This article originally appeared on niaid.nih.gov. To see the full article, click here.
The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has stopped administration of vaccinations in its HVTN 702 clinical trial of an investigational HIV vaccine. This action was taken because an independent data and safety monitoring board (DSMB) found during an interim review that the regimen did not prevent HIV. Importantly, the DSMB did not express any concern regarding participant safety.
The Phase 2b/3 study, named HVTN 702 or Uhambo, began in 2016 and is taking place in South Africa. It was testing an investigational prime-boost vaccine regimen based on the only vaccine regimen ever to show protection from HIV—the regimen tested in the RV144 clinical trial in Thailand led by the U.S. Military HIV Research Program and the Thai Ministry of Health. For HVTN 702, the vaccine regimen was adapted to the HIV subtype Clade C most common in southern Africa, where the pandemic is most pervasive.
“An HIV vaccine is essential to end the global pandemic, and we hoped this vaccine candidate would work. Regrettably, it does not,” said NIAID Director Anthony S. Fauci, M.D. “Research continues on other approaches to a safe and effective HIV vaccine, which I still believe can be achieved.”
The HVTN 702 study enrolled 5,407 HIV-negative volunteers at 14 sites across South Africa. The study population consisted of sexually active men and women aged 18 to 35 years. The study volunteers were randomly assigned to receive either the investigational vaccine regimen or placebo injections. Study participants received six injections over 18 months. As with all NIAID-sponsored HIV prevention trials, the safety of HVTN 702 study participants was closely monitored throughout the trial, and participants were offered the local standard of care for preventing HIV, including access to oral pre-exposure prophylaxis (PrEP).
The 2020 HIV Next Generation Conference hosted by CHIPTS welcomed 149 attendees to the UCLA Campus for a day of presentations, discussions, learning and networking. The conference, facilitated by Dallas Swendeman, CHIPTS Development Core Co-Director, welcomed attendees and participants from community based organizations, post-doctoral fellows, faculty and other partners seeking to end the HIV epidemic. The day also provided a unique opportunity for cross-collaboration and mentorship.
Steve Shoptaw, CHIPTS Director, and Norweeta Milburn, CHIPTS Development Core Director, gave opening remarks to lay the groundwork for the day, emphasizing the theme, “Ending the HIV Epidemic with Adolescents and Young Adults”. Marguerita Lightfoot, who presented on the topic “Activating Youth through Social Networks”, gave the inspirational opening plenary.
The day’s agenda featured informative presentations by panels of community members, postdoctoral fellows, and new and emerging investigators. The first panel discussion moderated by Ronald Brooks, CHIPTS Core Scientist, centered on innovative PrEP interventions. Jessica Saleska gave a presentation highlighting the role of race and place on PrEP awareness. Lindsay Young shed light on social network interventions aimed at diffusing PrEP among young black MSM, and Alicia Morehead Gee discussed using black beauty salons as sites for PrEP interventions alongside co-presenter Dilara Uskup, CHIPTS Postdoctoral Fellow. The next panel facilitated by Cathy Reback, CHIPTS Combination Prevention Core Director, had presentations by Sam Cavetti and Heather Gunn, both of whom focused on assessing mental health, substance use and social determinants of risk among youth. A Community Based Organization panel consisting of Nicole Cunningham, Brandon Harrison and Evelyn Everheart was facilitated by Dahlia Ferlito, CHIPTS Co-chair, and discussed community HIV program innovations. Chunqin Lin, Jesse Fletcher and Sona Oksuzyan discussed the integration of mental health, substance abuse and HIV prevention and treatment in a panel discussion moderated by Sung Jae Lee, CHIPTS Method Core Director.
Over the course of the day, poster presenters provided engaging presentations on innovative research during their poster sessions that attracted conference attendees.
As a final presentation, CHIPTS faculty shared information on the three local NIH funded projects, also known as the Ending the HIV Epidemic (EtHE) Supplement projects. Uyen Kao, CHIPTS Executive Director, Ronald Brooks and Raphael Landovitz, CHIPTS Co-Director, engaged the audience in an edifying discussion facilitated by Steve Shoptaw.
Nina Harawa, CHIPTS Policy Core Director, gave a tribute for William Cunningham, a beloved CHIPTS Core Scientist who embodied the tenets of mentorship and supported the work of new and emerging investigators to address HIV needs and disparities, particularly in under-served communities.
Finally, Norweeta Milburn gave the closing remark reminding attendees of the conference’s purpose and the need to work together towards ending the HIV epidemic.
The meeting agenda and presentation slides are available for download below. Visit the CHIPTS Facebook page for a mini gallery capturing some of the day’s highlights.
This report originally appeared on hiv.gov. To view the full report, click here.
On Friday, 1/24/20, the CDC published a major funding opportunity designed to advance Ending the HIV Epidemic: A Plan for America. The plan was announced by President Trump during the State of the Union last year; and Congress recently approved funding for the initiative, which is being coordinated by the Office of the Assistant Secretary for Health. The resources will be infused into communities most impacted by HIV and provide a major boost to the bold initiative to reduce new HIV infections by 90% by 2030.
This funding opportunity can help end this epidemic by infusing communities with the resources, technology, and expertise needed to strengthen HIV prevention and treatment. To achieve maximum impact, the funding targets geographic areas that account for more than half of new HIV diagnoses, and states with a substantial rural burden. In recent months, each of these jurisdictions has developed a comprehensive Ending the HIV Epidemic plan, informed by consultations with diverse stakeholders and community-level input.
The new funding opportunity includes three components:
Component A (up to 32 awards) will help state, local, and territorial health departments scale up four strategies that can end the epidemic: diagnosing all people with HIV as early as possible; treating people with HIV rapidly and effectively to reach sustained viral suppression; preventing new HIV transmissions with proven interventions, including PrEP and syringe services programs; and responding quickly to potential outbreaks to get needed prevention and treatment services to people who need them.
Component B (up to 8 awards) will fund health departments to use routinely collected HIV surveillance data to calculate CD4-based HIV incidence estimates. These estimates will help communities plan, implement, and evaluate prevention and treatment programs.
Component C (up to 8 awards) will allow health departments to scale up innovative HIV prevention services in STD clinics.
Details about the funding opportunity are available on CDC’s website. Applications are due on March 25, 2020 and the anticipated award will begin on June 1, 2020.
For more information about CDC’s role in Ending the HIV Epidemic, visit www.cdc.gov/endhiv.
You can also learn more about Ready, Set, PrEP, the new nationwide program that provides PrEP medications at no cost to thousands of individuals who qualify.
The preliminary report for this project is now available! Learn more and access the report on our website here.
January 24th, 2020- 150 community stakeholders, leaders, and county representatives attended the CHIPTS regional response meeting to end the HIV epidemic in CA on Friday, January 24th, 2020 from 8AM-4:30PM at the LA Music Center’s Dorothy Chandler Pavilion.
The meeting aimed to:
Gather ideas, feedback, and consensus from counties on collaborative opportunities to support Ending the HIV Epidemic Initiative’s (EHE) efforts
Identify resources, capacity building, and infrastructure needs to support these collaborations
Identify research and policy questions to support counties in the implementation of best practices and strategies to reach the EHE goals
Steve Shoptaw, Director of CHIPTS, began the morning with an overview of the day’s mission, highlighting examples of regional issues capable of being supported by the four EHE pillars and mentioning potential opportunities for regional/structural connections. The morning session then proceeded with two panel discussions orchestrated around presentations from federal and state government officials, alongside leaders from 8 targeted EHE counties. Federal and state perspectives were given by Harold Phillips from Health and Human Services (HHS), Christopher Gordon from the National Institute of Mental Health, Paul Weidle from the Center for Disease Control and Prevention (CDC), Captain John Moroney from Health Resources and Services (HRSA), Michelle Sandoval-Rosario from PACE, Benjamin Ayers from the US Department of Housing and Urban Development (HUD), and Andrew Forsyth from the California HIV/AIDS Research Program. In aiming to identify gaps and build bridges for regional coordination, Kevin Sitter of the State Office of AIDS moderated the panel discussion with county representatives Mario Perez from LA County Division of HIV and STD programs (DHSP),
Cynthia Turk from San Bernardino County Department of Health, Natalie Silva from Orange County Health Care Agency, Lea Morgan from Riverside University Health System, Patrick Loose from San Diego County HIV, STD, and Hepatitis Branch of Public Health Services, and Hanna Hjord from San Francisco County Department of Public Health, who presented alongside Bill Blum.
The afternoon session proceeded onwards with four panel discussions underscoring successes and potential new opportunities for regional responses to eliminate HIV transmission. Accomplishments from counties with existing collaborations were shared by Erica Washington from AIDS Healthcare Foundation, Jadawn Wright from the Pacific AIDS Education and Training Center (PAETC), and Aunsha Hall-Everett from the California Prevention Training Center. The following three panels focused on strategies specific towards each of the four EHE pillars: Diagnose, Treat, Prevent, and Respond.
Tom Donohoe of the LA AIDS Education and Training Center (LAAETC) moderated the panel for the Diagnose and Treat Pillars, with presentations for methods to increase screening, early treatment, and sustained viral suppression given by Erica Washington, Sonali Kulkarni from LA County DHSP, and Weyman Edwards and Dennis Tankersley from San Bernardino County Arrowhead Regional Medical Center. Pamina Gorbach of UCLA CHIPTS moderated the panel for the Respond Pillar, which included Philip Peters from the State Office of AIDS, Ryan Murphy from the STD Control Branch, Andrea Kim from LA County DHSP, and Patrick Loose who shared insight on enhancing data system coordination to more rapidly respond to outbreaks and better inform service planning. Lastly, Steve Shoptaw facilitated the panel for the Prevent Pillar. Panelists Gabriel Maldonado from TruEvolution, Luckie Alexander from Invisible Men, Lello Tesema from Substance Abuse Prevention and Control, and Mark Casanova from Homeless Health Care Los Angeles gave specific focus to understanding tools that may help increase PrEP, syringe service programs, and other proven interventions.
Each of the panel sessions was composed of inclusive representation at different levels, sectors, and counties, all in all emphasizing the importance of having community engagement and involvement. Questions, concerns, and suggestions were also voiced by attendees throughout the day, with written feedback accounted for each of the EHE Pillars (Diagnose, Treat, Respond, and Prevent).
Participant feedback showed a strong enthusiasm for the opportunity to learn from and network with the diverse group of HIV stakeholders at this meeting, and a strong desire to stay connected. In their comments, participants most commonly identified the need for an infrastructure to continue to support cross-jurisdictional collaboration, communication, and/or data sharing.
Expected outcomes of this meeting will include the following:
Summary report that will be shared with attendees
Follow-up with counties to support development of ideas, to facilitate connections, and to identify resources to build and sustain regional response to HIV
CHIPTS to work to sustain initial efforts and continue regional response (e.g. find funding, establish or build on regional working groups).
The meeting agenda and presentation slides are available for download below. Videos of each presentation are available on our YouTube channel, and linked at the bottom of this page. Visit the CHIPTS Facebook page for a mini gallery of the event.
January 16th, 2020- Fellows from the National Clinician Scholars Program, VAHSRD, UCLA led a social media workshop for professionals within various healthcare settings on Thursday, January 16th from 12pm-1pm at the MacDonald Research Laboratories (MRL) Room 1-441. Kimon L.H. Ioannides, MD, Jake Quinton, MD, and Hafifa Siddiq, PhD RN were among the fellows present to facilitate the workshop, which was open to all members of the healthcare community, providers and researchers alike. It aimed to share strategies for medical providers utilizing social media to engage with their patient population and medical researchers using social media as a recruitment and retention function. Additional tips were also explored on other related ideas for social media branding, use of communication conventions to engage in debate and gain influence, and being able to avoid major ethical issues with social media use in the healthcare field.
The workshop’s flyer and presentation slides are available for download below.
Key updates to the guidelines include the following:
The Panel has updated the recommendations on the use of dolutegravir (DTG) in pregnant women and women who are trying to conceive based on data available as of August 2019. Restrictions on the use of DTG during the first trimester and in women who are trying to conceive have been removed. DTG is now a Preferred antiretroviral (ARV) drug throughout pregnancy and an Alternative ARV drug for women who are trying to conceive.
In a number of sections, the Panel emphasizes the importance of patient counseling and recommends supporting informed decision-making regarding the use of DTG and other ARV drugs for women who are pregnant or who are trying to conceive. A counseling guide has been added to summarize the content that should be discussed with patients; this new section is titled Appendix D: Dolutegravir Counseling Guide for Health Care Providers.
In Recommendations for Use of Antiretroviral Drugs During Pregnancy, the Panel has updated the definitions for the Preferred and Alternative categories of ARV drugs recommended for use in pregnancy and in women who are trying to conceive. In addition, the Panel recommends that all pregnant women and women who might conceive should take at least 400 mcg of folic acid daily.
A new section was added to Teratogenicity with data about the association between integrase strand transfer inhibitors (INSTIs) and birth defects. This section was also updated to include recent data about an increased rate of microcephaly in HIV-exposed but uninfected children with in utero efavirenz exposure.
Combination Antiretroviral Drug Regimens and Maternal and Neonatal Outcomes was revised and reorganized to focus on data regarding preterm birth, fetal growth restriction, miscarriage, and stillbirth that has been published since 2015. This section also discusses data about hypertensive disorders of pregnancy and maternal HIV.
Lack of Viral Suppression now states that, after reviewing a woman’s full treatment history and drug resistance test results, a clinician may consider using an INSTI as part of a new regimen for a pregnant woman who is experiencing virologic failure on an ARV regimen that does not contain an INSTI.
Older ARV drugs that the Panel does not recommend for use in pregnant women or women who are trying to conceive because of unacceptable toxicities, inferior virologic efficacy, high pill burden, pharmacologic concerns, and/or limited data about use in pregnancy have been moved to a new section in Appendix B titled Archived Drugs; data about these drugs will no longer be reviewed by the Panel.
For a complete list of updates, please see What’s New in the Guidelines. Additions and revisions are highlighted in yellow throughout the PDF version of the guidelines.
To view or download the guidelines, go to the Perinatal Guidelines section of AIDSinfo’s website. The guideline tables and recommendations can also be downloaded as separate PDF files.
Key updates in this version of the guidelines include:
Antiretroviral Therapy to Prevent Sexual Transmission of HIV: Clinical trials have shown that using effective antiretroviral therapy (ART) to consistently suppress plasma HIV RNA levels to <200 copies/mL prevents transmission of HIV to sexual partners. When ART is used to prevent HIV transmission, this strategy is called treatment as prevention (TasP). The Panel has added a new section to the guidelines to help providers integrate TasP into their clinical practice.
The latest data on neural tube defects (NTDs) in infants born to women who received dolutegravir (DTG) around the time of conception have shown that the prevalence of NTDs is lower in these infants than initially reported. Based on the new data, the Panel has revised some recommendations related to the use of DTG in individuals who are of childbearing potential and who are trying to conceive, those who are sexually active and not using contraception, and those who are using effective contraception.
What to Start: The Panel has added DTG plus lamivudine to the list of Recommended Initial Regimens for Most People with HIV, except for individuals who have pre-treatment HIV RNA >500,000 copies/mL, who are known to have active hepatitis B virus (HBV) coinfection, or who will initiate ART before results of HIV genotype testing for reverse transcriptase or HBV testing are available.
Cost Considerations and Antiretroviral Therapy: A new sub-section on cost sharing that describes how varying cost-containment practices may impact the out-of-pocket payments for patients with Medicaid, Medicare, and Ryan White (AIDS Drug Assistance Program) coverage has been added. To help clinicians better understand the different ART-related pricing systems in the United States, a new table titled Table 19a. Insurance and Health Program Prescription Drug Pricing and Access was created.
Acute and Recent (Early) HIV Infection: Bictegravir/tenofovir alafenamide/emtricitabine has been added as a treatment option for persons with acute or recent HIV infection in cases where ART will be initiated before genotypic drug resistance testing results are available.
Initiation of Antiretroviral Therapy: The Panel recommends that ART be started immediately or as soon as possible after diagnosis to increase the uptake of ART, decrease the time required to achieve linkage to care and virologic suppression for individual patients, reduce the risk of HIV transmission, and improve the rate of virologic suppression among persons with HIV.
Laboratory Testing for Initial Assessment and Monitoring of People with HIV Receiving Antiretroviral Therapy: The Panel previously recommended monitoring fasting lipid profile and fasting glucose before and after initiating ART. This section now includes a new recommendation that allows for random (nonfasting) tests.
Tuberculosis/HIV Coinfection: This section now includes newly published data on short-course regimens in the treatment of latent tuberculosis infection and new drug-drug interaction data for antiretroviral drugs and rifampin and rifapentine.
For a complete list of guideline updates, please see What’s New in the Guidelines. Additions and revisions are also highlighted in yellow throughout the PDF version of the guidelines.
To view or download the guidelines, go to the Adult and Adolescent Antiretroviral Guidelines section of AIDSinfo’s website. The guideline tables and the boxed recommendations can also be downloaded as separate PDF files.
This article originally appeared on nih.gov. To view the full article, click here.
Efforts to prevent new HIV transmissions in the United States must be accompanied by advances in addressing HIV-associated comorbidities to improve the health of people already living with HIV, National Institutes of Health experts assert in the third of a series of JAMA commentaries. Previous commentaries detailed the proposed Ending the HIV Epidemic: A Plan for America, which aims to reduce new HIV transmissions in the United States by 75% in five years and 90% in 10 years, and discussed the challenges posed by the emerging opioid injection epidemic in rural areas.
Assuming the aspirational goals of Ending the HIV Epidemic are achieved, at least one million people in the United States still will be living with the virus. With effective antiretroviral therapy (ART), people with HIV can expect a near-normal lifespan.
Heather J. Gunn, PhD
Postdoctoral Scholar at UCLA
Global Center for Children and Families
Tuesday, December 10, 2pm-3pm
There are outcomes of interest, like math ability or anxiety, which cannot be directly measured. One way to indirectly measure these outcomes is to measure a set of variables that are related to the construct of interest (e.g., item responses). For instance, we often measure depression by administering the Patient Health Questionnaire, a set of 9 questions that measures the presence and severity of depression. Theoretically, we believe there is an underlying construct, called a latent variable, which directly influences the observed variables. If group comparisons on the latent variable are of interest, such as comparing males and females on depression, then the relationship between the latent variable and the probability of obtaining a particular score on the observed variables needs to be equal across groups. A measure is invariant if the groups have the same probability. If the groups do not have the same probability of obtaining a particular score on the observed variables, then the measure is non-invariant and the meaning and metric of the latent variable differs by group, making valid group comparisons impossible.
This presentation gave a brief overview of factor analysis and how measurement invariance is tested in the factor analytic framework.
The CHIPTS’ Methods Core hosts a monthly seminar series, which are one-hour workshops on research and statistical methods. The seminars are open to HIV researchers, faculty, students, and community. To see previous seminars, check out the Methods Seminar tag or you can find seminar videos on our Youtube Channel! This series is hosted by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and made possible by funds from the National Institute of Mental Health (MH058107).
December 9th, 2019- CHIPTS invited Dr. Goodman Sibeko, Head of Addiction Psychiatry at the University of Cape Town, to guest lecture at UCLA on Monday, December 9th in the MacDonald Research Laboratories, MRL 1-441. Dr. Sibeko’s work has focused on interventions using non-specialist workers in the management of severe mental illness, and he has a developing research portfolio focused on task sharing models for the treatment of harmful substance use, mental health and HIV.
His seminar outlined the following major themes:
The focus on behavioral health and HIV
Non-specialists workers and how training capacitates them
Factors and results of capacitating non-specialists workers
Dr. Sibeko provided insightful treatment recommendation techniques, perspective on task shifting/sharing, and study findings for behavioral intervention practices. Stories were also presented from workers and providers who received trainings from the South Africa HIV ATTC, all of which emphasized its impact on the clinical care given to their patients.
The seminar flyer and presentation slides are available for download below. A video of Dr. Sibeko’s presentation is available on our YouTube channel, and linked at the bottom of this page.
Cunningham, Brandon Harrison and Evelyn Everheart was facilitated by 
an the morning with an overview of the day’s mission, highlighting examples of regional issues capable of being supported by the four EHE pillars and mentioning potential opportunities for regional/structural connections. The morning session then proceeded with two panel discussions orchestrated around presentations from federal and state government officials, alongside leaders from 8 targeted EHE counties. Federal and state perspectives were given by 
written feedback accounted for each of the EHE Pillars (Diagnose, Treat, Respond, and Prevent).
Research Laboratories, MRL 1-441. Dr. Sibeko’s work has focused on interventions using non-specialist workers in the management of severe mental illness, and he has a developing research portfolio focused on task sharing models for the treatment of harmful substance use, mental health and HIV.