HPTN 083 Study Demonstrates Superiority of Cabotegravir for the Prevention of HIV

This article originally appeared on hptn.org. To see the full article, click here.

DURHAM, N.C. – Researchers from the HIV Prevention Trials Network (HPTN) announced today that the HPTN 083 clinical trial showed that a pre-exposure prophylaxis (PrEP) regimen containing long-acting cabotegravir (CAB LA) injected once every 8 weeks was superior to daily oral tenofovir/emtricitabine (TDF/FTC) for HIV prevention among cisgender men and transgender women who have sex with men. The results were reported at the 23rd International AIDS Conference (AIDS 2020: Virtual). HPTN 083 is a randomized, controlled, double-blind study comparing the safety and efficacy of a regimen including CAB LA to daily TDF/FTC at 43 sites around the world.

An independent Data and Safety Monitoring Board (DSMB) that reviewed interim study data in May 2020 found that the PrEP regimen including CAB LA injected once every 8 weeks safely and effectively prevented HIV acquisition in the study population. Consequently, the DSMB recommended stopping the blinded comparison, offering CAB to all study participants, and disseminating the results. The final analysis of these data demonstrates the superiority of CAB compared to TDF/FTC for PrEP in the HPTN 083 study population.

“The HPTN 083 results demonstrating the superiority of CAB to TDF/FTC have the potential to transform the landscape of HIV prevention for cisgender MSM and transgender women,” said HPTN 083 protocol chair Dr. Raphael J. Landovitz. “We know that some people have difficulty with or prefer not to take pills, and an injectable product such as long-acting CAB could be a very important option for them. We want to thank the study participants and research staff, as this study would not have been possible without their dedication and commitment.” Dr. Landovitz is a professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and co-director of the UCLA Center for Clinical AIDS Research & Education (CARE).

Overall, HPTN 083 enrolled 4,570 cisgender men and transgender women who have sex with men at research sites in Argentina, Brazil, Peru, South Africa, Thailand, the U.S., and Vietnam. Two-thirds of study participants were under 30 years of age, and 12% were transgender women. Half of the participants in the United States identified as Black or African American.

Read more about the HPTN 083 Study findings.

For general information about the HPTN 083 Study, visit the HPTN 083 website.

Dr. Raphael Landovitz, Co-Director of CHIPTS and the CHIPTS Combination Prevention Core, presented study findings on behalf  of the HPTN 083 Team at this year’s AIDS 2020 conference.  A copy of this slide presentation is also available on the HPTN 083 website here.

 

CHIPTS AIDS 2020 Conference Scholarship

Application Deadline: Tuesday, June 30, 2020

The Center for HIV Identification, Prevention and Treatment Services is pleased to announce scholarships for individuals who would like to attend the 23rd International AIDS virtual conference from July 6-10, 2020.

The scholarship aims to provide opportunities and support for community members including youth (ages 18-25 years), community advocates/researchers, students (undergraduate, graduate-level, pre-and post-doctoral students) and early-stage investigators in Southern California counties to attend the conference in an effort to promote science, foster networking, and increase capacity building. Individuals from underrepresented populations are encouraged to apply. There are a limited number of scholarships available based on availability of funding with certain restrictions applied.

Priority will be given to those who have not received scholarship funds from CHIPTS within the last 12 months and who have an HIV-related oral/poster presentation or workshop accepted at the conference.  The scholarship covers only the cost of the conference registration fee and will be provided as a reimbursement which will be processed at the end of the conference.

Please fill out the application form here.

For more questions about the scholarship, contact Damilola Jolayemi at ojolayemi@mednet.ucla.edu.

This scholarship is supported by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) NIMH grant P30MH058107.

Spotlight: Jesse Clark

Jesse Clark, MD, MSc, is an Associate Professor-in-Residence in the Department of Medicine, Division of Infectious Diseases, and Department of Family Medicine. A member of the CHIPTS Combination Prevention Core, his research focuses on questions of HIV prevention and STI control among men who have sex with men (MSM) and transgender women (TW) in the Americas.

Jesse came to UCLA in 2005 after finishing medical school and completing an Internal Medicine residency at Albert Einstein College of Medicine/Montefiore Medical Center in the Bronx, NY. Before beginning his Fellowship in Infectious Diseases, he planned to spend a year in Lima, Peru working under the guidance of Dr. Tom Coates where he began to explore the epidemiology and prevention of HIV and STIs among MSM and TW in the area. Halfway through the year, Jesse met his future husband and remained in Peru until 2015. While there, he worked to develop UCLA’s satellite office in Lima and to create the UCLA South American Program in HIV Prevention Research (SAPHIR). As Director of SAPHIR, he has had the pleasure of mentoring many future HIV researchers, several of whom he has proudly watched develop into independent investigators in their own right.

In his own work, Jesse focuses on the introduction of new diagnostic and prevention technologies through the social and sexual networks of MSM and TW. Collaborating with partners at the NGO’s Via Libre and Impacta, alongside the Universidad Peruana Cayetano Heredia, recent projects in Peru have explored: Use of TW social networks to support uptake and adherence to PrEP; Utility of nucleic acid screening for rectal STIs as a platform for delivery of an integrated biological-behavioral HIV prevention intervention to high-risk MSM/TW sexual networks; and Partner management for STI control in high-risk networks as a strategy to limit HIV transmission in the larger population.

After returning to Los Angeles in 2015, Jesse joined the team at Vine Street Clinic where he has contributed to studies of new HIV prevention tools through the HIV Prevention Trials Network (HPTN). Working on trials of antibody-mediated prevention and long-acting injectable PrEP, he has enjoyed the opportunity to work with Vine Street’s dynamic research team in their community-based approach to problems of HIV, STIs, and substance use. He has also initiated work on contingency management as a strategy to target the intersection of HIV and substance use in local MSM populations.

Outside of work, Jesse enjoys spending time with his husband Marcelo and their dog Lola, traveling, going to the theater, listening to music, and reading. A few of his favorite authors are J.M. Coetzee, Patrick Modiano, and Alejandro Zambra.

Each month, we’re featuring a member of our CHIPTS family and their work! To see past spotlights, check them out on the spotlights page  and make sure to check back to see who we feature next!

A Community’s Guide to Self-Care During a Pandemic

April 24th, 2020- As we continue to take care of ourselves amidst the stress of the coronavirus pandemic, gauging and understanding our individual needs could not be more important.

To help with these efforts, the COVID-19 Racism Equity Task-force at the UCLA Fielding School of Public Health’s Center for the Study of Racism, Social Justice, and Health has created culturally-responsive tips for holistic at-home care.

We encourage you to explore, utilize, and share these tips with your respective communities!

The info-graphics are also available for download below.

A Community's Guide to Self-Care - Version 1

 

A Community's Guide to Self-Care- Version 2

STD Awareness Week: Talk. Test. Treat.

April 18th, 2020- The CDC made the official decision this year to transition the historically observed STD Awareness Month of April to a STD Awareness Week. This week of April 12th-18th marked its beginning.

Sexual health is a vital part of individual health. Understanding the importance of testing and treatment goes beyond simply having the knowledge about the many Sexually Transmitted Infections/Diseases. It extends profoundly towards prevention and decreasing spread. Below are important suggestions created by the CDC for both healthcare providers and community members to increase the conversation, testing, and treatment around STDs/STIs, and ultimately aim to reduce the stigmas surrounding them.

TALK

Providing the best medical care possible means talking about sexual health.

Taking a sexual history should be a part of routine care.

  • Talking about sexual health can be challenging but studies show that patients want to be asked about sex.
  • Having an environment that is open to an honest discussion around sexual history—success in this area can garner important information that will allow the best care possible.

Consultations by healthcare providers on safe sex ensures patients know about today’s many prevention options. With condoms, hepatitis B and HPV vaccines, and even a daily medication to prevent HIV infection – there have never been more ways for protection.

Certain STD diagnoses can cause fear and anxiety.

TEST

Test for STDs as recommended.

STD screening recommendations  often differ by patient populations. Below is a brief overview:

  • Syphilis, HIV, chlamydia, and hepatitis B screening for all pregnant women, and gonorrhea screening for at-risk pregnant women starting early in pregnancy, with repeat testing as needed, will protect the health of mothers and their infants. (NOTE: Detailed screening recommendations for pregnant women also are available here.)
  • Annual chlamydia and gonorrhea screening of all sexually-active women younger than 25 years, as well as older women with risk factors, such as new or multiple sex partners, or a sex partner who has an STD.
  • Screening at least once a year for syphilis, chlamydia, and gonorrhea for all sexually active gay, bisexual, and other men who have sex with men (MSM).
  • All adults and adolescents from age 13 to age 64 should be tested at least once for HIV

Keep in mind that screening recommendations are sources of clinical guidance, not prescriptive standards. Always consider each patient’s sexual history separately alongside the burden of disease in their community.

TREAT

Follow CDC’s STD Treatment Guidelines to ensure appropriate treatment and care.

The 2015 STD Treatment Guidelines are the most current treatment recommendations for those who have, or who are at risk for STDs.

  • Download the free STD Tx Guide app to your Apple or Android devices to easily access the guidelines any time you need them.

More resources on STD care and prevention can be found on the CDC website here.

AIDSVu Releases Landmark County-Level Data and Interactive Maps on PrEP Use Across the U.S.

This article originally appeared on aidsvu.gov. To see the full article, click here.

ATLANTA – April 15, 2020 – AIDSVu today announced the release of new interactive county-level data and maps visualizing PrEP use from 2012 to 2018, showing a 39% increase in PrEP use across the U.S. from 2017 to 2018, continuing a trend of consistent growth in PrEP use since 2012. AIDSVu is releasing these first-ever county-level data on PrEP to offer a more granular view of trends and disparities in PrEP use across the U.S. and complement the state-level PrEP use data and maps first released on AIDSVu in March 2018.

PrEP, or pre-exposure prophylaxis, is when people at risk for HIV take medicine daily to lower their chances of getting infected with HIV. The Centers for Disease Control and Prevention (CDC) has estimated that approximately 1.1 million people are at high-risk for HIV exposure and could benefit from comprehensive HIV prevention strategies, including PrEP.

Read more here.

Collective Call to Action for HIV/AIDS Community-Based Collaborative Science in the Era of COVID-19

April 16th, 2020- A critical call to action was voiced in a recent publication co-authored by Drs. Steve Shoptaw, Raphael Landovitz, and David Goodman-Meza, faculty members of UCLA CHIPTS. The article, entitled “Collective Call to Action for HIV/AIDS Community-Based Collaborative Science in the Era of COVID-19”, highlights the significant impacts of the current COVID-19 pandemic on the nation’s “already strained health systems,” adding further complexity to many co-occurring epidemics and subsequently disrupting forward-focused eradication initiatives. This includes those created for the Ending the HIV Epidemic (EtHE).

The publication keenly acknowledges the need to “re-purpose scientific, clinical, and material resources” as an essential pandemic response tactic, prioritize “trickle down caring” alongside trickle-down economics, and collaboratively coordinate COVID-19 shifts within community-based HIV efforts. “We need now to integrate into our objectives shifts that accommodate responses needed for COVID-19 and to maintain commitments to make measurable progress not only to maintain gains in HIV treatment and prevention, but to end the HIV epidemic.”

Major insights were further provided on key HIV treatment measures presently in use and their foregoing relations to the COVID-19 crisis, such as Undetectable is Untransmittable, Pre-exposure Prophylaxis (PrEP), and HIV testing/counseling.

Read more on this call to action here, or download the PDF version available below.

[Download not found]

 

HHS Awards $90 Million to Ryan White HIV/AIDS Program Recipients for COVID-19 Response

This article originally appeared on hhs.gov. To see the full article, click here.

Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), awarded $90 million for Ryan White HIV/AIDS Program recipients across the country to prevent, prepare for, and respond to coronavirus disease 2019 (COVID-19). This funding is provided by the fiscal year 2020 Coronavirus Aid, Relief and Economic Security (CARES) Act, which President Trump signed into law on Friday, March 27, 2020.

“HRSA’s Ryan White HIV/AIDS Program recipients are serving on the frontlines of this pandemic, supporting clients and communities at higher risk from COVID-19,” said HHS Secretary Alex Azar. “This new investment is vital to enabling the Ryan White HIV/AIDS Program to continue responding to the increasing needs of their patients and communities during this challenging time. The Trump Administration remains committed to ending the HIV epidemic in America by 2030, and we will continue building on the success of the Ryan White HIV/AIDS Program to do it.”

This funding supports 581 Ryan White HIV/AIDS Program recipients across the country, including city/county health departments, health clinics, community-based organizations, state health departments, and AIDS Education and Training Centers, in their efforts to prevent or minimize the impact of this pandemic on people with HIV.

Read more here.

Sexual Partnership-Level Correlates of Intimate Partner Violence Among Men Who Have Sex with Men and Transgender Women in Lima, Peru

April 8th, 2020- Partnership-level correlates of IPV among men who have sex with men (MSM) and transgender women (TW) in Peru were analyzed in a recent publication. This analysis aimed to improve understanding of factors associated with intimate partner violence (IPV) and explore its role in sexually transmitted infection (STI) acquisition. Dr. Steve Shoptaw, CHIPTS Director, and Dr. Jesse Clark, CHIPTS Combination Prevention Core Scientist, were co-authors.

Read more about the article’s findings here, or download the PDF version below.

[Download not found]

Interim Guidance for COVID-19 and Persons with HIV

This article originally appeared on aidsinfo.nih.gov. To see the full article, click here.

This interim guidance reviews special considerations for persons with HIV and their health care providers in the United States regarding COVID-19. Information and data on COVID-19 are rapidly evolving. This guidance includes general information to consider. Clinicians should refer to updated sources for more specific recommendations regarding COVID-19.

Guidance for all Persons with HIV

  • In current reports, individuals aged >60 years and those with diabetes, hypertension, cardiovascular disease, or pulmonary disease are at highest risk of life-threatening COVID-19, the illness caused by the virus known as SARS-CoV-2.
  • The limited data currently available do not indicate that the disease course of COVID-19 in persons with HIV differs from that in persons without HIV. Before the advent of effective combination antiretroviral therapy (ART), advanced HIV infection (i.e., CD4 cell count <200/mm3) was a risk factor for complications of other respiratory infections. Whether this is also true for COVID-19 is yet unknown.
  • Some people with HIV have other comorbidities (e.g., cardiovascular disease or lung disease) that increase the risk for a more severe course of COVID-19 illness. Chronic smokers are also at risk of more severe disease.
  • Thus, until more is known, additional caution for all persons with HIV, especially those with advanced HIV or poorly controlled HIV, is warranted.
  • Every effort should be made to help persons with HIV maintain an adequate supply of ART and all other concomitant medications.
  • Influenza and pneumococcal vaccinations should be kept up to date.
  • Persons with HIV should follow all applicable recommendations of the U.S. Centers for Disease Control and Prevention (CDC) to prevent COVID-19, such as social distancing and proper hand hygiene. These recommendations are regularly updated.
  • Information on COVID-19 prevention in children with HIV for pediatric health care providers and the general public is available from CDC.
  • CDC also provides information about COVID-19 prevention during pregnancy.

See additional guidance and recommendations here.