Achieving the 90-90-90 target news

Controlling the HIV epidemic: ambitious funding, expanded workforce, innovations and micro-focus needed

Advocates who seek to end AIDS by 2030 should be ready to call on Hillary Clinton to massively increase United States support for the Global Fund to Fight AIDS and the US President’s Emergency Plan for AIDS Relief (PEPFAR) if she wins next month’s US presidential election, Professor Jeffery Sachs of Columbia University told the International Association of Providers in AIDS Care’s 'Controlling the HIV Epidemic with Antiretrovirals' summit last week in Geneva.

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Promising trends continue in UK diagnosis and treatment rates

A ‘mini report’ of the latest figures on HIV diagnoses, late diagnosis, and treatment uptake in the UK reports generally good results, with downward trends in infections, the proportion of people diagnosed late, and the proportion both on treatment and virally suppressed.

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Early infant HIV testing at birth and at 6 weeks of age will save lives, extend life expectancy and is cost-effective for South Africa, study finds

Early infant HIV diagnosis in South Africa will save lives, extend life expectancy and be cost-effective, according to a modelling study published in the online edition of the Journal of Infectious Diseases. Compared to no early infant diagnosis (EID), testing at either birth or 6 weeks of life reduced one-year mortality rates, led to a longer life expectancy and was cost-effective. Testing at both birth and 6 weeks had further benefits.

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Sweden the first country to achieve UNAIDS/WHO 90-90-90 target

Sweden has become the first country to achieve the UNAIDS/World Health Organization (WHO) 90-90-90 target, research published in HIV Medicine shows. At the end of 2015, 90% of HIV cases in Sweden were diagnosed, 99.8% of people were linked to care and 95% of people taking antiretrovirals for at least six months had a viral load below 50 copies/ml.

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Delays in updating HIV treatment guidelines in Africa blocking early treatment for millions

Delays in adopting the World Health Organization (WHO) 2015 recommendation of HIV treatment for all threaten the achievement of the 90-90-90 targets for HIV diagnosis and viral suppression by 2020, research carried out by the International Association of Physicians in AIDS Care (IAPAC) indicates.

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Progress towards 90-90-90: news highlights from other sources

Large increases in HIV suppression needed to reduce new infections in critical population

from National Institutes of Health

Achieving moderate reduction of new HIV infections among men who have sex with men (MSM) will depend on significantly increasing the percentage of HIV-positive MSM whose viral load is suppressed to undetectable levels, according to a new mathematical model based on data from Baltimore. Access and adherence to antiretroviral therapy are key to sustained HIV suppression, which dramatically reduces the risk of transmitting HIV to others.

To get to zero HIV infections, San Francisco needs to help the homeless

from BETA blog

Reaching the goal of zero HIV infections by 2020 – a goal experts say the city is poised to accomplish – will mean figuring out how to support some of our city’s highest needs cases: people who are homeless or marginally housed.

NYC Condom reaching key populations with targeted distribution, marketing and mobile phone app

from UNAIDS

New York City was the first city in the world to have its own municipally branded condom, and it currently maintains the largest free condom programme in the United States of America. Even in this high income, cosmopolitan city, free condom distribution is instrumental in preventing HIV, other sexually transmitted infections and unintended pregnancies among key populations. Free condom distribution is included as a cost-saving and cost-effective prevention strategy within the 2015 Blueprint for ending the AIDS epidemic in New York State by 2020.

Human rights – critical to ending the AIDS epidemic

from UNAIDS

At a meeting to discuss human rights and the 2016 Political Declaration on Ending AIDS, panellists underscored the urgent need to protect services for women, girls, people with disabilities, migrants and displaced people.

Fuzzy math at the global fund replenishment?

from Medium

Why $13 billion might not be $13 billion and why it’s insufficient even if it is.

Global Fund sees new donors, persistent gaps

from Devex

The Global Fund to Fight AIDS, Tuberculosis and Malaria hit its funding goal at the fifth replenishment conference in Montreal, Canada, from 16-17 September. But advocates warn that those funds may still fall short of what’s needed to reach the most vulnerable communities. The reasons include persistent human rights challenges and access to affordable drugs – both of which require new financing and better policy, advocates said.

UNAIDS encouraged for future of HIV funding as donors pledge full support to the Global Fund

from UNAIDS

The new financial commitments represent a significant increase compared to the US$12 billion in pledges made at the previous replenishment conference. Private donors and innovative financing mechanisms more than doubled their pledges to the Global Fund compared to the last conference. Several new countries made pledges and others increased commitments, including Canada, Germany and Japan.

Lessons learned from scaling up HIV treatment in Mozambique

from CDC

A new CDC study examining the first decade of HIV antiretroviral therapy (ART) scale-up in Mozambique revealed fewer people are dying from HIV in recent years, likely due to more patients starting treatment at earlier disease stages. The analysis also found that people who more recently began ART were less likely to remain engaged in HIV treatment and care over time. The analysis highlights participation in community ART support groups (CASGs), small groups of patients who support each other to remain on ART, as an effective strategy to significantly reduce loss to follow-up.

Global Fund donors pledge nearly $13 Billion to help end epidemics

from Global Fund to Fight AIDS, TB and Malaria

At the launch of the Global Fund's Fifth Replenishment, donors pledged over US$12.9 billion for the next three years, demonstrating extraordinary global commitment toward ending the epidemics of AIDS, tuberculosis and malaria for good.

Clinton Foundation plans to spin off flagship health project

from Reuters

The Bill, Hillary & Chelsea Clinton Foundation would spin off its flagship health project, the Clinton Health Access Initiative, into a "completely independent" charity if Hillary Clinton were to win the US presidency in November.

Why 2.1 million Indians living with HIV do not get the drugs they need

from Firstpost

Each of an estimated 2.1 million Indians living with the human immunodeficiency virus (HIV) should be getting a cocktail of drugs to prolong their lives and reduce infections, but no more than 44% do, the minister of health told the Lok Sabha (parliament’s lower house) in April 2016.

News from HIV Glasgow

New long-acting fusion inhibitor albuvirtide plus boosted protease inibitor matches standard triple-drug therapy

A new fusion inhibitor, albuvirtide, under development in China, combined with a boosted protease inhibitor, proved just as effective as a triple regimen of lopinavir/ritonavir plus two NRTIs in treatment-experienced patients, the International Congress on Drug Therapy in HIV Infection (HIV Glasgow) heard last week.

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Generic hepatitis C drugs purchased online achieve high cure rates

Use of generic versions of direct-acting antivirals resulted in very high cure rates for people who obtained the products through three buyers’ clubs, indicating that the generic products are effective, according to three presentations at the conference.

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Tests of online PrEP purchases by London clinic find no fakes, and adequate drug levels

A sexual health clinic in central London that offered to test drug levels in users of tenofovir/emtricitabine pre-exposure prophylaxis (PrEP) who had bought it online found adequate levels of both drugs in their blood, and no sample suggesting counterfeit drugs.

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The benefit of treatment has outweighed the clinical impact of lipodystrophy, conference hears

The conference heard last week that over a 20-year period, people who suffered lipodystrophy (fat redistribution) and especially lipoatrophy (fat loss) when they started antiretroviral therapy (ART) actually had better health outcomes than people who did not suffer from it.

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French study reveals the growing complexity of medical needs as people with HIV age

The complexity of the needs of people living with HIV will continue to increase as the population ages, and clinicians need to go beyond thinking about co-morbidities to consider multi-morbidities – clusters of medical conditions which complicate one another – when caring for these people, Dr Edouard Battegay of University Hospital Zurich told the conference.

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Dolutegravir and central nervous system side-effects: abacavir, older age increase the risk

Insomnia, dizziness, headache and other central nervous system side-effects are occurring more frequently with everyday use of dolutegravir than clinical trials had suggested, and are most likely to occur in women, people over 60 and people starting abacavir at the same time, a German research group told the conference.

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Two-drug HIV therapy just as effective as three-drug therapy

Simplification of an antiretroviral treatment to a boosted protease inhibitor and the nucleoside analogue lamivudine (a dual regimen) is highly effective in people switching from a stable three-drug regimen, researchers reported at the conference.

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New $90-$90-$90 target needed for global viral hepatitis, HIV and TB treatment

The costs of making drugs to treat viral hepatitis, HIV and tuberculosis (TB) are now so low that each disease could be treated for less than $90, Dr Andrew Hill of St Stephen’s AIDS Trust told the opening plenary of the conference in Glasgow.

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News from HIVR4P

Some of the Americans who need PrEP the most face the greatest barriers to getting it

The personal values and moral judgements of healthcare providers are likely to interfere with the appropriate provision of pre-exposure prophylaxis (PrEP), Sarah Calabrese of Yale University told the HIV Research for Prevention conference (HIVR4P) in Chicago. When medical students were given hypothetical scenarios of gay men seeking PrEP, they were less willing to provide it to men who were not monogamous and to men who acknowledged not using condoms. Men at a lower risk of acquiring HIV had a greater chance of getting PrEP.

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As PrEP knowledge increases in San Francisco, 12,500 people now thought to be on PrEP

Knowledge about and use of HIV pre-exposure prophylaxis (PrEP) has greatly increased over the past few years in San Francisco, and surveillance estimates suggest that some 12,500 people are now on PrEP, most of them gay and bisexual men, according to a presentation at the conference.

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New HIV prevention products will need marketing and effective health services to reach the people who need them

There is a naivety among many HIV prevention researchers and advocates about the steps needed to introduce and implement new HIV prevention technologies such as oral pre-exposure prophylaxis (PrEP), vaginal rings and vaccines, according to speakers at the conference in Chicago. Developing an effective prevention method is the easy part, they suggested – ensuring the product reaches end users can be more challenging.

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Huge diversity in current HIV vaccine research, Research for Prevention conference hears

The HIV vaccine research field is currently going through probably its most fertile and diverse period yet, the conference heard. A high proportion of presentations there were devoted to the multiplicity of different approaches scientists are taking towards making an effective a vaccine.

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New microbicide enema achieves high levels of drug in rectal tissues in monkeys

Rectal microbicides that protect against HIV transmission via anal sex are a bigger technical challenge than vaginal ones. The rectal lining is more delicate than the vaginal, so safety has been an issue; research has shown that many of the gel formulations used in lubricants damage rectal cells and may actually enhance HIV transmission.

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Rings, films or inserts? Researchers need to develop prevention products that make sense in women’s lives

“We need to think outside of the box,” Sharon Hillier of the Microbicide Trials Network told the conference. Researchers should not be aiming to develop the most scientifically elegant solution for HIV prevention, but should “figure out how to make products that can really fit into people’s lives”.

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Vaginal and rectal bacteria may have a big influence on HIV transmission and microbicide efficacy

A number of presentations at the conference looked at the influence vaginal bacteria have on HIV susceptibility, and one presentation found that vaginal bacteria may have profound effects on the levels of certain drugs used as microbicides – but not on others.

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Policy makers’ inaction is leading people to take PrEP ‘in the wild’

An increasing number of gay men and others at risk of HIV are seeking to protect their health with PrEP (pre-exposure prophylaxis), but the lack of PrEP provision and lack of regulatory approval in many countries is leading people to take PrEP without medical supervision and on an ad-hoc basis. This will undermine the safety and effectiveness of PrEP, Jerome Galea said as he presented results of the PrEP in the Wild survey to the conference.

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Anal sex may transmit four in ten HIV infections in US women at high risk

A study presented at the conference suggests that, in women at high risk of HIV infection, 40% or more of the HIV infections in this group might be transmitted via anal intercourse.

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Second case report of PrEP failure due to drug-resistant virus

A PrEP user in New York City has become HIV positive with virus that is resistant to Truvada and other antiretroviral drugs, the conference heard. This is only the second such case that has been reported, highlighting the rarity but not the impossibility of HIV infections in people who adhere to their PrEP (pre-exposure prophylaxis) medication schedule.

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Other aidsmap news

Only a small proportion of gay men with HIV receive anal cancer screening

In the absence of national screening guidelines, only 11% of HIV-positive gay and bisexual men in the US received anal pap smears to detect anal cancer or precancerous cell changes from 2009 to 2012, with disparities between patient groups and variations across centres, according to a presentation at IDWeek 2016, taking place this week in New Orleans.

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Mental health disorders common among people with HIV in British Columbia

Over 50% of people with HIV, many from disenfranchised groups, in British Columbia, Canada, are living with a mental health disorder, investigators report in AIDS Care. Such disorders were associated with decreased functioning and life satisfaction and a higher burden of stigma and discrimination. However, HIV treatment outcomes were similarly good for people with and without mental health problems.

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Editors' picks from other sources

HIV Patient Zero cleared by science

from BBC Health

One of the most demonised patients in history – Gaetan Dugas – has been convincingly cleared of reports he spread HIV to the US, say scientists

Final data backs early findings, WHO recommendations, showing shorter MDR-TB treatment course working better

from Science Speaks

Presenting results today of a nine-month treatment regimen that led to an 82% cure rate among 1006 people with multidrug-resistant tuberculosis, researchers called their findings a breakthrough that can support countries in adopting shorter, more effective and potentially less damaging treatment for TB that is resistant to more than one first-line treatment.

STD rates sharply rise in US says CDC – Will misinformation from PrEP critics prevail?

from Project Inform

The Centers for Disease Control and Prevention (CDC) just published a report on the rates of chlamydia, gonorrhea and syphilis in 2015, finding the highest number of case reports on these infections in 20 years and a steep increase over the last reported period in 2014. Is this a cause for concern? Absolutely. But, as will inevitably be the case, there are going to be questions about whether increasing use of pre-exposure prophylaxis (PrEP) is to blame and the answer is pretty conclusively “no” as far as one can tell from the available data and the CDC as much as says so.

Norway to provide free HIV-preventing PrEP drugs to at-risk gay men

from Pink News

Norway has become the second country in Europe to make PrEP available, announcing that PrEP drugs will be available free of charge to at-risk groups via its National Health Scheme. According to HIV Norway, Minister for Health and Social Care Bent Høie announced the move, making Norway the first country in Europe to make the drug completely free for users (French users have to pay a small and largely reimbursible upfront fee).

7 insurers alleged to have discriminated against HIV patients

from NPR

The Affordable Care Act prohibits insurers from discriminating against people with serious illnesses, but some marketplace plans sidestep that taboo by making the drugs that people with HIV need unavailable or unaffordable, complaints filed recently with the Department of Health and Human Services' Office for Civil Rights allege.