HIV & AIDS
Hornet Joins Undetectable = Untransmittable Campaign to Fight HIV Stigma
The CDC, UNAIDS and over 500 organizations from 65 countries have confirmed the science behind the U=U campaign verifying that an undetectable HIV viral load means HIV is untransmittable. Science has proven a person achieves an undetectable viral load when medication suppresses the virus to levels so low it can’t be measured by tests. This means an HIV-positive individual can live a long and healthy life and the virus cannot be passed on. Taking medication as prescribed ensures a person will continue to be undetectable. Hornet will continue their commitment to educate the global community about U=U and combat HIV stigma.
“Our partnership with Hornet will help lift the fear about transmitting HIV, and it will begin to dismantle the HIV stigma and ignorance that is still widespread in gay communities,” said Bruce Richman, who leads the U=U campaign and is HIV positive. “The very definition of what it means to live with HIV is changing, and that changes everything for our lives and for the epidemic.
There are many complex reasons why someone may not achieve an undetectable viral load. All HIV-positive individuals have a right to live free of stigma and discrimination and to pursue a fulfilling sexuality. To access medication and achieve an undetectable viral load is a privilege, and Hornet and U=U will work together to ensure that all people living with HIV have the right to quality health care and medications, so they can live long and healthy lives.
“We are very excited about this partnership with U=U. We’ve been committed to creating an online space that is free of stigma and discrimination. U=U has been a grassroots movement that has advanced basic principles of science while empowering people living with HIV and we are happy we can be a part of that. I’ve had HIV-positive and undetectable in my Hornet profile for years. It’s a way for me to affirmatively declare my status, educate others on the benefits to your health of being undetectable, and combat HIV-related stigma.” said Alex Garner, Senior Health Innovation Strategist at Hornet.
Hornet and the U=U campaign will conduct a series of events in key cities around the globe to maximize the reach of the partnership and U=U campaign. The first event will be in NYC in February, followed by other activities in Paris, Sao Paulo, and Taipei.
HIV Drugs Control Disease – for Those Who Can Afford Them
In the past few decades, HIV has gone from being a fatal diagnosis to a manageable disease. Although no known cure exists, researchers have developed antiretroviral therapies (ARTs) that stop the HIV virus’ ability to make copies of itself in the body. Effectively, this means that individuals with HIV who consistently comply with the regimen can keep their infection under control and live a long life.
ART takes a multi-pronged approach to combating HIV – patients often have to take at least three different drugs daily to suppress their infection. With that regime comes a host of challenges, like lifelong adherence to daily medication, the cost of drugs and regular checkups, and drug resistance, to name a few.
In a paper published this year, ViiV Healthcare, a pharmaceutical company specializing in HIV therapy development, showed that another, more streamlined treatment method might be on the horizon. The LATTE-2 study combined two drugs into an injectable therapy that could be delivered to patients every eight weeks – and found it to be as effective as a daily oral treatment.
A long-acting therapy would be an exciting and momentous shift in the landscape of HIV treatment. Compared to daily oral treatments, it could improve medication adherence and ease the psychological burden of taking HIV drugs and disclosing HIV status. But getting the therapy from exciting idea to viable product is likely to be pricey, so it’s crucial to work in the meantime toward improving HIV diagnosis rates and overall treatment accessibility.
It’s recommended that HIV-positive individuals begin treatment right away, but the reality of ART-related costs can be an insurmountable barrier. Because of the variety in medical coverage and insurance plans, many patients are unable to cover the cost of ART, which can range from several hundred to several thousand dollars per month. This high cost of treatment disproportionately burdens low-income patients and drives the disparity in rates of HIV that puts certain minority groups at a greater risk of infection.
Where does the LATTE-2′s drug combination fit into this complex picture? Currently, the study is in phase two of a three-phase clinical trial. It enlisted adults with HIV who, for 20 weeks, followed a current standard-of-care: a three-drug combination taken daily to prevent the HIV virus from multiplying. After 20 weeks, patients were split into three cohorts: one continued the oral therapy regime, while the other two were given an injectable combination of drugs every four weeks or eight weeks. For two years, each patient’s HIV levels were regularly measured and they were monitored for any adverse effects associated with the treatment. Incredibly, over 80 percent of patients in each group had low levels of HIV by the end of the study, with no significant differences between any of the treatments.
In the meantime, we are continuing to learn more about how HIV functions, how it infects the body, and how it can be treated. Ultimately, a better understanding of the disease will drive us towards an accessible and sustainable solution for people living with HIV all over the world.
Until that happens, more work needs to be done to prevent HIV, increase the ease of testing, and interface with policymakers on how to lower the cost of treatment. We have taken a step forward in developing HIV therapies, but are several steps behind in making sure they get to the individuals they intend to treat.
PrEP and Reaching People of Color, Trans Women, and Young People
PrEP is an effective method of preventing HIV that is available and can be affordable to most people who want to use it. But not everyone at risk for HIV knows about it, and many people who could benefit from PrEP believe it’s not for them.
A recent panel discussion hosted by New America Media and the San Francisco Department of Public Health explored this very issue with six representatives working in the field of HIV prevention in San Francisco.
Speaking about their work and the diverse communities they serve, the panelists shared some of the important barriers that people of color, trans women and young people face related to PrEP knowledge, access and adherence.
Who is PrEP for?
Panelists highlighted the lack of diversity in PrEP campaigns and advertisements that lead groups of people to conclude that PrEP isn’t an option for them.
“PrEP is for everyone, because HIV affects everyone,” said Tapakorn Prasertsith, HIV prevention program supervisor at API Wellness. “It’s not just for men who have sex with men. But, our communities don’t feel represented at all.”
Some trans women, said Prasertsith, are confronting stigma because early PrEP research lumped trans women into categories with men who have sex with men.
“PrEP has been presented as a ‘gay drug,’ and trans women are [referred to] as gay men. Representation has been a real struggle,” said Prasertsith. “A lot of trans women I work with will say, ‘I’m not a sex worker so I don’t need PrEP.’ So this is another stigma we’re fighting.”
Terrance Wilder, the DREAAM Project program coordinator for San Francisco AIDS Foundation, emphasized that promotional campaigns for PrEP have not visually represented people of color in an authentically visual way. People of color, women and trans people may not think that PrEP is an option for them if they don’t see people who look like them in PrEP promotional materials.
Jorge Vieto, a health systems navigator at GLIDE Foundation, works with clients who are marginally housed, who stay at shelters, who live in encampments or are recently released from jail.
One barrier, said Vieto, is that many people they work with don’t know that PrEP is available. “We also realized that most people had the misconception that PrEP wasn’t for them. PrEP uptake in San Francisco has primarily been by white gay men. When I talk to the populations I serve, they don’t see themselves in advertisements. They don’t see themselves in prevention efforts.”
Jorge Zepeda, manager of Latino Programs at San Francisco AIDS Foundation, said that it’s important for media campaigns promoting PrEP access to realize that Latinos and Latinas are not all the same. And, that there are important distinctions between Latinos born in the U.S. and those who are immigrants.
“[Realizing this] will help us understand the needs, and how we are going to support our community,” said Zepeda. “We are a beautiful, diverse group of individuals. We may share a language, we may share a continent. But we are also unique. Talk to us.”
Although access to PrEP or patient assistance programs does not require proof of residency, this is a common concern for people who are wary of accessing social services for this reason, said Michael Barajas, a PrEP navigator at the San Francisco Department of Public Health.
“This is something I have to stress to people I communicate with,” said Barajas, who serves Spanish-speaking clients in the Mission neighborhood of San Francisco. “We let them know it [residency status] doesn’t matter. We can still get them access to medication.”
Competing life concerns
The panelists all agreed that competing life concerns are a significant barrier to many people in the communities they serve.
Denny David, deputy director of LYRIC, said that it’s difficult for marginalized young people to think about taking care of their health when they feel systematically disconnected from institutions including school, religious communities, places of employment and health care.
“PrEP is more than just popping a pill,” said David. “It’s about an entire shift in point of view. It’s a sign of, I’m taking a step or stand for my self-worth. And it’s about envisioning a future self where you’re alive, happy and loved.”
LYRIC serves many youth clients who are people of color, immigrants and transgender or gender non-conforming. Many are homeless or marginally housed, and the percentage of clients experiencing homelessness is increasing every year.
“When you don’t know where you’re sleeping at night, remembering to take a pill is challenging,” said David.
Wilder, from San Francisco AIDS Foundation, expressed this same concern about the young men of African descent he sees in the DREAAM program.
“If you don’t know where you’re going to lay your head at or where your next meal is coming from, or if there are things going on in your family, it’s going to be hard to think about the daily discipline of taking a pill every day,” said Wilder.
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Learn more about PrEP & find PrEP services
PleasePrEPme.org is a website linking people seeking PrEP services to PrEP providers across the U.S. The site includes a searchable directory (by state, zip code or street address) for users to find PrEP clinics and PrEP clinicians with hours, contact information and health insurances accepted for each listing.
San Francisco City Clinic offers free and low-cost sexual health care to people in the Bay Area regardless of immigration or insurance status. They offer same-day PrEP enrollment during drop-in hours:
Monday, Wednesday, Friday: 8 am – 3 pm Tuesday: 1 pm – 5 pm
For trans people, San Francisco City Clinic offers PrEP services by appointment Thursdays from 8 am – 11 am or during the drop-in hours.
San Francisco AIDS Foundation offers free PrEP services at Strut (470 Castro Street in San Francisco) and at their main office (1035 Market Street in San Francisco). Find more information and make an appointment online.
The CDC offers more info about PrEP and videos about this HIV prevention option.
Prepfacts.org provides FAQs about PrEP and other PrEP info.
Why Relying on Someone Else’s PrEP Isn’t a Good Idea
It’s becoming even easier for gay and bi men to search for and find partners on PrEP. Many people talk to partners ahead of time about their PrEP use. Social networking apps, like Grindr, also allow users to find partners who use PrEP (or who use other HIV prevention strategies like treatment as prevention).
“A lot of people will list their HIV status in their profile, or their PrEP use in their profile. So it’s pretty easy—and I think pretty common—to serosort or PrEP-sort on apps,” said Kay Nilsson, health advocacy coordinator at San Francisco AIDS Foundation.
One word of warning, though, for people who rely on other people’s PrEP use as their primary HIV-prevention strategy:
“There are some potential drawbacks to this strategy, that may expose you to risk,” said Oliver Bacon, MD, MPH, an HIV clinician and PrEP providers in San Francisco. “One of the breakthroughs of PrEP is that it’s an HIV prevention tool that you have complete control over yourself. You take it, and it protects you regardless of what your partners are doing or not doing. Relying on someone else’s PrEP is not the same thing. In fact, it’s exactly the opposite.”
One such case was recently highlighted during HIV Grand Rounds at Zuckerberg San Francisco General Hospital. Last year, a person in San Francisco contracted HIV after seeking HIV-negative partners on PrEP.
“That was his risk reduction strategy. He himself was never on PrEP,” said Susa Coffey, MD. “This was failure of prevention in a guy who not only was high risk, but knew he was high risk.”
If you’re HIV-negative and worried that you may be at risk for HIV, it’s better for you to consider using PrEP yourself than to try to find HIV-negative partners on PrEP. In San Francisco, said Bacon, just about every person who wants to access PrEP should be able to afford it because of benefit programs that reduce or eliminate the cost. San Francisco City Clinic, where Bacon sees clients, offers drop-in same-day PrEP services. San Francisco AIDS Foundation offers free PrEP services in San Francisco at Magnet, its sexual health clinic in the Castro, and at its headquarters in the mid-Market area.
Learn more about PrEP & find PrEP services
PleasePrEPme.org is a website linking people seeking PrEP services to PrEP providers across the U.S. The site includes a searchable directory (by state, zip code or street address) for users to find PrEP clinics and PrEP clinicians with hours, contact information and health insurances accepted for each listing.
San Francisco City Clinic offers free and low-cost sexual health care to people in the Bay Area regardless of immigration or insurance status. They offer same-day PrEP enrollment during drop-in hours:
Monday, Wednesday, Friday: 8 am – 3 pm Tuesday: 1 pm – 5 pm
For trans people, San Francisco City Clinic offers PrEP services by appointment Thursdays from 8 am – 11 am or during the drop-in hours.
San Francisco AIDS Foundation offers free PrEP services at Strut (470 Castro Street in San Francisco) and at their main office (1035 Market Street in San Francisco). Find more information and make an appointment online.
The CDC offers more info about PrEP and videos about this HIV prevention option.
UNAIDS Calls to Quicken the Pace of Action to End AIDS
The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.
The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.
However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030. In order to step up progress and achieve the global targets adopted in the 2016 United Nations Political Declaration on Ending AIDS, all partners need to fully implement their country Fast-Track strategy. Ending AIDS requires steadfast political leadership, commitment to action and accountability towards shared responsibility and reaffirmed global solidarity. Increased effective and efficient investments are, and will continue to be, an essential prerequisite for success. Elimination of stigma and discrimination and full recognition of human rights are cornerstones of sustainable progress.
“Leadership, partnership and innovation will transform the epidemic,” said UNAIDS Executive Director Michel Sidibé.
President Museveni was the first head of state in Africa to launch a presidential Fast-Track initiative on ending AIDS as a public health threat, known as “Kisanja Hakuna Mchezo”, or “no time for playing games”.
“I am confident that working together with you all, we shall attain an AIDS-free Africa. It is possible to end AIDS in our generation!” said President Museveni.
During the event, the speakers outlined the positive impact that the Fast-Track approach to ending AIDS is having on people, health systems and the broader Sustainable Development Goals in Africa and beyond. They noted that addressing HIV within the Sustainable Development Goals will pave the foundation of the AIDS response.
“We must build on the Fast-Track commitments. We cannot stop before we have reached the finish line,” said Jacquelyne Alesi, a civil society representative from Uganda.
Speakers made a strong call for political leadership, global solidarity and shared responsibility to build momentum and deliver on the goal of ending AIDS by 2030, highlighting the role that supporting strengthened health systems plays, not just in making progress towards the Fast-Track Targets, but also in addressing stigma and discrimination.
“I am not speaking of a vague hope, but of a willingness of the heart. I do not say “we could defeat AIDS,” but rather “we will end AIDS,” said Line Renaud, singer and AIDS activist.
Momentum is building, but has not yet reached a critical mass. When the United Nations General Assembly adopted the Political Declaration on Ending AIDS in June 2016, Member States committed to achieve global and regional Fast-Track Targets by 2020.
In 2016, UNAIDS estimated:
19.5 million people were accessing antiretroviral therapy
36.7 million [30.8 million–42.9 million] people globally were living with HIV
1.8 million [1.6 million–2.1 million] people became newly infected with HIV
1.0 million [830 000–1.2 million] people died from AIDS-related illnesses
IAS 2017: Progress on PrEP, treatment as prevention, and HIV cure science
While the world’s top HIV experts reported no earth shattering progress in preventing, treating or curing HIV at the 9th IAS Conference on HIV Science (IAS 2017), which took place in July in Paris, it did serve as an important marker of progress. HIV researchers revealed new data that further strengthened the case for PrEP and HIV treatment as prevention — and issued a resounding declaration that a person with full viral suppression is essentially incapable of passing on HIV to their sex partners.
On the other hand, a joint meeting of HIV and cancer scientists, just before IAS 2017, ended on a more somber note. Though noting the rapid progress in our knowledge of the underlying mechanisms that make both HIV-infected cells and cancerous cells so hard for the body to get rid of, experts there also acknowledged that while long-term viral remission — with HIV still present in the body — can likely be achieved in many people, completely eliminating the virus will remain rare.
Here are some key highlights from the conference.
HIV Treatment Scale-up, Treatment as Prevention, and U=U
Two presentations and one issuance of a declaration statement, when combined, demonstrated just how much progress we are making at simultaneously improving the physical, mental and social health of people with HIV and substantially reducing the number of new HIV infections around the globe.
In terms of the societal impact of HIV treatment scale up and viral suppression, a new study out of Swaziland in the Kwazulu-Natal province in South Africa found that doubling the number of people with HIV who had full viral suppression was accompanied by a 50% drop in new infections. Though previous studies in multiple countries and cities had demonstrated less directly that increasing the number of people with HIV on ART was associated with significant drops in new HIV cases, this study represents the most direct correlation between viral suppression and HIV incidence to date.
A second presentation took these data to a very personal level. The previously reported PARTNER study, which predominantly enrolled heterosexual mixed HIV status couples, found zero cases of HIV transmission between people with HIV who had fully suppressed virus and their HIV-negative primary partner, despite thousands of condomless sex acts. The PARTNER study did enroll couples where both partners were male and where condomless anal sex was the primary risk, but the numbers were so small it was not possible to derive firm conclusions other than that lower HIV levels did offer good protection.
The Opposites Atract study focused solely on male-male mixed HIV status couples, and also found zero new infections between positive and negative partners despite nearly 17,000 condomless sex acts, a fair number of them occurring when the HIV-positive partner also had a sexually transmitted infection. Combined with the original PARTNER study, the top experts who convened the IAS 2017 conference, and high level officials from the U.S. government issued a strong declaration in support of the Undetectable = Untransmittable (U=U) campaign from the Prevention Action Campaign, which stresses the critical importance for people with HIV and the communities they live in to be aware of the fact that when a person living with HIV is on ART with a persistently undetectable viral load there is a negligible risk that they can transmit HIV to their sex partners. Growing consensus around this statement, and gaining buy-in and support from medical societies and various branches of government could considerably improve the physical, emotional and social well-being not only of people with HIV, but others in their communities.
PrEP
Perhaps the most helpful presentation on pre-exposure prophylaxis (PrEP) came from a second look at data from the IPERGAY study, which took place in France and Canada a couple of years ago, and which studied intermittent rather than continuous daily PrEP. Though efficacy rates were very high in IPERGAY — an 86% reduction in new HIV infections overall, but zero new infections in people who actually took their medication as directed — a critical uncertainty remained. Since the protocol recommended PrEP just before, during and after sex, and because so many participants had a lot of sex, a lot of the guys in the study were essentially taking daily PrEP.
The re-analysis of data on the subset of people who did go for longer stretches between sexual encounters, and who therefore could be considered as truly taking intermittent PrEP, showed that they also had high levels of protection against HIV transmission. It thus seems pretty clear that intermittent PrEP is a reasonable approach for those who go for longer periods between having condomless anal sex (provided that it is taken similarly to the protocol used in IPERGAY). It also lends further weight to the argument that even daily oral PrEP is likely to be incredibly forgiving of missed doses in those whose HIV risk is from condomless anal sex.
Pathway to a Cure
Since approximately 2010, when the world’s top scientists and government agencies began openly using the word “cure” as an achievable goal in the fight against HIV, we have gone from an initial burst of exuberance to an attitude of more sober optimism — the result of repeated experiments documenting the stubborn persistence of the virus and its ability to surge back to life when ART is stopped, even when the most sensitive tests seeking a trace of it come up blank over months or years.
Interestingly, as the consensus among scientists is that total elimination of the virus from a person’s body is highly unlikely, but that a long-lasting remission free of ART might be, we are now most intensively utilizing drugs designed for another condition where the word remission is the key: cancer.
Because both HIV-infected and cancerous cells hijack the biological machinery that protects the immune cells from attack by most viral infections, the IAS 2017 organizers convened a small pre-conference devoted to exploring the commonalities and the ways that some of the newest cancer drugs might also be promising as part of a combination approach to achieving long-lasting suppression of HIV when people stop taking ART.
Predominantly, those drugs are focused on the molecular markers on the outside of CD4 and CD8 cells that communicate with other immune cells. These checkpoint markers can affect whether a cell that has been activated by the presence of a virus essentially goes to sleep and becomes invisible to the rest of the immune system. While this is a desirable ability if we want to retain cells that can immediately mount strong immune response if we are exposed to a virus a second time, it is a total liability if those cells harbor reproducible portions of genetic material that can lead to the reemergence of HIV disease or cancer.
The good news is that several of the immune check-point blockers are so much more potent against some cancers than previous drugs, also appear to enhance the immune system to recognize and eliminate cells that are latently infected with HIV. Unfortunately, the drugs approved so far stop or reverse tumor growth in only about half of people with cancer, and the drugs almost always lose potency over time. This is leading researchers to believe that immune-checkpoint blocker therapy for cancer is possibly going to look a lot more like modern ART — combinations of drugs used together over the course of a person’s life.
Though sobered by these realities, however, the two-day pre-conference ended on a note of determination to succeed with the same zeal that delivered the medications that are making ending the epidemic a plausible reality for many parts of the globe.
NMAC Launches Campaign to Fight Proposed Cuts to HIV Services
Today, NMAC Launches “Save Our Services,” an innovative campaign created to empower Americans across the country in fighting the proposed federal budget cuts that would cause severe harm to vital HIV treatment and prevention services.
If passed, the president’s budget would:
- Eliminate the Secretary Minority AIDS Initiative FUND (SMAIF), a program that provides over $50 million in funding that helps get and keep people of color in care.
- Decrease funding to the Ryan White HIV/AIDS Program by $59 million thereby eliminating AIDS Education and Training Centers which would make it all but impossible for clients seeking HIV-related services to do so.
- Cut $610 billion from Medicaid – one of the largest payers of insurance for people living with HIV.
- Result in over one million fewer HIV tests each year, meaning thousands of people will be unaware of their status leading to over 30,000 more people becoming HIV-positive.
“These cuts would deprive communities of color – which are more greatly impacted by HIV – from vital treatment and prevention services,” said Kawata. “Make no mistake: these proposed cuts would lead to more people becoming sick, becoming HIV-positive, or even dying. We absolutely cannot back down in the fight against HIV/AIDS now that we are so close to a final victory in this decades-long fight.”
FDA Application Accepted for HIV Drug with New Mechanism of Action
Theratechnologies Inc. (Theratechnologies) (TSX: TH) announced Friday that it has been notified by its partner, TaiMed Biologics, Inc., that the U.S. Food and Drug Administration (FDA) has accepted for review the Biologics License Application (BLA) for ibalizumab as a treatment for multidrug resistant Human Immunodeficiency Virus-1 (MDR HIV-1). If approved, ibalizumab will be the first antiretroviral treatment (ART) with a new mechanism of action to be introduced in nearly 10 years and the only treatment that does not require daily dosing.
“We are excited to be one step closer to potentially bringing an important new treatment, with a new mechanism of action, to patients whose virus has become resistant to therapies in multiple classes and have limited treatment options for the long-term management of their condition,” said Luc Tanguay, President and Chief Executive Officer, Theratechnologies Inc. “The granting of Priority Review status is important since it confirms that, if approved, ibalizumab would represent a significant improvement in the treatment of this serious condition,” added Mr. Tanguay.
The FDA has set a Prescription Drug User Fee Act (PDUFA) target action date of January 3, 2018, for the ibalizumab application. Priority Review status accelerates FDA review time from 10 months to a goal of six months from the day of acceptance. In addition, ibalizumab received Breakthrough Therapy designation from the FDA in 2015, which is given if a therapy may provide a substantial improvement over what is currently available to address a serious and life-threatening condition. The FDA also granted Orphan Drug designation in 2014.
The BLA, submitted on May 3, 2017, is based on data from the phase III TMB-301 study, a single arm, 24-week study of ibalizumab plus an optimized background regimen (OBR) in treatment-experienced patients who had high pre-existing levels of drug resistance and advanced clinical disease.
The ibalizumab Expanded Access Program (EAP), or study TMB-311, is ongoing and enrolling patients. For more information about TMB-311 (NCT02707861), please refer to the ClinicalTrials.gov website (www.clinicaltrials.gov[clinicaltrials.gov]) or the study website (www.ibalizumab-eap.com[ibalizumab-eap.com]).
As HIV multiplies in the body, the virus may mutate to produce drug-resistant strains. Viral mutations may mean that HIV medicines that previously controlled a person’s virus are no longer effective, causing treatment to fail. There are approximately 20,000 to 25,000 Americans with HIV-1 that are resistant to at least one drug out of the three different classes of antiretroviral therapies. Up to 12,000 of these patients experience a virological failure over a period of 48 weeks of treatment, requiring their physician to modify their treatment.
About ibalizumab
Ibalizumab is an investigational humanized monoclonal antibody being developed for the treatment of MDR HIV-1 infection. Unlike other antiretroviral agents, ibalizumab binds primarily to the second extracellular domain of the CD4+ T cell receptor, away from major histocompatibility complex II molecule binding sites. It potentially prevents HIV from infecting CD4+ immune cells while preserving normal immunological function.
Ibalizumab is active against HIV-1 resistant to all approved antiretroviral agents.
AIDS United Releases Statement for Providing Trans-affirming HIV Medical Care, Support Services and Funding
In a community-created consensus statement released today, AIDS United provides critical guidance for clinical providers, funders and social service providers to strengthen their understanding of how best to engage and support transgender communities. The statement provides concrete and measurable steps organizations can take to improve their approach to HIV work in transgender communities and was drafted by 12 transgender leaders at a think tank convened by AIDS United and generously supported by Janssen Therapeutics, Division of Janssen Products, LP.
The transgender community is critically affected by HIV and faces unique challenges accessing HIV care. A landmark 2013 study estimates that 22 percent of transgender women in the United States are living with HIV. This makes transgender women the most heavily affected group in the United States, relative to their population size. This disproportionate risk is fueled by pervasive violence and discrimination faced by transgender and gender non-conforming individuals in areas such as housing, education and when accessing health care.
“Our recent survey shows 41 percent of the respondents reported lapses in health care for longer than six months. This speaks to the need to meaningfully involve trans people living with HIV in cultural competency training and program designs. Trans people are experts of their experiences and this consensus statement puts the expertise of trans people front and center,” said nationally recognized leader in civil rights and trans equality Cecilia Chung.
“Twelve trans leaders from across the country came together to create concrete recommendations so that funders, health care providers and social services organizations can serve our communities with the dignity and respect we deserve. There is power in this—and the best practices we outlined are critical for improving trans health and justice in this country,” said Chung.
Due to these factors, it is critical that clinics and support services are welcoming, inclusive and competent in serving transgender people. Additionally, funders must ensure that funding strategies and decisions are community informed to yield the greatest impact.
“We can no longer ignore the needs of the transgender and gender-nonbinary community. Our consciousness of their presence has been raised, but our services have not stepped up to meet their unique needs,” said AIDS United President & CEO Jesse Milan, Jr. “We cannot allow transgender people to be left out or left behind or we will not fully achieve our national goals.”
The Consensus Statement and the newly launched Transgender Leadership Initiative, also funded by Janssen Therapeutics, are programmatic efforts by AIDS United to better partner with transgender leaders to address the dire HIV epidemic in transgender communities, to improve transgender health outcomes and to solidify transgender power in our society. Proposals for support from the Transgender Leadership Initiative are due by Jun 14, 2017 at www.aidsunited.org.
“This statement is a foundational tool that every provider and HIV advocate can use. It is the newest tool in our toolbox for ending the HIV epidemic in this country and AIDS United is proud to release it to everyone,” said Milan.