NIH HIV Research Helps Advance National HIV/AIDS Strategy

This content originally appeared on NIH OAR. View the full article here.

World AIDS Day provides an annual opportunity to unite global efforts to end the HIV pandemic, show support for people with HIV, and remember those we have lost to the pandemic. This year, the White House Office of National AIDS Policy (ONAP) marked the World AIDS Day observance with the release of the National HIV/AIDS Strategy 2023 Interim Action Report.

The report details progress toward meeting the goals of the current National HIV/AIDS Strategy for the United States 2022-2025 (NHAS), which was released by President Biden on World AIDS Day in 2021 and provides a roadmap for the nation to accelerate efforts to end the HIV epidemic in the United States. The new NHAS 2023 Interim Action Report outlines key activities undertaken by federal agencies and highlights the critical role of ongoing research as part of the strategy to end the HIV epidemic in the United States by 2030.

The report emphasizes the incredible amount of work that is taking place across the federal government to address HIV, but also details how much lies ahead. Indeed, transformational research advances in HIV prevention and treatment have marked some of the most significant accomplishments in science and public health. But this progress is not reaching all communities equally. Staggering health disparities place a disproportionate impact of HIV on minoritized racial and ethnic groups and diverse sexual and gender populations. As the report outlines, future HIV research must address these issues to ensure all communities have equitable access to effective, evidence-based HIV testing, prevention, treatment, and care services.

Below are highlights from the report that underscore how the NIH HIV research program contributes to the national strategy to end the HIV epidemic. I look forward to building on these successes to ensure no community is left behind.

  • Ongoing NIH-funded research continues to lead to results that are improving the lives of people with HIV. Earlier this year, results from the NIH-supported REPRIEVE trial showed that statins can reduce major cardiovascular events by more than one-third in people with HIV. Statin use was associated with a 20 percent reduction of major adverse cardiovascular events and premature deaths. As a result, the findings are expected to directly influence clinical guidelines and standards of care for an aging population of people with HIV and add to the growing literature that demonstrates that people with HIV experience higher cardiovascular risk than the general population.
  • The NIH Office of AIDS Research (OAR) HIV and Aging Signature Program, launched in 2022, catalyzes interdisciplinary research and training to meet the increasing health needs of people aging with HIV. In fiscal year (FY) 2022, NIH provided support for nearly 340 research projects related to HIV and aging. In addition, a virtual NIH workshop in September 2023 and a follow-up panel discussion at the 2023 U.S. Conference on HIV/AIDS surveyed the landscape of current research at the intersection of HIV and aging and explored how federal agencies, researchers, health providers, the HIV community, and advocates can work together to prioritize research to improve the lives of people aging with HIV.
  • In FY22, NIH supported 69 early stage investigators studying HIV, an 8 percent increase over FY21. The OAR Early Career Investigator Signature Program aims to improve outreach to the next generation of HIV investigators and increase training and capacity-building programs. The OAR Workshop for Early Career Investigators in HIV, held in April 2023, drew more than 500 attendees to facilitate networking and share information about the NIH HIV research funding process.
  • NIH supports research to address stigma and discrimination that exacerbates HIV-related disparities and inequities. The NIH Stigma and Discrimination Research toolkit provides resources for researchers, partner federal agencies, community groups, and other partners to help integrate stigma research into policy and programs. In addition, NIH established a Stigma Working Group, with representation from across the U.S. Department of Health and Human Services, focused on stigma and discrimination research with particular attention on HIV-related intersectional stigma.
  • NIH supports syndemics research to investigate interactions between epidemics and the social and structural determinants of health. This research seeks to understand the complex interactions between behavioral, economic, and environmental factors that influence the HIV epidemic. In FY22, NIH sponsored a supplement in the American Journal of Public Health on the importance of addressing intersectional HIV-related stigma and discrimination.
  • NIH works with other federal agencies, including the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA), in the Interagency Federal Implementation Science Workgroup to coordinate research and program activities, determine priorities for NIH-funded research related to the Ending the HIV Epidemic in the U.S. (EHE) initiative, and collaborate to address critical gaps in order to meet evolving and urgent needs in communities. Several agencies participated in an NIH-hosted national EHE meeting in September 2022 to share best practices and research findings.
  • Implementation research is critical to prevent new HIV infections and improve health outcomes among people with HIV. NIH supports implementation research projects to develop strategies that translate evidence-based interventions into real-world settings to maximize HIV testing and linkage to care, initiate treatment as early as possible, and improve treatment adherence and retention. In FY22, NIH supported more than 370 implementation research projects totaling $160 million in funding, a 26 percent increase in funding over FY21.

As I reflect on the tremendous progress in HIV research, I have hope that, with continued commitment and partnerships among the federal government, researchers, and community, we will reach the finish line to achieve the domestic goals established in our national strategy to help end the global HIV pandemic.

Watch the on-demand NIH VideoCast of the NIH World AIDS Day 35 Event: Achieving Excellence and Equity in HIV Research to learn more about how the NIH HIV research program is addressing HIV-related inequities. To learn more about recent advances in HIV research, read the NIH World AIDS Day

AHEAD Dashboard: Redesigned and Improved

This content originally appeared on HIV.Gov. View the full article here.

HIV.gov is pleased to announce the redesigned and improved America’s HIV Epidemic Analysis Dashboard (AHEAD), driven by a commitment to enhancing user experience and data availability for diverse members of our HIV community.

The AHEAD dashboard is one tool which supports and/or tracks progress of the Ending the HIV Epidemic in the U.S. (EHE) initiative. The Dashboard helps track the six EHE indicators in the 57 prioritized EHE jurisdictions, as well as for all states. The Dashboard also presents data on seven social determinants of health indicators for the same jurisdictions, providing additional context.

“User feedback has been invaluable, inspiring us to introduce AHEAD features designed to streamline workflow with our enhancements such as customization for demographic stratifications, dynamically available data sources beneath charts, geographic displays of indicator data, and many more!” – Catarina Kim, MPHTM, AHEAD Coordinator/Epidemiologist, Office of Infectious Disease and HIV/AIDS Policy, HHS

We encourage individuals and organizations in all the jurisdictions to use AHEAD to visualize HIV data for policy and program development, create customized charts for their EHE data support needs, and learn more about their community.

AHEAD was developed and is managed by the HIV.gov team at the HHS Office of Infectious Disease and HIV/AIDS Policy with support from the Minority HIV/AIDS Fund and in collaboration with CDC’s Division of HIV Prevention.

Please continue to provide us feedback or meet with our team by emailing us here.

What is EHE?

The EHE initiative, a leading component of the work by HHS to implement the National HIV/AIDS Strategy, aims to reduce new HIV infections in the United States by 90% by 2030. Focusing additional resources in 57 jurisdictions where they are needed most, the EHE initiative has scaled up four science-based strategies focusing on ending the epidemic: diagnose, treat, prevent, and respond.

Click here to learn more about EHE.

Other Resources

There are many different HIV dashboards and resources available, we encourage users to also check out these tools:

  • CDC’s NCHHSTP AtlasPlus. This interactive tool creates customized tables, maps, and charts using CDC’s surveillance data on HIV, viral hepatitis, sexually transmitted diseases, and tuberculosis.

Ahead of World AIDS Day UNAIDS is calling for urgent support to Let Communities Lead in the fight to end AIDS

This content originally appeared on UNAIDS. View the full article here.

A new report by UNAIDS demonstrates the critical role communities play, and how underfunding and harmful barriers are holding back their lifesaving work and obstructing the end of AIDS.

LONDON/GENEVA, 28 November 2023—As World AIDS Day (1 December) approaches, UNAIDS is urging governments across the world to unleash the power of grassroots communities across the world to lead the fight to end AIDS. A new report launched today by UNAIDS, Let Communities Lead, shows that AIDS can be ended as a public health threat by 2030, but only if communities on the frontlines get the full support they need from governments and donors.

“Communities across the world have shown that they are ready, willing and able to lead the way. But they need the barriers obstructing their work to be pulled down, and they need to be properly resourced,” said Winnie Byanyima, Executive Director of UNAIDS. “Too often, communities are treated by decision-makers as problems to be managed, instead of being recognised and supported as leaders. Communities are not in the way, they light the way to the end of AIDS.”

 

The report, launched in London during a World AIDS Day event organized by the civil society organization STOPAIDS, shows how communities have been the driving force for progress.

Community advocacy from the streets to the courtrooms to parliaments has secured groundbreaking changes in policy. Communities’ campaigning helped open up access to generic HIV medicines, leading to sharp, sustained reductions in the cost of treatment from US$ 25 000 per person per year in 1995 to less than US$ 70 in many countries most affected by HIV today.

Let Communities Lead shows that investing in community-led HIV programmes delivers transformational benefits. It sets out how programmes delivered by community-based organizations in Nigeria were associated with a 64% increase in access to HIV treatment, a doubling of the likelihood of HIV prevention service utilization, and a four-fold increase in consistent condom use among people at risk of HIV. It also notes how, among sex workers reached by a package of peer-based services in the United Republic of Tanzania, the HIV incidence rate was reduced to below half (5% vs 10.4%).

“We are the vehicle for change that can end systematic injustices that continue to fuel HIV transmission. We have seen groundbreaking developments with U=U, improved access to medicines, and have made great strides in decriminalization,” said Robbie Lawlor, Co-Founder of Access to Medicines Ireland. “Yet, we are expected to move mountains without being financially supported. We are supposed to fight for a more equitable world and are tasked with dismantling stigma yet are side-lined in crucial discussions. We are at a tipping point. Communities can no longer be relegated to the periphery. The time for leadership is now.”

The report highlights how communities are at the forefront of innovation. In Windhoek, Namibia, a self-funded project by the youth Empowerment Group is using e-bikes to deliver HIV medicines, food and adherence support to young people who often cannot attend clinics due to their schooling hours. In China, community organizations developed smartphone apps that link people to self-testing which contributed to a more than four-fold increase in HIV tests across the country from 2009 to 2020.

The report reveals how communities are also holding service providers to account. In South Africa five community networks of people living with HIV inspected 400 sites across 29 districts and conducted more than 33 000 interviews with people living with HIV. In the Free State province, these findings led provincial health officials to implement new appointment protocols to reduce clinic wait times and three- and six-month dispensing of antiretroviral medicines.

“I am extremely concerned about the exclusion from health services of key populations like the LGBT+ community,” said Andrew Mitchell, Minister of State for Development and Africa. “The UK champions the rights of such communities, and we will continue to protect them, working closely with our partners in civil society. I thank UNAIDS for keeping us focused on the inequities driving the pandemic and I look forward to working with our partners to champion the voice of people living with HIV and end AIDS as a public health threat by 2030.”

Despite the clear evidence of community-led impact, community-led responses are unrecognized, under-resourced and in some places even under attack. Crackdowns on civil society and on the human rights of marginalized communities are obstructing communities from providing HIV prevention and treatment services. Underfunding of community-led initiatives is leaving them struggling to continue operating and holding them back from expansion. If these obstacles are removed, community-led organizations can add even greater impetus to end AIDS.

In the 2021 Political Declaration on ending AIDS, United Nations member states recognized the critical role communities play in HIV service delivery, particularly to people most at risk of HIV. However, whereas in 2012, when over 31% of HIV funding was channeled through civil society organizations, ten years later, in 2021, only 20% of funding for HIV was available—an unprecedented backsliding in commitments which has cost and is continuing to cost lives.

“At this time, community-led action is the most important countermeasure in the AIDS response,” said Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition. “Yet, shockingly, it isn’t a cornerstone of global plans, agendas, strategies, or financing mechanisms for improving pandemic preparedness and health for all. It is time to change that.”

Every minute, a life is lost to AIDS. Every week, 4000 girls and young women become infected with HIV, and out of the 39 million people living with HIV, 9.2 million do not have access to lifesaving treatment. There is a Path that Ends AIDS and AIDS can be ended by 2030, but only if communities lead.

UNAIDS is calling for: Communities’ leadership roles to be made core in all HIV plans and programmes; Communities’ leadership roles to be fully and reliably funded; And for barriers to communities’ leadership roles to be removed.

The report features nine guest essays from community leaders, in which they share their experience on the achievements they have secured, the barriers they face, and what the world needs to end AIDS as a public health threat.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on FacebookTwitterInstagram and YouTube.

Meet Gregory Victorianne, who has dedicated decades to HIV prevention and research in Los Angeles

This content originally appeared on UCLA Health News and Insight. View the full article here.

Gregory Victorianne remembers a certain day when he was sitting down with one of his best friends on the porch drinking margaritas.

“That’s when he told me; he had AIDS,” Victorianne says. “It caught me off guard. My glass dropped.”

That friend died two weeks later, and the church he attended would not even hold his funeral service despite the fact that he had volunteered there for several years, Victorianne says.

“That changed everything for me. That was my launching pad.”

Nearly four decades later, Victorianne sits in his office at UCLA’s David Geffen School of Medicine speaking about that moment. It shaped his transformation into the man he is today: a sexual health activist, community organizer, researcher, educator, and a vocal advocate for HIV prevention.

He focuses on the use of multi-level (social, structural, biomedical and clinical) interventions to reduce the acquisition and transmission of HIV among Black and Brown men having sex with men and women, who are disproportionately burdened by the epidemic.

He has successfully built relationships with Los Angeles communities – in particular Black same-gender-loving men — a population to which he belongs. He has led HIV prevention efforts in Boston and helped support research in Chicago as well as here in Los Angeles.

And for the last five years, he has served as the Recruitment and Retention Coordinator for the Mobile Enhancement Prevention Support (MEPS) Study, a community-based research study. The MEPS project has been testing a new way to help people without HIV to stay negative, avoid other infections and receive the services they need after being released from jail, prison or detention.

An agent of positivity

The MEPS study is a collaboration between UCLA, the Los Angeles Centers for Alcohol and Drug Abuse, Charles R. Drew University of Medicine and Science, and other Los Angeles-based treatment facilities and recovery bridge houses, headed by Nina T. Harawa, PhD.

A professor with the David Geffen School of Medicine, Dr. Harawa directs the HIV research core for the Center for HIV Identification, Prevention, and Treatment Services and the CTSI TL1 pre-/post-doctoral fellowship program. She is also the associate director for HIV Research at Charles R. Drew University of Medicine and Science.

Victorianne works on the recruitment and retention of community members for the MEPS study, which focuses on gay, bisexual men as well as transgender women who have been incarcerated. Black and Latino people are overrepresented within this vulnerable, stigmatized population, Dr. Harawa says. Victorianne’s vast experience and personality have been invaluable.

“He is outgoing and conveys positivity,” Dr. Harawa says. “When he talked with participants, he would affirm the good things in their lives. And they get the sense that this is someone they are going to interact with, who is going to speak a positive word. This is good for populations that are stigmatized and don’t have those positive interactions very often.”

Early on, the retention levels for the study were very low, but Victorianne was instrumental in changing that, she says.

This project posed a unique set of challenges Victorianne says he found daunting even with his experience and deep knowledge of the community, particularly the people being released from jail. Sometimes, it was as if he was working with an invisible group of people, he says.

“Some often go in and out of jail,” he says. “When they get out, their phone numbers change. They may not have alternate contacts because they may have burned bridges with families and friends. They don’t have email. They’re not on social media. Some of them have mental illnesses and substance abuse issues.”

Initially, the goal was to recruit directly from Men’s Central Jail, but the COVID-19 pandemic prevented the team from doing so. They had to pivot and recruit from recovery bridge and treatment facilities. It was hard, draining, work, sometimes frustrating and often sad.

“When they get lost, it’s a challenge,” Victorianne says. “What also hurts a lot is when they cross over. We lost three individuals to drug overdoses. You look at what you could’ve done. What could I have done better? And you have to take heart in the fact that you followed protocols and you did your best.”

The rewards have given him hope as well. Through the MEPS study, Victorianne says, many participants have been able to maintain a healthy lifestyle after their release.

“We’ve seen people get employed, go back to school, reestablish relationships with their families and loved ones,” he said. “They would tell me they got an ID card, a key step in them being able to access healthcare and social services.”

But what gave him great joy, Victorianne says, was to hear participants say they went to the doctor, got PrEP (pre-exposure prophylaxis) to prevent HIV, or got tested for sexually transmitted infections.

“To me, when they say they are taking care of themselves and getting health care – that is success,” he says.

Representation always matters

Representation absolutely matters when it comes to HIV research, prevention and community engagement efforts, Victorianne believes. In fact, he first took note of the gap because of his experience participating in a clinical trial in Boston.

“I was dressed down and showed up in a hoodie,” he says. “I had a bad experience with how I was treated.”

Victorianne pivoted into this area of work after quitting his job at a law firm.

“One of my mentors encouraged me to speak for those who can’t,” he says. “I thought about all the friends I had lost to AIDS. This was my calling.”

In 1992, Victorianne and a friend, Joseph Benson, self-published a notorious guerilla ‘zine called Buti Voxx, featuring Black, same-gender-loving erotica. He admits it was “in-your-face, raw sex stuff,” but says it also included sex education and important HIV/STI prevention information for readers.

The ‘zine helped platform the voices of Black writers who were struggling to get published elsewhere, he says. The publication’s illustrations served as HIV prevention messages as well.

“It was truly liberating work. It is important for everyone to understand that sex and sexual health are pieces that go together. They overlap.”

When it comes to recruiting participants from the community, Victorianne tries to infuse every foray with sensitivity, but also his trademark candor.

“When I’m with study participants, I try to engage them in the real sense,” he says. “I tell them I’m HIV-negative, that I’m on PrEP. I make that human connection so they can relate. I tell them, ‘Man, I was where you are right now.’ If they have questions or skepticism about the research, we talk about it.”

Victorianne says he tells participants that they are “not just a statistic, but a person we want to help.” He explains to them that the study was designed by Dr. Harawa, an African American woman.

“I let the people know who designed the study so they know they are people like us,” he says. “That is so important.”

Future of HIV research and prevention

Victorianne believes researchers must not only partner with grassroots organizations to help them connect to hard-to-reach communities, but also treat those community members with respect and dignity, and compensate them fairly for their time and efforts.

It is also important to make sure study participants have a good experience at the clinic, he says.

“This is a population that has been kicked to the curb. If we want to retain them, we need to treat them well. When they get to the clinic, give them water or juice. If you’re going to be late, let them know because most of them take public transit. And make sure they get paid because that $25 or $30 they get that day might be the only money they see that day, that week or that month.”

While he is happy to see HIV infection rates declining, Victorianne would also like to see more research and prevention work done within communities of color and by researchers of color.

“We should not have one culture dominating this field,” he says. “People focused on research and prevention need to come together. It shouldn’t matter if someone has a PhD or not.”

For Victorianne, it has been a long, rewarding, sometimes painful journey. On those tough days, he makes a trip to an Inglewood cemetery where many of his friends who died from AIDS lay at rest.

There are some days, Victorianne says, when you just need to be with your sisters and brothers.

NIH grants support UCLA and Charles Drew University researchers’ efforts to end HIV epidemic

This content originally appeared on UCLA Health. View the full article here.

The National Institutes of Health (NIH) has granted $2.1 million to UCLA’s Center for HIV Identification, Prevention, and Treatment Services (CHIPTS) and the UCLA-CDU Center for AIDS Research (CFAR) to support four research projects and an implementation science consultation hub. These awards will fund projects to strengthen research-community collaborations and enhance implementation strategies needed for the Ending the HIV Epidemic in the U.S. (EHE) initiative.

“These awards will support our scientists and community partners to address the systemic factors impacting our most vulnerable populations and explore innovative implementation strategies to help end the HIV epidemic,” said Steve Shoptaw, CHIPTS director and professor of family medicine at the David Geffen School of Medicine at UCLA. “We also look forward to continuing to support the research priorities of the EHE initiative through our Implementation Science Hub.”

Funded projects include:

Advancing HIV Implementation Research (Implementation Science Consultation Hub)

Implementation science plays an important role in the advancement of HIV research. The field recognizes that healthcare systems, public health agencies and communities often struggle to provide high quality services with limited resources. Alison Hamilton, professor-in-residence of psychiatry and biobehavioral sciences at UCLA’s Semel Institute for Neuroscience and Human Behavior and chief officer of implementation and policy at the VA Center for the Study of Healthcare Innovation, Implementation & Policy at Greater Los Angeles Healthcare System, will lead the UCLA Rapid, Rigorous, Relevant Implementation Science Hub, which will offer tailored coaching, training, and technical assistance to NIH-supported implementation research projects across the U.S. in efforts to end the HIV epidemic .

Addressing HIV Risk Among Vulnerable Youth

Dallas Swendeman, associate professor in the Division of Health Promotion and Behavioral Science in the School of Public Health at San Diego State University and a licensed clinical psychologist, will lead a project that explores strategies to support the implementation of an intervention to reduce HIV risk among sexual and gender minority and racial/ethnic minority youth aged 12 to 24. These groups face disproportionate risk of acquiring HIV due to various factors, including low uptake of pre-exposure prophylaxis (PrEP), yet effective and scalable interventions for youth remain limited. This study will accelerate implementation of the Adolescent HIV Medicine Trials Network (ATN) Protocol 149 Optimizing the HIV Prevention Continuum for Youth. The researchers will collaborate with community partners to explore implementation strategies for this intervention and prepare for application in real-world settings.

Enhancing HIV Prevention for Transgender and Nonbinary Individuals

Erik Storholm, professor of psychiatry and biobehavioral sciences at the Semel Institute, will lead a project to address low PrEP uptake and persistence among transgender and nonbinary individuals (TGNB) at-risk of HIV in Los Angeles County. Multiple syndemic barriers have been found to contribute to low PrEP uptake and persistence among TGNB individuals, such as intimate partner violence (IPV) and mental health burdens. This project will assess implementation outcomes and preliminary effects of integrating IPV prevention and mental health services into an ongoing gender-affirming PrEP program at a Los Angeles-based trans community center.

Reducing Barriers to HIV Prevention and Treatment among Black Americans

Black Americans are disproportionately affected by HIV, particularly young Black sexual minority men. Laura Bogart, professor-in-residence of psychiatry and biobehavioral sciences at the Semel Institute and chief officer of implementation and policy at the VA Center for the Study of Healthcare Innovation, Implementation & Policy at Greater Los Angeles Healthcare System will lead a study to enhance the implementation strategies and create a sero-status neutral version of the Rise intervention, a culturally tailored program to address adherence and retention barriers among Black individuals with HIV. Rise intervention, built on a 17-year community-academic partnership, will be expanded and tailored to address PrEP and antiretroviral therapy (ART) uptake and adherence among Black Americans in Los Angeles County  and in Jefferson County, Alabama.

Improving PrEP Access for Black, Latino Sexual Minority Men and People who Inject Drugs

Dr. Gabriel Edwards, associate project scientist at the Geffen School, aims to bridge disparities in PrEP uptake among Black and Latino sexual minority men and people who inject drugs. The study will partner with the Los Angeles Centers for Alcohol and Drug Abuse (L.A. CADA) to provide community outreach to expand HIV testing and linkage with PrEP navigators to help facilitate PrEP medication access. The study will identify factors affecting successful linkages to PrEP in order to develop recommendations for improvement.

“Taken together, these awards reflect UCLA’s and CDU’s commitment to ending the HIV epidemic through innovative and community-focused approaches by focusing on populations most impacted by HIV and addressing the systemic barriers that put these populations at risk,” said LaShonda Spencer, director of Drew CARES and professor of pediatrics and internal medicine at Charles R. Drew University of Medicine and Science.

Spotlight on CHIPTS Global HIV Lectures

Spotlight on CHIPTS Global HIV Lectures

HIV is one of the most serious global public health threats, impacting millions across the world. CHIPTS hosts global HIV lectures with visiting scientists to highlight innovative research focused on addressing HIV in international settings. Learn more about recent global HIV lectures and access the recordings below.

Cambodia – Dr. Siyan Yi

Dr. Siyan Yi, founding director at the KHANA Center for Population Health Research in Cambodia and adjunct associate professor at Touro University California in the United States, presented on Monday, October 9, 2023, on “Innovative Community-Based HIV/AIDS Implementation Programs and Research in Cambodia.” Dr. Yi provided updates on the HIV epidemic in Cambodia​, discussed major challenges among vulnerable and key populations​, and highlighted innovative programs in Cambodia within the past 10 years (e.g., SAHACOM, Flagship, Mobile Link).

Video: https://youtu.be/Hn_ypulZdqI

Slides: Innovative Community-Based HIV/AIDS Implementation Programs and Research in Cambodia - Slides

Vietnam – Dr. Giang Minh Le

Dr. Giang Minh Le, professor of epidemiology and global health at Hanoi Medical University in Vietnam, presented on Wednesday, June 21, 2023, about the “Collaborative Research and Education on Global Health between Hanoi Medical University and UCLA.” Dr. Li provided an overview of the three pillars of Hanoi Medical University (research, training, and clinical services), discussed the training programs and collaborative research in partnership with UCLA, and highlighted the University’s core centers that focus on sexual health promotion and substance use.

Video: https://youtu.be/O74OxCf6vvc

Slides: N/A

South Africa – Dr. Andrew Medina-Marino

Dr. Andrew Medina-Marino, honorary associate professor in the Department of Medicine at the University of Cape Town South Africa, presented on Tuesday, November 29, 2022, on “Improving Access to Tuberculosis Care and HIV Prevention in South Africa.” Dr. Medina-Marino shared recent findings from two ongoing studies – the Community PrEP Study which leveraged community-based platforms to improve access and adherence to PrEP among adolescent girls and young women, and a formative study exploring men’s preferences for a gender responsive intervention to support their engagement and retention in care.

Video: https://youtu.be/pV9omHCEYFw

Slides: Improving Access to Tuberculosis Care and HIV Prevention in South Africa - Slides

mSTUDY Overview, Findings, and Info-Sheet

About the mSTUDY

The MSM and Substances Cohort at UCLA Linking Infections, Noting Effects (mSTUDY- U01DA036267) is a 10-year NIDA funded U01 research platform to assess the impact of substance use, particularly stimulants and cannabis, in a diverse group of mostly men of color who have sex with men on HIV outcomes. mSTUDY scientists and collaborators conduct basic research including understanding the basic biology of HIV transmission and pathogenesis, study immune dysfunction and chronic inflammation, genetic determinants, and the social, behavioral and intersectional factors that present challenges and result in higher morbidity among people who use drugs (PWUD) and people living with HIV (PLWH). mSTUDY is led by Dr. Steve Shoptaw and Dr. Pamina Gorbach in collaboration with two study sites in Los Angeles: The Los Angeles LGBT Center and the UCLA Vine Street Clinic.

  • mSTUDY focuses on minority men with 43% identifying as black/African American, 37% as Latinx/Hispanic, 12% as white and 8% other races.
  • Enrolled participants come for in person visits every 6 months and completing an extensive survey on substance use, sexual behavior and a variety of lifestyle factors. In addition, participants receive point of care testing and provide blood, urine and other biological specimens to objectively assess STI rates and substance use while building a robust biorepository.
  • Our extensive biological sampling allows for basic science research on the effects of substance use on the mechanism of HIV contraction and development.
  • HIV prevention, disease progression, comorbid STI infection, comorbid mental and general health disorders, and sociobehavioral health disparities are just a few of the outcomes the mSTUDY is able to assess.

 

Select study findings

mSTUDY has yielded strong research findings in three key areas: clinical sciences, basic sciences and sociobehavioral research. Within clinical research, studies including Shoptaw et al1 exploring the relationship between methamphetamine use and clinical conditions, sexual risk factors and social adversity, have utilized the depth of mSTUDY data to quantify methamphetamine use frequency and chronic mental and physical health conditions, co-morbid infections and social harms. mSTUDY has also been a platform for clinical trials, including Dr. Marjan Javanbakht’s investigation into the effects of antibacterial mouthwash on prevention of recurrent pharyngeal gonorrhea (R21AI147969).

Basic science research has primarily been supported through the collection of biorepository specimens. Studies using mucosal rectal and plasma samples were used to assess systemic and rectal inflammation in individuals with methamphetamine use and those with rectal gonorrhea and chlamydia2. Serum was additionally used in research on endocannabinoids and immune-related biomarkers to determine the impact of frequency of cannabis use on the enzymic activity in PLWH3.

Research into sociobehavioral has ranged widely, reflecting the abundance of data longitudinally collected across diverse topics. Some recently published highlights include Wiss et al.’s exploration of adverse childhood events, particularly sexual abuse, with depression and anxiety in adulthood4 and Javanbakht et al.’s report on behavior modifications in methamphetamine use, and median number of sexual partners following a diagnosis of chlamydia, gonorrhea or syphilis, which showed that the reductions following diagnosis were no different in those who were not diagnosed with an STI and the rates of STI incidence was high in both follow up groups5.

 

Available data

  • We have 629 enrolled participants (338 PLWH and 291 PWOH) with over 4,800 unique study visits.
  • Our data includes behavioral survey data covering demographics, substance use and networks, sexual behavior, substance use during sex, HIV status, prevention and care, STI prevention and treatment, lubricant use and anal hygiene, intimate partner violence, vaccine history, social stigma, behavioral factors, services accessed and mental health status.
  • Each visit includes clinical data with a full review of systems, a baseline physical exam and medical history performed by a clinician.
  • Visits include HIV assessment, a blood panel, substance use testing and STI testing.
  • The biorepository includes over 74,300 samples including rectal swabs and sponges, plasma, serum, viable frozen PBMC’s PBMC pellets, saliva, hair and nails.

 

Ways to Use mSTUDY in Your Research

There are a wide variety of ways to use mSTUDY data. Some recent examples have included:

  • Adding questions to the mSTUDY questionnaire to target specific study questions
  • Utilizing repository blood samples to assess immune function
  • Utilizing hair samples to assess substance use over long periods
  • Recruitment of mSTUDY participants for supplemental questionnaires and qualitative research that can be linked to main mSTUDY data
  • Using mSTUDY as a platform for clinical trials

 

Download Info-Sheet

mSTUDY Overview and Findings - Factsheet

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contact Us

mSTUDY is excited to work with you! Please reach out to learn more and receive a copy of our sub-study proposal form.

Rachel Bolanos, Study Director

mstudy@mednet.ucla.edu

Pamina Gorbach, Co-PI

PGorbach@ucla.edu

Steve Shoptaw, Co-PI

SShoptaw@mednet.ucla.edu

 

Additional resources: http://themstudy.gorbach.ph.ucla.edu/

 

References

  1. Shoptaw S, Li MJ, Javanbakht M, Ragsdale A, Goodman-Meza D, Gorbach PM. Frequency of reported methamphetamine use linked to prevalence of clinical conditions, sexual risk behaviors, and social adversity in diverse men who have sex with men in Los Angeles. Drug Alcohol Depend. 2022 Mar 1;232:109320. doi: 10.1016/j.drugalcdep.2022.109320. Epub 2022 Jan 19. PMID: 35093681; PMCID: PMC8885921.
  2. Blair CS, Fulcher JA, Cho GD, Gorbach PM, Shoptaw S, Clark JL. Brief Report: Impact of Methamphetamine Use and Rectal STIs on Systemic and Rectal Mucosal Inflammation. J Acquir Immune Defic Syndr. 2023 Apr 1;92(4):281-285. doi: 10.1097/QAI.0000000000003143. PMID: 36515912; PMCID: PMC9974870.
  3. Murray CH, Javanbakht M, Cho GD, Gorbach PM, Fulcher JA, Cooper ZD. Changes in Immune-Related Biomarkers and Endocannabinoids as a Function of Frequency of Cannabis Use in People Living With and Without HIV.Cannabis and Cannabinoid. 2023. Apr 20; http://doi.org/10.1089/can.2022.0287.
  4. Wiss DA, Prelip ML, Upchurch DM, von Ehrenstein OS, Tomiyama AJ, Gorbach PM, Shoptaw SJ. Association between Childhood Maltreatment and Depressive and Anxiety Symptoms among Men Who Have Sex with Men in Los Angeles. J Urban Health. 2023 Apr;100(2):327-340. doi: 10.1007/s11524-023-00719-w. Epub 2023 Feb 24. PMID: 36826734; PMCID: PMC9951846.
  5. Javanbakht M, Miller AP, Moran A, Ragsdale A, Bolan R, Shoptaw S, Gorbach PM. Changes in Substance Use and Sexual Behaviors After a Sexually Transmitted Infection Diagnosis Among a Cohort of Men Who Have Sex With Men in Los Angeles, CA. Sex Transm Dis. 2023 Feb 1;50(2):112-120. doi: 10.1097/OLQ.0000000000001733. Epub 2022 Nov 6. PMID: 36342834; PMCID: PMC9839596.

Expanding PrEP Coverage in the United States to Achieve EHE Goals

This content originally appeared on HIV.Gov. View the full article here.

Dear Colleague:

Today, as part of CDC’s quarterly HIV Surveillance Data Tables, CDC published preliminary data on pre-exposure prophylaxis (PrEP) coverage. These preliminary data (Tables 3A-3C) indicate that in 2022, for the first time, more than one-third of people in the U.S. who could benefit from PrEP had been prescribed it. Increasing PrEP coverage is one of the key prevention strategies outlined in the Ending the HIV Epidemic in the U.S. (EHE) initiative.

 

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These data provide additional evidence that HIV prevention efforts in the U.S. are moving in the right direction. Earlier this year, CDC published data that showed accelerated progress in reducing new HIV infections over the past five years, likely due to expanded testing, treatment, and PrEP. This progress is promising, and efforts must be further strengthened and expanded to reach all populations equitably and achieve our national goals.

Overall in 2022, 36% of the 1.2 million people who could benefit from PrEP were prescribed it, compared to 23% in 2019, the year that EHE was announced. Today’s data also show progress in increasing PrEP uptake in virtually all EHE jurisdictions, despite the unprecedented public health challenges funding recipients faced during this period with the COVID-19 pandemic and outbreaks of mpox, which consumed considerable resources as EHE efforts were just getting underway.

While EHE jurisdictions across the nation were able to increase PrEP coverage during this period, substantial disparities and gaps in coverage remain. This is true across communities (Table 3C), and by sex and race/ethnicity.

While the preliminary data show improvement in PrEP prescriptions among all racial/ethnic groups from 2019 to 2022, the reach of this strategy is far from equal, and severe and widening inequities persist. Estimates suggest 94% of White people who could benefit from PrEP have been prescribed it, but only 13% of Black and 24% of Hispanic/Latino people who could benefit have been prescribed PrEP.

 

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The 2022 preliminary data indicate that more than 40% of males who could benefit from PrEP were prescribed it, compared with 15% of females.

 

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Deeply entrenched social determinants of health cause and exacerbate many of these disparities and their outcomes. Most new HIV infections in 2021 were among gay and bisexual men, the majority of whom were Black or Hispanic/Latino. About one-fifth of new HIV infections in 2021 were among women, and over half of those were among Black women. These data highlight the importance of focusing programs and policies to accelerate progress in prevention and treatment for disproportionately affected groups, particularly Black and Hispanic/Latino men and women.

 

Incidence-by-Transmission-Group-by-RE

CDC has continued to work to increase PrEP outreach in communities with unmet needs, including recently increasing funding for STI and other clinics to deliver PrEP as part of comprehensive sexual health services and expanding campaigns to reach Black women. Yet, prevention resources have not kept pace with needs.

Continued and expanded efforts will be vital to overcome the significant barriers that continue to hinder PrEP uptake, including lack of knowledge and lack of trusted or easily accessible PrEP providers in many communities. To end the HIV epidemic, we must ensure equitable access to HIV testing, treatment, and prevention, including PrEP. This will require increased investments in community outreach, education, and services, as well as efforts to address the root causes and social determinants that contribute to HIV disparities.

Thank you for your continued collaboration and support for HIV prevention. We will continue to provide updates on our collective progress, as we strive to end this epidemic for all.

Sincerely,

/Robyn Fanfair/

Robyn Neblett Fanfair, MD, MPH
Captain, USPHS
Acting Director
Division of HIV Prevention
National Center for HIV, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

Honoring National HIV/AIDS and Aging Awareness Day 2023: Collaboration in Care Conference

National HIV/AIDS and Aging Awareness Day (NHAAD) is observed each year on September 18 to recognize the increasing number of people living long, full lives with HIV. This awareness day also calls attention to the unique health and social needs, as well as the challenges of HIV prevention, testing, treatment, and care, among older adults.

On NHAAD 2023, the first ever Collaboration in Care Conference: Improving HIV and Aging Services kicked off in Sacramento, California. CHIPTS was delighted to join the Training and Health Equity Collaborative as an organizing partner for this exciting event on September 18-19 to bring service providers together to build capacity for addressing the needs of people aging with HIV in the Western United States.

The Collaboration in Care Conference recognized that people aging with HIV require clinical, mental, and social support services tailored to their needs. The conference engaged direct service providers from across the Western United States in disciplines that include mental health, service navigation, clinical care, social services, and other specialties in order to share lessons from HIV care, aging services, and more.

The conference learning objectives included:

  • Identify three service needs for people living with HIV over 50.
  • Identify three healthcare needs for people living with HIV over 50.
  • Evaluate strategies and care models to improve outcomes for people living with HIV over 50.

The conference began with a welcome from the Training and Health Equity Collaborative, followed by an impactful opening plenary from Harold Phillips, Director of the Office of National AIDS Policy (ONAP). He provided a national State of HIV and Aging message, drawing attention to the key concerns for people aging with HIV in today’s society. Breakout sessions in the conference were divided into three tracks: 1) California-focused topics, 2) clinical care, and 3) programmatic practices. Check out the full conference agenda and session slide sets on the conference website.

More information on NHAAD and HIV prevention, care, and treatment for older adults can be found here:

National Gay Men’s HIV/AIDS Awareness Day 2023

September 27, 2023 – Today, CHIPTS honors National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD), a day dedicated to recognizing the disproportionate impact of the HIV epidemic on gay men and promoting HIV prevention and treatment services that allow gay men to live long, healthy lives. Learn more about NGMHAAD below.

Gay and bisexual men accounted for 67 percent of new HIV diagnoses in the United States and dependent areas in 2021, according to the Centers for Disease Control and Prevention (CDC). Within this population, disparities persist among Black/African American and Hispanic/Latino gay and bisexual young men, who receive more new HIV diagnoses than other groups. In 2019, CDC reported that 26% of new HIV infections were among Black gay and bisexual men, 23% among Latino gay and bisexual men, and 45% among gay and bisexual men under the age of 35.

Several CHIPTS faculty have worked to examine contextual factors driving HIV infections and ways to improve HIV outcomes for gay, bisexual, and other men who have sex with men (MSM). Last year, CHIPTS Combination Prevention Core Affiliate Dr. Michael Li shared an illuminating reflection highlighting factors that are linked to increased risk of acquiring HIV, reduced access to preventive services such as PrEP, and reduced access to HIV care and antiretroviral therapy among this population, such as being unstably housed, using psychostimulants (e.g. methamphetamine), and developing mental health issues that derive from stigma and discrimination. Dr. Li discussed the significant role of intersectionality in HIV prevention and healthcare engagement, describing how race, ethnicity, age, disability, and/or class inform gay men’s preventive and care needs. His call to action aligned with the goals of National Gay Men’s HIV/AIDS Awareness Day, encouraging HIV researchers and service providers to adopt an intersectional lens and collaborate with the gay community to address HIV.

Recent publications on this topic from CHIPTS faculty include:

  • “That’s kind of like the big struggle right now is can we get PrEP?”: Facilitators and Barriers to PrEP Uptake Among Active Duty Gay and Bisexual Men – Beltran, R. M., Schuyler, A. C., Blair, C. S., Goldbach, J. T., Castro, C. A., & Holloway, I. W. (2023).
    • The US Military is experiencing a rise in HIV infections among gay and bisexual men (GBM) serving on active duty, yet little is known about this population’s uptake of pre-exposure prophylaxis (PrEP), an evidence-based intervention for HIV prevention.
  • The Use of Daily and On-Demand Oral Pre-Exposure Prophylaxis Dosing Strategies Among Young Adult Gay, Bisexual and Other Men who have Sex with Men Enrolled in an mHealth Adherence Intervention – Horvath, K. J., Ma, J., Storholm, E. D., Black, A., Klaphake, J., & Baker, J. V. (2023)
    • Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention option for gay, bisexual and other men who have sex with men (GBMSM). However, with newer PrEP options, a greater understanding of whether and why GBMSM switch dosing strategies is needed to inform clinical practice and research.
  • Beyond HIV prevention: Additional individual and community-level benefits of PrEP among Latino gay and bisexual men – Brooks, R. A., Nieto, O., Santillan, M., Jr, Landrian, A., Fehrenbacher, A. E., & Cabral, A. (2022).
    • HIV infections disproportionately impact Latino gay and bisexual men (GBM) in the United States. Pre-Exposure Prophylaxis (PrEP) is a proven prevention strategy that can help reduce new HIV infections in this population.

Check out these HIVinfo resources to learn more: