HIVR4P 2024 updates
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AI’s role in HIV prevention services Artificial intelligence (AI) in HIV prevention is just beginning to unfold. Maaya Sundaram of the Gates Foundation explored this in the session, The Digital Revolution and HIV Prevention: Social Media, Artificial Intelligence and Machine Learning, showcasing AI’s impact on drug discovery, PrEP delivery and on patient and provider support. Sundaram spoke to a 2023 study demonstrating that AI can provide high-quality, empathetic responses to patient questions and concerns, but was also clear that humans still need to be actively involved where AI is used, ensuring quality and accuracy of the AI responses to questions, and making sure the information they’re providing to patients is up-to-date. She reported that AI can use a predictive model to provide population-level insights such as how to support people who have fallen out of care, and highlighted its benefits in streamlining administrative tasks such as data entry. But even with these benefits, data security and privacy protection must be ensured for trial participants, patients and program clients, particularly for key populations seeking care in highly stigmatized and/or criminalized environments. Sundaram stressed the need for data from programs all over the world, not just the US and Western Europe, for AI tools to be culturally appropriate for all contexts. Beyond this, delegates cautioned the panel about the potential environmental impacts of AI noting that it’s a space advocates are watching. (courtesy of AVAC issue, 11/10/24) |
Women in Africa Opt for New HIV Prevention Methods African women are embracing new choices for HIV prevention. The dapivirine vaginal ring (DVR), which offers women more control over their HIV prevention, is gaining popularity. Elizabeth Irungu of Jhpiego presented data from the Catalyst study, which surveyed over 3,900 women across Kenya, South Africa, and other countries. The study revealed that 30% of the women opted for the DVR, while 66% preferred oral PrEP. Notably, the ring was particularly popular among pregnant and breastfeeding women. The DVR’s appeal lies in its convenience—users are not required to take daily pills, making it a promising option for women with multiple partners or those using contraceptives. The dapivirine vaginal ring is a flexible silicone device that releases the antiretroviral drug dapivirine over 28 days to help prevent HIV infection in women. "These findings show the importance of giving women options that suit their lifestyles," said Irungu. The ongoing CATALYST study will continue to track how these preferences evolve and inform strategies to increase HIV prevention uptake across Africa. Read more on the available options here |
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Africa: Time to Embrace HIV Prevention Tools While We Wait For The Cure The key positive takeaway from the HIVR4P 2024 is that people must not die while waiting for a cure when powerful preventive tools already exist. It’s time for all, especially those in vulnerable communities, men who have sex with men, trans and gender-diverse people, sex workers, and people who inject drugs, to take up these cool prevention methods as they become available. One of the most promising developments highlighted is the twice-yearly injectable PrEP drug, lenacapavir. In the recently conducted PURPOSE 1 and PURPOSE 2 trials, the drug demonstrated remarkable efficacy in preventing HIV acquisition. PURPOSE 1 showed a 100% reduction in HIV acquisitions among cisgender women in Africa, while PURPOSE 2 showed a 96% reduction across multiple countries, including South Africa and Uganda. Lenacapavir is a game-changing leap in HIV prevention. For people in under-resourced areas, the convenience of taking a biannual injection as opposed to a daily oral medication could be revolutionary. It offers a practical and stigma-reducing option, especially for women who have historically faced barriers to adherence to traditional PrEP. As Beatriz Grinsztejn, President of the International AIDS Society (IAS), noted, these findings could transform HIV prevention for all genders. Read more insights from Sethi Ncube's perspective here |
The high stakes of inclusion Key sessions highlighted the importance of ensuring equitable access to prevention tools for transgender and gender-diverse individuals (TGD), as well as addressing the policy and legal barriers that hinder care, particularly in countries with anti-LGBTQI+ legislation. “Trans people are giving our blood, our bodies, our time to clinical trials, and we need to make sure that findings from clinical trials—the right to science—the right to benefit from science comes back to us when we participate,” said Brian Minalga at the session, Policy and legal barriers to HIV services. Minalga pointed to the No Data No More manifesto and scorecard tool, resources for envisioning, designing, and grading clinical trials for meaningful trans and gender-diverse inclusivity. The scorecard uses 13 indicators to assess the inclusion of TGD people in clinical trials. The scorecard assessment found that prior to the IMPOWER and PURPOSE trials, TGD individuals made up less than 1% of HIV prevention studies. Adding to the conversation, Sara Melillo of USAID in Uganda discussed the adverse impact of Uganda’s 2023 Anti-Homosexuality Act (AHA), which has resulted in evictions, forced relocations, and a 60% drop in HIV services, though some services have since recovered. Read more from the updated report, Unwanted, Outlawed and Illegal: The cry from LGBTIQ+ Ugandans from Convening for Equality (CFE), and advocacy from LGBTQ+ Ugandans, AIDS activists and supporters during the recent UNGA meeting urging the World Bank to withhold lending to Uganda until the AHA is repealed. (courtesy of AVAC issue, 11/10/24) |
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