News from aidsmap

Second case of unintended HIV transmission during HIV cure study prompts questions about PrEP provision

A second case of HIV transmission from someone interrupting their HIV therapy as part of a cure study has been published. The report, by Dr Ainoa Ugarte, Dr Lorna Leal and colleagues from Barcelona University Hospital has prompted discussion about whether the HIV-negative partners of people involved in studies that feature so-called analytical treatment interruptions should be offered PrEP as a matter of course.

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People with HIV aged 75 and older receiving good HIV care but many at risk of frailty

People with HIV aged 75 years and older are receiving “almost perfectly managed” care, but are more likely to experience age-related health conditions, according to French research published in Médecine et maladies infectieuses. There were 65 adults (2%) living with HIV over the age of 75 in the Pays de la Loire region. Research showed that all were taking antiretroviral therapy and 98% had an undetectable viral load. Specialist assessment showed that a fifth were at risk of frailty and 4% were frail.

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Poor physical growth a common problem among HIV-positive adolescents in low- and middle-income countries

There is a high prevalence of stunted physical growth among HIV-positive adolescents living in low- and middle-income countries, investigators report in the Journal of the International AIDS Society. Approximately 50% had stunted growth at the time antiretroviral therapy was started. After the age of 12 years, adolescent boys were especially likely to have poorer than expected growth.

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Effectiveness and frequency of dosing are the most important factors affecting acceptability of injectable HIV therapy, says US study

Effectiveness and dosing frequency are the two key factors affecting the acceptability of long-acting injectable antiretroviral therapy, according to a small study conducted in the United States and published in AIDS and Behavior. Participants found injectable treatment moderately acceptable. The study included a broad spectrum of people living with HIV, including individuals with adherence problems, a likely target population for long-acting injectable therapy should it become available.

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Why do gay men do chemsex?

Stéphane, a volunteer with the French community organisation AIDES, set the tone for the recent 3rd European ChemSex Forum in Paris when he explained why he continues to use drugs in sexual situations. There are multiple reasons, many of them shared by other people, he said. “Firstly, the idea of pleasure is essential,” he said. “There is also the fear of not being able to do without, as well as the fear of not being up to the mark.”

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Mystery shopper exercise shows that HIV testing services for young gay men in the US need to be improved

A quality assurance exercise using 'mystery shoppers' in three US cities with high HIV incidence among young gay men showed that although most testing sites were perceived as welcoming, friendly and confidential, other problems were identified. Testing sites performed poorly on LGBTQ visibility, only a minority discussed relationship contexts or provided safer sex education, and information about PrEP was inconsistently provided. The study is published in the 1 December issue of the Journal of Acquired Immune Deficiency Syndromes.

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Vigilance over HIV drug interactions still needed

Problematic interactions between antiretroviral drugs and other medications remain a substantial challenge for people with HIV despite the shift away from the use of boosted protease inhibitors and older non-nucleoside reverse transcriptase inhibitors, research presented at the 17th European AIDS Conference showed (EACS 2019).

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Tesamorelin reduces liver fat and fibrosis progression in people with HIV and non-alcoholic fatty liver disease

Treatment with tesamorelin, a synthetic growth hormone-releasing hormone, reduced liver fat content and reduced the progression of liver fibrosis in people with HIV who had non-alcoholic fatty liver disease, researchers report in The Lancet HIV.

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Intermittent and lower-risk PrEP users may not be testing for HIV and STIs, German study finds

A survey of German PrEP users reported at the recent 17th European AIDS Conference (EACS 2019) found that one in nine of them had not had a single HIV, STI or renal function test during the time they were on PrEP. Of those who had taken an HIV test while on PrEP, 15.5% had taken a test less often than the recommended interval of three months, and 8.5% had had an STI check-up less often than the recommended once every six months. One in 25 PrEP users had not even had an HIV test shortly before starting PrEP.

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PrEP users have less HIV anxiety

Several qualitative studies have already found that gay and bisexual men using the preventative medication PrEP have reported benefits in terms of reduced anxiety about HIV, but until now there has been scarcely any quantitative data to confirm this. Now, an Australian study shows a statistically significant reduction in HIV anxiety among men who were eligible for PrEP and who were using it.

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One-third of people living with HIV in rural Tanzania report clinically relevant drug-drug interactions

A study from rural Tanzania, published online ahead of print in HIV Medicine, provides more evidence on the importance of appropriate management of clinically relevant drug-drug interactions for people living with HIV who are on antiretroviral therapy (ART). As life expectancy of people living with HIV has increased due to improved access to ART, co-morbidities and co-medications are also on the rise. But appropriate management of clinically relevant drug-drug interactions is sub-optimal, especially in low-resource settings.

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Serosorting between gay men may be in decline as ‘PrEP sorting’ rises, Canadian study finds

A Canadian study which compared the HIV status of gay men’s recent sexual partners with what would be expected if they chose partners regardless of status has found that HIV-negative men who used PrEP were nearly twice as likely to have HIV-positive partners as those who did not.

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Editors' picks from other sources

Brazil’s HIV/AIDS policies proved a success. But here are the new challenges

from Washington Post

In the global fight against AIDS, Brazil stands out for the pathbreaking set of AIDS policies it adopted in the 1990s. How did these policies unfold? In her new book State-Sponsored Activism, Jessica Rich draws lessons from Brazil about the role of community advocacy in sustaining AIDS policy achievements.

HIV treatment access isn't rising fast enough to reach 2020 targets, UNAIDS report shows

from Devex

There has been “significant progress” in expanding access to HIV treatment over the last decade, but testing and treatment gaps still place the goal of getting 30 million people on treatment by 2020 out of reach, according to new findings from UNAIDS.

HIV-positive babies fare better when treatment starts at birth

from Scientific American

A newborn immune system responds to HIV infection less effectively than a more mature one, so an HIV-positive baby should be started on antiretroviral therapy as soon after birth as possible, new research suggests. Although not practical in many areas, the approach reveals clues to how the immune system battles the infection.

Analysis: The number one challenge in South Africa's HIV response

from Spotlight

Only around 71.3% of people who know that they are HIV positive are estimated to be taking treatment. This problem has two sides – some people who test positive never start taking treatment, and some who do start taking treatment stop doing so.

'I'm known as an activist.' New UNAIDS leader takes charge

from Science

Earlier this month, Winnie Byanyima, a high-profile diplomat and Ugandan politician who ran the nonprofit Oxfam for the past 7 years, took over a top job in the HIV/AIDS world – where she is far from a known figure. She is stepping into the job at a tumultuous time. Not only is a UNAIDS-led push to end the AIDS epidemic falling short of its targets, but the organisation itself was also subjected to harsh criticism last year.

Top 10 HIV clinical developments of 2019

from TheBodyPro

Veteran clinician-researcher David Alain Wohl, M.D., guides us through the new research and other important moments of 2019 that have the greatest potential to alter the HIV clinical landscape in the months and years to come.

Barring cisgender women from the Descovy trials was a bad call

from STAT

The lack of cisgender women in clinical trials of HIV drugs and the FDA’s willingness to tolerate studies that do not include them are indicative of a broader and more systemic disregard for women’s health.