2019 International AIDS Society Conference
In July of this year, the 2019 Conference on HIV Science was held in Mexico City hosted by the International AIDS Society. Sessions focused on the latest in HIV prevention, clinical care and treatment, and cure research; as well as implementation science, policy, and global incidence updates. If you weren’t able to attend the conference, some of the key outputs from the Bay Area are summarized here, with a special emphasis on our partners within the Bay Area.
Research with Transgender Communities
The conference included a few sessions on transgender health care & HIV, with a few San Francisco practitioners sharing their research:
BETA blog article & video: New data on HIV incidence among trans women in San Francisco. Erin Wilson, DrPH, MPH shares research conducted with trans women in San Francisco, and explains why simply providing accessible gender-affirming services and HIV prevention and care isn’t enough to offset inequities.
BETA blog video: PrEP use by transmasculine & transfeminine folks: New data from Nor Cal. Carlo Hojilla, RN, PHD shares research showing that in a sample of more than 2,500 transgender clients receiving care from a large managed health care system, only 16% with an indication for PrEP were linked to PrEP care.
Asa Radix from Callen Lorde took the main stage for a plenary session that covered the basics related to HIV & PrEP care for trans people, but also a call to action for health care providers to make clinics welcoming & care effective for trans patients. Watch the video from IAS (it’s the last presentation).
HIV Treatment
Dolutegravir dual therapy suppresses viral loads as well as a three-drug regimen in people beginning HIV treatment & maintains viral suppression in people who switch from three-drug regimen. Coverage from aidsmap.
BETA blog video: Long-acting HIV medications. Dr. Neal Sheran shares information about long-acting HIV medications currently being studied—including who might benefit from them, and some outstanding concerns from the medical community.
Days off from HIV treatment: A study showing that—for people with an already undetectable viral load—an HIV treatment schedule that was four days on, three days off (the weekends), was as effective as daily treatment. Coverage from aidsmap.
New drug: Islatravir (a nucleoside reverse transcriptase translocation inhibitor) – being tested now for treatment + prevention. Read coverage from aidsmap.
Dolutegravir taken during pregnancy: risk of neural tube defects were lower than originally thought. The WHO now recommends that dolutegravir be available for all women.
Innovations in PrEP
BETA blog video: Personal agency is central to ending the HIV epidemic. PrEP advocate Damon L. Jacobs explains why agency -- the personal freedom of choice and equal access -- is critical and how access to information and research is an essential component.
PrEP implant: Data shared on a long-acting implant with a new drug called Islatravir showing that PrEP drugs can be slowly released over 1 year. HIV prevention efficacy of this drug delivery system + medication has not been tested yet, but early findings look promising. Coverage from aidsmap.
Long-acting HIV prevention agents including implants, microneedles & the ring. Watch Charles Flexner’s presentation for a good summary and plus Myron Cohen’s presentation on long-acting injections.
F/TAF compared to F/TDF – Descovy for PrEP. Read aidsmap coverage.
PrEP 2-1-1 study: Majority men who have sex with men participated in the Prevenir study of on-demand PrEP. There were zero HIV infections among people taking daily or on-demand PrEP (people could switch back and forth between the two regimens as needed). Slides from the presentation.
STIs and PrEP
There were a few sessions related to either STI prevention/treatment/care issues and/or STIs in the context of PrEP management.
Dr. Jason Ong from LSHTM, UK shared a meta-analysis of 88 PrEP studies from all over the world that included recent (2016 – 2018) STI data. STI rates were very high compared to general rates, but Ong emphasized the “glass half full” view that PrEP provision gives the opportunity to test & treat for STIs (sounds like STI services aren’t necessarily included with PrEP services in all places). See slides.
STIs in the era of PrEP – presentation by Connie Celum from U. of Washington. Great presentation, with the take-away that we need to do more, now. Watch the video from IAS.
Substance Use, Harm Reduction, and Disparities
BETA blog article: ARTEMIS improves mood, reduces viral load for men using meth
Accompanying video, featuring Adam Carrico, PhD. New research presented at IAS 2019 showed the effectiveness of a counseling intervention to improve mood, reduce substance use, and lower viral loads in men using meth.
“Missing the boat” with Black & Brown folks in HIV prevention & care – David Malebranche from Morehouse School of Medicine in Atlanta gave an incredible talk on how stigma, discrimination & implicit bias are exacerbating disparities in HIV. We need to re-frame our approach to ensure that we’re not perpetuating a culture of oppression. In regards to language, it’s not appropriate for people to describe Black & Brown folks as “underserved” or “vulnerable.” The emphasis needs to be on how WE are underserving Black and Brown folks.
Prepared by Emily Land, of the San Francisco AIDS Foundation.