’s HIV 360° Fellowship Program,” said Mary Beth Maxwell, HRC Senior Vice President for Programs, Research and Training. “Through their dedication, creativity, and hard work, these activists are changing lives, expanding opportunity, and combatting the stigma and discrimination facing so many people living with and affected by HIV in the U.S. We look forward to working with them over the coming year and into the future as they continue to speak out, act up, and bring an end the HIV and AIDS epidemic once and for all.”

“The Elton John AIDS Foundation is proud to support HRC’s second class of HIV 360° Fellows,” said Scott Campbell, EJAF Executive Director. “This impressive, diverse group of leaders has a vast amount of professional and real world experience and represents viewpoints from across the country. The future of LGBTQ rights and HIV activism is brighter because of their commitment and dedication.”

The new class reflects a diverse cross-section of the activists and advocates working tirelessly to combat both the stigma and spread of HIV across the country:

  • Ashley Young of Little Rock is an experienced public health professional whose work is aimed at the improvement of health systems and health outcomes for underserved communities specifically geared towards women and children. Ashley currently serves as the project manager for the Passion Project, a SAMHSA funded initiative designed to expand and enhance substance use disorder treatment, behavioral health, HIV & AIDS, and viral hepatitis services to high risk African-American women who have substance use or co-occurring substance use issues and mental health disorders.
  • Charlie Ferrusi of New York City is an impassioned social justice activist, seeking to eliminate the health disparities faced by LGBTQ people as well as people living with and affected by HIV. Charlie received his MPH in Community Health from New York University College of Global Public Health. He currently serves as a Contract Manager at the NYS Department of Health, AIDS Institute in the LGBT Health Services Unit. Charlie works closely with both the Columbia County Young Democrats and Hudson Pride Foundation.
  • Damon Johnson of Atlanta is a rising public health leader dedicated to transformational social change. Damon currently serves as the Associate Director of Programs at NAESM, Inc., a community-based organization focused on the impact of HIV on communities of color in the South. Damon and his team take a multidisciplinary approach to developing comprehensive programs and initiatives that address the complex needs of people from marginalized communities.
  • Daniel Downer of Orlando is a budding community advocate who firmly believes in fostering unity for everyone regardless of their ethnicity, gender identity, race, or sexual orientation. He currently works as an Early Intervention Specialist for the Hope and Help Center of Central Florida, Inc. Daniel is a well-respected leader in his community for his ability to captivate, empower, inspire, and mobilize others to erase the stigmas not only surrounding HIV, but also ethnic and gender identity, homelessness, mental health and substance abuse, race, and sexual orientation.
  • Daniel Szymczyk of New York City is a graduate of Appalachian State University and a rising, nonprofit professional. He is the founder and Executive Director of The HIV League, the nation’s only scholarship-granting organization for students living with HIV. Daniel began focusing his efforts on HIV-related issues once he grew comfortable with his own HIV-positive diagnosis.
  • Erika Usui of New York City is a graduate of the State University of New York Downstate Medical Center’s School of Public Health. Erika currently serves as Health Services Coordinator at The Ali Forney Center, a community-based organization whose mission includes protecting LGBTQ youths from the harms of homelessness. Erika is committed to providing LGBTQ youth with the HIV prevention and treatment tools they need and deserve.
  • Francisco Cortes of Philadelphia is the Youth Program Coordinator at Galaei, a queer Latinx social justice organization based in Philadelphia. Francisco currently serves on the Board of Directors for Juntos, and he is the youngest appointed Commissioner to the Office of LGBT Affairs in the city of Philadelphia.
  • Jalenzski Brown of Dallas seeks to find peace, love, happiness, and understanding in every moment of his human experience and help those around him do the same. Jalenzski studies the world around him, seeking new truths in an effort to create a greater tomorrow. He currently works at Resource Center – North Texas’ primary LGBT and AIDS service organization – as the MPowerment Programs Manager, where co-manages HIV and STD prevention and treatment services.
  • Socorro Moreland of Oakland is a Puerto Rican, classically trained chef who was born in 1985 to a revolutionary family committed to social justice liberation and the Black power movement. Socorro found his calling within the HIV prevention field 11 years ago and coordinates programming and support services for transgender people of color within the Bay Area. Socorro currently works for APEB, a community-based, nonprofit organization.
  • William Campillo Terrazas of Little Rock was born in Nogales, Sonora, Mexico and migrated to the United States at the age of 6. Upon receiving Deferred Action for Childhood Arrivals, William took a job as a Disease Intervention Specialist within the Arkansas Department of Health. In 2015, William helped co-found Latinxs Revolucion LGBTQ, a queer- and trans-led, community-based organization in Little Rock that focuses on the health and well-being of Latinx immigrants.

The new class of fellows will receive leadership and organizational development training, mentorship, as well as coaching in communications, leadership, fundraising, and other aspects of successful nonprofit management – all focused on strengthening their own community-based organizations and initiatives.

Members of last year’s inaugural fellowship class developed their non-profit management and leadership skills, and received a grant of up to $9,000 to design, implement, and evaluate innovative approaches to addressing the HIV and AIDS epidemic in their local communities. You can read more about their projects here. To date, the 2016 cohort’s efforts have helped more than 1000 LGBTQ people and allies access HIV-related programs and services in some of the nation’s hardest hit communities.

Since its founding, HRC has worked to end the dual epidemics of HIV and HIV-related stigma through federal, state and local advocacy as well as public education and outreach. By educating LGBTQ people and allies about the current realities of HIV, HRC has been able to mobilize its members and supporters to take action to support critical public health programs like the Ryan White Care Program, and to expand access to vital health care, treatment, and nondiscrimination protections made possible by the Affordable Care Act.

HRC has also worked with various public health organizations to raise awareness of and increase access to Pre-Exposure Prophylaxis (PrEP) in communities across the nation hardest hit by HIV. HRC also regularly trains healthcare providers, front line workers, and community advocates on how to best provide LGBTQ-competent, HIV-inclusive care to the people most in need, especially those living throughout the Deep South.

For more information about the program, please visit: www.hrc.org/hiv360.

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Public Health Experts Affirm Virally Suppressed People Living With HIV Do Not Transmit the Virus

NASTADToday, NASTAD (National Alliance of State & Territorial AIDS Directors), a leading non-partisan non-profit association that represents public health officials who administer HIV and hepatitis programs in the U.S. and around the world, published a new statement affirming that durably virally suppressed people living with HIV on antiretroviral therapy (ART) do not sexually transmit the virus. The statement accelerates NASTAD’s longstanding work to end HIV and promote policies and public health practice grounded in science.

”The science is clear that people living with HIV with a sustained undetectable viral load do not transmit the virus to others. What’s also clear is that we have the tools to end the HIV epidemic and HIV-related stigma and make new infections a thing of the past. Today, we tackle a major part of this work by raising awareness about the latest science of HIV transmission risk,” remarked NASTAD Executive Director Murray Penner.

“Until now, there hasn’t been anyone ensuring this life-changing information is communicated clearly and meaningfully to people living with HIV,” said Bruce Richman, Executive Director of Prevention Access Campaign and the Undetectable = Untransmittable Initiative. “NASTAD was the first non-profit to endorse the Prevention Access Campaign’s Consensus Statement last year representing a bold step toward sharing a message that will improve the social, sexual, and reproductive lives of millions of people living with HIV in the U.S. and around the world.”

  • The conclusive evidence about the highly effective preventative benefits of ART provides an unprecedented opportunity to improve the lives of people living with HIV, improve treatment uptake and adherence, and advocate for expanded access to treatment and care.
  • People living with HIV who are on ART and are durably virally suppressed are not only less likely to develop HIV-related complications, they also do not transmit the virus to others. This new evidence will help ameliorate decades of HIV-related stigma, discrimination, and criminalization by confirming that treatment is a powerful preventive intervention.
  • Zero new linked transmissions in the PARTNER study based on new findings and zero transmissions from virally suppressed partners in HPTN 052 trial studying whether ART can prevent sexual transmission of HIV equates to there being effectively no chance of sexual HIV transmission from people living with HIV who are on ART and durably virally suppressed.
  • An FAQ on the PARTNER study notes that STIs and likely small short-lived increases in viral load or ‘blips’ did not increase HIV transmission risk during sex in this study. STIs and viral blips have not been shown to increase transmission risk from an HIV positive person who is on ART and virally suppressed in any study or empirical evidence to date.
  • While viral suppression prevents the transmission of HIV, consistent and correct condom use and pre-exposure prophylaxis (PrEP) also prevent the transmission of HIV, and condoms provide additional protection for other sexually transmitted infections (STIs) and pregnancy.

These findings have been embraced by leading experts in the field, including:

“People living with HIV who achieve viral suppression are a fundamental part of ending new HIV infections in the United States and around the world in our lifetime. History will judge us by how well we respond to this unprecedented opportunity,” noted Dr. Demetre Daskalakis.

In conjunction with new and existing partners, NASTAD will continue to advocate at the national level to raise awareness about the latest science of HIV transmission risk and implement policies and practices grounded in our best science void of stigma and discrimination. Finally, NASTAD will continue to monitor the scientific landscape for advances that will enhance our understanding of how to reduce new HIV infections and optimize the quality of life for people living with HIV.

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First Large-scale Clinical Study of Long-acting Injectable HIV Drug Begins

The first large-scale clinical trial of a long-acting injectable drug for HIV prevention began today. The study, sponsored by the National Institutes of Health, will examine whether a long-acting form of the investigational anti-HIV drug cabotegravir injected once every 8 weeks can safely protect men and transgender women from HIV infection at least as well as the anti-HIV medication Truvada taken daily as an oral tablet. If injectable cabotegravir is found to be effective for HIV pre-exposure prophylaxis, also known as PrEP, it may be easier for some people to adhere to than daily oral Truvada, the only licensed PrEP regimen. Truvada consists of the two anti-HIV drugs emtricitabine and tenofovir disoproxil fumarate.

“We urgently need more HIV prevention tools that fit easily into people’s lives,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. “Although daily oral Truvada clearly works for HIV prevention, taking a daily pill while feeling healthy can be difficult for some people. If proven effective, injectable cabotegravir has the potential to become an acceptable, discreet and convenient alternative for HIV prevention.”

NIAID is collaborating on the Phase 3 clinical trial of injectable cabotegravir with ViiV Healthcare, Gilead Sciences, Inc., and the NIH-funded HIV Prevention Trials Network (HPTN). In a novel funding structure for an NIH HIV prevention study, NIAID and ViiV Healthcare are co-funding the trial. NIAID is sponsoring the study, called HPTN 083, and ViiV Healthcare and Gilead Sciences are providing the study medications.

The study will enroll 4,500 men who have sex with men and transgender women who have sex with men at 45 sites in eight countries in the Americas, Asia and Africa. Participants will be aged 18 years or older and at high risk for HIV infection. Results are expected in 2021.

“The annual number of new HIV infections among young people, especially young men who have sex with men and transgender women who have sex with men, has been on the rise despite nearly flat HIV incidence among adults worldwide,” said HPTN 083 Protocol Chair Raphael J. Landovitz, M.D., M.Sc. “It is essential to develop multiple effective HIV prevention modalities so the most vulnerable populations have a choice of preventive options. We hope injectable cabotegravir will become one such modality.” Dr. Landovitz is an associate professor of medicine at the David Geffen School of Medicine at University of California, Los Angeles, and associate director of the UCLA Center for Clinical AIDS Research & Education.

HPTN 083 study participants will be randomly assigned to either the cabotegravir group or the Truvada group. Neither the participants nor the study team will know who is in which group until the end of the trial.

Participants will be in the study for an average of 4.5 years. During their first five weeks after enrollment, they will receive two daily oral tablets: either cabotegravir or Truvada, and a placebo pill. Beginning in the sixth week, participants in the cabotegravir group will receive injections of cabotegravir and placebo tablets to be taken orally daily, while participants in the Truvada group will receive placebo injections and Truvada tablets to be taken orally daily. Injections will be administered by study staff. The first two injections will be four weeks apart, then once every 8 weeks for an average of nearly 3.5 years. After completing the injections, all participants will be offered 48 weeks of PrEP with daily oral Truvada.

HPTN 083 study participants will receive HIV prevention counseling, condoms and lubricant, as well as counseling to encourage and support adherence to the daily oral pill. Participants will be tested for sexually transmitted infections (STIs) throughout the study and referred for appropriate treatment if an STI is diagnosed. Study participants who become HIV-infected during the trial will stop receiving the study products and be referred to local medical providers for HIV care and treatment.

“The HPTN 083 study has the potential to provide game changing data as the first large-scale test of a long-acting injectable drug for HIV prevention,” said Protocol Co-Chair Beatriz Grinsztejn, M.D., Ph.D. Dr. Grinsztejn directs the Instituto de Pesquisa Clinica Evandro Chagas HIV/AIDS Clinical Research Centre of the Oswaldo Cruz Foundation-Fiocruz in Rio de Janeiro, Brazil.

A related study called HPTN 084 will test the safety and efficacy of injectable cabotegravir for HIV prevention in young women in sub-Saharan Africa beginning in 2017.

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