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

Note: May’s observance of Hepatitis Awareness Month is an opportunity to highlight approaches to addressing the syndemic of HIV and viral hepatitis, approaches called for in both the National HIV/AIDS Strategy and the Viral Hepatitis National Strategic Plan.

A, B, and C. These are the three most common hepatitis viruses. The first two are preventable by vaccines. The third is curable.

These facts come from the latest Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination 2021-2025 (January 2021), which states in its Executive Summary: “the nation faces unprecedented hepatitis A outbreaks, progress on preventing hepatitis B has stalled, and hepatitis C rates nearly tripled from 2011 to 2018.”

May is Hepatitis Awareness Month and May 19 is Hepatitis Testing Day.

Hepatitis C co-infection among persons with HIV is of particular concern as the disease progresses more rapidly and is more prevalent. From 15 to 30% of people with HIV are also infected with Hepatitis C, as cited in the Hepatitis C Coinfection chapter  of the National HIV Curriculum. Coinfection rates are much higher among injection drug users who have HIV, according to CDC.

Fortunately, effective treatments for hepatitis C are available.

Hepatitis C Treatment

Hepatitis C treatments called Direct-Acting Antivirals  (DAAs) became available in recent years They are more effective than earlier interferon-based regimens. For the first time, persons infected with hepatitis C can be cured, with all-oral, once-daily treatment regimens that last 8-24 weeks. Efficacy rates for these medications are high (above 90%) for both hepatitis C monoinfected and HIV/hepatitis C coinfected people. Side effects or contraindications of these medications are minimal.

Moreover, studies have shown that hepatitis C treatment is effective for individuals with substance abuse disorders. See the AETC on Myths about Treating Substance Users with Hepatitis C Virus .

HHS guidelines recommend that all people with HIV be tested for HCV, with those testing positive be considered for HCV treatment. CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020 recommend expanded screening for all individuals over 18 years of age and testing for various groups, including people with HIV.

Clinician Resources

HRSA’s HIV/AIDS Bureau has developed provider resources on hepatitis screening and treatment for use by Ryan White HIV/AIDS Program (RWHAP) agencies. These and other tools are summarized on the AETC National Coordinating Resource Center’s (NCRC) viral hepatitis confection topic page . Highlights include the HIV/HCV Coinfection: An AETC National Curriculum  and the National HIV Curriculum’s Hepatitis C Coinfection  section.

The HIV/HCV Coinfection: An AETC National Curriculum includes HIV/HCV Co-infection Resources  for providers as well as patients and patient educators, like tools to engage patients in HCV care.

Hepatitis C and Planning – Incorporating Hepatitis C in Integrated HIV Prevention and Care Planning  is a webinar review of how select RWHAP jurisdictions are integrating hepatitis C services within their HIV care and prevention plans.

HCV/HIV Care Delivery

In addition to the AETC clinic-focused curricula and patient tools, HRSA’s work on HCV/HIV coinfection care also includes identification of innovative interventions. RWHAP agencies are also using HRSA performance and data monitoring guidance to measure efforts and efficacy in providing care to HIV/HCV co-infected individuals. These initiatives, and resulting technical assistance tools, can be found in our Hepatitis topic page . Highlights include:

• Hepatit is C Prescriber Toolkit , a directory of state-specific resources (prescribing restrictions, ADAP coverage, Medicare coverage) and contact information for all state programs.
• Curing Hepatitis C among People of Color Living with HIV . This SPNS initiative (2017-2020) focused on expanding a full array of services for HCV/HIV coinfected individuals, in collaboration with SAMHSA-funded substance abuse agencies. Among the products developed by the Curing Hepatitis C project were mobile apps for use by patients and staff (clinical and non-clinical) to educate clients and improve the patient/provider experience. See ConnQuer HepC and TACKLE Program  and download their apps.
• Jurisdictional Approach to Curing Hepatitis C among HIV/HCV Coinfected People of Color . This HRSA HCV SPNS initiative (2016-2019) focused on improving HCV services among HIV/HCV-coinfected people of color.
• Performance Measurement. The HRSA HIV/AIDS Bureau has a framework of resources to support RWHAP programs in monitoring the delivery of HIV care, inclusive of hepatitis. HAB’s Performance Measures are comprised of multiple sets, with an adolescent/adult set of measures that includes specific measures addressing hepatitis B screening and vaccination and hepatitis C screening.
• Data Monitoring . HRSA’s Ryan White Services Report, the RSR client-level data system , is used by RWHAP recipients and subrecipients to collect performance measure data on hepatitis B screening and vaccination as well as hepatitis C screening.

Listen to insights on hepatitis care from HRSA and front-line RWHAP agencies in a range of workshops  convened at the 2020 Ryan White Conference on HIV Care and Treatment.

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

The Indian Health Service is announcing five million dollars in funding for “Ending the HIV Epidemic in the U.S. ” to support work toward the elimination of HIV and hepatitis C in Indian Country.

“At HHS, we continue to confront the HIV epidemic head-on by ensuring resources are focused on the communities and people who most need them,” said HHS Secretary Xavier Becerra. “This funding will help us reach people in Indian Country and engage people who are disproportionately impacted by HIV.”

“We are excited about this new funding opportunity for Indian Country to address diagnosis, treatment and prevention activities that are aimed at eliminating disparities and reducing HIV’s impact,” said Acting Director Elizabeth Fowler. “We are committed to providing American Indians and Alaska Natives who are at risk, or are living with HIV, with the culturally-appropriate support and services they need.”

The funds include $2.48 million for three-year cooperative agreements for tribes, tribal organizations, and urban Indian organizations to support activities that address HIV/HCV and sexually-transmitted infections. The deadline for tribes, tribal organizations, and urban Indian organizations to apply for the funding is June 17, 2022.

Since the late 1980s, enormous progress has been made in the fight against HIV, but there is still work to be done. National interventions have reduced the number of new HIV infections, but not everyone is benefiting equally from these advances. New diagnoses are highly concentrated among men having sex with men; minorities, including American Indians and Alaska Natives; and those who live in the southern United States. Among people living with HIV, American Indians and Alaska Natives have the largest percentage of persons with undiagnosed HIV infection.

Stigma in Native communities can also be a debilitating barrier preventing someone living with HIV or at risk for HIV from receiving the health care services they need and deserve. IHS continues to address barriers for people living on Indian reservations and in other rural communities that limit opportunities for education and HIV testing.

In addition to the cooperative agreements, approximately $1.5 million will support clinical training, including funding for ongoing case-based training and technical assistance. Approximately $620,000 will support national infrastructure, and approximately $400,000 will support a national media campaign.

This funding comes in addition to the several Indian Health Service activities that are also supported by the Minority HIV/AIDS Fund, which has provided national-level programs like web-based youth education and prevention services, clinical training for HIV care, expansion of pre-exposure prophylaxis for HIV prevention, case management support for people living with HIV, support of National Native HIV/AIDS Awareness Day, and indigenizing the National HIV/AIDS Strategy. In June 2021, the IHS distributed close to $10.5 million through this competitive funding opportunity.

The Biden Administration is also continuing its support of the Ending the HIV Epidemic initiative within Indian Country. The president’s budget requests $52 Million in FY 2023 for IHS to treat or reduce the transmission of HIV and Hepatitis C.

The IHS, an agency in the U.S. Department of Health and Human Services, provides a comprehensive health service delivery system for approximately 2.7 million American Indians and Alaska Natives who belong to 574 federally-recognized tribes in 37 states.

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

The 2022 National Drug Control Strategy was released on April 21, 2022. Over the course of a year, it was developed through requests for written consultations from more than 2,000 external stakeholders, including the entirety of the U.S. Congress; all 50 Governors; and hundreds of advocates representing law enforcement, public health, and Tribal communities.

This new Strategy is the first ever to emphasize working directly with people who use drugs to prevent overdose and infectious disease transmissions, improve their physical, mental, and social wellbeing, and offer flexible options for accessing medical care and substance use treatment. This evidence-based approach builds trust and engagement with people at risk for an overdose and is known as harm reduction.

The Strategy breaks ground and proposes bold, targeted, and consequential actions to bend the curve on overdose deaths in the immediate term and reduce drug use and its consequences in the long term. These actions are grouped around eight thematic areas. Two of these action areas are highlighted below and are relevant to those working on HIV-related issues:

• Helping people who use drugs access the services they need to stay alive long enough to enter treatment, the Biden-Harris Administration will focus on three priority harm reduction interventions:
• Expanding access to the overdose reversal medication naloxone, which is a cost-effective tool that has the most potential to save lives today.
• Ensuring people who use drugs can access drug testing strips so they can detect the presence of fentanyl and other dangerous substances in their supply.
• Supporting syringe services programs that facilitate linkages to substance use treatment and prevent the spread of infectious diseases like HIV/AIDS and hepatitis.
• Supporting people with undiagnosed or untreated substance use disorders who too often end up interacting with the justice system, creating severe consequences for individuals, their families and communities and society. Furthermore, arrest and incarceration for crimes related to substance use and possession disproportionately affect Black, Indigenous, and People of Color (BIPOC) communities.

The National Drug Control Strategy aligns with the Administration’s emphasis on equity and breaks new ground by including a criminal justice chapter that directs agencies to ensure that non-violent offenders in incarcerated settings, as well as those who re-enter society do not overdose and instead have access to the continuum of services and support, thereby removing unnecessary barriers to treatment.

This Strategy also aligns with the National HIV/AIDS Strategy. For people experiencing substance use disorder and those at risk for and with HIV, these strategies call for effective programs, policies, and services to improve public health and end both the opioid and HIV epidemics.

For more information on the new National Drug Control Strategy, click here.

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

Every year, on April 10th,  National Youth HIV & AIDS Awareness Day (NYHAAD) provides an important opportunity to both reflect on accomplishments and chart the way forward. Taking stock of what our nation’s young people need this year is especially important as we’ve come to realize the true toll that the past two years have taken on their physical and mental health.

The data on HIV prevalence among young people tells us that about 20% or 1 in 5 new diagnoses occur in those aged 13 to 24 years and those rates tend to be higher among young men who have sex with men (MSM) and transgender women.¹ HIV-related data also tell us that approximately 44% of young people with HIV do not know they have the virus¹ and so are not receiving care for themselves or reducing their viral load to prevent further transmission. Among high school students, in 2019, only 9% had ever been tested for HIV.²

Data on health behaviors and experiences that put youth at risk for HIV present a more nuanced picture. Over the ten years prior to the COVID-19 pandemic, sexual risk behaviors and high-risk substance use declined significantly, but condom use decreased significantly. More than 10% of female high school students reported that they had been sexually assaulted, a trend that has been unchanged for at least 10 years, and more students reported not going to school because of safety concerns. Finally, mental health, which had been moving in the wrong direction for a number of years, became even more concerning during the pandemic, particularly for LGBTQ youth.³

Acknowledging that there is more work to be done to support young people experiencing risk for or living with HIV, the National HIV/AIDS Strategy designates youth ages 13-24 as one of its priority populations.⁴ The Strategy calls for an enhanced focus on primary prevention for youth, increasing HIV testing, status awareness, and linkage to prevention or care services for youth, and improving viral suppression among youth with HIV. There are additional strategies that affect youth, including increasing the number of schools that have implemented LGBTQ-supportive policies and practices and increasing the number of schools providing on-site sexual health services. CDC will continue to do all it can to collaborate with federal and nonfederal partners to implement actions that improve HIV outcomes for youth and help the nation achieve the NHAS goals.

One of the primary ways we can support youth to prevent HIV is through their schools. Schools play a critical role in the primary prevention of HIV by providing young people with knowledge and skills through health education. They can also be an important bridge to needed HIV prevention services like condoms, HIV and STI testing, and PrEP. But one of the most important things that schools can provide is a sense of connectedness and belonging, and a safe space for all youth, including LGBTQ youth.

CDC’s What Works In Schools approach harnesses the power of schools to be places where youth can thrive. Our approach promotes quality health education, helps schools set up systems to connect youth to health services, and makes schools safer and more supportive by promoting activities to increase school connectedness and support for LGBTQ youth. 

We have seen that schools that implement the What Works In Schools approach demonstrate improvements among their students in reduced sexual risk, decreases in substance use, and are less likely to experience sexual assault or avoid going to school because of concerns about violence.⁵ In schools that implement policies and practices to support LGBTQ students, like creating or strengthening Gender and Sexuality Alliances (GSAs), identifying safe spaces, and having anti-harassment policies, we see not only better mental health and lower rates of suicide attempts among sexual minority students, but also fewer suicide attempts among heterosexual students.^{6, 7} Reducing behaviors and experiences that increase risk for HIV and STIs while also supporting our youth who need it most is a goal that is within our reach today.

On NYHAAD and every day, CDC joins with our partners to ensure that young people have every opportunity to stay safe, stay healthy, and stay well.  Help us promote NYHAAD by accessing our digital toolkit and downloading and sharing materials on social media using the #NYHAAD hashtag. Together we can help to ensure a healthy future for our young people.

¹ CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

² CDC. Youth Risk Behavior Surveillance—United States, 2019. MMWR Suppl 2020;69(1):1-83.

³ CDC. Youth Risk Behavior Survey: Data Summary & Trends Report: 2009-2019. Atlanta: Centers for Disease Control and Prevention; 2020.

⁴ The White House. 2021. National HIV/AIDS Strategy for the United States 2022–2025. Washington, DC.

⁵ Robin L, Timpe Z, Suarez NA, Li J, Barrios L, Ethier KA. Local Education Agency Impact on School Environments to Reduce Health Risk Behaviors and Experiences Among High School Students. J Adolesc Health. 2022 Feb;70(2):313-321. doi: 10.1016/j.jadohealth.2021.08.004. Epub 2021 Sep 14. PMID: 34531096; PMCID: PMC8792165.

⁶ Kaczkowski W, Li J, Cooper AC, Robin L. Examining the Relationship Between LGBTQ-Supportive School Health Policies and Practices and Psychosocial Health Outcomes of Lesbian, Gay, Bisexual, and Heterosexual Students. LGBT Health. 2022 Jan;9(1):43-53. doi: 10.1089/lgbt.2021.0133. Epub 2021 Dec 17. PMID: 34935516.

⁷ Harper CR, Johns MM, Orenstein D, Pampati S, Jones TM, Leonard S, Taylor KR, Robin L. Association Between LGBTQ Student Nondiscrimination Laws in Selected States and School District Support for Gay-Straight Alliances. J Adolesc Health. 2022 Feb 11:S1054-139X(21)00678-9. doi: 10.1016/j.jadohealth.2021.11.032. Epub ahead of print. PMID: 35165028.

CHIPTS Strategic Launch Meeting

On Monday, March 14, 2022, CHIPTS was honored to host 37 members, affiliates, and community advisory board representatives at the UCLA Luskin Conference Center for the CHIPTS Strategic Launch Meeting. The launch meeting was an opportunity to discuss innovative approaches to advance intersectional science in HIV and co-morbid psychosocial and structural conditions, and ways to elevate the Center’s impact for the new 5-year grant cycle. CHIPTS Director Dr. Steve Shoptaw provided the opening remarks, emphasizing the importance of taking risks, lifting up new, strong leaders in the field, and expanding the Center’s partnerships and reach both locally and globally.

Global HIV Prevention Science at CHIPTS

CHIPTS Global HIV Co-Director Dr. Pamina M. Gorbach moved the conversation forward by discussing the impactful work of CHIPTS scientists globally on the topics of PrEP, substance use, and STIs. Dr. Gorbach highlighted the importance of establishing collaborative networks among UCLA programs with existing global training opportunities, including CHIPTS, the Fielding School of Public Health, and the David Geffen School of Medicine, to expand global HIV prevention science. Group discussion centered on how to best use available funding mechanisms and leverage partnerships to elevate CHIPTS’ global work in the new grant cycle.

The State of HIV and STDs in Los Angeles County and Aligning with the Local Ending the HIV Epidemic Initiative

Dr. Shoptaw then welcomed Mario J. Perez, Director of the Division of HIV and STD Programs (DHSP), and Julie Tolentino, Ending the HIV Epidemic (EHE) Program Manager, from the Los Angeles County Department of Public Health to share the state of HIV and STDs in LA County and discuss local initiatives that target the national EHE goals.

Mr. Perez offered promising data showing an overall decline in the number of new HIV diagnoses in LA County while highlighting significant concerns regarding health disparities, retention in care rates, syphilis rates, and perinatal HIV transmissions. He noted that these issues are all exacerbated by intersecting health challenges (e.g. substance use, mental illness) and social and structural conditions. Ms. Tolentino then provided an update on the EHE Initiative in LA County, which takes an equity-oriented approach to addressing the HIV epidemic and related syndemics with a focus on disproportionately impacted communities including Black and Latinx populations. She defined several activities of focus under each EHE pillar (diagnose, treat, prevent, respond). Mr. Perez and Ms. Tolentino both emphasized a need to continue leveraging the partnership between DHSP and CHIPTS to support effective implementation of strategies and resources to address the HIV epidemic in LA County.

Brainstorming Solutions/Opportunities

CHIPTS Co-Director Dr. Raphy Landovitz facilitated the final portion of the meeting, which was dedicated to brainstorming solutions and opportunities to address local EHE needs and meet Center goals. Participants  were split up by core (methods, policy, combination prevention, and development/administrative) to respond to a set of guiding questions with actionable core-specific and cross-core recommendations. Community advisory board members were invited to share their ideas, discuss priorities, and consider roles they could play in connection with each core.

Each group discussion was led by the respective core’s leaders and focused on strategies to address challenges presented throughout the meeting, ways to increase diversity at the Center and within each core, and ways to align with and support the local EHE goals and priorities outlined by Mr. Perez and Ms. Tolentino. Additionally, cores discussed methods to enhance collaborative efforts with the UCLA Center for AIDS Research (CFAR), Clinical and Translational Science Institute (CTSI), and other partners.

Brainstormed strategies were written on poster paper and presented to all participants at the end of the activity. Participants were then invited to view all strategies brainstormed by each core and indicate their top priorities. This information will be used to inform core-specific and CHIPTS-wide activities moving forward.

View our mini-gallery featuring photos from the meeting.

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

The National Institute of Mental Health has renewed its support for UCLA’s collaborative Center for HIV Identification, Prevention and Treatment Services, or CHIPTS, with a five-year, $7.5 million grant.

The center, made up of leading scientists from UCLA, Charles R. Drew University of Medicine and Science, the Friends Research Institute and the RAND Corp., has worked for 25 years to combat the HIV/AIDS epidemic both locally and globally through scientific research and treatments, network building and collaborations with community and agency partners.

The new federal funding will support a research agenda aimed at reducing HIV transmission across Southern California, the nation and the world — in line with the U.S. Department of Health and Human Service’s initiative to end the epidemic in the United States by 2030.

The grant program will be directed by Steven Shoptaw, a professor of family medicine and of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA, where he is also vice chair of research in family medicine.

“This award is a testament to the unwavering commitment of our scientists and community partners,” Shoptaw said. “With this funding, we look forward to pursuing innovative, high-impact approaches to address the HIV epidemic and the conditions that drive it.”

Currently, approximately 38 million people globally and 1.2 million nationally are living with HIV, with about 35,000 new cases diagnosed each year in the U.S., according to the Centers for Disease Control and Prevention.

Under the new grant, CHIPTS will guide a regional strategy for Southern California that aligns with the HHS national Ending the HIV Epidemic plan. The center will support research aimed at developing and improving multifaceted approaches to suppressing the virus in people already infected with HIV and preventing infections among at-risk populations, with a particular focus on those with mental health and substance use disorders and those who face social and structural barriers in accessing health care.

In these efforts, CHIPTS will work closely with scientific, community and public health partners while promoting efforts to improve diversity, equity and inclusion among the next generation of HIV investigators.

“The center plays a critical role in advancing HIV prevention science that innovates in combination prevention strategies and shifts policy to influence health outcomes,” said CHIPTS co-director Dr. Raphael Landovitz, a professor of medicine at the Geffen School. “We are extremely grateful for the opportunity to continue and expand our work in this next cycle.”

The National Institute of Mental Health is part of the National Institutes of Health.

This content originally appeared on FDA Newsroom. View the full article here.

Other FDA-Cleared Condoms Can Continue to Be Used for Contraception and to Prevent STIs

[On February 23], the U.S. Food and Drug Administration authorized the marketing of the first condoms specifically indicated to help reduce transmission of sexually transmitted infections (STIs) during anal intercourse. The condoms, which will be marketed as the One Male Condom, are also indicated as a contraceptive to help reduce the risk of pregnancy and the transmission of STIs during vaginal intercourse.

Before today’s authorization, the FDA had not cleared or approved condoms specifically indicated for anal intercourse. Unprotected anal intercourse carries the greatest sexual exposure risk of HIV transmission. Consistent and correct condom use has the potential to significantly help decrease the risk of STIs. While today’s authorization underscores the public health importance of condoms tested and labeled specifically for anal intercourse, all other FDA-cleared condoms can continue to be used for contraception and STI prevention. It’s important to continue to use condoms consistently and correctly to reduce the risk of STI transmission, including HIV, and to prevent pregnancy.

“The risk of STI transmission during anal intercourse is significantly higher than during vaginal intercourse. The FDA’s authorization of a condom that is specifically indicated, evaluated and labeled for anal intercourse may improve the likelihood of condom use during anal intercourse,” said Courtney Lias, Ph.D., director of the FDA’s Office of GastroRenal, ObGyn, General Hospital, and Urology Devices in the Center for Devices and Radiological Health. “Furthermore, this authorization helps us accomplish our priority to advance health equity through the development of safe and effective products that meet the needs of diverse populations. This De Novo authorization will also allow subsequent devices of the same type and intended use to come to the market through the 510k pathway, which could enable the devices to get on the market faster.”

The One Male Condom is a natural rubber latex sheath that covers the penis. It has three different versions: standard, thin and fitted. The fitted condoms, available in 54 different sizes, incorporate a paper template to aid in finding the best condom size for each user. When used during anal intercourse, the One Male Condom should be used with a condom-compatible lubricant.

The safety and efficacy of the One Male Condom was studied in a clinical trial comprised of 252 men who have sex with men and 252 men who have sex with women. All participants were between 18 through 54 years old.

The study found that the total condom failure rate was 0.68% for anal intercourse and 1.89% for vaginal intercourse with the One Male Condom. Condom failure rate was defined as the number of slippage, breakage or both slippage and breakage events that occurred over the total number of sex acts performed. For the One Male Condom, the overall percentage of adverse events was 1.92%. Adverse events reported during the clinical trial included symptomatic STI or recent STI diagnosis (0.64%), condom or lubricant-related discomfort (0.85%), partner discomfort with lubricant (0.21%) and partner urinary tract infection (0.21%). The symptomatic STI or recent STI diagnoses observed in the study were self-reported and may be the result of subjects having intercourse without a condom or may have preceded use of the One Male Condom, as STIs were not measured at baseline.

The FDA reviewed the One Male Condom through the De Novo premarket review pathway, a regulatory pathway for low- to moderate-risk devices of a new type. Along with this De Novo authorization, the FDA is establishing criteria called special controls that define the requirements related to labeling and performance testing. When met, the special controls, in combination with general controls, provide a reasonable assurance of safety and effectiveness for devices of this type. This action also creates a new regulatory classification, which means that subsequent devices of the same type with the same intended use may go through the FDA’s 510(k) pathway, whereby devices can obtain clearance by demonstrating substantial equivalence to a predicate device.

The FDA granted the marketing authorization to Global Protection Corp.

Related Information

• Evaluation of Automatic Class III Designation (De Novo) Summaries
• HIV.gov

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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

In an HIV.gov video conversation yesterday, NIH’s Dr. Carl Dieffenbach discussed some of the pivotal HIV research advances presented this week at the 2022 virtual Conference on Retroviruses and Opportunistic Infections (CROI 2022). Dr. Dieffenbach, Director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID), covered developments in HIV cure research, HIV treatment and HIV prevention. Watch the conversation with Dr. Dieffenbach:

Here are some highlights from Dr. Dieffenbach’s conversation with HIV.gov:

HIV Cure Research

Dr. Dieffenbach first discussed a person whose HIV is in remission as the result of a stem cell transplant with an HIV-resistant mutation. The case was presented at CROI by Dr. Yvonne Bryson of the University of California, Los Angeles. This is only the third such case of HIV remission and the first in a woman and a person of mixed-race ancestry. The woman was diagnosed with leukemia after having been on treatment for HIV for several years. When she needed a stem cell transplant to treat the cancer, doctors used a combination of cord blood with the HIV-resistant mutation and stem cells from a close relative. About 37 months after the transplant, the woman stopped taking antiretroviral therapy (ART). No HIV has been detected in the woman for 14 months since cessation of ART. Dr. Dieffenbach reflected on the importance of this case, what it might mean for the future, and when and why the terms remission and cure are used. Read the NIAID news release about this study. Read the study abstract on the CROI website .

Very Early Treatment in Infants and the Promise of HIV Remission

Another study Dr. Dieffenbach discussed explored the effects of early intensive ART on achieving HIV remission in infants. The study, presented by Dr. Deborah Persaud of Johns Hopkins University, is following two small cohorts of children who acquired HIV in the womb and began receiving ART within 48 hours of birth. She presented virologic outcomes indicating that most the infants had achieved viral suppression, defined as HIV RNA less than 200 copies/mL, at six months of age. She also presented data on the amount of HIV DNA detected in the children’s cells, which reflected the size of their viral reservoir. Most of the children had no HIV DNA at two years of age. Having a smaller reservoir may make it possible for these children to stop taking ART and still maintain viral suppression. To evaluate this, in the next stage of the study, children who meet strict criteria will stop taking ART and have their HIV RNA levels closely monitored. Dr. Dieffenbach shared why that’s important and why he thinks pediatric studies are critical for HIV cure research. Read the study abstract on the CROI website . View more information on the study on the IMPAACT Network website .

Antibodies: A Possible Treatment Option for Very Young Children with HIV

Reflecting on future directions in HIV treatment, Dr. Dieffenbach discussed a proof-of-concept study on using broadly neutralizing antibodies (bNAbs) to treat HIV in children in Botswana. These powerful anti-HIV antibodies can stop a wide variety of HIV strains from infecting human cells in the laboratory. In the study, presented by Dr. Roger Shapiro of the Harvard T.H. Chan School of Public Health, 25 children with HIV between ages 2 and 5 years who had begun ART less than 7 days after birth and had undetectable viral loads were given monthly infusions of two bNAbs. The bNAbs were delivered first in combination with ART, and then later, if the children’s HIV remained undetectable, without ART. Eleven (44%) of the children maintained viral suppression through 24 weeks of bNAb-only treatment, and 14 (56%) had viral rebound before 24 weeks. The infusions were safe and well-tolerated. As Dr. Dieffenbach explained, parents found the bNAb infusions acceptable, with many preferring them to daily ART. He also discussed why he thinks bNAbs will be an important tool in future HIV treatment, prevention, and cure research.  View the abstract on the CROI website.

Additional Data on Long-acting, Injectable Cabotegravir for PrEP

Finally, Dr. Dieffenbach highlighted a study providing additional data about long-acting injectable cabotegravir PrEP. Dr. Raphael Landovitz of the University of California Los Angeles reported data from one year of unblinded follow-up in the HIV Prevention Trials Network (HPTN) Study 083  among cisgender men and transgender women who have sex with men. This Phase 2b/3 randomized controlled trial previously demonstrated that a long-acting form of the HIV drug cabotegravir (CAB-LA) injected once every 8 weeks was more effective than daily oral Truvada at preventing HIV acquisition in the study population. At CROI, Dr. Landovitz reported that during the unblinded phase of the trial, the reduction in the risk of HIV acquisition from taking CAB-LA versus daily oral Truvada remained the same as during the blinded phase. Dr. Dieffenbach observed that scaling up available forms of PrEP and other HIV prevention tools will be key factors in achieving the goals of the National HIV/AIDS Strategy and the Ending the HIV Epidemic in the U.S. initiative. View the study abstract on the CROI website .

About CROI

CROI is an annual scientific meeting that brings together top researchers from around the world to present and discuss the latest studies that can help accelerate global progress in the response to HIV/AIDS and other infectious diseases, including COVID-19. More than 3,000 HIV and infectious disease researchers are gathering virtually this year over two weeks for this forum for translating laboratory and clinical research into progress against these diseases. Among the studies being presented are many that have been conducted or supported by NIH and CDC.

Join us again for another conversation with Dr. Dieffenbach at the conclusion of CROI 2022 next Thursday, February 24, 2022, at 5:15 PM (ET).

The Mark A. Etzel Scholarship was founded in honor of the late Mark A. Etzel, MPP, to provide opportunities and support for early-career HIV scientists or community researchers doing work related to policy impact, structural factors, or implementation science. The 2021 scholarship awardee was Dr. Anne E. Fehrenbacher. Please read more about Dr. Fehrenbacher below.

Anne E. Fehrenbacher, PhD, MPH is a Research Scientist in the UCLA Department of Psychiatry and Biobehavioral Sciences in the Semel Institute for Neuroscience and Human Behavior at the David Geffen School of Medicine. Dr. Fehrenbacher is a social epidemiologist specializing in biobehavioral HIV prevention with sex workers and sexual and gender minority populations. Dr. Fehrenbacher received her PhD and MPH in Community Health Sciences at the UCLA Fielding School of Public Health and her BA in Public Health from Johns Hopkins University. Dr. Fehrenbacher completed postdoctoral training in HIV Combination Prevention at UCLA and a Fogarty GloCal Fellowship sponsored by the UC Global Health Institute with the Public Health Research Institute of India and Ashodaya Samithi in Mysore, Karnataka.

Dr. Fehrenbacher is the PI for two pilot studies on PrEP acceptability and adherence barriers with more than 400 sex workers across India and Co-PI for a study on the impact of the COVID-19 pandemic on the livelihoods of sex workers in West Bengal. Dr. Fehrenbacher is currently preparing to launch a new study on PrEP implementation science with hard-to-reach populations in India evaluating policy, structural, and organizational barriers to widespread rollout of PrEP. The Mark A. Etzel Scholarship will support Dr. Fehrenbacher’s research to develop scalable, sustainable, and effective PrEP implementation strategies with the ultimate goal of reducing disparities in HIV incidence in India and globally. Dr. Fehrenbacher will use the scholarship funds to cover transcription and translation of stakeholder interviews for this project in India.

Dr. Fehrenbacher’s current research focuses on harnessing technologies to improve PrEP uptake among stigmatized populations in India, particularly transgender sex workers. This scholarship will support Dr. Fehrenbacher’s efforts to build strong academic-community partnerships for implementation science research to improve access to PrEP services for the most socially and economically marginalized populations.

Outside of work, Dr. Fehrenbacher treasures spending time with her pups and experimenting in the kitchen to create her dream food truck menu. She is also an avid cinephile and loves to plan film festivals line-ups to enjoy during her time off.